STATE OF FLORIDA ~ anne AGENCY FOR HEALTH CARE ADMINISTRATION... roy meng FLAGLER PHARMACY DISCOUNT, INC. d/b/a FLAGLER PHARMACY DISCOUNT, Petitioner, DOAH CASE NO: 05-0533MPI provider no.: 105271300 audit no.: C.1. 04-2430-000 Vv. AGENCY FOR HEALTH CARE ADMINISTRATION, = Respondent. - = ae / ane aad nN FINAL ORDER ae “y us: THIS CAUSE concems an Amended Petition for Formal Administrative Hearing that the ~~ Petitioner filed on November 17, 2004. On February 14, 2005, the Petition was forwarded to the Division of Administrative Hearings (“DOAH”) by the Agency and assigned to an Administrative Law Judge (“ALJ”). On May 2, 2005, the Petitioner filed a Notification of Withdrawal of Petition for Administrative Hearing. On May 3, 2005, the ALJ issued an Order Closing File based on the Petitioner’s Notification of Withdrawal of Petition for Administrative Hearing. IT IS THEREFORE ORDERED AND ADJUDGED THAT: The Petition for Formal Administrative Hearing is dismissed. Unless payment has already been made, payment in full of $529,074.84, plus statutory interest, is now due from the petitioner as a result of the agency action. Such payment shall be made in full within 30 days of Care Administration, and shall be mailed to the Agency for Health Care Administration, Office of Finance and Accounting, Attn. Jean Lombardi, 2727 Mahan Drive, Fort Knox Building 2, Mail Stop 14, Tallahassee, FL 32308. DONE and ORDERED this _/4 “Gay of DF Le , 2005, in Tallahassee, Florida. a } ALAN LEVINE, Secretary , AGENCY FOR HEALTH CARE ADMINISTRATION NOTICE OF RIGHT TO JUDICIAL REVIEW A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER {S ENTITLED TO JUDICIAL REVIEW, WHICH SHALL BE INSTITUTED BY FILING THE ORIGINAL NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A COPY ALONG WITH THI FILING FEE PRESCRIBED BY LAW WITH THE DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES. REVIEW PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE FLORIDA APPELLATE RULES. THE NOTICE OF APPEAL MUST BE FILED WITHIN 30 DAYS OF THE RENDITION OF THE ORDER TO BE REVIEWED. CERTIFICATE OF SERVICE 1 HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furmished by U.S. or interoffice mail to the persons named below on this “S~ day of TE __, 2005. Agency for Health Care Administration 2727 Mahan Drive, MS 3 Tallahassee, Florida 32308 (850) 922-5873 COPIES FURNISHED TO: F. S, Rivas Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Anthony C. Vitale, Esquire 799 Brickell! Place, Suite 700 Miami, Florida 33131 L. William Porter II, Esquire Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, MS#3 Tallahassee, Florida 32308 Medicaid Program Integrity Agency for Health Care Administration 2727 Mahan Drive, MS#4 Fort Knox Building IL Tallahassee, Florida 32308 John Hoover Finance & Accounting

Docket for Case No: 05-000533MPI