STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION | TAMIAMI PHARMACY DISCOUNT NO. 3, INC., Petitioner, DOAH CASE NO. 05-0808MPI AHCA C.I. NO. 00-1205-000 RENDITION NO. Vv. STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, S TN Respondent, = ee / Pr H FINAL ORDER U tN a THIS CAUSE concerns a Petition for Formal Hearing that the Petitioner ted on November 24, 2004. On March 3, 2005, the Petition for Formal Hearing was forwarded to the Division of Administrative Hearings by the Agency and assigned to an Administrative Law Judge. On June 22, 2005, the Petitioner filed a Withdrawal of its Petition for Formal Hearing. On June 24, 2005, the Administrative Law Judge assigned to the case issued an Order Closing File based on the Petitioner’s Withdrawal of its Petition for Formal Hearing. IT IS THEREFORE ORDERED AND ADJUDGED THAT: The Petition for Formal Hearing is dismissed. Petitioner is required to repay the sum of the overpayment determined by the Agency in its Final Agency Audit Report dated November 5, 2004. Petitioner shall make full payment of the monies, totaling $594,229.64, plus any statutory interest, to the Agency for Health Care Administration within 30 days of the rendition of this Final Order. Petitioner shall pay by check payable to the Agency for Health Care Administration and mailed to the Agency for Health Care Administration, Office of Finance and Accounting, 27271 Mahan Drive, Fort Knox Building 2, Mail Stop 14, Tallahassee, Florida 32308. DONE and ORDERED this 29 day of Une , 2005, in Tallahassee, Mabel Yip Lome? { for ALAN LEVINE; Secretary AGENCY FOR HEALTH CARE ADMINISTRATION Florida. NOTICE OF RIGHT TO JUDICIAL REVIEW A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS 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 THE 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 CERITRICALE OF SER 1 HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished by U.S. or interoffice mail to the persons named below on this A cD. day of i 2005. oo SN a“ CY =< iO ¢ Oe RICH . , Agenty Clerk Agency for Health Care Administratio: 2727 Mahan Drive, MS 3 Tallahassee, Florida 32308 (850) 922-5873 oe COPIES FURNISHED TO: Patricia M. Hart Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 David W. Nam, Esquire Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, MS#3 Tallahassee, Florida 32308 Anthony C. Vitale, Esquire Anthony C. Vitale, P.A. 799 Brickell Plaza, Suite 700 Miami, Florida 33131 Medicaid Program Integrity Agency for Health Care Administration 2727 Mahan Drive, MS#4 Fort Knox Building III Tallahassee, Florida 32308 Jean Lombardi Finance & Accounting

Docket for Case No: 05-000808MPI