Petitioner: PUBLIC HEALTH TRUST, D/B/A JACKSON MEMORIAL LONG TERM CARE CENTER
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: FLORENCE SNYDER RIVAS
Agency: Agency for Health Care Administration
Locations: Miami, Florida
Filed: Apr. 26, 2005
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Thursday, July 7, 2005.
Latest Update: Dec. 25, 2024
STATE OF FLORIDA i
AGENCY FOR HEATH CARE ADMINISTRATION.
PUBLIC HEALTH TRUST, d/b/a
JACKSON MEMORIAL LONG TERM
CARE CENTER,
Petitioner,
CASE NO. 05-1518MPI
Audit No. 02-0650-000
AGENCY FOR HEALTH CARE
ADMINISTRATION,
RENDITION NO.: AHCA-C5- C4WyrS-MDO
Respondent.
/
_
FINAL ORDER
THE PARTIES resolved all disputed issues and executed
a “settlement agreement”, which is incorporated by
reference. The parties are directed to comply with the
terms of the “settlement agreement”. Based on the
foregoing, this proceeding is CLOSED.
DONE. and ORDERED on this the ps. day of
MAA ET , 2005, in Tallahassee, Florida.
Al evine, Secretary
Agency for Health Care Administration
A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER Is
ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY
FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK
OF AHCA, AND A SECOND COPY ALONG WITH FILING FEE AS
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 RENDITION OF THE ORDER TO BE REVIEWED.
Copies furnished to:
Eugene Shy, Jr.
Assistant County Attorney
Miami-Dade County
Public Health Trust
Jackson Memorial Hospital
1611 N.W. 12° Avenue
Miami, Florida 33136-1096
Debora Fridie, Esquire
Attorney for Agency
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive
Fort Knox Building 3, Mail Stop 3
Tallahassee, Florida 32308
Florence Snyder Rivas
Administrative Law Judge
Division of Administrative
Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
Medicaid Program Integrity
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the
foregoing has been furnished to the above named addressees
by U.S. Mail on this the ae day of Age '
2005.
Agency Clerk
State of Florida
Agency for Health Care
Administration
2727 Mahan Drive,
Building #3, Mail Stop 3
Tallahassee, Florida 32308-5403
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
PUBLIC HEALTH TRUST, d/b/a JACKSON
MEMORIAL LONG TERM CARE CENTER
Petitioner,
DOAH Case No. 05-1518MPI
C.I. NO. 02-0650-000
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Respondent .
/
STIPULATION AND AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(“AHCA” or “the Agency”), and PUBLIC HEALTH TRUST, d/b/a JACKSON
MEMORIAL LONG TERM CARE CENTER (“PROVIDER”), by and through the
undersigned, hereby stipulate and agree as follows:
1. The two parties enter into this agreement for the
purpose of memorializing the resolution to this matter.
2. PROVIDER is a Medicaid provider in the State of
Florida, operating under provider number 1032771 00.
3. In its Final Agency Audit Reports C.I. No. 02-0650-000-
3/H/RDS (the "Audit Letter") AHCA notified PROVIDER that review
of Medicaid claims performed by Medicaid Program Integrity (MPI)
indicated that, in its opinion, some claims in whole or in part
were not covered by Medicaid. The Agency sought repayment of an
overpayment in the amount of $54,739.70. In response, PROVIDER
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DOAH Case No. 05-1518MPI
Public Health Trust vs. AHCA
Stipulation and Agreement
petitioned for a formal administrative hearing with the Division
of Administrative Hearings, Case No. 05-1518MPI.
4. After the provider requested a formal hearing, AHCA
reviewed documentation that was previously unavailable to them.
Based upon that review, AHCA adjusted the overpayment to
$11,443.19. PROVIDER agreed to pay the adjusted overpayment
plus some of AHCA’s investigative costs, in the amount of
$3,556.81, for a total repayment of $15,000.00.
5. In order to resolve this matter without further
administrative proceedings, PROVIDER and AHCA expressly agree as
follows:
(a) AHCA will accept the payment set forth herein as a
complete resolution of the overpayment issues arising
from the MPI review cited in paragraphs 3 and 4 above.
(b) Within thirty (30) days of issuance of the Final
Order, PROVIDER agrees to make a single payment to
AHCA of Fifteen Thousand and no/100 Dollars
($15,000.00). AHCA retains the right to perform a 6-
month follow-up review.
(c) PROVIDER is responsible for ensuring timely delivery
of the payment. Failure to timely make the payment
will render the balance due and payable immediately,
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Public Health Trust vs. AHCA
Stipulation and Agreement
with interest, and interest will continue to accrue
until the entire balance is paid.
PROVIDER and AHCA agree that full payment as set forth
above will resolve and settle this case completely and
release all parties from all liabilities arising from
the findings in the audit referenced as C.I. Number02-
0650-000.
PROVIDER agrees that it will not rebill the Medicaid
Program in any manner for claims that were not covered
by Medicaid, which are the subject of the audit in
this case.
PROVIDER agrees to fully cooperate with any follow up
reviews conducted by the Agency.
Payment shall be made to:
AGENCY FOR HEALTHCARE ADMINISTRATION
Medicaid Accounts Receivable
Post Office Box 13749
Tallahassee, Florida 32317-3749
And payment shall clearly indicate that it is per a stipulation
and agreement and shall reference the C.I. Number and the
Provider Number.
6.
PROVIDER agrees that failure to pay any monies due and
owing under the terms of this Agreement shall constitute
PROVIDER’S authorization for the Agency, without further notice,
to withhold the total remaining amount due under the terms of
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Stipulation and Agreement
this agreement from any monies due and owing to PROVIDER for any
Medicaid claims.
7. AHCA reserves the right to enforce this Stipulation
and Agreement under the laws of the State of Florida, the Rules
of the Medicaid Program, and all other applicable rules and
regulations.
8. The parties agree to bear their own attorney’s fees
and other costs, if any.
9. The signatories to this Agreement, acting ina
representative capacity, represent that they are duly authorized
to enter into this Agreement on behalf of the respective
parties. Furthermore, PROVIDER agrees that its signature alone
binds PROVIDER to make the payment as set forth in this
agreement. PROVIDER shall furnish the actual signed Stipulation
and Agreement to AHCA; however a facsimile copy shall be
sufficient to enable AHCA to cancel a hearing scheduled in this
case.
10. This Agreement shall be construed in accerdance with
the provisions of the laws of Florida. Venue for any action
arising from this Agreement shall be in Leon County, Florida.
11. This Agreement constitutes the entire agreement
between PROVIDER and the AHCA, including anyone acting for,
associated with or employed by them, concerning all matters and
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Stipulation and Agreement
supersedes any prior discussions, agreements or understandings;
there are no promises, representations or agreements between
PROVIDER and the AHCA other than as set forth herein. No
fication or waiver of any provision shall be valid unless a
modi
written amendment to the Agreement is completed and properly
executed by the parties.
12. This is an Agreement of settlement and compromise,
made in recognition that the parties may have different or
incorrect understandings, information and contentions, as to
facts and law, and with each party compromising and settling any
potential correctness or incorrectness of its understandings,
information and contentions as to facts and law, so that no
misunderstanding or misinformation shall be a ground for
rescission hereof. This Stipulation and Agreement does not
constitute an admission of wrongdoing or error by either party
with respect to this case or any other matter. However, the
parties believe that this matter should be resolved because the
parties have agreed to the terms contained within this
agreement.
13. PROVIDER expressly waives in this matter its right to
any hearing pursuant to Sections 120.569 or 120.57, Florida
Statutes, the making of findings of fact and conclusions of law
by the Agency, and all further and other proceedings to which it
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Stipulation and Agreement
may be entitled by law or rules of the Agency regarding this
proceeding and any and all issues raised herein. PROVIDER
further agrees that the Agency should issue a Final Order which
is consistent with the terms of this Stipulation and Agreement,
that adopts this agreement and closes this matter.
14. Provider does hereby discharge the State of Florida,
Agency for Health Care Administration, and its agents,
representatives, and attorneys of and from all claims, demands,
actions, causes of action, suits, damages, losses and expenses,
of any and every nature whatsoever, arising out of or in any way
related to this matter, C.I. No. 02-0650-00 and AHCA’s actions
herein, including, but not limited to, any claims that were or
may be asserted in any federal or state court or administrative
forum, including any claims arising out of this agreement, by or
on behalf of Provider.
15. This Stipulation and Agreement is and shall be deemed
jointly drafted and written by all parties to it and shall not
be construed or interpreted against the party originating or
preparing it.
16. To the extent that any provision of this Stipulation
and Agreement is prohibited by law, for any reason, such
provision shall be effective to the extent not so prohibited,
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and such prohibition shall not affect any other provision of
this Stipulation and Agreement.
17. This Stipulation and Agreement shall inure to the
benefit of and be binding on each party’s successors, assigns,
heirs, administrators, representatives and trustees.
18. All times stated herein are of the essence in this
Stipulation and Agreement.
19. This Stipulation and Agreement shall be in full force
and effect upon execution by the respective parties in
counterpart.
PETITIONER
PUBLIC HEALTH TRUST, D/B/A
MEMORIAL LONG TERM CARE CENTER
MAK. Date: Tf 7 , 2005
BY:
“Ev Pfec C
(Printed name and title)
MIAMI-DADE COUNTY ATTORNEY
Li, ‘ o/ vi
BY: Dated: , 2005
EVGere | 7 Je
Beh sda Choos fit Rene,
(Printed name of atto ney)
Page 7 of 8
DOAH Case No. 05-1518MPI
Public Health Trust vs. AHCA
Stipulation and Agreement
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
Date: e-/ Ss , 2005
JAMES D. BOY:
Inspector General
Clucche. Colavaos Date: # | a 2005
WEDLTAM HL-ROBERTS CHEISTA CHUAWAS
Aeting General Counsel
Qebna Frtulkh Date: Fh tL. 2005
DEBORA E. FRIDIE
Assistant General Counsel
Page 8 of 8
Docket for Case No: 05-001518MPI
Issue Date |
Proceedings |
Aug. 24, 2005 |
Final Order filed.
|
Jul. 07, 2005 |
Order Closing File. CASE CLOSED.
|
Jul. 07, 2005 |
Notice of Stipulation in Principle and Joint Motion to Close File filed.
|
May 31, 2005 |
Respondent`s Second Request for Production of Documents filed.
|
May 11, 2005 |
Respondent`s First Request for Production of Documents filed.
|
May 11, 2005 |
Respondent`s Notice of Service of Interrogatories and Expert Interrogatories filed.
|
May 05, 2005 |
Order of Pre-hearing Instructions.
|
May 05, 2005 |
Notice of Hearing by Video Teleconference (video hearing set for July 21 and 22, 2005; 9:00 a.m.; Miami and Tallahassee, FL).
|
Apr. 28, 2005 |
Notice of Unavailability of Counsel for the Respondent Agency filed.
|
Apr. 28, 2005 |
Joint Response to Initial Order filed.
|
Apr. 27, 2005 |
Initial Order.
|
Apr. 26, 2005 |
Pharmacy Audit - Final Report filed.
|
Apr. 26, 2005 |
Final Agency Audit Report filed.
|
Apr. 26, 2005 |
Request for Formal Administrative Hearing filed.
|
Apr. 26, 2005 |
Order of Dismissal without Prejudice Pursuant to Sections 120.54 and 120.569, Florida Statutes and Rules 28-106.111 and 28-106.201, Florida Administrative Code to Allow for Amendment and Resubmission of Petition filed.
|
Apr. 26, 2005 |
Motion for Enlargement of Time to File Amended Petition Requesting Formal Hearing filed.
|
Apr. 26, 2005 |
Notice of Appearance (filed by E. Shy, Esquire).
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Apr. 26, 2005 |
Letter to Mr. Shoop from E. Shy concerning filing Notice of Appearance and Motion for Enlargement of Time to File Amended Petition Requesting Formal Hearing filed.
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Apr. 26, 2005 |
Order Granting Extension of Time to Respond to the Order of Dismissal without Prejudice filed.
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Apr. 26, 2005 |
Amended Request for Formal Hearing filed.
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Apr. 26, 2005 |
Notice (of Agency referral) filed.
|