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ACT CORPORATION, INC. vs AGENCY FOR HEALTH CARE ADMINISTRATION, 05-002262MPI (2005)

Court: Division of Administrative Hearings, Florida Number: 05-002262MPI Visitors: 16
Petitioner: ACT CORPORATION, INC.
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: DON W. DAVIS
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Jun. 22, 2005
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Friday, August 26, 2005.

Latest Update: Nov. 15, 2024
STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS 200, £PR 2 | ACT CORPORATION, INC. Petitioner, CASE NO.: 05-002262MPI Old Case No.:03-0573MPI v. CI. No. 02-0240-010 JUDGE: Don W. Davis STATE OF FLORIDA, AGENCY FOR Medicaid Provider No.: 060311203 HEALTH CARE ADMINISTRATION, > 3S Respondent. f=2 So oe ! BRe e 7 SS TF BS unt Aa pa < Po 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 attached settlement agreement. Based on the foregoing, this file is CLOSED. wz . DONE and ORDERED on this the /7 day of _g@a@zeZ— , 2006, in Tallahassee, Florida. iin Levine, Secretary a 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: James M. Barclay Attorney for Petitioner RUDEN, McCLOSKY, SMITH, SCHUSTER & RUSSELL, P.A. 215 South Monroe Street, Suite 815 Tallahassee, FL 32301 John G. Van Laningham Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, FL 32399 Anthony L. Conticello, Esquire Agency for Health Care Administration (Interoffice Mail) James D. Boyd, Inspector General Agency for Health Care Administration (Interoffice Mail) Timothy Byrnes, Bureau Chief Medicaid Program Integrity Agency for Health Care Administration (Interoffice Mail) Bureau of Finance and Accounting \ . Agency for Health Care Administration (Interoffice Mail) 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’ day ¥ , 2006. : ZS _ > Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA FF [ LL. fs D DIVISION OF ADMINISTRATIVE HEARINGS 200b APA : ACT CORPORATION, INC., 24 P i 43 DIVISION OF Petitioner, ADMINISTRATIVE ‘CASE NO: 05-002262MEHARINGS - v. JUDGE: Don W. Davis AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and ACT CORPORATION., (“Provider”), by and through the undersigned, hereby stipulate and agree as follows: 1. This Agreement is entered into between the parties for the purpose of avoiding the costs and burdens of litigation, and neither party concedes the other’s position. 2. Provider is Florida Medicaid Provider 060311203. 3. In its Final Agency Audit Report CI. No. 02-0240-010 dated January 6, 2003, (hereafter, “Audit Report”), AHCA notified Provider that review of Medicaid claims performed by Medicaid Program Integrity (MPI) for the period January 1, 1999 — December 31, 2001, indicated that, in its opinion, some Behavioral Health Overlay (BHOS) claims in whole or in part were not covered by Medicaid. The Agency initially sought overpayment in the amount of $61,103.00. In response, Provider filed a petition for a formal administrative hearing, which was assigned Case No: 03- 0573MPI. TAL53920:1 4. Subsequently, DOAH Case Number 03-3479MPI was remanded to the Agency by the Division of Administrative Hearings for the purposes of allowing the parties time to resolve the overpayment issues, and to allow Provider time to locate documents which were allegedly destroyed during a hurricane. The case was remanded to DOAH and received a New Case Number 05-002262MPI. While the matter was pending, the Agency reviewed the matter and arguments of Petitioner and adjusted the overpayment amount for the claims involved in the Audit Report to $27,500 .00 (the “Adjusted Overpayment”). 5. In order to resolve this matter without resort to further administrative proceedings, Provider and AHCA expressly agree as follows: (A) AHCA shall accept full payment set forth herein in settlement of all overpayment issues arising from the MPI review, including AHCA’s investigative costs. (B) Within thirty (30) days of receipt of a Final Order incorporating this Settlement Agreement, Provider agrees to pay to AH(CA the Adjusted Overpayment, plus $2,500.00 in investigative costs. The total settlement shall be $30,000.00 ($27,500.00 plus $2,500.00), which shail be in full and complete settlement of all claims in this proceeding. (C) Provider and AHCA agree that full payment as set forth above will resolve and settle this case completely and release both parties from all liabilities arising from the Audit Report. TAL:53920:1 (D) 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 Report. (E) _ This Settlement Agreement does not constitute an admission of guilt, wrongdoing or error by either party with respect to this case or any other matter. 6. 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 settlement agreement, shall reference both the Provider Number, and the C.1. Number. 7. 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 this agreement from any monies due and owing to PROVIDER for any Medicaid claims. 8. AHCA reserves the right to enforce this Agreement under the laws of the State of Florida, the Rules of the Medicaid Program, and all other applicable rules and regulations. 9. The parties agree to bear their own attorney’s fees and costs, if any. 10.‘ The signatories to this Agreement, acting in a 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 Settlement Agreement TAL:53920:1 to AHCA, however a facsimile copy shall be sufficient to enable AHCA to cancel a final hearing, if one is pending, and have the Division of Administrative Hearings relinquish jurisdiction back to the Agency. 11. This Agreement shall be construed in accordance with the provisions of the laws of Florida. Venue for any action arising from this Agreement shall be in Leon County, Florida. 12. This Agreement constitutes the entire agreement between PROVIDER and the ABCA, including anyone acting for, associated with or employed by them, concerning all matters and 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 modification or waiver of any provision shall be valid unless a written amendment to the Agreement is completed and properly executed by the parties. 13. 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. 14. | 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 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 settlement, that adopts this agreement and closes this matter. TAL:53920:1 15. 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. 02-0240-010, 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 Facility. 16. This 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. 17. To the extent that any provision of this Agreement is prohibited by law, for any reason, such provision shall be effective to the extent not so prohibited, and such prohibition shall not affect any other provision of this Agreement. 18. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 19, All times stated herein are of the essence of this Agreement. 20. This Agreement shail be in full force and effect upon execution by the respective parties in counterpart. TAL:53920:1 PETITIONER: ACT CORPORATION BY: Was ne Dreggars ITS: reg: dent and CEY SM. BAR ey for Petitioner AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 J. SD. BOYD Inspector General Assistant General Counsel TAL:53920:1 Dated: honey cal 2006. Dated: 3. 7 _, 2006. PLACE CORPORATE SEAL ABOVE 1 yee Dated: el A , 2006. Dated: 4] 10 , 2006. Dated: 3 1? 2006.

Docket for Case No: 05-002262MPI
Issue Date Proceedings
Apr. 24, 2006 Final Order filed.
Aug. 26, 2005 Order Closing File. CASE CLOSED.
Aug. 25, 2005 Agreed Notice of Settlement filed.
Aug. 22, 2005 Amended Notice (change of location only) of Taking Non-party Deposition Duces Tecum filed.
Aug. 04, 2005 Subpoena Duces Tecum (1) filed.
Aug. 04, 2005 Notice of Taking Non-Party Deposition Duces Tecum filed.
Jul. 29, 2005 Respondent`s First Request for Production of Documents filed.
Jul. 29, 2005 Notice of Service of Respondent`s First Interrogatories to Petitioner, Respondent`s First Request for Admissions, and Respondent`s First Request to Produce filed.
Jul. 29, 2005 Respondent`s First Request for Admissions filed.
Jul. 13, 2005 Order of Pre-hearing Instructions.
Jul. 13, 2005 Notice of Hearing (hearing set for September 13 and 14, 2005; 10:00 a.m.; Tallahassee, FL).
Jul. 07, 2005 Order (Motion of Petitioner to transfer filings of DOAH Case No. 03-0573MPI to DOAH Case No. 05-2262MPI is granted).
Jul. 06, 2005 Unilateral Response to Initial Order filed.
Jul. 01, 2005 ACT Corporation`s Unilateral Motion to Transfer Filings from DOAH Case Number 03-0573MPI to DOAH Case Number 05-2262MPI filed.
Jul. 01, 2005 ACT Corporation`s Unilateral Response to Order Re-opening File.
Jun. 22, 2005 Order Re-opening File and Requiring Parties` Response (parties are directed to respond in writing within 10 days of the date of this order setting forth mutually convenient dates for the final hearing, formally DOAH Case No. 05-0573).
Jun. 09, 2005 Motion to Reopen (formally DOAH Case No. 05-0573MPI) filed.
Apr. 22, 2003 Order Closing File issued. CASE CLOSED
Apr. 21, 2003 Joint Motion to Remand without Prejudice (filed via facsmile).
Apr. 09, 2003 Notice of Unavailability and Absence of Jursdiction (filed via facsimile).
Mar. 31, 2003 Petitioner, ACT Corporation, Inc.`s Notice of Serving First Set of Interrogatores to Respondent, Agency for Health Care Administration filed.
Mar. 31, 2003 Petitioner`s First Request for Production of Documents filed.
Mar. 31, 2003 Petitioner`s First Request for Admissions filed.
Mar. 06, 2003 Notice of Hearing (hearing set for April 29, 2003; 9:30 a.m.; Tallahassee, Fl).
Mar. 06, 2003 Order of Pre-hearing Instructions.
Feb. 27, 2003 Joint Response to Initial Order (filed by Respondent via facsimile).
Feb. 20, 2003 Initial Order issued.
Feb. 20, 2003 Provisional Agency Audit Report filed.
Feb. 20, 2003 Final Agency Audit Report filed.
Feb. 20, 2003 Petition for Formal Administrative Hearing filed.
Feb. 20, 2003 Notice (of Agency referral) filed.
Source:  Florida - Division of Administrative Hearings

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