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AGENCY FOR HEALTH CARE ADMINISTRATION vs AKSHAR CHEMISTS, INC., D/B/A THE MEDICINE SHOPPE, 06-004703MPI (2006)

Court: Division of Administrative Hearings, Florida Number: 06-004703MPI Visitors: 15
Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: AKSHAR CHEMISTS, INC., D/B/A THE MEDICINE SHOPPE
Judges: CAROLYN S. HOLIFIELD
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Nov. 17, 2006
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Friday, April 27, 2007.

Latest Update: Dec. 23, 2024
FILED AHCA STATE OF FLORIDA AGENCY CLERK AGENCY FOR HEALTH CARE ADMINISTRATION) way 31. P 3:07 AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, Y, Y) , , ee vs. CASE NOW06-A730MBE = AKSHAR CHEMISTS, INC., AUDIT NO. 06- 4264- 00 d/b/a THE MEDICINE SHOPPE, Respondent. / FINAL ORDER THE PARTIES resolved all disputed issues and executed a Settlement Agreement. The parties are directed to comply with the terms of the attached settlement agreement. Based on the foregoing, this file is CLOSED. DONE and ORDERED on this the 3! day of Mag 2007, in Tallahassee, Florida. Andrew C. Agwunobi, M.D., 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: Karen Dexter, Esquire Agency for Health Care Administration (Interoffice Mail) James M. Barclay, Esq. Ruden, McClosky Law Firm 215 South Monroe Street Suite 815 Tallahassee, FL 32301 (U.S. Mail) The Honorable Carolyn S. Holifield Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Tim Byrnes, Bureau Chief, Medicaid Program Integrity (Interoffice Mail) Linda Keen, Inspector General (Interoffice Mail) Finance and Accounting (Interoffice Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has sé been furnished to the above named addressees by U.S. Mail on this the /_ day of # é a , 2007. Richard Shoop, Agency Cler! Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3 Tallahassee, Florida 32308-5403 (850) 922-5873 phone (850) 921-0158 fax STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS AGENCY FOR HEALTH CARE ADMINISTRATION, a GM oe els? ATH ~ Petitioner, Lb- y Wer EA INGS ve CASE NO:.-06-4730MPI v. CLL. No. 06-4264-000 AKSHAR CHEMISTS, INC., d/b/a THE MEDICINE SHOPPE, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (‘AHCA” or “the Agency”), and AKSHAR CHEMISTS, INC., d/b/a THE MEDICINE SHOPPE (“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 2 Medicaid provider in the State of Florida, provider number 025325100 and was a provider during the audit period. 3. In its Final Audit Report (final agency action) dated August 29, 2006, AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity (MPD), Office of the AHCA Inspector General, indicated that certain claims, in whole or in part, has been inappropriately paid by Medicaid. The Agency sought recoupment of this overpayment in the amount of $102,981.44, a fine sanction of $5000.00 for violation(s) of Rule Section 59G- AKSHAR CHEMISTS, INC., d/b/a THE MEDICINE SHOPPE, Settlement Agreement 9.070, F.A.C.. In response to the audit letter dated August 29, 2006, PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH Case No. 06-4703MPI. 4, Subsequent to the original audits that took place in these matters and in preparation for hearing, AHCA re-reviewed the PROVIDER’S claims and evaluated additional documentation submitted by the PROVIDER. As a result, AHCA determined that the overpayment was adjusted to $86,676.97. 5. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: (1) (2) G3) (4) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. On or before June 1, 2007, PROVIDER agrees to pay the Agency ninety one thousand six hundred seventy six dollars and ninety seven cents ($91,676.97), which includes $5000 in sanctions, in one lump sum. AHCA retains the right to perform a 6 month follow-up review. 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 findings in the audit referenced as C.1. 06-4264- 000. PROVIDER agrees that it will not re-bill the Medicaid Program in any manner for claims that were not covered by Medicaid, which are the subject of the audit in this case. AKSHAR CHEMISTS, INC., d/b/a THE MEDICINE SHOPPE, Settlement Agreement 6. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 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. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. 10. Each party shall bear its own attorneys’ fees and costs, if any. 11. 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. 12. 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. 13. 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 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. AKSHAR CHEMISTS, INC., d/b/a THE MEDICINE SHOPPE, Settlement Agreement 14. 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. 15. | 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 it shall not challenge or contest any Final Order entered in this matter which is consistent with the terms of this settlement agreement in any forum now or in the future available to it, including the right to any administrative proceeding, circuit or federal court action or any appeal. 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 shall be in full force and effect upon execution by the respective parties in counterpart. AKSHAR CHEMISTS, INC., @/o/a THE MEDICINE SHOPPE, Agreement AKSHAR CHEMISTS, INC., d/b/a THE MEDICINE SHOPPE, Dated: 5 6 2007 Tallahassee, FL 32308-5403 | ) Dated: They 3! _,207 Inspector General (hail Lol . Dated: he 3 ‘a0 Ghig S General Counsel i Dated: 529 OF +, 2007 Assistant General Counsel .

Docket for Case No: 06-004703MPI
Issue Date Proceedings
Jun. 01, 2007 Final Order filed.
Apr. 27, 2007 Order Closing File. CASE CLOSED.
Apr. 25, 2007 Joint Motion to Relinquish Jurisdiction filed.
Apr. 17, 2007 Petitioner`s Witness and Exhibit List filed.
Apr. 04, 2007 Notice of Medicine Shoppe?s Responses to AHCA?s First Interrogatories and Expert Interrogatories filed.
Apr. 04, 2007 Medicine Shoppe?s Response to AHCA Request for Admissions filed.
Apr. 04, 2007 Medicine Shoppe?s Response to AHCA First Request for Production of Documents filed.
Apr. 04, 2007 Medicine Shoppe?s First Request for Admissions to AHCA filed.
Mar. 06, 2007 Order Granting Continuance and Re-scheduling Hearing (hearing set for May 2 and 3, 2007; 9:30 a.m.; Tallahassee, FL).
Mar. 02, 2007 Agreed Motion to Continue Final Hearing filed.
Feb. 22, 2007 Notice of Service of Interrogatories, Expert Interrogatories, First Request for Admissions & Frist Request for Production of Documents filed.
Jan. 23, 2007 Order Granting Continuance and Re-scheduling Hearing (hearing set for March 20 and 21, 2007; 9:00 a.m.; Tallahassee, FL).
Jan. 12, 2007 Agreed Motion to Continue Final Hearing filed.
Dec. 29, 2006 Order of Pre-hearing Instructions.
Dec. 29, 2006 Notice of Hearing (hearing set for January 30 through February 1, 2007; 9:30 a.m.; Tallahassee, FL).
Nov. 28, 2006 Joint Response to Initial Order filed.
Nov. 20, 2006 Initial Order.
Nov. 17, 2006 Final Audit Report filed.
Nov. 17, 2006 Akshar Chemists, Inc., d/b/a The Medicine Shoppe`s Request for Peer Review Under Section 465.188, Florida Statutes and Alternative Petition for Formal Administrative Hearing filed.
Nov. 17, 2006 Notice (of Agency referral) filed.
Source:  Florida - Division of Administrative Hearings

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