i STATE OF FLORIDA |" /: AGENCY FOR HEALTH CARE AD UISERATION 22 PH 3: some «9: LARGO MEDICAL CENTER, WH Op : Me TRAT ye Petitioners, DOAH CASE NO. 07-2832 AHCA NO. 2007006742 v. DETERMINATION NO. 20070329-004 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. FINAL ORDER THIS. CAUSE concerns a Request for Administrative Review (“Request”) that the Petitioner filed on June 18, 2007. On June 26, 2007, the Petition was forwarded to the Division of Administrative Hearings by the Agency and assigned to an Administrative Law Judge (“ALJ”). On August 1, 2007, the Petitioner filed a Notice of Voluntary Dismissal with Prejudice, stating that it wanted to dismiss its Request. On August 1, 2007, the ALJ assigned to the case entered an Order Closing File, relinquishing jurisdiction back to the Agency. Based upon the foregoing, IT IS THEREFORE ORDERED AND ADJUDGED THAT: The Petitioner’s Petition is dismissed with prejudice and the Agency’s June 4, 2007 Dismissal is hereby upheld. The parties shall govern themselves accordingly. DONE and ORDERED this S2/ day of put , 2008, in Tallahassee, Florida. HOLLY BENSON, Secretary AGENCY FOR\HEALTH CARE ADMINISTRATION 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 I 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 LZ day. of. RICHARD J. SHOOP, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, MS #3 Tallahassee, Florida 32308 (850) 922-5873 COPIES FURNISHED TO: Honorable Daniel M. Kilbride Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Katherine M. Balonis HCA Patient Account Services — Tampa Bay 31975 U.S. Highway 19 North Palm Harbor, Florida 34684 Mari H. McCully, Esquire Department of Financial Services Division of Worker’s Compensation 200 East Gaines Street Tallahassee, Florida 32399-4229 Jan Mills Facilities Intake Elizabeth Dudek _ Health Quality Assurance STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS LARGO MEDICAL CENTER, Petitioner, vs. Case No. 07-2832 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. ORDER CLOSING FILE This cause having come before the undersigned on the Notice of Voluntary Dismissal with Prejudice, filed August 1, 2007, and the undersigned being fully advised in the premises, it is, therefore, ORDERED that: 1. The Notice of Voluntary Dismissal with Prejudice is hereby granted. 2. The final hearing in this cause scheduled for August 8, 2007, is hereby canceled. 3. The file of the Division of Administrative Hearings in the above-captioned matter is hereby closed. DONE AND ORDERED this lst day of August, 2007, in Tallahassee, Leon County, Florida. DANIEL M. KILBRIDE Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this lst day of August, 2007. COPIES FURNISHED: Joanna Daniels, Esquire Agency for Health Care Administration Workers' Compensation Medical Services 200 East Gaines Street Tallahassee, Florida 32399-4229 Katherine M. Balonis HCA Patient Account Services-Tampa Bay 31975 US Highway 19 North Palm Harbor, Florida 34684 rag ee tee 7277733988 11:34:57 a.m. 08-01-2007 TAL DOAH Fax Filing (850) 921-6847 J, Daniels Fax: (850) 488-9373 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS LARGO MEDICAL CENTER, DOAH Case No.: 07-2832 Petitioner, v. ALJ: DANIEL M. KILBRIDE AGENCY FOR HEALTH CARE ADMINISTRATION, Determination # 20070329-004 Respondent. AHCA # 2007006742 Notice Of Voluntary Dismissal With Prejudice The Petitioner, LARGO MEDICAL CENTER, by and through the undersigned representative, hereby gives notice that the Petition for Administrative Hearing (titled “Request for Administrative Review”) filed with the Agency Clerk on June 18, 2007 in the above- referenced matter is hereby voluntarily dismissed with prejudice. The Petitioner therefore requests that the Administrative: Law Judge close the DOAH file and return the matter to the Agency for Health Care Administration for entry of a final order. DATED this |S _of August, 2007. ! Gina Carbonaro, Manager Payment Resolutions | HCA Patient Account Services - Tampa Bay | | Phone: (727) 773-4059 Fax: (727) 773-4060 | Email: Gina.Carbonaro@HCAHealthcare.com | | For Petitioner, Largo Medical Center | CERTIFICATE OF SERVICE I HEREBY CERTIFY that on Wednesday, August 01, 2007, a true and correct copy of the foregoing was furnished via [7 FACSIMLE [[] E-File [J] US MAIL to Joanna Daniels, Esq., Workers’ Comp Medical Svcs. Legal, 200 East Gaines Street, Tallahassee, FL 32399-4229, T: (850) 413-1606 Fax: (850) 488-9373, E-Mail: Joanna.Daniels@fldfs.com For Petiioper Largo Medical Center

Docket for Case No: 07-002832