FILED AGE pha STATE OF FLORIDA GENCY CLERK AGENCY FOR HEALTH CARE ADMINISTRATION] OCT 25 A ¢ g) MILTON D. CANIZALEZ d/b/a PAIN AND HEALTH RESTORATION CENTER, Petitioner, AHCA No.: 2007005872 DOAH No.: 07-3260 vs. RENDITION NO.: AHCA-07-Cyp5] -S-OLC STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, ay a Respondent. eS a i \" FINAL ORDER ~ ZI ci be at wd Having reviewed the Notice of Intent to Deny dated May 292007, attached hereto and incorporated herein (Ex. 1), and all other matters of record, the Agency for Health Care Administration (“Agency”) has entered into a Settlement Agreement (Ex. 2) with the parties to these proceedings, and being otherwise well-advised in the premises, finds and concludes as follows: ORDERED: 1. The attached Settlement Agreement is approved and adopted as part of this Final Order, and the parties are directed to comply with the terms of the Settlement Agreement. 2. Upon full execution of this agreement, the parties agree to the following: a. The Notice of Intent to Deny is deemed superseded. b. The Petitioner's petition for a formal administrative proceeding is deemed withdrawn. c. That upon the full execution of this Settlement Agreement, the Petitioner's application for health care clinic licensure will be deemed submitted and the time period in which the Agency must take final action on the initial licensure application pursuant to law will commence. d. Nothing in this Agreement shall prohibit the Agency from denying Petitioner’s application for licensure based upon any statutory and/or regulatory provision, including, but not limited to, the failure of Petitioner to satisfactorily complete a survey reflecting compliance with all statutory and rule provisions as required by law. 3. Each party shall bear its own costs and attorney’s fees. 4. The above-styled case is hereby closed. DONE and ORDERED this o29day of _ C¥Fabe 9007, in Tallahassee, Leon County, Florida. Andrew C. Agwunobi, M.D., Secretary ( ~ Agency for#ealth Care Administratio A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO 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 OF 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: Manuel A. Machin, Esq. Attorney for Petitioner Machin Law Group 607 A. W. Martin Luther King, Jr. Blvd. Tampa, Florida 33603 (U. S. Certified Mail) Alba M. Rodriguez, Esq. Assistant General Counsel Agency for Health Care Administration 8350 N. W. 52 Terrace — Suite 103 Miami, Florida 33166 (Interoffice Mail) Jan Mills Agency for Health Care Administration | 2727 Mahan Drive, Bldg #3, MS #3 Tallahassee, Florida 32308 (Interoffice Mail) Jan Mills Agency for Health Care Administration 2727 Mahan Drive, Bldg #3, MS #3 Tallahassee, Florida 32308 Health Care Clinic Unit Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 (Interoffice Mail) (Interoffice Mail) (U.S. Mail) | Roger Bell | Unit Manager Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive, Bldg #1, MS #9 Tallahassee, Florida 32308 (Interoffice Mail) Daniel Manry Administrative Law Judge Division of Administrative Hearing 1230 Apalachee Parkway Tallahassee, Florida 32399 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of this Final Order was served on the above-named person(s) and entities by U.S. Mail, or the - method designated, on this the Briay of ~~ e&xéaBe- _, 2007. Richard J. Shoop = Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308 (850) 922-5873 PAGER Ub/id ware sor euur doe ad ovu¥oo Io Mew ) PLORIOA AGIINGY FOR UZ21TH BE AOMUNB TRATION, CHARLIE CRIST NE NESTE ANDREW C. AGWUNOBI, M:D GOVERNOR SECRETARY May 29, 2007 . File#5637 Certified Articte Number | ATIN: Administrator 710 3502 9899 9553 DUE PAIN AND HEALTH RESTORATION CENTER INC, 2575 HARN BOULEVARD SUITE B CLEARWATER FL 33764 NOTICE OF INTENT TO DENY LICENSURE #2007 00 5872 Tt is the decision of this Agency that the application for an initial health care clinic license for PAIN ANO HEALTH RESTORATION CENTER INC. to operate as a Health Care Clinic, be DENIED, SENDERS RECORD. =... ; The Agency's factual and legal basis for this action is as follows: 1. On or about April 26, 2007, PAIN AND HEALTH RESTORATION CENTER INC. [Hereinafter Applicant] filed an initial application for licensure with the Agency for a health care clinic. The applicant Provided to the Agency required fingerprint cards for the background screening of MILTON CANIZALEZ (100% owner), 2. § 400.991 (7) (a), (b) and (d), Florida Statutes (“F.S."), require individuals defined as Applicants to successfully complete Florida's level 2 background screening for criminal offenses set forth in § 435.04, F.S., and background screening for insurance fraud under § 817.234, F.S. Compliance with these background screening requirements is one of the minimum requirements for clinic licensure. 3. The following individual failed to successfully meet the above-referenced statutory requirements pertaining to either (a) Level 2 Background Screening requirements; or (b) background screening for insurance fraud under § 817.234, F.S., within the past five years; or (c) the requirement that, if convicted of insurance fraud in any jurisdiction at any time, that his/her civil rights must have been restored prior to the submission of the application: Name Title Reason MILTON D_CANIZALE: WINER of 10% or moré __FDLE RECORD - NOT OK EXPLANATION OF RIGHTS AB Ae one Pursuant to Section 120.569, Florida Statutes, (F.S.) a person substantially affected by this intended agency action has the right to request an administrative hearing. In order to obtaina formal proceeding before the Division of Administrative Hearings under Section 120.57(1), F.S., the request for an administrative hearing must conform to the requirements in Section 28- >_> SS 2727 Mahan Drive, MS#52 , ELORiDa | . Visit ANCA onting at Tallahassee, Florida 32308 . . “ — nttp-Mahca.myflorida.cam EXHIBIT ———_tL___ FACE B// HY . Witwer: scree evuruvses: mu 106.201, Florida Administrative Code (F.A.C,), and must state the material facts disputed by the petitioner. Failure to reque: i i Notice will result in th 9 Health Care Clinic Unit Division of Health Quality Assurance STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION PAIN AND HEALTH RESTORATION CENTER, INC., AHCA No.: 2007005872 Petitioner, Vv. STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. SETTLEMENT AGREEMENT Respondent, State of Florida, Agency for Health Care Administration (hereinafter the “Agency” ) , through its undersigned representatives, and Petitioner, Pain and Health Restoration Center, Inc. (hereinafter ‘“Petitioner”), pursuant to Section 120.57(4), Florida Statutes each individually, a “party,” collectively as “parties,” hereby enter into this Settlement Agreement (“Agreement”) and agree as follows: WHEREAS, the Petitioner is an applicant for health care clinic licensure pursuant to Chapter 400, Part xX, Florida Statutes, Section 20.42, Florida Statutes and Chapter 59A- 33, Florida Administrative Code; and EXHIBIT a WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over licensure of health care clinics pursuant to Chapter 400, Part X; and WHEREAS, the Agency served the Petitioner with a Notice of Intent to Deny on or about May 29, 2007, notifying the party of its intent to deny Petitioner’s initial application for health care clinic licensure; and WHEREAS, the Petitioner requested a formal administrative hearing by petition filed on or about June 25, 2007; and WHEREAS, the parties have agreed that ae fair, efficient, and cost effective resolution of this dispute would avoid the expenditure of substantial sums to litigate the dispute; and WHEREAS, the parties stipulate to the adequacy of considerations exchange; and WHEREAS, the parties have negotiated and agreed that the best interest of all the parties will be served by a settlement of this proceeding; and NOW THEREFORE, in consideration of the mutual promises and recitals herein, the parties intending to be legally bound, agree as follows: 1. All recitals are true and correct and are expressly incorporated herein. Page 2 of 6 2. Both parties agree that the “whereas” clauses incorporated herein are binding findings of the parties. 3. Upon full execution of this Agreement, Petitioner agrees to a withdrawal of its Petition for a _ formal administrative proceeding; agrees to waive any and all appeals and proceedings to which it may be entitled including, but not limited to, an informal proceeding under Subsection 120.57(2), a formal proceeding under Subsection 120.57(1), appeals under Section 120.68, Florida Statutes; and declaratory and all writs of relief in any court or quasi-court (DOAH) of competent jurisdiction; and agrees to waive compliance with the form of the Final Order (findings of fact and conclusions of law) to which it may be entitled. Provided, however, that no agreement herein, shall be deemed a waiver by either party of its right to judicial enforcement of this settlement agreement. 4. Upon full execution of this agreement, the parties agree to the following: a. The Notice of Intent to Deny is deemed superseded. b. The Petitioner's petition for a formal administrative proceeding is deemed withdrawn. Cc. That upon the full execution of this Settlement Agreement, the Petitioner’s application for health care clinic licensure will be deemed submitted and the time Page 3 of 6 period in which the Agency must take final action on the initial licensure application pursuant to law will commence. d. Nothing in this Agreement shall prohibit the Agency from denying Petitioner's application for licensure based upon any statutory and/or regulatory provision, including, but not limited to, the failure of Petitioner to satisfactorily complete a survey reflecting compliance with all statutory and rule provisions as required by law. 5. Venue for any action brought to enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie in the Circuit Court in Leon County, Florida. 6. By executing this Agreement, the Petitioner admits the allegations raised in the Notice of Intent to Deny referenced herein. 7. Upon full execution of this Agreement, the Agency shall enter a Final Order adopting and incorporating the terms of this Agreement and closing the above-styled case. 8. Each party shall bear its own costs and attorney’s fees. 9. This Agreement shall become effective on the date upon which it is fully executed by all the parties. 10. The Petitioner for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, does hereby discharge the Agency for Health Care Administration, Page 4 of 6 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 and the Agency’s actions, 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 the Petitioner or related facilities. 11. This Agreement is binding upon all parties herein and those identified in the aforementioned paragraph ten of this Agreement. 12. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. 13. This Agreement contains the entire understandings and agreements of the parties. 14. This Agreement supersedes any prior oral or written agreements between the parties. 15. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement shall he void. All parties agree that a facsimile signature suffices for an original signature. Page 5 of 6 16. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. a Elizabpth Dudek Depu Secretary Division of Health Quality Assurance. Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 Dated: (oe) 202 7 MMph Lh A Craig H. Smith General Counsel Agency for Health Care Administration 2727 Mahan Drive Tallahassee, Florida 32308 Dated: /6 ied a S -o 7 Marfue . Machin, Esq. Attorney for Petitioner Machin Law Group 607 A. W. Martin Luther King, Jr. Blvd. Tampa, Florida 33603 Dated: @gG- Of - UD Alba M. Gtba, Mn. Gods me x Assistant General counsel Agency for Health Care Administration 8350 N.W. 52 Terrace - #103 Miami, Florida 33166 Dated: 4- 7-07

Docket for Case No: 07-003260