Ba STATE OF FLORIDA... - AGENCY FOR HEALTH CARE AD MANES R ARIK 30 BARTZOKIS, SECKLER, & RUBINSTEIN MD PL, EG LERE i) SEP 23 A % 3b Petitioner, vs. FRAES No.: 2008002995 CASE No.: 08-1701 STATE OF FLORIDA, AGENCY FOR RENDITION NO.: AHCA-08- C244 -S-OLC HEALTH CARE ADMINISTRATION, Respondent. ___/ FINAL ORDER Having reviewed the Notice of Intent to Deem Application Incomplete and Withdrawn from Further Review, dated March 10, 2008, attached hereto and incorporated herein (Ex. 1), and all other matters of record, the Agency for Health Care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 other party 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. Each party shall bear its own costs and attorney’s fees. 3. The above-styled case is hereby closed. DONE and ORDERED this _/7 day of Meeirhoer , 2005" in Tallahassee, Leon County, Florida. Holly Benson, Agency for Health Care Administration 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: Thomas Bartzokis, M.D. Shaddrick A. Haston Bartzokis, Seckler & Rubinstein, M.D., | Assistant General Counsel P.L. Agency for Health Care Administration 1000 NW 9" Court #101 2727 Mahan Drive, Bldg #3, MS #3 Boca Raton, Florida 33486 Tallahassee, Florida 32308 (U. S. Mail) (Interoffice Mail) Jan Mills Elizabeth Dudek Agency for Health Care Administration | Deputy Secretary 2727 Mahan Drive, Bldg #3, MS #3 Agency for Health Care Administration Tallahassee, Florida 32308 2727 Mahan Drive, Bldg #1, MS #9 (Interoffice Mail) Tallahassee, Florida 32308 Interoffice Mail) Karen Rivera Laboratory Unit Manager Agency for Health Care Administration 2727 Mahan Drive, MS #28 Tallahassee, Florida 32308 (Interoffice Mail) John G. Van Laningham Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (U.S. Mail) 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-23” day of — 2006 —— Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 joes CHARLIE CRIST FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION: ne SEROLBY BENSON 2 GOVERNOR : ul ©" SECRETARY March 10,2008. = RECEIVED tified. Artic! GENERAL COUNSEL 7140 3901 9345 4792 0658 BARTZOKIS, SECKLER, & RUBINSTEIN TOSS dpa aig ah os ine es 2 1000 NW STH CT #01 BME SENDERS RECORD BOCA RATON, FL 33486 Agency ior Healtt; License/File Number: 800013944 Care Administration Case #: 2008002995 _ NOTICE OF INTENT TO DEEM APPLICATION INCOMPLETE AND-WITHDRAWN FROM FURTHER REVIEW. Your application for licensure renewal is deemed incomplete and withdrawn from further consideration pursuant to Section 408.806(3)(b), Florida Statutes. Section 408.806(3)(b), F.S. contains the following language: Requested information omitted from an application for licensure, license renewal, or change of ownership, other than an inspection, must be filed with the agency within 21 days after the agency's request for omitted information or the application shall be deemed incomplete and shall be withdrawn from further consideration and the fees shall be forfeited. You were notified by correspondence dated July 12, 2007, to provide further information addressing identified apparent errors or omissions within twenty-one days from the receipt of the Agency’s correspondence. Our records indicate you received this correspondence by certified mail on July 16, 2007. As the following information was not received, your application is deemed incomplete and withdrawn from further consideration: Refer to enclosed copy of omission letter dated July 12, 2007. EXPLANATION OF RIGHTS Pursuant to Section 120.569, F.S., you have the right to request an administrative hearing. In order to obtain a formal] proceeding before the Division of Administrative Hearings under Section 120.57(1), F.S., your request for an administrative hearing must conform to the requirements in Section 28-106.201, Florida Administrative Code (F.A.C), and must state the material facts you dispute. EXHIBIT Visit AHCA online at 2727 Mahan Drive, MS# 32 http://ahca.myflorida.com Tallahassee, Florida 32308 SEE ATTACHED ELECTION AND EXPLANATION OF RIGHTS FORMS. Agency for Health Care Administration “By: Karen Rivera, Manager Laboratory Unit ce: Agency Clerk, Mail Stop 3 Legal Intake Unit, Mail Stop 3 Certified Article Numbe 71b0 "3901 qe4s 1133 bo" - SENDERS RECORD , FLORIDA AGENCY FOR HEAITH CARE ADMINISTRATION CHARLIE CRIST ANDREW C. AGWUNOBI, M.D. GOVERNOR SECRETARY July 12, 2007 Certified Mail ———-_ —FHOMAS-BARTZOKIS ~ BARTZOKIS, SECKLER, & RUBINSTEIN MD PL 1000 NW 9TH CT #101 BOCA RATON, FL 33486 a 3 4 RE: license # 800013944 Dear Laboratory Services Provider: my =< This letter is to acknowledge receipt of your application for your Clinical Laboratory. Afies review it was found to be incomplete. Applicants for licensure receive only one omission letter describing the corrections, omissions or revisions needed to deem the application complete. If the response to this omission letter does not satisfactorily address what is outlined below, the application will be denied. Therefore, pursuant to section 120.60(1), Florida Statutes, no further action can be taken until the following is received: . “Hd €@ das 6 Complete and return the enclosed "Declaration of Proposed Test Menu" form. This form is also available at . _ bttp://ahca.myflorida.com/MCHQ/Health Facility Regulation/Laboratory Licensure/clint cal.shtml. According to the test menu submitted you need to upgrade your license. The Accumetrics Aspirin Assay is a moderate complexity test. Performing this test with a Certificate of Exemption means you are out of compliance. To upgrade your license remit an additional $1,492, this is based on your test volume, and a letter stating that you wish to upgrade. A survey will also need to be set up. If you do not wish to upgrade your license a new test menu and a letter on letterhead, stating this testing is no longer performed, signed by the director will need to be submitted. Complete and return the enclosed Health Care Licensing Application Addendum. This form is also available at: http://ahca.myflorida.com/MCHQ/Corebill/index.shtml FLORIDA 2727 Mahan Drive, MS#32 PARE CARE Visit AHCA online at Tallahassee, Florida 32308 COME: in the Sunshine http://ahca.myflorida.com www.FloridaC ompareCare.gov BARTZOKIS, SECKLER, & RUBINSTEIN MD PL Page 2 July 12, 2007 Please send the required information, with a copy of this letter, no later than 21 days from the ~~ receipt of this letterto: Agency for Health Care Administration Laboratory Unit Mail Stop 32 2727 Mahan Drive ‘Tallahasseé, FD 32308 "If the applicant fails to submit all the information required in the application within 21 days of this letter, the application will be denied and the fees shall be forfeited as required in subsection 408.806(3)(b), Florida Statutes. If you have any questions regarding this letter, please contact me at (850)414-0340. Sincerely, A,’ Nabk April Scott, MLT (ASCP) Biological Scientist III Laboratory Licensure Unit STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION GP Gin RE: Bartzokis, Seckler, & Rubinstein MD PL CASE NO: 2008002995 ELECTION OF RIGHTS ‘This Election of Rights form is attached to.a proposed Notice of Intent to Deem Incomplete and Withdraw from Further Review of the Agency for Health Care Administration (AHCA). The title may be Notice of Intent to Deem Incomplete and Withdraw from Further Review. or row Ob aA 2008 MAR 2@ P OB some other notice of intended action by AHCA. An Election of Rights must be returned by mail or by fax within 21 days of the day you receive the attached Notice of Intent to Deem Incomplete and Withdraw from Further Review or any other proposed action by AHCA. If an Election of Rights with your selected option is not received by AHCA within twenty- one (21) days from the date you received this notice of proposed action, you will have given up your right to contest the Agency’s proposed action and a final order will be issued. (Please reply using this Election of Rights form unless you, your attomey or your representative prefer to reply according to Chapter 120, Florida Statutes (2006) and Rule 28, Florida Administrative Code.) . Please return your ELECTION OF RIGHTS to: Agency for Health Care Administration Attention: Agency Clerk 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 Phone: (850) 922-5873 Fax: (850) 921-0158 PLEASE SELECT ONLY 1 OF THESE 3 OPTIONS: OPTION ONE (1) I admit to the allegations of facts and law contained in the Notice of Intent to Deem Incomplete and Withdraw from Further Review, or other notice of intended action by AHCA and I waive my right to object and have a hearing. I understand that by giving up my right to a hearing, a final order will be issued that adopts the proposed agency action and imposes the proposed penalty, fine or action. OPTION TWO (2) I admit to the allegations of facts contained in the Notice of Intent to Deem Incomplete and Withdraw from Further Review, or other proposed action by AHCA, but I wish to be heard at an informal proceeding (pursuant to Section 120.57(2), Florida Statutes) where I may submit testimony and written evidence to the Agency to show that the proposed administrative action is too severe or that the fine should be reduced. OPTION THREE (3) x T dispute the allegations of fact contained in the Notice of Intent to Deem Incomplete and Withdraw from Further Review or other proposed action by AHCA, and I request a formal hearing (pursuant to Section 120.57(1), Florida Statutes) before an Administrative Law Judge appointed by the Division of Administrative Hearings. PLEASE NOTE: Choosing OPTION THREE (3), by itself, is NOT sufficient to obtain a formal hearing. You also must file a written petition in order to obtain a formal hearing before the Division.of Administrative Hearings under Subsection 120.57(1), Florida Statutes. It must be received by the Agency Clerk at the address above within 21 days of receipt of this proposed administrative action. The request for formal hearing must conform to the requirements of Rule 28-106.201, Florida Administrative Code, which requires that it contain: 1. The name and address of each agency affected and each agency’s file or 2. 3. 7. 8. identification number, if known: Your name, address, and telephone number, and the name, address, and telephone number of your representative or lawyer, if any; An explanation of how your substantial interests will be affected by the Agency’s proposed action; A statement of when and how you received notice of the Agency’s proposed action; : A statement of all disputed issues of material fact. If there are none, you must state that there are none; A concise statement of the ultimate facts alleged, including the specific facts you contend warrant reversal or modification of the Agency’s proposed action; A statement of the specific rules or statutes you claim require reversal or modification of the Agency’s proposed action; and A statement of the relief you are seeking, stating exactly what action you wish the Agency to take with respect to its proposed action.’ (Mediation under Section 120.573, Florida Statutes, may be available in this matter if the Agency agrees.) License type: Clinical Labratory License number: 800013944 Licensee Name: Bartzokis, Seckler, & Rubinstein MD PL Contact person: ! hom As Baer zokis Mb. N - . . Ti . Address: £00 Lo, ge ce az] Bec Phoon ft, BAH¥ ( Street and number City Zip Code E-Bay No Leb 308-4 KO Telephone No. of “HY4T Bax No 4l-3 Email (optional) I hereby certify that I am duly authorized to submit this Notice of Election of Rights to the Agency for Health Care Administration on behalf of the licensee referred to above. Print Name: Ct! 3/24 [0% ‘Date: “Phew ac Brérrokig Title. Mb. Od lis 2008) LDIWb bbl Jbtbdby PAGE 62 STATE OF FLORIDA _ £13 AGENCY FOR HEALTH CARE ADMINIST BARTZOKIS, SECKLER, & RUBINSTEIN MD PL, Petitioner, FRAES No,: 2008002995 CASE No.: 08-1701 vs, . STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, _ Respondent, a ___, SETTLEMENT AGREEMENT Respondent, . State of Florida, Agency for Health Care Administration (hereinafter the “Agency”), through its undersigned representatives, and Petitioner, Bartzokis, Seckler, & Rubinstein MD PL (hereinafter “Petitioner”), | Pursuant to Section 120.57(4), Plorida Statutes, each individually, a “party,” collectively as “parties,” hereby enter into this Settlement Agreement (“Agreement”) and agree as follows: . WHEREAS, the Petitioner is a clinical laboratory licensed pursuant to Chapter 483, Part I, Florida Statutes and the Chapter 59A-7, Florida Administrative Code; and ; WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over licensure of Petitioner; and WHEREAS, the Agency served the Petitioner with 4 Notice of Intent to ..Deem Application Incomplete and Withdrawn. from Further Review, notifying EXHIBIT 2 wmlis cous 1D Ub Dblsbebsb3 PAGE 3 -the Petitioner of its intent to withdraw its renewal application from further review for failure to provide omitted Information within the required timeframe; and WHEREAS, the parties have agreed that a 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 exchanged; and WHEREAS, the parties have negotiated In good faith and agreed that the best interest of all the parties will be served by a settlement of this proceeding; anc | , 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. . 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 waive any and all proceédings and appeals 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 (O8/14/2088 1dtdb bb 3bHbSES PAGE 84 or quasi-court (DOAH) of competent jurisdiction; and further agrees to walve . 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 Agreement. ; . . 4. Upon full execution of this Agreement, the parties agree to the following: a. The Notice of Intent to Deem Application Incomplete and Withdrawn from Further Review is deemed superseded by this agreement, b. . Upon the full execution of this Agreement, the Agency shall begin processing Petitioner’s application. c. 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 compllance with all statutory and rule provisions as required by law. 5, Venue for any action brought to Interpret, challenge or enforce the terms of this Agreement or the Final Order entered pursuant hereto shall llé solely in the Circuit Court in Leon County, Florida. OY/11/20U8 1bib 5b 13686563 PAGE 5 6. By executing this Agreement, the Petitioner neither admits nor denies the allegations raised in the Notice of Intent to Deem Application . Incomplete and Withdrawn from Further Review 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(s). 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 and its agents, representatives, and attorneys of 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 or resulting. organizations. 11. This Agreement Is binding upon all parties herein and those identified in the aforementioned paragraph of this Agreement. Bsr ll/ 200s Lob obi sbubob3 PAGE 86 12. In the event that Petitioner fs or was a Medicaid provider, this _ settlement does not prevent the Agency from seeking Medicaid overpayments or from Imposing any sanctions pursuant to Rule 596-9.070, Fiorida Administrative. Code. This agreement does not prohibit the Agency from taking action regarding Petitioner’s Medicaid provider status, - conditions, requirements or contract. 13, The undersigned have read and understand this Agreement and have authority to bind their respective principals to it, Petitioner’s representative has the capacity to execute this Agreement and has done so without the advice of counsel. The Petitioner understands that it has the right to-consult with counsel and has knowingly and freely entered into this Agreement without exercising its right to consult with counsel. The Petitioner fully understands that counsel for the Agéncy represents solely the Agency and Agency counsel has not provided legal advice to or influenced the Petitioner in its decision to enter into this Agreement. 14. This Agreement contains the entire understandings and agreements of the parties, - 15. This Agreement supersedes any prior ora! or written agreements between the, parties. This Agreement may not be amended except In writing. Any attempted assignment of this Agreement shall be void. 16. All parties agree that a facsimile signature suffices for an original signature. OI li/ 2005) 1950b | Dbl gbebdbs PAGE Uf 17. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. 2727 Mahan Drive, Bidg 1 Tallahassee, Florida 32308 Craig H. Smith General Counsel Florida Bar No. 96598 Agency for Heaith Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 patep: __f 1G = 0% ’ Bartzokis, Seckler, & Rubinstein, M.D., P.L. 1000 NW 9" Court #101. Boca Raton, Florida 33486 Shaddrick A. Haston Assistant General Counsel Agency for Health Care Administration - 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308 DATED:

Docket for Case No: 08-001701