Apr 22 2009 11:41 APR-22-2089 12to4 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@2/11 FILEL STATE OF FLORIDA ANCA AGENCY FOR HEALTH CARE ADMINISTRATION —- AGENCY CLERK 209 APR 22 A 17: STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, Case No.; 08-5324MPI vs. CLL. No.: 07-5913-000 Judge: P, M. HART SHERIDAN EMERGENCY PHYSICIAN A -09- #5 -S-MDO SERVICES, RENDITION NO.: AHCA-09- 23 -S-MD Respondent. FINAL ORDER THE PARTIES resolved all disputed issues and executed a settlement agreement, which is attached and incorporated by reference. The parties are directed to comply with the terms of the attached settlement agreement. Based on the foregoing, this file is hereby CLOSED. DONE AND ORDERED on this the gar day of Apo ( , 2009, in Tallahassee, Florida, eX Holly Benson, Secretary Agency for Health Care fe Agency for Health Care Administration y. Sheridan Emergency Physician Services, Final Order (Case No.: 08-5324MPI) Page 1 of 3 Apr 22 2009 11:41 APR-22-2089 12to4 AGENCY HEALTH CARE ADMIN 856 921 4158 P4311 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: Linda Campbell! Ken Yon, Bureau Chief Sheridan Emergency Physician Services Medicaid Program Integrity 1613 North Harrison Parkway 2727 Mahan Drive Building C, Suite 200 Building 2, Mail Station 6 Sunrise, Florida 33323 Tallahassee, Florida 32308 (Via U.S. Mail) (Interoffice Mail) Justin M. Senior, General Counsel Peter Williams, Inspector General Agency for Health Care Administration Medicaid Program Integrity 2727 Mahan Drive 2727 Mahan Drive Building 3, Mail Station 3 Building 2, Mail Station 6 Tallahassee, Florida 32308 Tallahassee, Florida 32308 (Interoffice Mail) (Interoffice Mail) Kim Kellum, Chief Medicaid Counsel Division of Administrative Hearings Agency for Health Care Administration. The Desoto Building 2727 Mahan Dnve 1230 Apalachee Parkway Building 3, Mail Station 3 Tallahassee, Florida 32399-3060 Tallahassee, Florida 32308 (Via U.S. Mail) (Interoffice Mail) Tracie L. Wilks, Esquire Agency for Health Care Administration Agency for Health Care Administration Bureau of Finance and Accounting 2727 Mahan Drive 2727 Mahan Drive Building 3, Mail Station 3 Building 2, Mail Station 14 Tallahassee, Florida 32308 Tallahassee, Florida 32308 (Interoffice Mail) (Interoffice Mail) Agency for Health Care Adminisiration v. Sheridan Emergency Physician Services, Final Order (Case No.; 08-3324MPI) Page 2 of 3 Apr 22 2009 11:42 APR-22-2889 12:55 AGENCY HEALTH CARE ADMIN 856 921 @158 P.@4-11 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, or the method designated, on this the 27 Tay of Pa atl 2009. Richard Shoop, Esquire Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 Ageney for Health Care Administration v. Sheridan Emergency Physician Services, Final Order (Case No.: 08-5324MPI) Page 3 of 3 Apr 22 2009 11:42 APR-22-2089 12:55 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@5-11 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, ; Case No.: 08-5324MPI vs. CI No: 07-5913-000 Judge: P.M. HART SHERIDAN EMERGENCY PHYSICIAN SERVICES, Respondent. / SETTLEMENT AGREEMENT Petitioner, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, (“AHCA” ot “Agency”), and Respondent, SHERIDAN EMERGENCY PHYSICIAN SERVICES (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. The parties enter into this agreement for the purpose of memorializing the resolution to this matter. 2. PROVIDER is a Medicaid provider in the State of Florida, provider number 2722534-00, and was a provider during the audit period. 3. In its Final Audit Report, dated September 25, 2008, AHCA notified PROVIDER that review of Medicaid claims performed by the Office of Medicaid Program Integrity (“MPI”), of the AHCA Inspector General, indicated that certain claims, in whole or in part, were inappropriately paid by Medicaid. The Agency sought repayment of this overpayment, in the amount of thirty-three thousand, four hundred sixty-one dollars and eighty-six cents ($33,461.86). In addition, the Agency’ applied sanctions in accordance with Sections Apr 22 2009 11:42 APR-22-2089 12:55 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@611 Sheridan Emergency Physician Services Settlement Agreement CLL No. 07-§913-000 Case No.: 08-5324MPI1 409.913(15), (16), and (17) Florida Statutes, and Rule 59G-9.070(7)(e) Florida Administrative Code. Provider was assessed a one thousand, five hundred dollar ($1,500.00) fine for violation of 59G-9.070(7)(e) Florida Administrative Code, and a Corrective Action Plan in the form of an Acknowledgement Statement. In response to the audit report dated September 25, 2008, PROVIDER sent a letter to the Agency requesting a Formal Hearing. 4. The total amount due is thirty-four thousand, nine hundred sixty-one dollars and eighty-six cents ($34,961.86). In addition, PROVIDER still owes 2 Corrective Action Plan in the form of an Acknowledgement Statement. 5, In order to resolve this matter without further administrative proceedings, PROVIDER and AHCA expressly agree as follows: ql) AHCA agrees to accept the payment set forth herein in settlement of the - overpayment issues arising from the MPI review. (2) Within thirty (30) days of the date of execution of a Final Order adopting this Settlement Agreement, PROVIDER agrees to make a payment of thirty-three thousand, four hundred sixty-one dollars and eighty-six cents ($33,461.86), plus a sanction in the amount of one thousand, five hundred dollars ($1,500.00). The total amount due is thirty-four thousand, nine hundred sixty-one dollars and eighty-six cents ($34,961.86). (3) PROVIDER will submit the Corrective Action Plan in the form of an Acknowledgement Statement to the Agency within thirty (30) days of execution of the Final Order adopting this Settlement Agreement. (4) PROVIDER and AHCA agree that such payments as set forth above will resolve and settle this case completely and release both parties from all Settlement Agreement, Sheridan Emergency Pysician Services (Case No, 08-5324MFI) Page 2 of 6 Apr 22 2009 11:43 APR-22-2089 12:55 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@?71i Sheridan Emergency Physician Services Serllement Agreement CI. No,: 07-5913-000 Case No.: 08-5324M PI liabilities arising from the findings in the audit referenced as C.I. Number 07-5913-000. (5) 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 in this case. 6. Payment shall be made to: AGENCY FOR HEALTH CARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 7. Overpayments owed to the Agency bear interest at the rate of 10 percent per year from the date of determination of the overpayment by the Agency, and payment arrangements must be made at the conclusion of legal proceedings, pursuant to Section 409.913(25)(c), Florida Statutes. 8. 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. 9, 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. 10. This setement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. Tl, 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. Settlement Agreement, Sheridan Emergency Pysician Serviccs (Case No. 08-5324MPT) Page 3 of 6 Apr 22 2009 11:43 APR-22-2089 12:56 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@811 Sheridan Emergency Physician Services Settlement Agreement CLL. No.: 07-5913-000 Case No.: 06-5324MPI 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 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 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. 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 tules 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 foram now or in the future available to it, Including the night to any administrative proceeding, circuit or federal court action or any appeal. Settlement Agreement, Sheridan Emergency Pysician Services (Case No. 08-5324MPI) Page 4 of 6 Apr 22 2009 11:43 APR-22-2089 12:56 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@911 Sheridan Emergency Physician Services Settlement Agreement CL No.: 07-5913-000 Case No.: 08-5324MPI 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. THE REMAINDER OF THIS PAGE IS INTENTIONALLY BLANK Settlement Agreement, Sheridan Emergency Pysician Services (Case No. 04-5324MP1) Page 5 of 6 Apr 22 2009 11:44 APR-22-2089 12:56 AGENCY HEALTH CARE ADMIN 856 921 4158 P1811 Sheridan Emergency Physician Services Settlement Agreement CLL No.: 07-5913-000 Case No.: 08-5324MPI SHERIDAN EMERGENCY PHYSICIAN SERVICES ghee J st Dated: ol20 , 2009 BY: TAY 4. MpeTh (Print name) AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Bldg. 3, Mail Stop #3 Tallahassee, FL 32308-5403 (eo Om Dated: Awul Zo 2009 Peter Williams Inspector General Lgl. pated: Ar 10" —_ n009 in Senior General Counsel A a LAW Dated: ..3/ | > , 2009 Kim Kellum ‘ Chief Medicaid Counse} . ; i Cw AGL bAL kd Dated: M a le , 2009 Tracie Wilks Assistant General Counsel Pape 6 of 6 Apr 22 2009 11:44 APR-22-2089 12:5? AGENCY HEALTH CARE ADMIN 856 921 4158 P.di/1i RECEIY =... AKC ro GEMERAL COUNSEL “00 FER 230 hog February 20, 2009 Tracie L Wilks VIA FAX & Fed Ex Assistant General Counsel Agency for Healthcare Administration 2727 Mahan Drive Bldg 3 - Mail Station 3 Tallahassee, FL 32308 Re: Sheridan Emergency Physician Services vs Agency for Healthcare Administration C.I. No. 07-5913-000, DOAH Case No. 08-5324MPI Settlement Agreement Dear Ms Wilks: Enclosed please find the signed Settlement Agreement for the above named case, for the purpose of memarializing resolution to this matter. Thank you for your time and attention to this process. Please contact me if you need to discuss this matter further. Thank you. Respectfully, | ) id tu Compt Linda Campbell Compliance Specialist Sheridan Healthcorp, Inc 1613 N Harrison Parkway, Bldg C, Suite 200 Sunrise, FL 33323 Phone (954) 838-2565 Fax (954) 858-0114 TOTAL FP.ii

Docket for Case No: 08-005324MPI