Apr 22 2009 11:48 OPR-22-2089 13:81 AGENCY HEALTH CARE ADMIN 850 921 Gise = P.a2-a9 FILED STATE OF FLORIDA AMCA DIVISION OF ADMINISTRATIVE HEARINGS AGERSY CLERK AGENCY FOR HEALTH CARE mos APR 22 A IT ADMINISTRATION, Petitioner, DOAH Case No,: 08-6217MPI V5. PROVIDER NO.: 376698508 AHCA CLI. No.: 07-5929-000 UNIVERSITY OF FLORIDA, RENDITION NO.: AHCA-09- 249 -S-MDO 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 CLOSED. DONE AND ORDERED on this the AO” day of Apesl —_, 2009, in pas Tatlahassee, Florida. BY fe. Holly Benson, Secretary Agency for Health Care Administration Apr 22 2009 11:49 APR-22-2089 13:81 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@3-89 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 Fumished to: Lester J. Perling, Esquire Broad & Cassel One Financial Plaza Fort Lauderdale, Florida 33394 Kelly Bennett, Assistant General Counsel Agency for Health Care Administration (Interoffice) Peter Williams, Inspector General Agency for Health Care Administration (Interoffice) D. Kenneth Yon, Bureau Chief Medicaid Program Integrity (Interoffice) Finance & Accounting (Interoffice) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing was served to the above named addresses by mail or interoffice mail this A day of _ Lp if o 2009. Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Bldg. 3, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5873 Apr 22 2009 11:49 APR-22-2883 13'@2 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@4-89 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS AGENCY FOR HEALTH CARE ADMINISTRATION, | Petitioner, vs. CASE NO.: 08-6217MPI PROVIDER NO.: 376698508 AHCA C.J. NO.: 07-5929-000 UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC. A/K/A UNIVERSITY OF FLORIDA JACKSONVILLE FACULTY PRACTICE Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (AHCA” or “the Agency”), and UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC. A/R/A UNIVERSITY OF FLORIDA JACKSONVILLE FACULTY PRACTICE, (“PROVIDER”), by and through the undersigned, hereby stipulates and agrees as follows: 1. This Agreement is entered mto for the purpose of tmemorializing the final resolution of the matters set forth in this Agreement. 2. PROVIDER is a Medicaid provider (Medicaid Provider No. 376698508) in the State of Florida. 3. AHCA Medicaid Program Integrity (MPI) conducted a review of PROVIDER’S Medicaid reimbursernents for dates of service during the period of October 1, 2005 through September 30, 2006. The review involved 140 claims submitted on behalf of 76 patients and preliminarily resulted in an assessment of an overpayment in the amount of $69,130.38.. Through the standard audit processes, a Final Agency Audit Report dated November 18, 2008 Apr 22 2009 11:49 APR-22-2089 13:82 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@5-89 was issued, By way of this report, AHCA indicated that, in its opinion, some claims in whole or in part were not covered by Medicaid and that an overpayment in the amount of $15,476.97 had been identified. Additionally, AHCA MPI imposed a fine in the amount of $500.00, 4. The PROVIDER requested an administrative hearing to dispute MPI’s findings. Additionally, PROVIDER and MPI held a telephone meeting wherein the submitted documentation was discussed and further reviewed. This resulted in an adjusted determination _ of overpayment such that MPI seeks repayment of $4,985.05, payment ofa fine in the amount of $500.00, and payment in the amount of $514.95 toward a portion of the AHCA investigative expenses; MPI seeks payment of $6,000.00, 5. ‘Yn order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: (a) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review, (b) PROVIDER agrees to make a single payment of six thousand dollars ($6,000.00), in full and complete settlement of all claims in this matter, to be made on or before April 1, 2009. (©) 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, No. 07-5929-000. (d) The overpayment is derived from the remaining disallowed claims as follows: [# [DOS | bisallowed | 41) 07/17/06 $35.81 13 05/08/06 $35.81 34 8809/05/06 $37.25 44 42/30/05 $35.81 48 01/13/06 $18.58 Page 2 of 6 Apr 22 2009 11:49 APR-22-2089 13:82 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@6-89 (ce) | AHCA agrees to hold a telephone conference with PROVIDER to further discuss the basis for the disallowances in order to assist PROVIDER in ensuring accurate billing. AHCA shall coordinate with PROVIDER for the telephonic conference by way of communication with PROVIDER'S Office of the General Counsel, through direct contact with Mr. Robert Pelaia, Esq. and shall provider a detailed explanation of the denial/adjustment basis. 6. PROVIDER shall make payment 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 and PROVIDER reserve 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. In fact, while AHCA alleged administrative errors it does not allege any submission of false claims, or fraud in connection with this matter. 10. Each party shall bear its own attorneys’ fees and costs, if amy, except as set forth herein. 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. Page 3 of 6 Apr 22 2009 11:50 APR-22-2089 13:83 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@?-ag 12. This Agreement shall be construed in accordance with the provisions of the laws of Flonda. 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 eniployed by them, conceming all matters and supersedes any prior discussions, agreements or undetstandings; 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. 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 herem. 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. Page 4 of 6 Apr 22 2009 11:50 APR-22-2089 13:83 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@889 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. 21. In the event either party breaches this Agreement, the costs and attorney fees incurred by the non-breaching party associated with enforcement or collection activity pertaming to this Agreement shall be paid by the party breaching this Agreement to the non-breaching party. UNIVERSITY OF FLORIDA JACKSONVILLE PHYSICIANS, INC. A/K/A UNIVERSITY OF FLORIDA JACKSONVILLE FACULTY PRACTICE 655 West 8" Street Jacksonville, Florida 32209 a efoto S : Dated: _~ [399 , 2009 Robert C. Nuss, M.D. * Dean of the Regional Campus University of Florida College of Medicine — Jacksonville Authorized Representative for Provider LESTER J. PERLING, ESQUIRE BROAD AND CASSEL One Financial Plaza Fort Laudgrdale, Flonda 33394 Dated: 7? / >. [: OF? _, 2009 _ Page 5 of 6 Apr 22 2009 11:50 APR-22-2089 13:83 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@9a9 FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 _& ao Dated: __ Ayre [ 20 _, 2009 Peter Williams Inspector General (all jo Dated: April /O* , 2009 J in Senior” Dated: => 1A , 2009 General Counsel Assistant General Counsel Page 6 of 6 TOTAL FP.@o

Docket for Case No: 08-006217MPI