STATE OF FLORIDA 1 AGENCY FOR HEATH CARE ADMINISTRATION J? 22 DOCTOR’S NETWORK, INC., Petitioner, vs. CASE NO. 96-2162 CI 94-0859-000-G AGENCY FOR HEALTH CARE RENDITION NO. AHCA-O1- 164 -S- MDO ADMINISTRATION, Resnondent . / a FINAL ORDER THE PARTIES resolved all disputed issues and executed a “settlement agreement”, which is incorporated by reference. The parties are directed to comply with the terms of the “settlement agreement”. Based on the foregoing, this proceeding is CLOSED. DONE and ORDERED on this the 25 day of — nwe- , 2002, in Tallahassee, Florida. Rhond . lr. MD, Secretary Agency for Health Care Administration 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: Benjamin Metsch, Esquire 1455 NW 14°" Street Miami, Florida 33125 Kim A. Kellum, Esquire Attorney for Agency AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive Fort Knox Building 3, Mail Stop 3 Tallahassee, Florida 32308 Linda M. Rigot Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Willie Bivens, Finance and Accounting Mike Morton, Medicaid'Program Integrity CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named adarpeyees by U.S. Mail,or by Interoffice Mail on this the wa day of Pky , 2002. Leohunh nbn Leland McCharen, Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3, Mail Stop 3 Tallahassee, Florida 32308-5403 FEB-25-2#¢2 15:29 RGENCY FOR HEALTH CARE AD $52 <2 9322 ©.@2 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION DOCTOR'S NETWORK, INC., Petitioner, vs. CASE NO.: 96-2162 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. SETTLEMENT AGREEMENT Respondent, the State of Florida, Agency for Health Care Administration, and Petitioner, Doctor’s Network, Inc., by and through the undersigned individuals, hereby stipulate and agree as follows: 1. This settlement agreement is entered into between the parties in order to resolve a dispute that arose as the result of an Agency audit. 2. Ina final agency audit letter dated April 2, 1996, Petitioner was informed that the Agency detexminec that 1t was overpaid. Consequently, Respondent sought reccupment in the amount of $52,419.52. A copy of the recoupment letter is attached to this agreement. ad T2:FT 2007-2T-SHN " FEB-25-20¢2 15:29 AGENCY FOR HEALTH CARE AD BE@ 413 9313 P.@3 3. In a petition dated April 23, 1996, Petitioner challenged Respondent’s action and requested a formal hearing regarding the overpayment. 4d. Subsequently, Respondent reviewed additional documer tation presented to the Agency regarding the claims in quee'ion. After this subsequent review, Respondent recalculated the overpayment amount. §. Accordingly, Respondent no longer contends that Petiticner owes Respondent $52,419.52. Respondent has withheld $190.42 of this amount from Medicaid payments owed to the Peitioner. It is therefore proper for this case to be settied with an additional payment of $18,000.00 from Petitiorer. 6. The Agency agrees to allow the Petitioner, Doctor's Network, Inc., to pay the Agency the total sum of 318,000.00 plus ter, percent interest in twenty-four monthly instali~ents of $830.61 on the first day of each month beginniig August 1, 2001 and continuing until satisfaction of the full amount of $16,000.00 plus ten percent interest. 7. Payment shall be made to: AGENCY FOR HEALTH CARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, FL 32317-3749 8. In the event the Petitioner fails to make any payment due hereunder, the Respondent may, at its option and £a°4 T2:PP 2OO2-2T del ” FER-25-2002 15:25 AGENCY FOR. HEALTH CARE AD 854 413 3213 P.ad upon fifteen days written notice to Petitioner, declare Petitioner in default. Its provider number shall be suspended until such time as the Agency receives payment of the balance in full. 9, This settlement does net constitute an admission of wrongdoing or exror by either party. However, the parties believe that this matter should be settied. 10. Both parties requeat that the above-referenced file be closed. 11. Each party shall bear its own attorney’s fees and costs. 12. This agreement represent3 the entire agraement between the parties regarding settlement of this case. No modification or waiver of any provision shall be valid unless a written amendment to the agreement is competed and properly executed by the parties. The signatories to this agreement, acting in a representative capacity, represent that they are duly authorized to act on behalf of tha parties to the agreement. Venue for any action arising from this agreement shall be in Leon County, Florida. rad Té:PT @O02-2T-ab AGENCY FOR HEALTH CARE AD ao . a7 Cated this ee? day of [ule af 2002. su'd AGENCY FOR HEALTH CARE AOMINISTRATION William H. Roberts, Acting General Counsel State of Florida Agency fcr Health Care Administration 2727 Mahan Drive Ft. Knox Executave Center #1 Tallahassee, Florida 32308 Inspector General State of Florida Agency for Health Care Administration 2727 Mahan Drive Ft. Knox Executive Center #1] Tallahassee, Florida 32308 DOCTOR'S NETWORK, INC. Déctor’s Network, Ync. 13500 North Kendall Drive Suite 112 Miami, FL 33136 Benjamin Metsch, Esq. 1455 Nw 14™ Street Miami, FL 33125 ceiPt 858 413 331 P.@S 2802-2 T-YdW YUNTUTMEUUE TAU 12) 99 TT PRURESSIUNAL’ OFFICES 3055457224 P, 06 JUN~06-208 @9136 AGENCY FOR HEALTH CARE aD 858 413 9313p gg AGENCY FOR HEALTH CARE ADMINISTRATION AMORTIZATION SCHEDULE Doctor's Network, Inc/Provider # 0517313-00/C. 1. # 84-0859-000 Table sturts af date: of payment number { Date ornare | Regine) Ending Cumulative interest Balance rears ed TOO 00 150.00 17,310.35 | 830.87 | oaora00! 17310.39 | 14433 | epeag wees: | a5qss Poet -———— oye /2001 18,6533.11 198.64 692.00 19,944.14 482.04 [80.8 O01 [15,941.11 1 432.84 687,77 16,243.34 566.78 AY: janiaoo! 15,243.34 127.03 703.58 14,539.76 692.61 Oe ou 01/2002 | 14,690.76 {| 121.16 700.45 43,830,341 213.97 B 13.60.31 | 415.25 716.38 13,714.08 9.23 830.87 owotr2002 19,116.06 | 109.29 721.42 12,303.64 | 1,036,52 ° 890.67 Oarot/2002_| 12,393. a 103.28 727.3 14,688.3 : 141.20 Ce B5/01/2002 600 97; 733.38 10,032.67 | 8 30,5 i ; oBotizeca | 10'98292 61.11 79050 | ttesat | 45012 [836.61 —— 0701/2002 0,193.41 84.05 746.86 9447.76 1,415,07 830.61 08/1/2002 {0,447.75 1 78.75 751.86 8695.67] 1,403.00 | _ BSC ET 09/01/2002 | 8,805.87 | 72.47 758.14 7,937.73 | 1,686.27 ee — tororgoo2 | 7.997.73 $6. 8 Tose 7,179.26 1,932.4 i ; at] 11/01/2002 |” 7,173.26 4,405.49 o2.1@ [8906 | 1201/2002 | 8,402.43 53. 3 $.625.17 i 766. 54 O1o1/2003 | _§,425.17 46.68 7, 7” 4,841.44 4,792.42 — 16 | O8Oia003 4,841.44 15 4,061.18 1,832.77 20 03/01/2003 4,051.18 10 a5 3,264,93 1,866.59 21 3,264.93 Pega 1 of 1

Docket for Case No: 96-002162