Petitioner: HALIFAX MEDICAL CENTER
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: D. R. ALEXANDER
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: May 13, 1999
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Monday, November 8, 1999.
Latest Update: Dec. 25, 2024
Hatha.
. a : ; STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
HALIFAX MEDICAL CENTER,
Petitioner,
vs. =
Audit CI No. 97-1306-075 ie
STATE OF FLORIDA, Rendition No. AHCA-01-222-S-MDO
AGENCY FOR HEALTH CARE
ADMINISTRATION, ”) RA Cu) SS
Respondent.
/
FINAL ORDER
THE PARTIES resolved all disputed issues and executed a Settlement
Agreement on Anyus {OQ __, 2001, which is 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 Lothaes ot /lugulT, 2001, in
Tallahassee, Florida.
hj
i" Rhonda4. Medows, MD, FAAFP, Secretary
Agency for Health Care Administration
i eee ning ep ee
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:
L. William Porter II, Esquire
Agency for Health Care
Administration
(Interoffice Mail)
Donald R. Alexander
The Division of Administrative Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-30060
David J. Davidson, Esquire
General Counsel
Halifax Community Health System
Post Office Box 2830
Daytona Beach, Florida 32120-2830
Charlie Ginn, Chief, Medicaid Program Integrity
Mike Morton, Program Administrator, Medicaid Program Integrity
Willie Bivens, Finance and Accounting
CERTIFICATE OF SERVICE
LERTIPILAIGC VEE ee
I HEREBY CERTIFY that a trué and correct copy of the foregoing Final Order has
been furnished tg the above-named persons or entities, by U.S. Mail or inter-office
mail, on this [4 = day of Daptiunber 1 2001.
Diane A. Grubbs, Agency Clerk
Agency for Health Care Administration
2727 Mahan Drive, Suite 3431
Fort Knox Building III, MS 3
Tallahassee, Florida 32308
850/922-5865
HALIFAX MEDICAL CENTER DOAH No. 99-2183
Provider No. 010184200 . C.I. No. 97-1306-075
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(‘AHCA’ or “the Agency”), and Halifax Medical Center (“PROVIDER”), by and through
the undersigned, hereby stipulate and agree as follows:
1. This Agreement is entered into between the parties for the purpose of
avoiding the costs and burdens of litigation, and neither party concedes the others
position.
2. PROVIDER is a Medicaid provider in the State of Florida.
3. In its final agency audit report dated April 7, 1999, AHCA notified
PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity
(MPI) indicated that, in its opinion, some claims in whole or in part were not covered by
Medicaid. The Agency sought overpayment in the amount of $28,097.28. In response
to the audit letter dated April 7, 1999, PROVIDER filed a petition for a formal
administrative hearing which was assigned DOAH Case No. 99-2183.
4. In order to resolve this matter without further administrative proceedings,
PROVIDER and the AHCA expressly agree as follows:
(1) | AHCA agrees to accept the payment set forth herein in settlement
of the overpayment issues arising from the MPI review.
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(2) Within thirty days of receipt of the final order, PROVIDER agrees to
pay the Agency the sum of fourteen thousand forty-eight dollars
($14,048.00) to be made in one lump sum in full and complete
settlement of all claims in the proceedings before the Division of
Administrative Hearings (DOAH Case No. 99-2183).
(3) 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. 97-1306-075.
(4) 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.
5. Payment shall be made to:
AGENCY FOR HEALTHCARE ADMINISTRATION
Medicaid Accounts Receivable
Post Office Box 13749
Tallahassee, Florida 32317-3749
6. 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.
7. 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.
omen mes we copra
8. This settlement does not constitute an admission of wrongdoing or error
by either party with respect to this case or any other matter. However, the parties
believe that this matter should be settled because the parties have agreed to the terms
contained within this agreement.
9. Each party shall bear its own attorneys’ fees and costs, if any.
10. 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. .
41. | 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.
12. In the event that a party breaches this Agreement, and enforcement of this
Agreement or recovery of damages for breach hereof is obtained by law or by legal
proceedings through an attorney at law, all costs of collection or enforcement, including
reasonable attorneys’ fees, shall be paid by the breaching party to the non-breaching
party. .
13. This Agreement constitutes the entire agreement between PROVIDER
and the 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 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 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 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.
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.
1b ee ar RF oe
20. This Agreement shall be in full force and effect upon execution by the
respective parties in counterpart.
Dated: Joly 30 , 2001
(Print name)
ITS: Geueral G vnsel
FLORIDA AGENCY FOR HEALTH CARE
ADMINISTRATION ;
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
Dated: B// , 2001
Rufus Noble
inspector General
Dated: 6) | , 2001
“Wited: S- G G , 2001
L. William Porter II
Assistant General Counsel
es
cose ster rene tee coe ee oe ee
DAVID J. DAVIDSON
GENERAL COUNSEL
HALIFAX
aan
COMMUNITY HEALTH SYSTEM
April 22, 1999
APR 29 1999
Edward W. Turner, Chief
Medicaid Program Integrity MEDICAID PROGRAN
State Health Purchasing INTEGRITY. M
Agency for Health Care Administration
2727 Mahan Drive
Tallahassee, FL 32308-5403
Re: Final Agency Audit Report ~ Corrected
CI 97-1306-075
Provider No. 010184200
Dear Mr. Turner:
~ This letter shall serve as Halifax Medical Center’s request for an informal hearing pursuant to
. Florida Statutes §120.57 in regards to the determination that we were overpaid in regards to
certain services rendered to patients Dominique J. Barton ($780.48); Dale A. Quatto, Jr. .
-. ($6,243. 84); Alfred W. Heindl, Ir. ($5,463.36); Michael J. Toby ($5,463.36); Bianca R. Hull *
($780.48); Joshua D. Vigeant ($3,902.40); Brandy L. Larkowski ($1,560.96); Nicholas B.
Ardella ($1, 560.96); and Mari E. King ($780.48). ‘It is our position that these services were
indeed properly reimbursed, ‘and the $26,536.32 allegedly overpaid for these services was in
fact properly paid. Please consider this our request for an informal hearing.
vee Thank you for your cooperation. ~~
General punsel
Associates in Medicine »Clyatt's Quality Care Florida Health Care Plans «Halifax Home Health + Halifax Mecca Center
- HMC Foundation « Healthy Families * Hospice of Volusia/Flagier « Volusia Health Network
303 N. Clyde Morris Boulevard * Post Office Box 2830 + Daytona Beach, Florida 32120-2830 « (904) 254- 4000
Docket for Case No: 99-002183
Issue Date |
Proceedings |
Sep. 18, 2001 |
Final Order filed.
|
Nov. 08, 1999 |
Order Closing File sent out. CASE CLOSED. |
Aug. 06, 1999 |
Order Granting Continuance and Placing Case in Abeyance sent out. (Parties to advise status by October 8, 1999.) |
Aug. 05, 1999 |
Joint Motion for Continuance (filed via facsimile). |
Jul. 14, 1999 |
(Heidi Hughes) Notice of Appearance and Substitution of Counsel filed. |
Jul. 12, 1999 |
(Heidi Hughes) Notice of Appearance and Substitution of Counsel (filed via facsimile). |
Jun. 07, 1999 |
Notice of Hearing sent out. (hearing set for September 14, 1999, September 15 is also reserved; 9:00am; Tallahassee) |
May 27, 1999 |
(Petitioner) Response to Initial Order (filed via facsimile). |
May 17, 1999 |
Initial Order issued. |
May 13, 1999 |
Notice; Request for Informal Hearing (letter); Agency Action Letter filed. |