STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS ALINA DE LA PAZ, f’ (7 Ky - Petitioner, Cc / Q ze.| vs. CASE NO. 99-4154 CI No.: 98-1332-000 STATE OF FLORIDA, RENDITION NO.: AHCA-02~0171 -S-MDO AGENCY FOR HEALTH CARE ADMINISTRATION, 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 437 dayof_ WTR 2007in Tallahassee, Florida. - Medows, MD, Secretary Agency for Health Care Administration Copies Fumished to: Craig A. Brand, Esquire Brand & Fernandez, P.A. Ocean Optique Building 2 NE 40" Street, Suite 403 Miami, Florida 33137 Anthony Conticello Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 Patricia H. Malono Administrative Law J udge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Charlie Ginn, Chief Medicaid Program Integrity ; Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #6 Tallahassee, Florida 32308 Finance & Accounting CERTIFICATE OF SERVICE SEL AT BE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been TEb furnished to the above named addresses by U.S. Mail on this the es=2 day of Tuly— , 2002. Mn Lealand McCharen, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5865 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS ALINA DE LA PAZ, Petitioner, vs. CASE NO. 99-4154 STATE OF FLORIDA, CLI. No. 98-1332-000 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and ALINA DE LA PAZ (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: lL. This Agreement is entered into between the parties for the purpose of avoiding the costs and burdens of litigation. 2. PROVIDER is a Medicaid provider in the State of Florida. 3. In its Final Agency Audit Report issued on August 27, 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 originally sought overpayment in the amount of $60,672.73. In response to the Audit Letter dated June 4, 1999, PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH Case No. 99-4154. During litigation PROVIDER supplied documentation and information to AHCA that ultimately reduced the Overpayment amount to slightly more than $8,100.00. 4. In 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) Within thirty days of Provider's executing this Agreement, PROVIDER agrees to deliver to AHCA the sum of seven thousand dollars ($7,000.00), to be made in two payments with interest at the statutory rate of ten percent (10%), as full and complete settlement of all claims in the proceedings before the Division of Administrative Hearings (DOAH Case No. 99-4154). The first payment due 30 days after PROVIDER'S execution of this settlement agreement and the second payment is due on the same day of the next month. An amortization schedule is attached hereto and incorporated herein by reference. (c) At any time during the payment terms set forth above, PROVIDER may repay the entire remaining principal due in a lump sum payment, without penalty for the scheduled interest that is due subsequent to the lump sum payment. 5. 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.I. No. 98-1332-000. 6. 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. 7. Payment shall be made to: AGENCY FOR HEALTH CARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 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 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. Il. In the event that PROVIDER fails to deliver the full payment due hereunder, the Agency may, with ten (10) days notice to PROVIDER, deem PROVIDER in default. If notice is given and PROVIDER fails to remit the outstanding payment or payments to AHCA in full within ten (10) days after receipt of the notice, PROVIDER shall be in default. If PROVIDER is in default, the full outstanding balance specified in paragraph 4 (d) shall be due and payable. In such event, PROVIDER’S participation in the Medicaid program shall be suspended until such time as the Agency receives payment of the balance in full. Nothing in this paragraph shall be construed to limit in any way the ability of the AGENCY to terminate PROVIDER pursuant to Section 409.907(2), F.S. (1999). Notwithstanding the foregoing, the AGENCY agrees not to terminate PROVIDER based on findings in the instant audit so long as PROVIDER complies with this Agreement. However, if PROVIDER fails to cure its default hereunder within ten (10) days of written notice, PROVIDER understands and agrees that the Agency may exercise its option to terminate PROVIDER from the Medicaid program. 12, 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. 13. Each party shall bear its own attorneys’ fees and costs, if any. 14, 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. 15. 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. 16. This Agreement constitutes the entire agreement between PROVIDER and the AHCA, including anyone acting for, associated with or employed by them, concerming 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. 17. 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. 18. 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 forum now or in the future available to it, including the right to any administrative proceeding, circuit or federal court action or any appeal. 19, 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. 20. 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. 21. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees, 22. All times stated herein are of the essence of this Agreement and shall be strictly complied with. 23. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. ALINA DE LA PAZ Dated: S/G@ [ol , 2001, AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 WAG Daten; 6/4 ,200R- Rurus NOBLE Fay ‘ *! DATED: Lo, 200%, Jub GabtacuEn Ut /4r7 W AGGEDTS - pew 2001. INY CONTICELLO ASSISTANT GENERAL COUNSEL

Docket for Case No: 99-004154