Petitioner: ESTHER B. EISENSTEIN, M.D.
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: ERROL H. POWELL
Agency: Agency for Health Care Administration
Locations: Fort Lauderdale, Florida
Filed: Oct. 10, 2000
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Wednesday, February 14, 2001.
Latest Update: Nov. 19, 2024
he le Be eee
: STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
ESTHER B. EISENSTEIN, MD,
pearls
Petitioner,
GuERs
vs. DOAH Case tI ¢
Audit C.I. No. 97-0735-000
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
Pry
settlement. Based on the foregoing, this file is CLOSED.
DONE and ORDERED on this the_/ Ah day of Ap ri] 2001, in
Tallahassee, Florida.
ing-Shaw, Jr., 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:
James M. Barclay, Esquire
Ruden, McClosky, Smith, Schuster &
Russell, PA
215 South Monroe Street, Suite 815
Tallahassee, Florida 32301
Heidi Hughes, Esquire
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308-5403
P. Michael Ruff .
Administrative Law Judge
Division of Administrative Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-2060 -
John Owens, Chief
Medicaid Program Integrity ;
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #6
Tallahassee, Florida 32308
a Finance & Accounting
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing has been fumished to
the above named addresses by U.S. Mail on this the XA y) day of
2001.
R.S. Power, Agency Clerk
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308-5403
(850) 922-5865
aa all Hk iy
Pe IN CULL FR -GOUTHLOM USL Feb 15 "OL 12:03 P. 03/09
STATE OF FLGRIDA
DIVISION OF ADMINISTRATIVE HEARINGS
ESTHER B. EISENSTEIN, MD,
Petitioner, |
vs. : . Case No. 00-4268
. Provider No, 036259000
CL No. 97-0735-000
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Respondent.
/
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(AHCA™ or "the Agency"), and ESTHER B, BISENSTEIN MD. (“PROVIDER’), by and
through the undersigned, hereby stipulate and agree as follows:
L This Agreement is entered into between the parties to resolve issues of Petitioner's
compliance with Chapter 409, Florida Statutes, and the Medicaid Provider Handbook.
2. PROVIDER isa x Medicaid provider in the State of Florida.
3. By letter dated July 20, 2000, ABICA notified the PROVIDER that a Final
dicated an ov overpayment from the Medicaid Program in the
amomnt tof $59,584.32 for the period July 1, 1995 ‘hog aly 22, 1997.
Page 1 of 6.
govd ‘ar
Iv La AHSOTDOW N3GNA:WOas BO: b1 ta-e1-dgas
ANUP ONERAL WUUNDEL Fax :8oU-415-9313 Feb 13 01 12:04 = P0409
4. In order to resolve this matter without further administrative proceedings, the
PROVIDER aud AHCA expressly agree as follows: .
a) AHICA agrees to accept the payment set forth herein in fill and complete
settlement of the overpayment issues uncovered by the above-referenced
audit, and agrees not to impose any fines or penalties arising from
Medicaid billings for the period July 1, 1995 through July 22, 1997.
b.) AHCA agrees not to terminate the PROVIDER as a Provider for the
Overpayments uncovered by the audit so long as PROVIDER complies
with this Agreement, and continues to comply with Florida Statutes, and
all other rules, regulations aad policies applicable to the Medicaid
Program. ;
©) PROVIDER agrees to pay the Agency the total sum of forty-four thousand
dollars ($44,000.00) plus ten percent interest, in twenty-four monthly
installments of two thousand and thirty dollars and thitty-cight cents
($2,030.38) due on the first day of each month beginning April 1, 2001
and continuing unt! payment in ful, A amortization schedule is attached
oe : hereto and incorporated hereiy by reference.
3. Payment shall be made to:
_ AGENCY FOR HEALTH CARE ADMINISTRATION
sos Medicaid Accounts Receivable
_. . Post Office Box 13749
- Tallahassee, Florida 31317-3749
6. Upon ful payment © the : Agency of the amount provided in paragraph four (4),
the Agcy herohy agrees to release the Provider fom any and all liability arising from the
Page 2 of 6
: DoW NFaNe:WOAA SO: bi 1O-e1-aat
Live a5vd Iw LA ANSOT =
“LIS
soWd : ‘al
AOVTCOCNERAL, QUUNDSEL © FaXTuDU415-YS1S Feb 43 ’O1 12:04 P.05/09
findings in the audit of Medicaid billings for the period of July 1, 1995 through July 22, 1997
(CL No. 97-0735-000) as set forth in the Agency's preliminary audit letter dated July 20, 2000,
incorporated herein by reference,
7. In the event that PROVIDER fails to make any payment duc hereunder, the
Agency may, at its option and upen fifteen days written notice to PROVIDER, deem
PROVIDER in default. If PROVIDER fails to remit all payments due within ten days after
xeceipt of the notice, PROVIDER shall be in default and the full outstanding balance specified in
paragraph 4 (c) shall be due and payable. PROVIDER’S participation in the Medicaid program
shall be suspended until such time as the Agency receives payment of the balance in full.
Nothing im this Agreement shall be construed to lirnit in gay way the ability of the AGENCY to
termmate PROVIDER pursuant to Section 409.907(2), FS. (1999). Notwithstanding the
foregoing, the AGENCY agrees not to terminate PROVIDER based on findings in the instant
audit sc long as PROVIDER complies with this Agreement. However, if PROVIDER fuils 8
cure its default hereunder within ten (10) days of written notice, PROVIDER understands and
agrees that the Agency may exercise its option to tenninate PROVIDER from the Medicaid
program,
&. _TROU Eons tat bey my ais gm
de the tems of i sgreement fom 2 any
~ ynonies ss due and owing to 10 PROVIDER for any Medicaid elaiens,
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 mules and regulations.
10. Each party to the Agreament shal bear its own stomeys fees and costs, if ny.
Page 3 of 6
Iv LA AMSOTOOW NAanY:WOaa GO+bI 1a-Eel-sas
_ sova | coe eeee
AULECORNERML WUUNDEL FAX ESOURLS-Y515 Feb 13 04 12:04 P.06/09
11. The signatories to this agreement acknowledge that they are duty authorized to
enter into this Agreement on behalf of the respective parties.
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. 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 attomey at law, all costs of collection or enforcement, including reasonable attomey's
fees shall be paid by the breaching party to the nonbreaching party.
14. This Agreement constitutes the entire agreement between PROVIDER and
AHCA, including anyone acting for, associated with or employed by them, conceming all
taaiters and supersedes any prior discussions, agreements or understandings; there are no
Promises, Teptesentations Or agreements between PROVIDER and the ARCA ofber than as set
forth herein. No modification or waiver of any provision shall be valid unless 2 writter
amendment to the Agreement is completed and properly executed by the parties,
15. This is an Agreement of settlement and compromise, made in recognition that the
parties may have different or incorrect understandings, information and contentions, as 10 facts
and law, and with each party compromising snd suiting any potential correctness or
incorrectness of its understandings, information and contentions as to facts and law, 50 that nO
: mulsanderstanding or misinformation shall be aground for restsson hero
16. PROVIDER expressly Waives in this matter its right to any hearing pursyant to
Sections 120, 569 or 120. 57, Florida Statutes, the > muaking or findings of fact and conclusions of
~ Pagedofo
aw ia ANSOTIOW NAdNaA:WOdsa GO: bl te@-e1-ag4
ee
VR UUNERPL LUUNDEL FAK RSSUILSH9S1 5 Feb 13°01 12:05 ~~ P.o7vo9
Medicaid billing for the petiod of July I, 1995 through July 22, 1997 {CL No. 97-0735-000).
PROVIDER further agrees that it shall not challenge or contest any Final Order entered in this
matter in any forum now or in the fimre available to it, including the right to any administrative
proceeding, circuit or federal court action or any appeal, except to enforce the obligations of the
" AGENCY under this Agreement.
17. This Agreement is and shall be deemed jointly drafted and written by all parties to
. itand shall not be constmmed or interpreted against the party originating or preparing it.
18. To the extent that any Provision of this Agreement is prohibited by law for any
teason, such Provision shall be effective to the extent not so prohibited, and such prohibition
_ shall not affect any other: Provision of this Agreement.
19, This Agreement shall ine to the bene of and be binding on each party’
Successors, assigns, heirs, administrators, Tepresentatives and trustees. ;
20. All times stated herein are the essence of this Agreement. °
21. This Agreement shall be in ull fore aud effect upon execution by the respective
_ Page 5 of 6
a50d 7a Tew LA AMSOTIION NAGnNa:WOda GO: bl 1@-£1-ag4a
ERR GUERPE UUNSEL FAK FBSUMAIS-~US15 Feb 13°01 12:05 — P_og/09
ANB trick Ty Dated: ° Ie ___C201)
Esther B. Eisenstein, MD ef
FLORIDA AGENCY FOR HEALTH CARE
ADMINISTRATION
2728 Mahan Drive, Ft. Knox Bldg. 43
Tallahassee, FL 32308-5403
1 Ae. Dated: L 2001
Page 6 of 6
= Te “gowa ee at Ww LT ANSOTOON N3ana:wOsa Ol: bl 19-E1-aga
Docket for Case No: 00-004208
Issue Date |
Proceedings |
Apr. 23, 2001 |
Final Order filed.
|
Feb. 14, 2001 |
Order Closing File issued. CASE CLOSED.
|
Feb. 13, 2001 |
Notice of Settlement and Joint Motion to Close File (filed by Heidi Hughes via facsimile).
|
Dec. 06, 2000 |
Order of Pre-hearing Instructions issued.
|
Dec. 06, 2000 |
Notice of Hearing issued (hearing set for March 6 and 7, 2001; 9:00 a.m.; Fort Lauderdale, FL).
|
Dec. 04, 2000 |
Joint Response to Revised Initial Order filed.
|
Nov. 22, 2000 |
Order Granting Extension of Time issued.
|
Nov. 17, 2000 |
Joint Motion for Extension of Time to Respond to Revised Initial Order filed.
|
Oct. 18, 2000 |
Order Granting Extension of Time issued.
|
Oct. 16, 2000 |
Joint Motion for Extension of Time to Respond to Revised Initial Order (filed via facsimile).
|
Oct. 11, 2000 |
Initial Order issued. |
Oct. 10, 2000 |
Final Agency Audit Report filed.
|
Oct. 10, 2000 |
Petition for Formal Administrative Hearing filed.
|
Oct. 10, 2000 |
Notice filed by the Agency.
|