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ESTHER B. EISENSTEIN, M.D. vs AGENCY FOR HEALTH CARE ADMINISTRATION, 00-004208 (2000)

Court: Division of Administrative Hearings, Florida Number: 00-004208 Visitors: 17
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.
Source:  Florida - Division of Administrative Hearings

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