“9 “STATE OF FLORIDA epeb fly oe pgp vs DIVISION OF ADMINISTRATIVE HEARINGS D&J MEDICAL SUPPLY, INC., * Petitioner, ‘vs. _ AGENCY FOR HEALTH CARE ADMINISTRATION, . Respondent Tallahassee Florida. ~ CASE NO. 00-4560 _ AUDIT REPORT NO. CI 99-0040-000 RENDITION NO. AHCA-01-163-S-MDO Laura Branker, Acting Secretary Agency for Health Care Administration _ (Interoffice Mail) -’ Division of Administrative Hearings 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 es TO BE REVIEWED. Copies furnished to: L. William Porter II, Esquire Agency for Health Care Administration _ Damaris Oliva, President — ae 1840 West 49th Street, Suite 220- 20 we Ts Hialeah, Florida 33012 , EE neg Administrative Law Judge Willie Bivens, Finance and Accounting “a CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addressees by U.S. Mail on this the? _ day , 2001. R.S. Power, Esquire Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 | (850) 922-5865 : ) Sear D & J MEDICAL SUPPLY, INC. DOAH No. 00-4560 Provider No. 950833300 C.1. No. 99-0040-000 ~ SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (‘AHCA” or “the Agency”), and D & J Medical Supply, Inc. (‘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 _ : position. 2. PROVIDER isa 2 Medicaid provider in the State of Florida. AH A agrees tos ac cept the payment : set forth herein in settlement _ of the overpayment issues arising from the MPI review. me avoiding the costs and burdens of F litigation, and neither r Party concedes the other's oe ~ (2) PROVIDER agrees to pay to the Agency a penalty in the amount of | _ five thousand dollars ($5,000.00) to be made in ten (10) equal “monthly payments in full and compléte settlement of all claims in the proceedings before the Division of Administrative Hearings | (DOAH Case No. 00-4560). The fi rst installment will be due thirty i (30) ¢d days after the entry of a final order, . (3) "PROVIDER and AHCA agree that full payment as set forth above will resolve and settle this case completely and release both partes ; “from all liabilities arising ‘from the fi findings | in the audit it referenced as Cd. - 9-0040-000. (4) Pp VIDER agrees that it wal not rebill the “Medicaid Program in : any manner for "claims that were not covered by Medicaid which 8 Payment shall be made to AGENCY FOR HEALTHCARE A ADMINISTRATION _ Medicaid Accounts Receivable _ Post Office Box 13749 Tallahassee, Florida 32317-3749 e total remaining amount due under the terms of this, agreement from any r monies s due and ¢ owing to PROVIDER for any Medicaid claims : respective patties, the laws of Florida. Venue for any action arising from this Agreement shall be in Leon proceedings through an attorney at law, all costs of collection or enforcement, in a 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 11. This Agreement shall be construed in accordance with the provisions of wounty, Florida. 1 2. ; vIn the event that ta party breaches this Agreement and enforcement of this Agreement or Fecovery of ‘damages: for breach hereof is obtained by law ¢ or r by legal reasonable attomeys' fees, shall be paid by the breaching party to the non-br tre agreement between PROVIDER’ Praca cus detentions : ° 14. This is an Agreement of settlement and compromise, made i in recognition that the parties may have different or incorrect “understandings, information a id contentions, as to facts and law, and with each party compromising and s tiling potential correctness or " incorractness of its understandings, information and contentions ase he 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 bering 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 arta is proceeding and any and all Po 20. Bey respective parties in counterpart. D & J MEDICAL St PLY, INC. is

Docket for Case No: 00-004560