FILES 2" STATE OF FLORIDA 01 Jul | i PHT 3 0 DIVISION OF ADMINISTRATIVE HEARINGS | Visas PHYSICIANS HEALTHCARE ADMIN ats VE "oLER PLANS, INC., . HEARINGS Petitioner, , | | AFM : vs. DOAH CASE NOS. 00- 4066 ~ a! oe 00-4687 ) STATE OF FLORIDA, 00-4688 : _ AGENCY FOR HEALTH CARE 00-4689 : ADMINISTRATION, 00-4690 | 00-4691 | Respondent. ; AUDIT CI NO. 98-0250-000 Rendition No. AHCA-01-115-S-77. Do | parties are “directed | to , comply with the terms of th agreement. Based o on 1 the foregoing, this file i is CLOSED. DONE ani ORDERED on this the se Zl tay of Lin face 2001, in ° Tallahassee Florida. Laura Beénker, Acting Secretary Agency for Health Care Administration "<" John Owens, Chie 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: . Seann M. Frazier, Esquire Greenberg Traurig, P.A. 101 E. College Avenue Tallahassee, Florida 32301 Karen A. Varn, Esquire Agency for Health Card Administration 2727 Mahan Drive, Mail Stop #3 - » . Tallahassee, Florida 32308-5403 ~~ ~ Medicaid Program Integrity - es Agency for Health Care Administration ~ 2727 Mahan Drive, Mail Stop #6: me _. Tallahassee, Florida 32308 ~. Finance & Accounting CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addresses by U.S. Mail on this the | O day of 2001. R.S. Power, Esquire ~ Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5865 appre gs ee eee tonne app enegeneerin STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS PHYSICIANS HEALTHCARE PLANS, INC. Petitioner, vs. . CASENO. 00-4066 00-4687 AGENCY FOR HEALTH CARE 00-4688 ADMINISTRATION, 00-4689 ~ - 00-4690 Respondent. : 00-4691 eee SETTLEMENT AGREEMENT. Respondent, State of Florida, Agency for Health Care Administration e (“Agency”), and Petitioner, Physicians Healthcare Plans, Inc. (CPR ", by and through _ the undersigned individuals, hereby stipulate and agree as s follows: a 1. ‘The partis to ‘this agreement intend, by its terms, to resolve completely, the matters in litigation ander all of the above case 3 numbers. This settlement agreement is entered into by and between the Agency and PHP ” pursuant to Section 120 57( Florida Statutes, to resolve any "collateral issues emanating from these disputes in ~ litigation. 2. In Agency Audit number(s) 00-0544-001 trough 00- 0544-013 final agency action letters (FAL) dated August 10, 2000 were served upon . the Petitioner, overpayments totaling ‘$169,021.00. "Petitioner ‘timely requested an adminis ions, and litigation ensued. A‘ hearing to ‘challenge those determi Physicians Healthcare Plans, Inc. Settlement Agreement numbers 00-0544-001 through 00-0544-013 and the ensuing litigation shall collectively be referred to as the “Pending Litigation.” | 3. Discovery was undertaken the Pending Litigation. Records were obtained and reviewed. After negotiation and further investigation, the Agency learned that the Petitioner expended amounts in order to ensure coverage for physician and other health care services, paid medical claims and paid for prescriptions for enrollees who were the subject of the audit. PHP’s costs in this regard totaled $9,843.67. 4. Petitioner and the Agency (the “Parties”) have therefore determined that it is fair, reasonable, equitable and in their respective best interests to resolve, settle and compromise any and all disputes, claims, disagreements and differences between them which are at issue in the Pending Litigation, without suggestion o admission of - 7 wrongdoing, with the following particular agreements: a. PHP shall pay the © Agery the sum \ of $159, 17: 33, which sepresents Peli : 5 Physicians Healthcare Plans, Inc. Settlement Agreement thereafter, enter Final Orders in the Pending Litigation, adopting this Settlement Agreement. 6. Petitioner, on behalf of itself and its Predecessors, Successors and Assigns, hereby waives, releases and forever discharges the Agency, along with its Predecessors, Successors and Assigns, of and from any and all manner of actions, causes of action, _ suits, debts, dues, sums of money, attorneys’ fees, accounts, covenants, contracts, controversies, damages, claims and demands of whatsoever nature, direct or indirect, known or unknown, matured or not matured, now or hereafter discovered, which PHP now has, claims to have or ever may have had from the beginning of time to the date hereof, only to the extent related to, or connected with, the matters at issue in the Pending Litigation. | / | | 7. The Agency, on behalf of itself and its Predecessors, Successors and Assigns, hereby waives, releases and forever discharges PHP, along with its ee Predecessors, Successors and Assigns of and from any and all manner of actions, a causes of action, suits, debs, dues, sums of money, attomeys! fees accounts, covenants contracts, controversies damages, claims and demands of whatsoever nature, direct or indirect, known ¢ or unknown, matured 0 or not ‘matured, now or hereafter discovered a sete. 4 which the Agency now has, claims to have or ever may have had from the beginning of : | time to the date hereof, only to the e extent related to, or connected with, the matters at issue in the Pending Litigation. Physicians Healthcare Plans, Inc. Settlement Agreement 8. This Settlement Agreement does not constitute an admission of wrongdoing or error by either party with respect to any allegation in the Pending Litigation or any other matter. The Parties believe that this matter should be settled because the parties have agreed to the terms contained within this Settlement Agreement. 9. The Parties shall each bear their own attorney's fees and costs in the _ Pending Litigation. 10. This Settlement Agreement constitutes 5 the entire ‘agreement between the Parties and nothing herein i is or ‘shall be construed to be an admission of liability or wrongdoing by any Pasty hereto. 11. No modification c or waiver of any provision shall be e valid unless a written parties. The signatories | to this Settlement Agrument acting, in a 2 represent ; Florida. : Physicians Healthcare Plans, Inc. Settlement Agreement Dated this Z Pfhday of Seann M. Frazier Greenberg Traurig, 101 E. College Avenue Tallahassee, Florida 32301 On behalf of Physicians Healthcare _Plans, Inc. e, Taspector State of. Florida 2727 Mahan Dr., Bldg. 3 Tallahassee, FL 32308 Jer KR Veo Agency for Health Care Administration 2001. AE C-MISKIS Julie Gallagher, General Counsel State of Florida ge ncy for Health Care Administration 7 Mahan Drive Ft. Knox Executive Center #3 Tallahassee, Florida 32308 Karen Varn State of Florida Sigenc cy for Health Care Administration ” ahan Drive Lk Ft. Knox Executive Center #3 Tallahassee, Florida 32308 ogee et

Docket for Case No: 00-004689