STATE OF FLORIDA ocp oe DIVISION OF ADMINISTRATIVE HEARINGS oP 2 02 AHA PEPSE TANT CLERK HENRY LEON & COCONUT GROVE os HOLDING COMPANY, d/b/a COCONUT GROVE PHARMACY, o nm Petitioner, _ wn " he la Ren WB oe Wf chore nee mS vs. CASE NO. 00-4783 =? ya Audit Report CI 95- -16895900-3 = ey wow AGENCY FOR HEALTH CARE ™ 5 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 Z{ day of fv “ wes —2000, in Tallahassee, Florida. i ofthe MD, 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: Deborah H. Korray 3850 West Flagler Street Miami, FL. 33134 Anthony Conticello Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 Errol Powell Administrative Law Judge 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 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 La day of Wotan. 2002. 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA Oo | fe & DIVISION OF ADMINISTRATIVE HEARINGS, LA HENRY LEON & COCONUT GROVE HOLDING COMPANY, d/b/a COCONUT GROVE PHARMACY, Petitioner, vs. CASE NO. 00-4783 Audit Report CI 95-1689-000-3 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), the Office of the Attorney General (“Attorney General”), and HENRY LEON, by and through the Estate Representative (“Leon”) & COCONUT GROVE HOLDING COMPANY, d/b/a COCONUT GROVE PHARMACY (“Coconut Grove”) (collectively referred to as the “PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. This Agreement is entered into between the parties. 2. PROVIDER is a Medicaid provider in the State of Florida, holding the provider no. 1041193-00. 3. In its Final Agency Audit Report issued on (the "Audit Letter") 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 sought overpayment in the amount of $659,649.90. In response to the Audit Letter, PROVIDER disputed AHCA’s findings and filed a petition for a formal administrative hearing that was assigned DOAH Case No. 00-4783 (the “Administrative Matter”). 4. While the Administrative Matter was pending, and on behalf of AHCA, the Attorney General’s office filed a civil action against Provider seeking overpayment and restitution from Provider in the amount of $139,546.46 (the “Civil Matter”). The Civil Matter robo * was filed in the 11" Judicial Circuit, in and for Miami-Dade County, bearing case No. 01-2866 CA 22. 5. Leon is now deceased. In order to resolve the Administrative Matter and the Civil Matter, PROVIDER and AHCA expressly agree as follows: (1) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. (2) PROVIDER agrees to pay to the Attorney General, on or before January 31, 2002, the sum of one hundred twenty five thousand dollars and no cents ($125,000.00) to be made in one lump sum payment as full and complete settlement of the Administrative Matter and the Civil Matter. Attorney General shall forward the settlement proceeds, minus any administrative costs, to AHCA in satisfaction of the overpayment (3) PROVIDER is responsible for ensuring timely delivery of the payment to the Attorney General. F urthermore, failure to timely make the payment will render the balance due and payable immediately, with interest, and interest will continue to accrue until the entire balance is paid. AHCA and Attorney General reserve the right to seek enforcement of this agreement by any legal means. (4) PROVIDER, AHCA and Attorney General agree that full payment as set forth above will resolve and settle this case completely and release each other from all liabilities arising from the findings in the audit referenced as: C.I. No. 95-1689-000-3; the Administrative Matter — Case No. 00- 4783; and the Civil Matter - Case No. 01-02866 CA 22. (5) 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. 5, Payment shall clearly indicate that it is per a settlement agreement, shall reference the DOAH Case Number, shall reference the Civil Matter Number, and shall reference the C.I. Number, 6. 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. 7. 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. 8. The parties agree to bear their own attorney’s fees and costs, if any. 9. 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. Furthermore, PROVIDER agrees that its signature alone binds PROVIDER to make the payment as set forth in this agreement. The parties further agree that a facsimile or photocopy reproduction of this agreement with PROVIDER’S signature shall be sufficient for the Agency to enforce the agreement and to cancel the hearing in this matter. 10. 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. 11. This Agreement acknowledges that Provider and Attorney General have entered into a separate settlement agreement simultaneous with this agreement. The terms of the Attorney General’s Agreement and this Agreement shall be read together to encompass the entire agreement amongst AHCA, Attorney General and PROVIDER. To the extent that the terms conflict: AHCA agrees that the settlement sum ($125,000.00) paid by PROVIDER to Attorney General shall constitute payment under this settlement agreement; PROVIDER agrees to be bound by the terms in both settlement agreements; all parties agree the most stringent terms shall apply. 12. 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. 13. 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. 14, 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 rules of the Agency regarding this proceeding and any and all issues raised herein. PROVIDER further agrees that the Agency should issue a Final Order which is consistent with the terms of this settlement, that adopts this agreement and closes this matter. 15. Provider, does hereby discharge the State of Florida, Agency for Health Care Administration, and its agents, representatives, and attorneys of and from all claims, demands, actions, causes of action, suits, damages, losses and expenses, of any and every nature whatsoever, arising out of or in any way related to this matter DOAH Case No. 00-4783, CI Number 95-1689-000-3, and AHCA’s actions herein, including, but not limited to, any claims that were or may be asserted in any federal or state court or administrative forum, including any claims arising out of this agreement, by or on behalf of Facility. 16, 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. 17. 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. 18, This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 19. All times stated herein are of the essence of this Agreement. 20. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. PETITIONERS OF HENRY LE Dated: ret , 2001 ONLEON ITS: PERSONAL REPRESENTATIVE Secspsien ol ar Dated: red , 2001 BYZ4ESSICA T. LEON ITS: PERSONAL REPRESENTATIVE COCONUT GROVE HOLDING COMPANY, d/b/a COCONUT GROVE PHARMACY Affix corporate seal above. Aig deat Dated: | 0 PO) , 2001 EOFFREY SMITH, ESQ, KELLI SCOTT, ESQ, BLANK, MEENAN & SMITH, P.A. Attorneys for Coconut Grove & Henry Leon In the Administrative Proceeding AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 Inspector General — WILLIAM ROBERTS Acting General Counsel Dated: Dated: 5/2] LMG , 2002 , 2002 SUD 9135 S21u Pie” : UHla MiAML MAY-1Li2d2 14333 OFFICE OF 'THE ATTORNEY GENERAL , DEPARTMENT OF LEGAL AFFAIRS fim s ! ; Dated: Nair | 200% —___ — ty RICHARD DORAN, DEPUTY ATTORNEY GENERAL TOTAL P.@2

Docket for Case No: 00-004783