Petitioner: HORIZON HEALTH CARE SYSTEMS, INC.
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: HARRY L. HOOPER
Agency: Agency for Health Care Administration
Locations: Chipley, Florida
Filed: Mar. 23, 2001
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Friday, May 11, 2001.
Latest Update: Jan. 05, 2025
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
HORIZON HEALTH CARE SYSTEMS, ee
Petitioner,
vs. DOAH CASE NO. 01-1153 eal :
Audit No. 98-1330-49 C0. >> an
Rendition No. AHCA- 02-0178-S-MDO'“"
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Respondent.
I.
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 A 6 day of owe , 2002, in
Tallahassee, Florida.
wef AC__
Rhonda M.\ledows, MD, Secretary
ealth 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 Fumished to:
Colby Peel Esquire
Post Office Box 550
Chipley, Florida 32428
Anthony Conticello ‘
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308-5403
Harry L. Hooper
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 | k _ day of
Cs , 2002.
Chie ERE Tg deans
Sp CAgency Clerk
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308-5403
(850) 922-5873
STATE OF FLORIDA & y
DIVISION OF ADMINISTRATIVE HEARINGS en,
HORIZON HEALTH CARE SYSTEMS,
Petitioner,
CASE NO: 01-1153
v.
JUDGE: HOOPER
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Respondent.
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(“AHCA” or “the Agency”), and HORIZON HEALTH CARE SYSTEMS (“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 avoiding the
costs and burdens of litigation.
2. PROVIDER is a Medicaid provider in the State of Florida, with the provider No.
1095293-00.
3. In its Final Agency Audit Report dated January 18, 2001 (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 $16,048.97. In response to the
Audit Letter, PROVIDER filed a petition for a formal administrative hearing, which was
assigned DOAH Case No. 01-1153.
4. In order to resolve this matter without further administrative proceedings,
PROVIDER and the 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) Starting the first day of the month following the execution of this
Agreement, PROVIDER agrees to pay the Agency the total sum of twelve thousand dollars
($12,000.00) plus ten percent interest, in six monthly installments. The first five monthly
installments shall be for two thousand and fifty-eight dollars and seventy-four cents ($2,058.74),
and the sixth and final monthly installment shall be for two thousand and fifty-eight dollars and
seventy-two cents ($2,058.72). The installments are due on the first day of the month following
the execution of this agreement, and continuing until payment in full. An amortization schedule
is attached hereto and incorporated herein by reference in regard to principal amount, monthly
payment amount, and interest amount.
(3) PROVIDER and AHCA agree that full payment as set forth above will
resolve and settle this case completely and release both parties from all liabilities arising from
the findings in the audit referenced as DOAH Case No. 01-1153.
(4) 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 be made to:
AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid Accounts Receivable
Post Office Box 13749
Tallahassee, Florida 32317-3749
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. This settlement does not constitute an admission of wrongdoing or error by either
party with respect to this case or any other matter.
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 respective parties.
11. 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.
12. This Agreement constitutes the entire agreement between PROVIDER and the
AHCA, including anyone acting for, associated with or employed by them, concerning all
matters and supersedes any prior discussions, agreements or understandings; there are no
promises, representations or agreements between PROVIDER and the AHCA other than as set
forth herein. 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 it shall not challenge or contest any Final Order entered in this matter which is
consistent with the terms of this settlement agreement in any forum now or in the future available
to it, including the right to any administrative proceeding, circuit or federal court action or any
appeal.
15. 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.
16. 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.
17, This Agreement shall inure to the benefit of and be binding on each party’s
successors, assigns, heirs, administrators, representatives and trustees.
18. All times stated herein are of the essence of this Agreement.
19. This Agreement shall be in full force and effect upon execution by the respective
parties in counterpart.
HORIZON HEALTH CARE SYSTEMS
Y/t
Wa ee pact: Manes |
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
ph wll Dated: 6 lee , 2002—
Rufus Noble
Inspector General
Dated: , 200.2
Charlie Ginn
Deputy Medicaid Program Integrity
Dated: 6/20, 200R,
hers per Af R360
Dated: on tC 6 , 2001
Anthony Cv Conticello
Assistant General Counsel
Docket for Case No: 01-001153
Issue Date |
Proceedings |
Jul. 12, 2002 |
Final Order filed.
|
May 11, 2001 |
Order Closing File issued. CASE CLOSED.
|
May 07, 2001 |
Notice of Settlement (filed by Respondent via facsimile).
|
Apr. 04, 2001 |
Respondent`s First Request for Production of Documents (filed via facsimile). |
Apr. 04, 2001 |
Respondent`s First Request for Admissions (filed via facsimile). |
Apr. 04, 2001 |
Notice of Service of Respondent`s First Interrogatories to Petitioner; Respondent`s First Request for Admissions; and Respondent`s First Request to Produce (filed via facsimile). |
Apr. 02, 2001 |
Joint Response to Initial Order (filed by Respondent via facsimile).
|
Apr. 02, 2001 |
Notice of Hearing issued (hearing set for May 10, 2001; 9:00 a.m.; Chipley, FL).
|
Mar. 30, 2001 |
Joint Response to Initial Order (filed via facsimile). |
Mar. 26, 2001 |
Initial Order issued.
|
Mar. 23, 2001 |
Petition for Formal Administrative Hearing filed.
|
Mar. 23, 2001 |
Final Agency Audit Report filed.
|
Mar. 23, 2001 |
Notice (of Agency referral) filed.
|