STATE OF FL : AGENCY FOR HEALTH CARE Bi TRA A hy i bie Pe on * M.A. EL-TOBGUI, M.D., Noga! “Vg Petitioner, vs. - DOAH CASE NO. 01-1341 DOY77-CWS Audit No. CI. 94-0982-375-2 Rendition No. AHCA-01- 217_-S-MDP STATE OF FLORIDA, 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 attached settlement agreement. Based on the foregoing, this file is CLOSED. DONE and ORDERED on this the Peay of fey 0. in Tallahassee, Florida. f° Ritonda f Medows, MD, FAAFP, 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: Anthony L. Conticello, Esquire Agency for Health Care Administration (interoffice Mail) M.A. El-Tobgui, M.D. 117 Lansing Island Drive Indian Harbour Beach, FL 32937 Charlie Ginn, Chief, Medicaid Program Integrity Willie Bivens, Finance and Accounting «i CERTIFICATE OF SERVICE LER TIPIVALE Ww SSeS | HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished to the above-named persons or entities by U.S. Mail, or by inter- office mail for AHCA personnel and entities, on the Keay of , 2001. Diane A. Grubbs, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Suite 3431 Fort Knox Building III, MS 3 Tallahassee, Florida 32308 850/922-5865 a STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS “MLA. EL-TOBGUI, M.D., Petitioner, CASE NO: 01-1341 v. : ; JUDGE: Manry : - AGENCY FOR HEALTH CARE ! ADMINISTRATION, ' t Respondent. ' / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION cope ree nr (“AHCA” or “the Agency”), and M.A. EL-TOBGUI, M.D., (“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. ih its Final Agency Audit Rep ort t dated J anuary 18, 2001 (the “Audit Letter”) 3. CA 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 FOUR THOUSAND NINE HUNDRED SIXTY-SEVEN DOLLARS AND EIGHTEEN CENTS ($4,967.18). In response to the Audit Letter, PROVIDER filed’a petition for a formal administrative hearing, which was | | assigned DOAH Case No. 01-1341. . Oe Dot ; ' Fe ie oe 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 THREE THOUSAND FIVE HUNDRED DOLLARS AND NO CENTS (33,500.00) plus ten percent interest, in three monthly installments. The first installment shall be due on July 1, 2001. The following installments are due on the first day of the each following month, 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. 01-1341. (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 er Piece ae! 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. 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 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. _ 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 attorney at law, all costs of collection or enforcement, including reasonable attorneys’ fees and costs, shall be paid by the breaching party to the non-breaching party. 13. 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. ce egeees seo magee ee et ee coopers ween lager we eee 14. 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. 15. | 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 . tules 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. 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. ve? M.A. EL-TOBGUI, M.D., Awd jus - _ Of2 efi , 2001 AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 Le ple Dated: o/b , 2001 ufus Npble Inspector General SS Dated: NX 2001 Charlie Ginn Cheif Medicaid Program Integrity Dated: bY ; 2001 Dated: 7 3 2001 thony L. Co lo Assistant General Counsel cep oe ET en pee corer opnemnee eee

Docket for Case No: 01-001341