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INTERNATIONAL PHARMACY AND DISCOUNT vs AGENCY FOR HEALTH CARE ADMINISTRATION, 01-001733 (2001)

Court: Division of Administrative Hearings, Florida Number: 01-001733 Visitors: 8
Petitioner: INTERNATIONAL PHARMACY AND DISCOUNT
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: STUART M. LERNER
Agency: Agency for Health Care Administration
Locations: Miami, Florida
Filed: May 04, 2001
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Tuesday, July 3, 2001.

Latest Update: Nov. 19, 2024
STATE OF FLORIDA : AGENCY FOR HEALTH CARE ADMINISTRATION INTERNATIONAL PHARMACY & DISCOUNT, VY) Van Petitioner, C Jo vs. DOAH CASE NO. 01-1733 CI No. 98-1330-053-3 Rendition No. AHCA-02-0170-S-MDO 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 25 day of wow, , 2002, in Tallahassee, Florida. pth MD, Secretary Ag ency 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: Craig A. Brand, Esquire Brand & Fernandez, P.A. Ocean Optique Building 2 NE 40" Street, Suite 403 Miami, FL 33137 Anthony Conticello Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 Florence S. Rivas Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Charlie Ginn, Chief Via Interoffice Mail, Mail Stop #6 Finance & Accounting CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been : Tae furnished to the above named addresses by U.S. Mail on this the ‘ se day of Duby , 2002. Leaud dren Lealand McCharen, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5865 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS INTERNATIONAL PHARMACY & DISCOUNT, Petitioner, CASE NO: 01-1733 JUDGE: Stuart M. Lerner AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and INTERNATIONAL PHARMACY & DISCOUNT (“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. 3. In its Final Agency Audit Report issued on May 17, 2000, 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 $732.52. In response to the Audit Letter dated June 15, 2000, PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH Case No. 01-1733. 4. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: (a) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. (b) Within thirty days of Provider's executing this Agreement, PROVIDER agrees to deliver to AHCA the sum of five hundred dollars ($500.00), to be made in one lump sum payment, as full and complete settlement of all claims in the proceedings before the Division of Administrative Hearings (DOAH Case No. 01-1733). 5. 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 CI NO.: 98-1330-053-3. 6. 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. 7. Payment shall be made to: AGENCY FOR HEALTH CARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 8. 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. 9. 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. 10. 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. 11. In the event that PROVIDER fails to deliver the full payment due hereunder, the Agency may, with ten (10) days notice to PROVIDER, deem PROVIDER in default. If notice is given and PROVIDER fails to remit the outstanding payment or payments to AHCA in full within ten (10) days after receipt of the notice, PROVIDER shall be in default. If PROVIDER is in default, the full outstanding balance specified in paragraph 4 (d) shall be due and payable. In such event, PROVIDER’S participation in the Medicaid program shall be suspended until such time as the Agency receives payment of the balance in full. Nothing in this paragraph shall be construed to limit in any way the ability of the AGENCY to terminate PROVIDER pursuant to Section 409.907(2), F.S. (1999). Notwithstanding the foregoing, the AGENCY agrees not to terminate PROVIDER based on findings in the instant audit so long as PROVIDER complies with this Agreement. However, if PROVIDER fails to cure its default hereunder within ten (10) days of written notice, PROVIDER understands and agrees that the Agency may exercise its option to terminate PROVIDER from the Medicaid program. 12, 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. 13. Each party shall bear its own attorneys’ fees and costs, if any. 14. 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. 15. 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. 16. | 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. 17. 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. 18. | 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. 19. 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. 20. 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. 21. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 22. All times stated herein are of the essence of this Agreement and shall be strictly complied with. 23. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. Dated: Sf 2? __, 2001. AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 fet DATED: &/ Be , 2004 RuFus NOBLE INSPECTOR GENERAL Daren, Nas , 2001. Le Darep: 2/7 __, 2009 TLE Gator: Wee sqer FRO STF Dateo: (O/ ? , 2001, CONTICELLO ASSISTANT GENERAL COUNSEL

Docket for Case No: 01-001733
Issue Date Proceedings
Jul. 08, 2002 Final Order filed.
Jul. 03, 2001 Order Closing File issued. CASE CLOSED.
Jul. 02, 2001 Notice of Settlement (filed by Respondent via facsimile).
Jun. 29, 2001 Respondent`s Unilateral Pre-Hearing Statement (filed via facsimile).
Jun. 28, 2001 Respondent`s Motions in limine and Motions to Strike or Exclude (filed via facsimile).
Jun. 28, 2001 Motion to Compel Discovery and Motion for Sanctions (filed by Respondent via facsimile).
Jun. 28, 2001 Motion to Deem Request for Admissions Admitted (filed by Respondent via facsimile).
Jun. 28, 2001 Letter to C. Brand from A. Conticello (regarding case activity) filed via facsimile.
May 29, 2001 Notice of Telephone Hearing issued (telephonic hearing set for July 5, 2001, 9:30 a.m.).
May 29, 2001 Order of Pre-hearing Instructions issued.
May 17, 2001 Respondent`s First Request for Production of Documents (filed via facsimile).
May 17, 2001 Respondent`s First Request for Admissions (filed via facsimile).
May 17, 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).
May 16, 2001 Joint Response to Initial Order (filed via facsimile).
May 07, 2001 Initial Order issued.
May 04, 2001 Final Agency Audit Report filed.
May 04, 2001 Request for Appeal/Formal Hearing filed.
May 04, 2001 Notice filed.
Source:  Florida - Division of Administrative Hearings

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