STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS MEDIC PHARMACY, INC., d/b/a MEDIC PHARMACY-SURGICAL, Petitioner VS CASE NO. 01-1928MPI C.I. NO. 00-1884-000-3 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. - / FINAL ORDER THE PARTIES resolved all disputed issues and executed a “Stipulation and Agreement”, which is incorporated by reference. The parties are directed to comply with the terms of the “Stipulation and Agreement”. Based on the foregoing, this proceeding is CLOSED. Ve Leon County, gt DONE and ORDERED on this the /7~ day of , 2006, in Tallahassee, Florida. an Levine, § fr retary ( A gency for Health Care Administration qa ils CASE NO. 01-1928MPI C.I. NO. 00-1884-000-3 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: William M. Furlow, Esquire Attorney for Provider Akerman Senterfitt 106 Bast College Avenue, Suite 1200 Tallahassee, Florida 32301 Debora Fridie, Esquire Attorney for Agency Agency for Health Care Administration 2727 Mahan Drive Fort Knox Building 3, Mail Stop 3 Tallahassee, Florida 32308 The Honorable Florence Snyder Rivas Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Medicaid Program Integrity, MS #6 CASE NO. 01-1928MPI C.I. NO. 00-1884-000-3 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished to the above named addressees by U.S. Mail on this the DW aay of Lc L , 2006. Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3, Mail Stop 3 Tallahassee, Florida 32308-5403 GENERAL COUNSEL STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION MAR 27 2006 MEDIC PHARMACY, INC., D/B/A Agency for Health MEDIC-PHARMACY SURGICAL Care Administration Petitioner, vs. C.I. No. 00-1884~000-3/H4¢wM Provider No. AGENCY FOR HEALTH CARE ADMINISTRATION, 10434 00 + 23 = noe Bee p Le DAS bys Yo =x. 70 aii Respondent. BES, a al / a ™ (aa) (4) ns STIPULATION AND AGREEMENT The Respondent, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (a/k/a “AHCA” or “Agency”), and the Petitioner, MEDIC PHARMACY, Inc., d/b/a MEDIC PHARMACY SURGICAL (a/k/a hereby stipulate and agree as follows: 1. “Medic Pharmacy” or “Provider”) by and through the undersigned, The two parties enter into this agreement for the purpose of memorializing the resolution to this matter. 2. Florida, PROVIDER is a Medicaid provider in the State of 3. operating under provider number 1043463 00. In its Final Agency Audit Report C.I. No. 00-1884-000- 3/GWM (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 repayment of a Page 1 of 7 C.I. No. 00-1884-000-3/H/GWM Provider No. 1043463 00 Medic Pharmacy, Inc v. AHCA Stipulation and Agreement Medicaid: overpayment in the amount of $1,221,098.85. In response, PROVIDER petitioned for a formal administrative hearing with the Division of Administrative Hearings (DOAH). The matter was referred to DOAH and assigned Case No. 01-1928. After the PROVIDER requested a formal hearing, AHCA reviewed documentation that was previously unavailable to them. Based upon that review, AHCA adjusted the Medicaid overpayment to $11,269.76. The PROVIDER filed a Withdrawal of Petition for Administrative Hearing dated October 6, 2005. 4, Both sides stipulate and agree that the PROVIDER has paid in full the adjusted Medicaid overpayment amount of $11,269.76. AHCA agrees to accept the payment of $11,269.76 as and for full payment of the adjusted Medicaid overpayment amount. 5. PROVDER agrees that it will not rebill the Medicaid Program in any way for claims that were not covered by Medicaid, which are the subject of the audit in this case. 6. AHCA retains the right to perform a 6-month follow-up review. PROVIDER agrees to fully cooperate with any follow up reviews conducted by the Agency. 7. AHCA reserves the right to enforce this Stipulation and Agreement under the laws of the State of Florida, the Rules Page 2 of 7 C.I. No. 00-1884-000-3/H/GWM Provider No. 1043463 00 Medic Pharmacy, Inc v. AHCA Stipulation and Agreement of the Medicaid Program, and all other applicable rules and regulations. 8. The parties agree to bear their own attorney’s fees and other costs, if any. 9. The signatories to this Agreement, acting ina 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. PROVIDER shall furnish the actual signed Stipulation and Agreement to AHCA; however a facsimile copy shall be sufficient to enable AHCA to cancel a hearing scheduled in this case. 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 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 Page 3 of 7 C.I. No. 00-1884-000-3/H/GWM Provider No. 1043463 00 Medic Pharmacy, Inc v. AHCA Stipulation and Agreement written amendment to the Agreement is completed and properly executed by the parties. 12. 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. This Stipulation and Agreement 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 resolved because the parties have agreed to the terms contained within this agreement. 13. PROVIDER expressly waives in this matter its right to any hearing pursuant to §§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 Page 4 of 7 C.I. No. 00-1884-000-3/H/GwM Provider No. 1043463 00 Medic Pharmacy, Inc v. AHCA Stipulation and Agreement with the terms of this stipulation and agreement and that adopts this agreement and closes this matter. 14. 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, C.I. No. 00-1884-000-3/H/GWM, 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 Provider. 15. This Stipulation and 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 Stipulation and 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 Stipulation and Agreement. Page 5 of 7 MAR-24-2008 FRI 01:48 PM MEDIC PHARMACY FAX NO, 954 484 8678 P, 02 c.f. No. 00-188 4-000-3/H/GWM Provider No. 1043463 00 Medic Pharmacy, Inc v. AHCA Stipulation and Agreement 17. This Stipulation and Agreement shall inure to the penefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 18. All times stated herein are of the essence in this Stipulation and Agreement. 19, This Stipulation and Agreement shall be in full force and effect upon execution by the respective parties in counterpart. AKERMAN SENTERFITT t , BY: U Y Wrovs Nh, Pa Dated: YT 06 , 2006 WILLIAM M. FURLOW, ESQUIRE Attorney for Medic Pharmacy Suite 1200 106 Bast College Avenue, Tallahassee, Florida 32301 PETITIONER MEDIC PHARMACY, INC. D/B/A MEDIC PHARMACY~SURGICAL ve Mach A hh, sevea 3a ¥_, 208 Mi chart Leplid, RES (Printed name and title) / Page 6 of 7 C.I. No. 00-1884-000-3/H/GWM Provider No. 1043463 00 Medic Pharmacy, Inc v. AHCA Stipulation and Agreement AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 BY: _Lansoezhiaayll Dated: tl} 2006 JMMES D. BOYD Inspector General Cbwsta Clason Dated: Aevit, jo 2006 CHRISTA CALAMAS General Counsel BY: vatea Vlortch) CF ,2006 - BY: DEBORA FRIDIE Assistant General Counsel Page 7 of 7 4 e ve LAHICA ne A ene me AGENCY FOR HEALTH CARE ADMINISTRATION ‘L JEB BUSH, GOVERNOR ; RUBEN J. KING-SEAi, aia April 11, 2001 CERTIFIED MAIL - RETURN RECEIPT NO. 7099 3400..0013.8445.1563 00°. Provider No. 1043463 00 O} License No. PH0008817 ete 8 Lb alee nea it net Michael Kaplan, R.Ph., President wat Medic Pharmacy, Inc. d/b/a Medic Pharmacy~Surgical 5100 W. Commercial Blvd. Ft. Lauderdale, Florida 33319 WEDICAID PROGRAM - RE: FINAL AGENCY AUDIT REPORT "INTEGRITY C.I. No. 00-1884-000-3 /H/GWM . ADMINISTRATION Dear Mr. Kaplan: An on-site audit of your pharmacy was initiated on September 7, 2000. The audit period was from January 1, 1999, through ~ . July 21, 2000. The Florida Medicaid Program through the Agency... ....-. 0) for Health Care Administration has determined that you have been” - overpaid $1,221,098.85 in connection with claims submitted to’ Medicaid during the audit period. This conclusion is supported by the audit results. oo . : This review and the determinations were made in accordance with the provisions of Chapter. 409, Florida Statutes (F.S.), and Chapter 59G, Florida Administrative Code (F.A.C.). In applying for Medicaid reimbursement, providers are required to follow the applicable statutes, rules, Medicaid provider handbooks, statements of Medicaid policy, and federal laws and regulations. Medicaid cannot properly pay for claims that do not meet Medicaid requirements. When a provider receives payment in violation of, these provisions, those funds must be repaid... REVIEW DETERMINATIONS The audit included a statistical analysis of a random sampling, with the results applied to the random sample universe of claims submitted during the audit period. The actual overpayment was calculated using a procedure that has been proven valid and is” deemed admissible i ami istrative and law courts as evidence of the overpayment. “" °°" """ ; | , ioe e ECEIVED. APR 25 200! MEDICAID PROGRAM: 2727 Mahan Drive * Mail Stop #6 visit ATEGRIIN ai Tallahassee, FL 32308 www.fdhe.state.flus Michael Kaplan, R.Ph., President Medic Pharmacy, Inc. d/b/a Medic Pharmacy-Surgical Page 2 Attached are the overpayment calculations, a summary of documented _ discrepancies, and an itemized listing of. discrepancies noted in the review of the random sample. - If you "accept or concur with these findings, “please ‘send your check in the amount of $1,221,098.85, for the identified. , overpayment, made payable to the Florida Agency, for. Health, Care ~ Administration, to: : : Agency for. Health Care Administration Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317- 3749 Bing ated Be “ BO (Note: The check must be payable. ‘bo ‘the. FL da ‘Agency | Eor ot Health Care Administration, not to any empl f agency.) To ensure proper credit, be sure that your provider number is shown on your check. Questions regarding payment should be directed to Ms. Willie Bivens at (850) 487-4298. You have the right to request a formal or informal hearing . pursuant to section 120.569; F.S. Ifa petition for formal = - hearing is made, the petition must be made in compliance with rule section 28-106.201, F.A.Cc. Please note that rule section 28-106.201(2), F.A.C., specifies that the petition shall contain a concise discussion of specific items in dispute. Additionally, you are hereby informed that if a request for a hearing is made, the request or petition must be received within - twenty-one (21) days of receipt of this letter. Failure to : timely request a hearing shall be deemed a waiver of your right to a hearing. . : It is important that a request for an informal hearing or a petition for a formal hearing be ‘sent. only 'to” the following vs , RECEIVED. | Mr. Charles G. Ginn, Chief ; Medicaid Program Integrity Office of the Inspector General . APR. 25 2001 Agency for Health Care Administration 2727 Mahan Drive, Mail Stop # 6 fallahassee, Florida 32308-5403 MEDICAID PROGRAM INTEGRITY Do not send requests or petitions to any other address. If a hearing request is not received within 21 days from the date of receipt of this letter, the right to such hearing is waived, and repayment of the above-stipulated overpayment will be due. and ~~ payable at the end of that 21- day period. MedicPhySurgicalHeritageOSRSStatReviewAAL, OC ange, ’ , Michael kaplan, R.Ph. , President Medic Pharmacy, Inc. d/b/a Medic Pharmacy-Surgical - Page 3 . - Any questions that you may have regarding this matter should be “ directed to: Gary W. Marsh, Senior Pharmacist, Agency for Health Care Administration, Medicaid Program Integrity, Office of the” °° Inspector General,’ 2727 Mahan Drive, Mail Stop # 6, Tallahassee, Florida 32308-5403, telephone number (850) 922-4374. Sincerely D. Kenneth Yon Program Administrator DKY/ gwm Attachment (s) ca: Medicaid Program Integrity Administrative Section Medicaid Accounts Receivable, Attn: Willie Bivens Heritage Information Systems, Inc. : : Medicaid Program Development = Area Medicaid Office’: 90" RECEIVED APR 25 2001 MEDICAID PRO GRA INTEGRITY "

Docket for Case No: 01-001928