STATE OF FLORIDA * ! = «0: AGENCY FOR HEALTH CARE Sosy -l, 02 COMPREHENSIVE PHARMACY SERVICES, LTD., Petitioner, CrseNO. OF BITA v. CLI. NO. 00-1890-000-3 STATE OF FLORIDA, AGENCY : TV FOR HEALTH CARE ADMINISTRATION, Respondent. . / FINAL ORDER WHEREFORE, subsequent to the Final Agency Audit Report dated April 12, 2001, the parties agreed that the Agency for Health Care Administration (AHCA) would review further documentation submitted by Comprehensive Pharmacy Services, Ltd. Upon review of the documentation, on October 16, 2001, an Amended Final Agency Audit Report was issued which | concluded that AHCA would not pursue an overpayment or sanctions in this matter. Based on the foregoing, this file is CLOSED. . DONE and ORDERED at Tallahassee, Leon County, Florida wif lad day of » prsodn~ 2001. act Medows, MD, Secretary i Agency for Health Care Administration eee fora A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO 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 OF 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: Comprehensive Pharmacy Services, LTD 3540 South University Drive, Suite B Davie, Florida 33328 Kelly A. Bennett Assistant General Counsel Agency for Health Care Administration (Interoffice Mail) Charles Ginn, Chief, Medicaid Program Integrity Willie Bivens, Finance & Accounting CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of this Final Order was served on the above named persons this AL day of ! val ees . , 2008 | — oS x He Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building 3 ~~ Tallahassee, FL'32308 cere ee ORC we ee eee Setar oe ee ee roms STATE OF HC ~ AGENCY FOR HEALTH CARE ADMINISTRATION CA JEB BUSH, GOVERNOR CERTIFIED MAIL - RETURN RECEIPT NO. 7000 1670 0009 9415 3576 Provider No. 1061747 00 License No. PH0015470 Comprehensive Pharmacy Services, LTD p, ESV lj Attn: Pharmacy Manager 3540 South University Drive, Suite B Davie, Florida 33328 ) OCT 1.6 2001 RE: AMENDED FINAL AGENCY AUDIT REPORT . AGENCY FOR HEALTH CARE C.I. No. 00-1890-000-3/H/JDI ADMINISTRATION-LEGAI Dear Provider: aety The Agency for Health Care Administration {the Agency), Medicaid ‘Program Integrity office has completed a review of your paid Medicaid claims with dates of service from January 1, 1999, through June 30, 2000. A final agency audit report, dated April 12, 2001, was sent to you indicating you were overpaid $127,551.91 for these claims. In response to our letter, you sent documentation to validate your claims. We have performed a subsequent review, in light of the additional documentation you provided, and have concluded that you were overpaid $189.32 for claims that in whole or in part are not covered by Medicaid. A copy of the Pharmacy Audit Final Report (amended) is attached for.your review. The Agency is not pursuing the overpayment or applying sanctions. By copy of this letter, the Medicaid Accounts Receivable office is advised of this action. Since areas of non-compliance have been identified, we are taking this opportunity to remind you of Medicaid policies and procedures to assist you in correcting the areas.of non-compliance. The Medicaid Provider Agreement states that the provider agrees to participate in the Florida Medicaid program under the terms and conditions specified in the provider agreement. This includes, but is not limited to, complying with federal and state laws, regulations, rules, Medicaid handbooks and policies. Section 409. 913(7), Florida “Statutes (Fs ‘Ss. yy ‘states in part that a provider is responsible for the preparation and submission of a claim that is true and accurate and is for goods and services that are provided in accordance with applicable provisions of all Medicaid rules, regulations, handbooks, policies, federal, state, and local laws. Visit AHCA online at www.fdhe.state.fl.us 2727 Mahan Drive ¢ Mail Stop #6 Tallahassee, FL 32308 ae (died Stam a, i ace a eS a a a a a ee ll i. a i dh. ee ee ie ls le ie cha ke sm i Comprehensive Pharmacy Services, LTD Page 2 Section 409.913(8), F.s., requires a Medicaid provider to retain medical, professional, financial, and business records pertaining to goods and services furnished to Medicaid recipients for a period of five years after the date of furnishing the goods and services. Section 409.913(14), (15), and (16), F.S., provides that the Agency may séek any remedy provided by law, including administrative sanctions, if the provider is not in compliance with provisions of Medicaid rules, regulations, handbooks, policies, federal, state, and local laws. Administrative sanctions may include a fine, and/or suspension or termination from the Medicaid program. Chapter 465, F.S., and Rule 64B-16, Florida Administrative Code (F.A.C.), address, among other things, pharmacy practice regulations, records requirements, and the responsibility of the pharmacist to ensure the validity of prescriptions received. Other regulations include, but are not limited to: Chapter 499, F.S., the Florida Drug and Cosmetic Act, and Chapter 893, F.S., the Florida Comprehensive Drug Abuse Prevention and Control Act. It is recommended that you review the regulations that govern your practice, to include the applicable Medicaid provisions found in Chapter 409, F.S., Rule 59G, F.A.C., and the Florida Medicaid Provider Coverage, Limitations, and Reimbursement Handbook for Prescribed Drug Services. The handbook was previously sent to you by the fiscal agent. As previously indicated, the Agency is not pursuing the overpayment; however, appropriate actions hecessary to correct the problems noted in the audit report must be taken. Should a subsequent audit reveal similar problems or other areas of non-compliance, you will be subject to repayment of any overpayment, sanctions, and/or other actions deemed appropriate. If you have any questions, please telephone Ms. JoAnn D. Jackson at (850) 922-4374. Sincerely, @ %G- D. Kenneth Yon, AHCA Administrator Medicaid Program Integrity Attachment cc: Area Medicaid Office Willie Bivens, Medicaid Accounts Receivable : Salih Peter A. Lew Pa ae rer oper ae were

Docket for Case No: 01-002154