STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS KENDALL MEDICAL CENTER, Petitioner, N We p CASE NO. 01-4508 Vv. oucke Me, O1L0ISECE AGENCY FOR HEALTH CARE Audet VE Ct. OL pK COD ADMINISTRATION, Revideion Ad, AHAA OS OLS MSP Respondent. FINAL ORDER THE PARTIES resolved all disputed issues and executed a Settlement Agreement, which is 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. f DONE and ORDERED on this the JS day of Fabry , 2003, 7 in Tallahassee, Florida. Rhonda M. Medows, MD, Secretary Agency for Health Care Administration la Ahn pelle 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: L. William Porter II, Esquire Agency for Health Care Administration (Interoffice Mail) Jeffrey T. Royer, Esquire Buckingham, Doolittle & Burroughs, LLP 2500 N. Military Trail, Suite #480 Boca Raton, Florida 33431 (U.S. Mail) Michael Parrish Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Tim Byrnes, Chief, Medicaid Program Integrity Debbie Lynn, Medicaid Program Integrity Willie Bivens, Finance and Accounting CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addressees by U.S. Mail on this the A day if, 2003. .f ) y. 4 6 CU ilu Uicujad 40 Qealand McCharen, Esquire Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS 03 FEB 20 AM 9: 37 CHV GS KENDALL MEDICAL CENTER, AD ie " Petitioner, 7 CASE NO. 01-4508 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION . (“AHCA” or “the Agency”), and Kendall Medical Center (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1, This Settlement Agreement (the “Agreement”) is entered into between the parties for the purpose of resolving the disputes between them and avoiding the costs and burdens of further litigation. Neither party concedes the other’s position. 2. PROVIDER is a Medicaid provider in the State of Florida, provider number 012013800. 3, In its Final Agency Audit Report (final agency action) (the “Audit Report”) dated September 17, 2001, AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity (MPI), Office of the Inspector General, audit number C.I. 01-0662- 000, indicated that, in the opinion of MPI, certain claims, in whole or in part, were not covered by Medicaid. The Agency sought recoupment of this overpayment in the amount of Kendall Medical Center Settlement Agreement $178,745.61. In response to the Audit Report, PROVIDER filed a Petition for Formal Hearing, which was assigned DOAH Case No. 01-4508. 4. Subsequent to the original audit that took place in this matter and in preparation for trial, AHCA re-reviewed the PROVIDER’s claims and evaluated additional documentation submitted by the PROVIDER. Asa result, AHCA adjusted the overpayment to $131,463.33. 5. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: {a) (b) (c) (4) AHCA agrees to accept the payment set forth in subparagraph 5(b) herein in full and final settlement of all overpayment issues arising from the inpatient admissions that were the subject of the MPI review. Within thirty days of receipt of the Final Order, PROVIDER agrees to make a single lump sum payment to AHCA of One Hundred Twenty Thousand Dollars ($120,000.00) (the “Settlement Amount”), in full and complete settlement of all claims in the proceedings before the Division of Administrative Hearings (DOAH Case No. 01-4508). 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 C1. 01-0662- 000 which gave rise to DOAH Case No. 01-4508. 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. Kendall Medical Center Settlement Agreement (e) If AHCA offsets, inadvertently or otherwise, all or a portion of the Settlement Amount from any future Medicaid reimbursement payable to PROVIDER (except as authorized under Paragraph 7, below), AHCA agrees that PROVIDER may credit the amount of any such offset against the Settlement Amount at the time PROVIDER tenders such payment. 6. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 7. PROVIDER agrees that failure to pay the Settlement Amount as required under the terms of this Agreement shall constitute PROVIDER’S authorization for the Agency, without further notice, to withhold the total or any remaining amount due hereunder from any monies due and owing to PROVIDER for any future Medicaid claims. 8. The parties reserve 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, 9. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. 10. Each party shall bear its own attorneys’ fees and costs, if any. 11. 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. 12, 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. Kendall Medical Center Settlement Agreement 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. 14, This is an Agreement of settlement and compromise, made in recognition that the parties may have different or incorrect understandings, information and contentions, or may be mistaken, as to the facts or applicable law, and each party is compromising and settling any understanding, information, contention or mistake as to facts and law, so that no misunderstanding, misinformation, or mistake of fact or law shall be a ground for rescission of this Agreement. 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 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 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. Kendall Medical Center Settlement Agreement 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. KENDALL MEDICAL CENTER Dated: if27 , 2003. MAuklen S/RVGIT (Print name) irs: _CHier Fee oFtbgR Kendall Medical Center Settlement Agreement AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 Rufus Nobié Inspector General Valda Clark Christian General/Counsel M Dated: L. Wi Porter II Assistant General Counsel «CL2:163414_2» a AE et Dated: , 2003. ed a4 , 2003, 2 3 , 2003.

Docket for Case No: 01-004508MPI