FILE Save Pe STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS AUS 16 Q2 AKCA DTPARTMENT CLERK K<) BAY MEDICAL CENTER, > wel Oc & ue sha re SG ot Petitioner, mee Lore DOAH CASE NO: 02-00147 5". ite) Ti v. provider no.: 01000640Q 3% » cy audit no.: C.I. 01-06594 B00: = ae wo AGENCY FOR HEALTH CARE SPD Lace m ADMINISTRATION, 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 “settlement agreement”. foregoing, Based on the this proceeding is CLOSED. DONE and ORDERED on this the 27 day of Ju ‘a , 2002, in Tallahassee, Florida. ie ondd/M. Medows, M.D., 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: Franklin Harrison, Esquire 304 Magnolia Avenue Panama City, FL 32401 Kelly Bennett, Esquire Attorney for Agency AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive Fort Knox Building 3, Mail Stop 3 Tallahassee, Florida 32308 Sue Gibson Medicaid Program Integrity 2002 Old St.Augustine Rd. Bldg. D MS# 6 Tallahassee, FL Bob Maryanski Medicaid Program Development 2727 Mahan Drive Fort Knox Building 3, Mail Stop 20 Tallahassee, Florida 32308 Charlie Ginn Medicaid Program Integrity 2002 Old St.Augustine Rd. Bldg. D MS# 5 Tallahassee, FL 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 CC day of (nt uk , 2002. - _ Chysaeles - \{ \¢ UU SSON Actagency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3, Mail Stop 3 Tallahassee, Florida 32308-5403 Bay Medical Center DOAH Case No.: 02-00014 STATE OF FLORIDA Ae 0 DIVISION OF ADMINISTRATIVE HEARINGS yp 19 AM o. Aus iy 2: 22 40M): Wy Of BAY MEDICAL CENTER, HEAP RINGS RA) VE Petitioner, DOAH CASE NO: 02-0014 v. provider no.: 010006400 audit no.: C.I. 01-0653-000 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT This settlement agreement (“Agreement”) is entered into by and between the Agency for Health Care Administration (“AHCA”), and BAY MEDICAL CENTER, (“Petitioner”). 1, This matter arises out of AHCA’s review of Petitioner’s paid claims to Medicaid. On October 1, 2001, AHCA issued a Final Agency Action Letter (FAAL) that determined Petitioner had been overpaid by Medicaid in the amount of $111,662.35. 2. Petitioner filed a petition challenging AHCA’s determination and requesting a formal administrative hearing and requesting a formal reconsideration pursuant to Rule 596-4.150, Florida Administrative Code (regarding Notices of Adverse Determination). 3. Petitioner provided additional arguments and documentation regarding the claims at issue in this audit. Upon formal consideration, the overpayment amount was determined to be $84,201.89 (C.I. no.: 01-0653-000). 4. During the course of discovery in this matter, Petitioner’s expert and AHCA’s expert twice met to further discuss the factual disputes in this matter. Upon review of the complete records of Petitioner, and after consultation with experts, many of the claims to Medicaid were DOAH Case No 0200014 deemed medically necessary and properly documented. The final overpayment was determined to be $40,687.89. 5. In order to resolve this matter without further administrative proceedings, Petitioner has agreed to pay the adjusted overpayment amount of $40,687.89, and to withdraw its request for administrative hearing with prejudice to refilling the petition. 6. AHCA agrees to accept $40,687.89, in the manner set forth herein in settlement of the overpayment issues arising from the Medicaid review (C.L 00-0653-000). 7. Petitioner agrees to pay to AHCA in one lump sum, the amount of forty thousand six hundred eighty-seven dollars and eighty-nine cents ($40,687.89), to be paid within thirty (30) days of the issuance of a final order adopting this agreement. 8. Petitioner is responsible for ensuring timely delivery of the payment. Furthermore, failure to timely make the payment will render the balance due and payable immediately, with interest, and interest will continue to accrue until the entire balance is paid. 9. Petitioner 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: C.I. 01-0653-000. 10. Petitioner 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. 11. Payment shall be made payable to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 Payment shall clearly indicate that it is per a settlement agreement, shall reference the DOAH Case Number, and shall reference the C.1. Number. Bay Medical Center DOAH Case No.: 02-0014 12. Upon complete execution of this Agreement by Petitioner, this Agreement constitutes Petitioner’s’ dismissal of the petition and authorizes AHCA to file a Motion to Relinquish Jurisdiction with the Division of Administrative Hearings. 13. The parties will bear their own fees and costs associated with these proceedings. 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 Petitioner and AHCA, including anyone acting for, associated with or employed by them, concerning all matters relating to audit no. CI 01-0653-000 and supersedes any prior discussions, agreements or understandings; there are no promises, representations or agreements between Petitioner 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. Petitioner 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. Petitioner further agrees that the Agency shall issue a Final Order adopting the terms of this settlement. However, if for any reason AHCA does not adopt this agreement, Petitioner reserves the right to re-open this matter with the Division of Administrative Hearings and shall have not waived any rights. 18. 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. Bay Medical Center DOAH Case No.: 02-00014 19, 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. 20. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. BAY MEDICAL CENTER 615 North Bonita Avenue Panama City, FL 32401 2 2 A. AEC Dated: G (i a , 2002 By: Dawet \ tL Moors pr) (print name above) Dated: _G, |i 7 [02 , 2002 Harrison, Sale, McCloy, & Thompson 304 Magnolia Avenue P.O. Drawer 1579 Panama City, FL 32402 AGENCY FOR HEALTH CARE - ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 wor Dated: fs , 2002 Rufus Noble Inspector General LB tak Daed: “<¥H (2F__ 00 < William Roberts Acting General Counsel Bay Medical Center DOAH Case No.: 02-00014 f Dated: Ufezce, 70 2002 Kelly Bénnett Assistant General Counsel

Docket for Case No: 02-000014MPI