INTERVENTION SERVICES, INC., Pp vs. STATE OF FLORIDA ; AGENCY FOR HEATH CARE ADMINISTRATION Hcy -! etitioner, CASE NO. 02-085SMPI. cI 01-0550-053 : AGENCY FOR HEALTH CARE provider No. 360212500 ADMINISTRATION , s Respondent. 7 / TT THE PA a “settleme reference. terms of th - FINAL ORDER RTIES resolved all disputed issues and executed nt agreement”, which is incorporated by The parties are directed to comply with the e “settlement agreement”. Based on the foregoing, this proceeding is CLOSED. DONE and ORDERED on this the &7 _ day of fiheh— , 2002, in Tallahassee, Florida. Mb be Rhonda M. Medows, M.D., Secretary . agency for Health Care Administration BR PARTY WHO IS ADVERSELY APFECTED 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: Intervention Services, Inc. 150 Spartan Drive Maitland, Florida 32751 Kim A. Kellun, Esquire Attorney for Agency AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive Fort Knox Building 3, Mail Stop 3 Tallahassee, Florida 32308 D.S. Manry Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Willie Bivens, Finance and Accounting Donna Harrington, Medicaid Program Integrity 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 or by Interoffice Mail on this the day of | love here. , 2002. _——— Craclene Maxjssop @€Lealand McCharen, Esquire Agency Clerk State of Florida Agency for Health Care Administration ~ 2727 Mahan Drive, Building #3, Mail Stop 3 Tallahassee, Florida 32308-5403 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION? INTERVENTION SERVICES, INC., Petitioner, vs. Case No. 02-O0855MPI : Provider No. 360212500 CI No. 01-0550-053 AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. SETTLEMENT AGREEMENT Respondent, the State of Florida, Agency for Health Care Administration, and Petitioner, Intervention Services, Inc., by and through the undersigned individuals, hereby stipulate and agree as follows: 1. This settlement agreement is entered into between the parties in order to resolve a dispute that arose as the result of an audit. _ 2. -In a final agency audit letter dated November 9, 2001, Petitioner was informed that the Agency sought recoupment in the amount of $16,612.87. A copy of the recoupment letter is attached to this agreement. 3. Petitioner remitted partial payment in the amount of $6,937.37. 4. Petitioner challenged Respondent's action and requested a formal hearing regarding the remainder of the claims in question. 5. Subsequently, the Respondent reviewed additional documentation submitted and adjusted the overpayment to $6,937.37. 6. Petitioner, Intervention Services, Inc., has already submitted payment in the amount of $6,937.37. 7. This settlement does not constitute an admission of wrongdoing or error by either party. However, the parties believe that this matter should be settled. 8. Both parties request that the Agency close the file in this case. 9. Each party shall bear its own attorney's fees and costs. 10. This agreement represents the entire agreement between the parties regarding settlement of this case. 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. The signatories to this ~ ‘agreement, acting in a representative capacity, represent that they are duly authorized to act on behalf of the - parties to the agreement. Venue for any action arising from this agreement shall be in Leon County, Florida. Dated this _£7 day of bbobo of 2002. AGENCY FOR HEALTH CARE ADMINISTRATION Llde LME span . Ualda Cletle bdO/) Acting-General Counsel Agency for Health Care Administration 2727 Mahan Drive Ft. Knox Building 3 Tallahassee, Florida 32308 Rufus MOble, Inspector General Agency for Health Care Administration 2727 Mahan Drive Ft. Knox Building 3 Tallahassee, Florida 32308 INTERVENTION SERVICES, INC. oS Qk. Intervention Services, Inc 150 Spartan Drive Maitland, Florida 32751 Cc: Donna Harrington, Medicaid Program Integrity Willie Bivens, Finance and Accounting

Docket for Case No: 02-000855MPI