Petitioner: CEDARS MEDICAL CENTER
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: PATRICIA M. HART
Agency: Agency for Health Care Administration
Locations: Miami, Florida
Filed: May 14, 2002
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Thursday, May 30, 2002.
Latest Update: Dec. 23, 2024
STATE OF FLORIDA
AGENCY FOR HEALTH CARE ADMINISTRATION
CEDARS MEDICAL CENTER, b HL ~obeue
Petitioner, DOAH Case No.: 02-1968MPI
C.L. 97-1306-127
v. _AHCA Provider No.: 10036600 8
Perel Ae AHA OS CHOW MD P
STATE OF FLORIDA,
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Respondent.
/
FINAL ORDER
THE PARTIES resolved all disputed issues and executed a settlement agreement,
which is attached and 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.
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DONE AND ORDERED on this the _ | 4 day of L7AIDCUAE. , 2003, in
J
Rhonda M. Medows, , secre!
Agency for Health Care Administration
Tallahassee, Florida.
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:
Peter M. Feaman, Esquire
Jeffrey T. Royer, Esquire
Buckingham, Doolittle and Burroughs
2500 N. Military Trail, Ste 480
Boca Raton, FL. 33431
(U.S. Mail)
Susan Felker-Little, Esquire
Senior Attorney
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308-5403
(Interoffice)
Patricia H. Malono
Administrative Law Judge
Division of Administrative Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
(Interoffice)
Bob Maryanski, Program Administrator
Medicaid Program Development
Agency for Health Care Administration
2727 Mahan Drive
Tallahassee, Florida 32308
(Interoffice)
Finance & Accounting
(Interoffice)
CERTIFICATE OF SERVICE
1 HEREBY CERTIFY that a true and correct copy of the foregoing has been
furnished to the above named addresses by U.S. Mail on this the / 142, “day of
‘Marlene x MEK
foe Lealand McCharen, td Clerk
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308-5403
(850) 922-5873
03 FEB 20 AM 9:37
STATE OF FLORIDA ney ont
EV Gare
AGENCY FOR HEALTH CARE ADMINISTRATION ADMIN
E!
CEDARS MEDICAL CENTER,
Petitioner, DOAH Case No. 02-1968MPI
AHCA Provider No. 010036600
v. C.I, 97-1306-127
STATE OF FLORIDA,
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Respondent.
/
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(“AHCA” or “the Agency”), and CEDARS 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 avoiding the costs and burdens of litigation, and neither party concedes the
other’s position.
2. PROVIDER is a Medicaid provider in the State of Florida, with provider number
010036600.
3. In its Final Agency Audit Report dated March 25, 2002, AHCA notified
PROVIDER that a retrospective review of Medicaid claims for inpatient hospital admissions for
mental disorder diagnoses, performed by First Mental Health, Inc., indicated that, in its opinion,
some claims submitted by PROVIDER were not covered by Medicaid in whole or in part. The
Agency sought overpayment in the amount of Twenty-Seven Thousand Two Hundred Fifty-Nine
Cedars Medical Center v. AHCA
DOAH Case No.02-1968MPI
AHCA PROVIDER NO. 010036600
C.1. 97~-1306-127
SETTLEMENT AGREEMENT
Page 2 of 6
Dollars and Eighteen Cents ($27,259.18). In response to the Final Agency Audit Report,
PROVIDER filed a Petition for a Formal Administrative Hearing, the matter was referred to the
Division of Administrative Hearings (DOAH), and DOAH assigned the matter DOAH Case No.
02-1968MPI.
4, Thereafter, the parties entered into settlement negotiations, the parties filed a Joint
Motion to Relinquish Jurisdiction in DOAH, and DOAH entered an order closing its file and
referring the matter back to AHCA for completion of settlement.
5. In order to resolve this matter without further administrative proceedings,
PROVIDER and AHCA expressly agree as follows:
(a) AHCA agrees to accept the payment set forth herein in settlement of the
overpayment issues arising from the First Mental Health, Inc. review.
(b) Within thirty (30) days of receipt of the Agency for Health Care
Administration Final Order incorporating by reference this Settlement
Agreement, PROVIDER shall make a single payment in the total sum of
TWENTY-TWO THOUSAND DOLLARS AND NO CENTS
($22,000.00) (the “Settlement Amount”) in Full and Final settlement of all
claims in these proceedings referenced as C.I. 97-1306-127
(c) The Settlement Amount will be made payable and remitted to:
Agency for Health Care Administration
Attn. Medicaid Accounts Receivable
P. O, Box 13749
Tallahassee, FL 32317-3749
Payment shall clearly indicate that it is pursuant to a settlement agreement
and shail reference Audit C.I. 97-1306-127.
Cedars Medical Center v. AHCA
DOAH Case No.02-1968MPI
AHCA PROVIDER NO. 010036600
CI. 97-1306-127
SETTLEMENT AGREEMENT
Page 3 of 6
(d) | PROVIDER and AHCA agree that full payment of the Settlement Amount
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. 97-1306-127.
(e) PROVIDER is responsible for ensuring timely delivery of the Settlement
Amount set forth herein. Furthermore, failure to timely make the payment
will render the balance due and payable immediately, with statutory
interest, and interest will continue to accrue until the entire balance is paid.
AHCA reserves the right to seek enforcement of this agreement by any
legal means.
(f) 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 by paragraph 6 below), AHCA agrees
PROVIDER may credit the amount of any such offset against the
Settlement Amount at the time PROVIDER tenders such payment.
(g) 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.
6. PROVIDER agrees that failure to pay any monies due and owing under the terms
of this Agreement shall constitute PROVIDER’s authorization for the Agency, without further
Cedars Medical Center v. AHCA
DOAH Case No.02-1968MPI
AHCA PROVIDER NO. 010036600
CLL. 97-1306-127
SETTLEMENT AGREEMENT
Page 4 of 6
notice, to withhold the total remaining amount due under the terms of this Agreement from any
monies due and owing to PROVIDER for any Medicaid claims.
7. AHCA reserves 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.
8. This settlement does not constitute an admission of wrongdoing or error by either
party with respect to this case or any other matter.
9. The parties agree to bear their own attorney’s fees and costs, if any, except as
hereinabove stated.
10. 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.
11. 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.
12, This Agreement constitutes the entire agreement between PROVIDER and
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 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.
13. 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 setting any potential correctness or
Cedars Medical Center v. AHCA
DOAH Case No.02-1968MPI
AHCA PROVIDER NO. 010036600
C.1. 97-1306-127
SETTLEMENT AGREEMENT
Page 5 of 6
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.
14. 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, including appeals, 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 that 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.
15, 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.
16. 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.
17. This Agreement shall inure to the benefit of and be binding on each party’s
successors, assigns, heirs, administrators, representatives and trustees.
18. All times stated herein are of the essence of this Agreement.
19. This Agreement shall be in full force and effect upon execution by the respective
parties in counterpart.
Cedars Medical Center v. AHCA
DOAH Case No.02-1968MPI
AHCA PROVIDER NO. 010036600
Cu. 97-1306-127
SETTLEMENT AGREEMENT
Page 6 of 6
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
Pree Dated: @ , 2008
BOB SHARPE
Deputy Secretary, Medicaid
ho ee
CHRISTIAN
Efe Lf
VALDA CLARK
General Counsel
} . 3 f/f,
z / : tia Dated: ~/ 2 , 2002.
SUSAN C. FELKER-LITTLE
Assistant General Counsel
CA}
~
«CL2:164172_4»
Docket for Case No: 02-001968MPI