Petitioner: IZZ & SONS, INC., D/B/A ROBERT`S DRUG STORE
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: MICHAEL M. PARRISH
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Sep. 10, 2002
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Monday, April 28, 2003.
Latest Update: Dec. 25, 2024
STATE OF FLORIDA APR 23. 919
DIVISION OF ADMINISTRATIVE HEARINGS * 23 03
AHCA
DEPARTMOAT CLERK
IZZ & SONS, INC. d/b/a ROBERT’S
DRUG STORE,
4a (O
Petitioner, mit (
Vv.
AGENCY FOR HEALTH CARE
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 attached settlement agreement. Based on the
foregoing, this file is CLOSED.
DONE and ORDERED on this the ZAaAday of _7 yrs (/ , 2003,
in Tallahassee, Florida.
fothonda pla MD, Secretary
fotnons 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:
L. William Porter II, Esquire
Agency for Health Care
Administration
(Interoffice Mail)
Paul H. Amundsen, Esquire
Amundsen & Gilroy, P.A.
502 E. Park Avenue
Tallahassee, Florida 32301
(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
JoAnn Jackson, Medicaid Program Integrity
John Hoover, Finance and Accounting
CERTIFICATE OF SERVICE
} 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 YPoday
1 €
of _ Ci va { , 2003.
late Nhat
ipelealand cCharen! 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
IZZ & SONS, INC. d/b/a ROBERT’S
DRUG STORE,
Petitioner,
CASE NO: 02-3586
Vv.
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Respondent.
/
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(“AHCA” or “the Agency”), and Izz & Sons, Inc. d/b/a Robert’s Drug Store (“PROVIDER”), by
and through the undersigned, hereby stipulate and agree as follows:
1, This Agreement is entered into between the parties for the purpose of resolving
the disputes between them as set forth in the Agency’s Final Audit Letter under case number 01-
1155. The parties seek to avoid the costs and burdens of further litigation. Neither party
concedes the other’s position or admits any wrongdoing.
2. PROVIDER is a Medicaid provider in the State of Florida, provider number
106388000.
3. In its final agency audit report (final agency action) dated January 22, 2001,
AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program
Integrity (MPI), Office of the Inspector General, indicated that certain claims, in whole or in
part, were not covered by Medicaid. The Agency sought recoupment of this overpayment, in the
Izz & Sons, Inc. d/b/a Robert’s Drug Store
Settlement Agreement
amount of $102,729.16. In response to the audit letter dated January 22, 2001, PROVIDER filed
a petition for a formal administrative hearing, which was assigned DOAH Case No. 01-1155.
4. The DOAH case was closed on July 26, 2001 pending re-review and possible
settlement. AHCA re-reviewed the PROVIDER’s claims and evaluated additional
documentation submitted by the PROVIDER. As a result, AHCA determined that the
overpayment was adjusted to $50,051.00.
5. Settlement, however, could not be reached and the case was re-opened September
17, 2002 under case number 02-02-3586. Additional documentation was presented by
PROVIDER, resulting in the overpayment being adjusted to $36,367.79.
6. In order to resolve this matter without further litigation, PROVIDER and the
AHCA agree as follows:
qd) AHCA agrees to accept the payment set forth herein in settlement of the
overpayment issues arising from the captioned MPI review.
(2) Within thirty days of receipt of the Agency Final Order, PROVIDER
agrees to pay thirty six thousand three hundred sixty seven dollars and
seventy nine cents ($36,367.79) in full and complete settlement of all
claims in the proceedings before the Division of Administrative Hearings
(DOAH Case No. 02-3586).
(3) | 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 C.I. 00-1069-
000-3.
Izz & Sons, Inc. d/b/a Robert's Drug Store
Settlement Agreement
(4) | 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.
(5) The review of this matter by AHCA did not indicate fraud or abuse of the
Medicaid program, and appeared to be a matter of inadvertence and
misunderstanding on the part of the PROVIDER.
7. Payment shal! be made to:
AGENCY FOR HEALTHCARE ADMINISTRATION
Medicaid Accounts Receivable
Post Office Box 13749
Tallahassee, Florida 32317-3749
8. 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
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.
9. 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.
10. This settlement does not constitute an admission of wrongdoing or error by either
party with respect to this case or any other matter. The PROVIDER maintains that it committed
no wrongdoing or purposeful error.
11. Each party shall bear its own attorneys’ fees and costs, if any.
12. 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.
13, 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.
Izz & Sons, Inc. d/b/a Robert's Drug Store
Settlement Agreement
14. 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.
15, 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 settling any potential correctness or
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.
16. | 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 settlement 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.
17. This Agreement is and shall be deemed jointly drafted and written by ail parties to
it and shall not be construed or interpreted against the party originating or preparing it.
lzz & Sons, Inc. d/b/a Robert’s Drug Store
Settlement Agreement
18. To the extent that any provision of this Agreement is prohibited by law for any
Teason, such provision shall be effective to the extent not so prohibited, and such prohibition
shall not affect any other provision of this Agreement.
19, This Agreement shall inure to the benefit of and be binding on each party’s
successors, assigns, heirs, administrators, representatives and trustees.
20. All times stated herein are of the essence of this Agreement.
21, This Agreement shall be in full force and effect upon execution by the respective
parties in counterpart.
BERT’S DRUG STORE
> ey
Paul H. Amundsen
Amundsen & Gilroy, P.A.
502 East Park Avenue
Tallahassee, FL 32301
Counsel for Izz & Sons, Inc.
d/b/a Roberts Drug Store
Dated:
op) | A , 2003
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
Lfrorble Dated: LY | AA , 2003
Rufus Noble
Inspector General
a
Lis. th
Vdida Clark Christian
Genegal Counsel
Dated: esi: Lo, 2003
UR dated: O4 -O7- , 2003
L. William Porter I
Assistant General Counsel
Docket for Case No: 02-003586MPI
Issue Date |
Proceedings |
Apr. 28, 2003 |
Order Closing File issued. CASE CLOSED.
|
Apr. 24, 2003 |
Joint Status Report filed by Petitioner.
|
Apr. 24, 2003 |
Final Order filed.
|
Feb. 18, 2003 |
Order Continuing Case in Abeyance issued (parties to advise status by April 18, 2003).
|
Feb. 18, 2003 |
Joint Motion to Hold Case in Abeyance (filed by Respondent via facsimile).
|
Dec. 18, 2002 |
Order Granting Continuance and Placing Case in Abeyance issued (parties to advise status by February 17, 2003).
|
Dec. 04, 2002 |
Joint Motion to Hold Case in Abeyance (filed by Respondent via facsimile).
|
Dec. 02, 2002 |
Notice of Cancellation of Deposition (Ai. Aryan) filed via facsimile.
|
Nov. 19, 2002 |
Subpoena Duces Tecum (2), (Ai. Aryan and Am. Aryan) filed via facsimile.
|
Nov. 19, 2002 |
Notice of Deposition (Ai. Aryan and Am. Aryan) filed via facsimile.
|
Nov. 14, 2002 |
Notice of Telephone Deposition (M. Castro, M.D.) filed via facsimile.
|
Sep. 17, 2002 |
Order Reopening Case issued.
|
Sep. 17, 2002 |
Notice of Hearing issued (hearing set for December 16 and 17, 2002; 9:00 a.m.; Tallahassee, FL).
|
Sep. 16, 2002 |
Notice of Withdrawal of Objection to Motion to Re-Open (Previously Filed Under DOAH Case No. 01-1155) filed.
|
Sep. 13, 2002 |
Objection to Motion to Re-Open filed.
|
Sep. 13, 2002 |
Respondent`s Amended Motion to Re-Open Case (filed via facsimile).
|
Sep. 10, 2002 |
Motion to Re-Open (filed via facsimile).
|
Mar. 23, 2001 |
Final Agency Audit Report filed.
|
Mar. 23, 2001 |
Petition for Formal Administrative Proceedings filed.
|
Mar. 23, 2001 |
Notice (of Agency referral) filed.
|