STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION RUBEN GARCIA, M.D., Ube Petitioner. PME vs. CASE NO. 02-4301MPI Cc. I. 98-1620-000 STATE OF FLORIDA, AGENCY FOR RENDITION NO.: AHCA-03-¢C/@-S- MDO 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. DONE AND ORDERED on this the 6 day of _Tawaw PY 2003, in Tallahassee, Florida. Rhonda M'Medows, MD, 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: Ruben R. Garcia, M. D. 411 East Nelson Avenue DeFuniak Springs, FL 32433 Grant P. Dearborn, Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (Interoffice) Judith E. Hefren, Deputy Inspector General Medicaid Program Integrity Agency for Health Care Administration 2727 Mahan Drive, MS #5 Tallahassee, Florida 32308 (Interoffice) Willie Bivins Finance & Accounting Medicaid Accounts Receivables Agency for Health Care Administration 2727 Mahan Drive, MS #14 (nteroffice) Robert Maryanski Medicaid Program Development Agency for Health Care Administration 2727 Mahan Drive, MS #20 (Interoffice) P. Michael Ruff Julie Canfield-Buddin Administrative Law Judge Analyst, MPI DOAH (nteroffice Mail) CERTIFICATE OF SERVICE T 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 ml day of ( LAWALL, 2003. ; (| one kes ye ic wal TOO - Lealand McCharen, Esquire ~ Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION RUBEN GARCIA, MLD., Petitioner, vs. CASE NO. 02-4301MPI STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT The State of Florida, Agency for Health Care Administration (SAHCA”), and Ruben Garcia, M.D. (“PROVIDER”), stipulate and agree as follows: 1. This 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 enrolled in the Medicaid program in the State of Florida. 3. In its Final Agency Audit Report C.I. 98-1620-000, dated May 1, 2002, AHCA notified PROVIDER that a review of Medicaid claims performed by Medicaid Program Integrity (MPI) indicated some claims submitted by PROVIDER were not covered by Medicaid, either in whole or in part. The Agency sought to recoup overpayment in the amount of $49,665.89. In response, PROVIDER petitioned for a formal administrative hearing, which matter was referred to the Division of Administrative Hearings and given DOAH Case No. 02-4301MPI. Subsequently and after additional information was provided, AHCA reviewed the disputed claims and determined the outstanding amount of overpayment should be adjusted to $42,427.11 plus $2,000.00 in investigative/legal fees. 4. In order to resolve this matter without further administrative proceedings, AHCA and PROVIDER expressly agree as follows: a. AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from this MPI review. b. AHCA will enter a Final Order incorporating the terms of this Settlement Agreement. c. Within thirty (30) days of receipt of the Final Order, PROVIDER agrees to make a single payment to AHCA of Forty-Two Thousand Four Hundred Twenty- Seven and 11/100 Dollars ($42,427.11) in full and complete settlement of all claims in these proceedings, plus Two Thousand and No/100 Dollars ($2,000.00) in investigative/legal fees. e. PROVIDER and AHCA agree 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. 98-1620-000. f. PROVIDER agrees it will not re-bill the Medicaid Program in any manner for claims which are the subject of the audit in this case. 5. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 6. PROVIDER agrees the failure to pay any monies due and owing under the terms of this Settlement Agreement shall constitute PROVIDER’S authorization for AHCA, without further notice, to withhold the total remaining amount due under the terms of this Settlement Agreement from any monies due and owing to PROVIDER for any Medicaid claims. 7. AHCA reserves the right to enforce this Settlement Agreement under Florida law, 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. Each party to this Settlement Agreement stipulates its undersigned representative is duly authorized to enter into and execute this Settlement Agreement on its behalf. 10. This Settlement Agreement shall be construed in accordance with Florida law. Venue for any action arising from this Settlement Agreement shall be in Leon County, Florida. 11. This Settlement 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 Settlement Agreement is completed and properly executed by the parties. 12. ‘In the event that a party breaches this Agreement, and enforcement of this Agreement or recovery of damages for breach hereof is obtained by law or by legal proceedings through an attorney at law, all costs of collection or enforcement, including reasonable attorneys’ fees and costs, shal! be paid by the breaching party to the non-breaching party. 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 settling any understanding, information, and contention as to fact and law, so that no misunderstanding or misinformation shall be a ground for rescission of this Settlement Agreement. 14, PROVIDER expressly waives in this matter its right to any hearing under §§120.569 or 120.57, Florida Statutes, the making of findings of fact and conclusions of law by AHCA, and all other proceedings, including appeals, to which it may be entitled by law regarding any and all issues raised in this case. PROVIDER further agrees it shall not challenge or contest any Final Order which is consistent with the terms of this Settlement Agreement, waiving its rights to any administrative proceeding, state or federal court action, or any appeal. 15. This Settlement Agreement is and shall be deemed jointly drafted and written by all parties to it and shall not be construed or interpreted against either party. 16. To the extent any provision of this Settlement Agreement is prohibited by law for any reason such prohibition shall not affect any other provision of this Settlement Agreement. 17. This Settlement 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 Settlement Agreement. 19. This Settlement Agreement shall be in full force and effect upon execution by the respective parties in counterpart. 20. Provider will cooperate in and consent to a comprehensive follow-up review in 6 months to ensure that they are billing Medicaid correctly. RUBEN GARCIA, M.D. Rul 2. (a) ff mM) Dated: (Z [ Q , 2002 By: Attomey for Petitioner Petitioner’s Representative for Ruben Garcia, M.D. FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 Lofeorldle Dated: vA Z- Rifus Ndbie, Inspector General eb MAG A Dated: £2 (3h grXalda Christian, General Counsel | VICE eal pated: Pec il Grant P. Dearborn, Assistant General Counsel , 2002 , 2002

Docket for Case No: 02-004301MPI