STATE OF FLORIDA 4 AGENCY FOR HEALTH CARE ADMINISTRATION .~ “ RAFAEL R. TAPIA, M.D., Petitioner, 7 ce , esp hes PS CASE NO.02-4302MPI° vs. : AHCA Provider No. 0538931-09 CI No. 97-1831-000 AGENCY FOR HEALTH CARE Perdition Ale, HCL CS OF18-'S BES ADMINISTRATION, ve aA) 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 _3\|__ day of ft ; 2003, in Tallahassee, Florida. Medows, MD, Secretary 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: Dr. Rafael R. Tapia, M.D. Carmen Tapia 115 East Lancaster Road Suite A Orlando, FL 32809 Jeff B. Clark Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, FL 32399 George Daven Shirejian, Esq. Agency for Health Care Administration (Interoffice Mail) Rufus Noble, Inspector General Agency for Health Care Administration (Interoffice Mail) Art Williams, Medicaid Program Integrity Agency for Health Care Administration (Interoffice Mail) Willie Bivens, Finance and Accounting Agency for Health Care Administration (Interoffice Mail) 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 LL day of CLuquat , 2003. f Charter Uheukson Ag Lealand McCharen, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION RAFAEL TAPIA, M.D., Petitioner, DOAH CASE NO. 02-4302/MPI v. AHCA Provider No. 0538931-00 STATE OF FLORIDA, AGENCY FOR HEALTH CARE C.I. No. 97-1831-000// CM-M/HOT ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, (“AHCA” or “the Agency”), and RAFAEL TAPIA, M.D., (“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 avoiding the costs and burdens of litigation. 2 PROVIDER is a Medicaid provider in the State of Florida, with provider number ee 0538931-00. 3. In its final agency audit report dated August 9, 2002 AHCA notified PROVIDER that a review of Medicaid claims, performed by Medicaid Program Integrity (MPI), indicated that, in its opinion, some claims in whole or in part were not covered by Medicaid. The Agency sought overpayment in the amount of $40,486.80. In response to the final agency (407) 857-1001 p.2 May 19 603 O2:20p Rafael Tapia M.D. P.G2 MAY-19-2@03 12:14 Rafael Tapia, M.D. DOAH Case No. 02-4302MPI Settlement Agreement Page 2 of 6 audit report, on September 27, 2002 PROVIDER filed a petition for a formal adsninistrative hearing. f oo , » The matter was referred to the Division of -\dr iinistrative Hearinzs (DOAH) and assigned DOAH Case No. 02-4302 M.P.1. Subsequently, AH A, adjusted the overpayment to $20,392.92. 5. In order to resolve this matter without furth or ¢ Iministrative proceedings, PROVIDER and AHCA expressly agree: as follows: (a) AHCA agrees to accept the payment ¢2t forth herein in settlement of the overpayment issues arising from the M.’I review. (b) Within thirty (30) days of receipt of the Agency for Health (Care Administration Final Order incurpora ing by reference this Settlerient co Agreement, PROVIDER agrees to riak 2 a single payment in the total sum of TWENTY THOUSAND THRE2 HUNDRED NINETY TWO a DOLLARS AND NINETY-TWO CENTS ($20,392.92), which constitutes: (1) Medicaid claims overpa: ment of $20,392.92. aaa (c) The payment of $20,392.92 shall be mi de payable and remitted to: Agency for Health C'ar:' Administration Attn. Medicaid Accour ts Receivable P.O. Box 13749 Tallahassee, FL 32317-2749 in full and complete settlement of all cli ums in the audit reterenced as C.1. i No, 97-1831-000/CM-M/HOT. Payment shall clearly indicate that it is TOTAL P.@2 Rafael Tapia, M.D. DOAH Case No. 02-4302MPI Settlement Agreement Page 3 of 6 6. (d) (©) 109) (g) pursuant to a settlement agreement and shall reference Audit C.1. No. No. 97-1831-000/CM-M/HOT. 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. No. 97- 1831-000/CM-M/HOT PROVIDER is responsible for ensuring timely delivery of the payment 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 Jegal means. 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. PROVIDER will cooperate in a comprehensive follow-up review within 6 months of the date of the Final Order in the cause to ensure that PROVIDER is billing Medicaid correctly. 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 Rafael Tapia, M.D. DOAH Case No. 02-4302MPI 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. Rafael Tapia, M.D. DOAH Case No. 02-4302MPI Settlement Agreement Page 5 of 6 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 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. 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 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 settlement 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. i Rafael Tapia, M.D. DOAH Case No. 02-4302MPI Settlement Agreement Page 6 of 6 19. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. PROVIDER: / Va ; Z Dated: — 7F L _, 2003. RAFAE PIA, M.D. THE AGENCY: a Dated: 3 , 2003. RUFUS-NOBLE Ousiny | [ Ackiny Inspector General ay LLade Lita Dated: bod LT _n003. VALDA CLARK CHRISTIAN General Counsel

Docket for Case No: 02-004302MPI