Petitioner: MEMORIAL HEALTHCARE GROUP, INC., D/B/A MEMORIAL HOSPITAL JACKSONVILLE
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: ELLA JANE P. DAVIS
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Mar. 12, 2003
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Wednesday, May 21, 2003.
Latest Update: Dec. 25, 2024
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
MEMORIAL HEALTHCARE GROUP, INC.
d/b/a MEMORIAL HOSPITAL JACKSONVILLE,
Petitioner, (ik
CASE NO: 03-0882MPY=::
vs. OG:
AUDIT NO. C.I. 01-1837- 7-400 Q,
° Kerk Hon VW. Ate a- = OUG- ne
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.
DONE AND ORDERED on this the 30 _ dayof_Qetrber __, 2003, in
Tallahassee, Florida.
is, 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:
Thomas Konrad, Esquire
Rutledge, Ecenia, Purnell & Hoffman, P.A.
Post Office Box 551
Tallahassee, FL 32302-0551
Grant P. Dearborn, Assistant General Counsel
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308-5403
(Interoffice)
Timothy Byrnes, Chief
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
(Interoffice)
Ella Jane P. Davis
Administrative Law Judge
DOAH
(Interoffice)
Ken Yow Analyst
CERTIFICATE OF SERVICE
I 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 of day of
2003.
Lealand McChafen, Esquir
ye 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
MEMORIAL HEALTHCARE GROUP, INC.
d/b/a MEMORIAL HOSPITAL JACKSONVILLE,
Petitioner,
vs. CASE NO: 03-0882MPI
AUDIT NO. C.I. 01-1837-000
AGENCY FOR HEALTH CARE
ADMINISTRATION,
Respondent.
/
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(“AHCA” or “the Agency”), and MEMORIAL HEALTHCARE GROUP, INC. d/b/a
MEMORIAL HOSPITAL JACKSONVILLE (“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, and neither party concedes the other’s position.
2. PROVIDER is a Medicaid provider in the State of Florida.
3. In its final agency audit report dated November 14, 2002, AHCA notified
PROVIDER that 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 $1 15,148.05. In response to said audit letter,
PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH
Case No. 03-0882MPI. Subsequently and after additional information was provided, AHCA
through KeyPro reviewed the disputed claims and determined the outstanding amount of
overpayment should be adjusted to $62,200.03.
4. In order to resolve this matter without further administrative proceedings,
PROVIDER and the AHCA expressly agree as follows:
qd) AHCA agrees to accept the payment set forth herein in settlement of the
overpayment issues arising from the MPI review.
(2) Within thirty days of receipt of the final order, PROVIDER agrees to
make a single payment of sixty three thousand two hundred dollars and
three cents ($63,200.03) in full and complete settlement of all claims for
this audit. One thousand dollars of this amount is for costs and fees.
(3) | PROVIDER and AHCA agree that full payment as set forth above will
resolve and settle this case completely and release both parties from ail
liabilities arising from the findings in the audit referenced as C.J. 01-1837-
000.
(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. Payment shall be made to:
AGENCY FOR HEALTHCARE ADMINISTRATION
Medicaid Accounts Receivable
Post Office Box 13749
Tallahassee, Florida 32317-3749
6. PROVIDER agrees that failure to pay any monies due and owing under
the terms of this Agreement shal] 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.
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. Each party shall bear its own attorneys’ fees and costs, if any, except as set forth
herein.
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 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.
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
tules 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.
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.
20. 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 legal proceedings
through an attorney at law, all costs of collection or enforcement, including reasonable attorneys’
fees and costs, shall be paid by the breaching party to the non-breaching party.
MEMORIAL HEALTHCARE GROUP, INC.
d/b/a MEMORIAL HQSPITAL JACKSONVILLE
Ln Dated: Lolo , 2003
Signature of Representative
BY: Ledney Vawhey-
(Print name)
VA Dated: “~ of (6 , 2003
Thomas Konrgd, Esquire
Attorney for Petitioner
FLORIDA AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
Dated: Octotsec 30 _, 2003
efreg) Acting Inspector General
SPL
iA Dated: C CT, IS , 2003
Grant P. Dearborn, Assistant General Counsel
~~
WY Dated: » 2003
Kim Kellum, Chief Medicaid Counsel
OA Li io Dated: Ly Ze , 2003
éneral Counsel
Valda Clark-Christians
Docket for Case No: 03-000882MPI
Issue Date |
Proceedings |
Nov. 05, 2003 |
Final Order filed.
|
May 21, 2003 |
Order Closing File issued. CASE CLOSED.
|
May 20, 2003 |
Joint Motion to Relinquish Jurisdiction (filed by Respondent via facsimile).
|
Apr. 29, 2003 |
Notice of Unavailability (filed by G. Dearborn via facsimile).
|
Apr. 28, 2003 |
Notice of Supplementing Discovery Response (filed by Respondent via facsimile).
|
Mar. 25, 2003 |
Amended Notice of Hearing issued. (hearing set for June 10 and 11, 2003; 9:30 a.m.; Tallahassee, FL, amended as to Venue only).
|
Mar. 25, 2003 |
Motion for Rehearing or Reconsideration of Order Titled "Notice of Hearing" (filed by Respondent via facsimile).
|
Mar. 18, 2003 |
Order of Pre-hearing Instructions issued.
|
Mar. 18, 2003 |
Notice of Hearing issued (hearing set for June 10 and 11, 2003; 9:30 a.m.; Jacksonville, FL).
|
Mar. 18, 2003 |
Joint Response to Initial Order (filed by Respondent via facsimile).
|
Mar. 18, 2003 |
Notice of Unavailability (filed by G. Dearborn via facsimile).
|
Mar. 14, 2003 |
Respondent`s First Interrogatories to Petitioner (filed via facsimile).
|
Mar. 14, 2003 |
Respondent`s Request for Admissions (filed via facsimile).
|
Mar. 14, 2003 |
Respondent`s First Request for Production of Documents (filed via facsimile).
|
Mar. 14, 2003 |
Notice of Service of Interrogatories, Request for Admissions, & Request for Production of Documents (filed by Respondent via facsimile).
|
Mar. 14, 2003 |
Withdrawal of Motion to Extend Time to Respond to and Object to Petitioner`s Discovery (filed by Respondent via facsimile).
|
Mar. 12, 2003 |
Motion to Extend Time to Respond to and Object to Petitioner`s Discovery (filed by Respondent via facsimile).
|
Mar. 12, 2003 |
Order for Petitioner to Show Cause filed.
|
Mar. 12, 2003 |
Final Agency Audit Report filed.
|
Mar. 12, 2003 |
Petition for Formal Administrative Hearing filed.
|
Mar. 12, 2003 |
Notice (of Agency referral) filed.
|
Mar. 12, 2003 |
Initial Order issued.
|