STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION WESTSIDE PEDIATRICS, P.A., Petitioner, Provider No. 3720446-00-" 3720446-0: vs. DOAH NO. 03-1567MPI CI No. 01-1899-000 AGENCY FOR HEALTH CARE WL ADMINISTRATION, DOAH NO. 03-1542MPI J CI No. 01-1900-000 Respondent. RENDITION NO.: AHCA-03-C&u4-S-MDO / 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 _]4 day of _@etrt2n ; 2003, in Tallahassee, Florida. {prong M. MeddWs, MD, Secretary Agency ‘or 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: Chris Parrella, Esquire Anthony C. Vitale, P.A. 799 Brickell Plaza, Suite 700 Miami, FL 33131 John G. Van Laningham 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) Judith E. Hefren, Acting 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 “Dogs to the above named addressees by U.S. Mail on this the /le day of teil , 2003. a McChare OD oak Agency for Health Care Administration 2727 Mahan Drive, Building #3, MSC #3 Tallahassee, Florida 32308-5403 (850) 922-5873 Sep O5 2003 10:37AM HEALTH LAW OFFICE OF ANTH 305-358-5113 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS WESTSIDE PEDIATRICS P.A., Petitioner, CASE NO: 03-1542MPI 03-1567MPI A AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, (“AHCA” or “the Agency”), and WESTSIDE PEDIATRICS, P.A. (“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 numbers 3720446-00 and 3720446-01. 3. _ In the two final agency audit reports dated March 26, 2003 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 amounts of 50,969.59 (C.1. # 01-1899-000/CM-M/PCS) and 34,322.34 (C.I. # 01-1900-000/CM-M/PCS). In response to the final agency t Sep O05 2003 10:37AM HEALTH LAW OFFICE OF ANTH 305-358-5113 Westside Pediatrics, P.A. * DOAH Case Nos. 03-1542 MPI and 03-1567MPI Settlement Agreement Page 2 of 6 wudit reports, on April 14, 2003 PROVIDER filed two petitions for formal administrative hearings, which contested the aggregate overpayment amount of $85,291.93. 4. The two matters were referred to the Division of Administrative Hearings (DOARH) and assigned DOAH Case Nos, 03-1567 MPI (C.1. # 01-1899-000/CM- M/PCS)($50,959.59) and 03-1542 MPI (C.L # 01-1900-000/CM-M/PCS)($34,322.34). 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 MPI review. (b) Within. thirty days of receipt of the final order, PROVIDER agrees to make a TEN THOUSAND DOLLAR ($10,000.00) INITIAL PAYMENT along with the firat installment to repay the romaining overpayment of SEVENTY FIVB TOUSAND TWO HUNDRED NINETY ONE DOLLARS AND NINE- THREE CENTS ($75,291.93), at a statutory interest of 10%, to be paid in twenty-four (24) equal monthly payments of THREE THOUSAND FOUR HUNDRED SEVENTY-FOUR DOLLARS AND THIRTY-FOUR CENTS ($3,474.34) each. (c) The twenty-four (24) consecutive monthly payments of $3,474.34 each shall be made payable and remitted to: Agency for Health Care Administration Attn. Medicald Accounts Receivable P. O. Box 13749 Tallahassee, FL 32317-3749 Sep O5 2003 10:37AM HEALTH LAW OFFICE OF ANTH 305-358-5113 ’ Weatside Pediatrics, P.A. * DOAH Case Nos. 03-1542 MPI and 03-1567MPI Settlement Agreement Page 3 of 6 in full and complete settlement of all claims in the formal hearing proceedings before AHCA conceming the audits referenced as C.I. No. 03- 1567 MPI (C.1. # 01-1899-000/CM-M/PCS) and 03-1542 MPI (C.I. 01-1900- 000/CM-M/PCS). Each payment shall clearly indicate that it is pursuant to a settlement agreement, and each payment shall reference Audits C.I. No. 03-1567 MPI (C.L # 01-1899-000/CM-M/PCS) and 03-1542 MPI (C.I. 01-1900-000/CM-M/PCS). (d) PROVIDER and AHCA agree that full payment as set forth above will resolve ‘and scttle this case completely and release both parties from all liabilities arising from the findings in the audits referenced as C.1. No. 03-1567 MPI (C.I. # 01-1899-000/CM-M/PCS) and 03-1542 MPI (C.I. # 01-1900- 000/CM-M/PCS). (c) PROVIDER is responsible for ensuring timely delivery of the payments 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 seck enforcement of this agreement by any legal means. (f) 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. Sep O05 2003 10:37AM HEALTH LAW OFFICE OF ANTH 305-358-5113 Weatside Pediatrics, P.A. DOAH Case Nos, 03-1542 MPI and 03-1567MPI Settlement Agreement Page 4 of 6 . (g) PROVIDER will ccoperate 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. 6. 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. 7. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. 8. Parties agree to bear their own attomey’s fees and costs, if any, except as hereinabove stated. 5, 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. 10. 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. 11. This Agreement constitutes the entire agreement between PROVIDER and AHCA, including anyone acting for, associated with or employed by them, concerming al] miatters and supersedes any prior discussions, agreements or understandings; there are no promises, representations or agreements between PROVIDER and AHCA other than as set forth heroin. 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. 12. 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, Sep 05 2003 10:37AM HEALTH LAW OFFICE OF ANTH 305-358-5113 + * cons ; o @ Westside Pediatrice, PA. ~ - DOAH Case Nos, 03-1542 MPI and 03-1 567MPI Settlement Agreement Page 5 of 6 ‘ and with each party compromising and settling any potential correctness or incorrectness of its understandings, information and contentions as to facts and Jaw, so that no misunderstanding or misinformation shall be a ground for rescission hereof. 13. 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 al] further and other proceedings to which it may be entitled by Jaw 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 Fina] Order entered in this matter that is istent 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. 14. This Agreement is and shall be deemed jointly drafted and written by all partics to it _ and shall not be construed or interpreted against the party originating or preparing it. 15. 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. 16. | This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 17. All times stated herein are of the essence of this Agreement. 18. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. Sep OS 2003 10:37AM HEALTH LAW OFFICE OF ANTH 305-358-5113 Westside Pediatrics, P.A. DOAH Case Nos. 03-1542 MPI and 03- 1567MPI Settlement Agreement Page 6 of 6 PROVIDER: ne Authérized Representative for Westside Pediatrics P.A. THE AGENCY: HE Inspector General -ALDA CLARK CHRISTIAN Generel Counsel ted: G 7 x , 2003. Dated: Qe toto. LT , 2003. Dated: ay g , 2003.

Docket for Case No: 03-001542MPI