FILED STATE OF FLORIDA AGENGY FOR AGENCY FOR HEALTH CARE ADMINISTRA PROMTH oA CARE AONINISTRATION CLERK MARIA M. ALONSO —- PRIEGUEZ, M.D., Petiti 9 etitioner: m mp clpsedl v. DOAH CASE NO. 03-1972MPI AHCA Provider No. 0424838002. 3 Audit No. C.I. 00-1329-000 z STATE OF FLORIDA, oe 7 < AGENCY FOR HEALTH CARE x e - ADMINISTRATION, RENDITION NO.: AHCA-04- one ae 28: MDO a Respondent. 3 / o 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 this 4“day of _2eY ; Lavo Agency for Health Care SNICAIIN SELAE LS Administration 2004, in Tallahassee, Leon County, Florida. A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH THE AGENCY CLERK AND A SECOND COPY, ALONG WITH FILING FEE AS PRESCRIBED BY LAW, IN THE DISTRICT COURT OF APPEAL 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 THIRTY (30) DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies furnished to: Gregory A. Chaires, Esq. Webster, Chaires & Partners, P.L. P.O. Box 2310 Winter Park, Florida 32790-2310 (U.S. Mail) Tom Barnhart, Esq. Agency for Health Care Administration 2727 Mahan Drive Bldg #3 MS#3 Tallahassee, Florida 32308 (Interoffice Mail) Mary Clemmons (Interoffice Mail) M. M. Parrish Administrative Law Judge The Desoto Building 1230 Apalachee Parkway Tallahassee, FL 32399-3060 (U.S. Mail) Finance & Accounting Agency for Health Care Administration 2727 Mahan Drive Bldg MS#14 Tallahassee, Florida 32308 (Interoffice Mail) Timothy Byrnes Bureau Chief of MPI 2002 Old St. Augustine Rd. Bidg. D Tallahassee, FL 32301 CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of this Final Order was served on the above-named person(s) by U.S. Mail, or the method designated, on this the (3 day of ZY af 1) CMnn zallery qek'eala d McChdren, Agency Clerk Agency for Health Care Administration 2004. 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 JAN 13 2004 14:58 HP LASERJET 3200 e-3 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION FEB 1 0 R 2004 ECE, VE MARIA M. ALONSO - PRIEGUEZ, M.D., Q Petitioner, v. DOAH CASE NO. 03-1972MPI ABCA Provider No. 042483800 Audit No. C.I. 00-1329-000 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and MARIA M. ALONSO - PRIEGUEZ, M.D. (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. PROVIDER is a Medicaid provider in the State of Florida, provider number 042483800 and was a provider during the audit period. 2. In its final agency audit report (final agency action) dated April 16, 2003, AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity (MPD), 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 amount of $45,504.25. In response to the audit letter dated April 16, 2003, PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH Case No. 03-1972MPI. Based on subsequent documentation submitted by the PROVIDER, the overpayment was subsequently adjusted to $36,373.35. JAN 13 2004 14:58 HP LASERJET 3200 3. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: (1) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. (2) PROVIDER and AHCA agree to a settlement amount of Thirty-Six Thousand Three Hundred Seventy -Three Dollars and Thirty — Five Cents ($36,373.35). PROVIDER agrees to make a lump sum payment of $36,373.35 within thirty-days of receipt of the Final Order. (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. 00-1329- 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) | PROVIDER will cooperate in a comprehensive follow-up review within months of the Final Order in this case to ensure that PROVIDER is billing Medicaid correctly. JAN 13 2004 14:59 HP LASERJET 3200 4. Payment shal! be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 5. 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, 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. Each party shall bear its own attorneys’ fees and costs, if any. 9. 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 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. JAN 13 2004 15:00 HP LASERJET 3200 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, 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. 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 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 hercin. 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. 14. 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. 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, Tepresentatives and trustees. 17, All times stated herein are of the essence of this Agreement. JAN 13 2004 15:01 HP LASERJET 3200 18. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. MARIA M. ALONSO - PRIEGUEZ, M.D ). blonse. VireGye 2 BY: Dated: 2 200) (Print yame) ITS: AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 4 ; a pace 20 Zan Jafies D. Boyd Inspector General } “ fal LS Dated: ed x _,20977 General Counsel | 4 Tom Barnhart Dated: / 18 , 2007 Tom Barnhart Assistant General Counsel

Docket for Case No: 03-001972MPI