Petitioner: ELOMAR DRUG CORPORATION, D/B/A CARDENAS PHARMACY
Respondent: AGENCY FOR HEALTH CARE ADMINISTRATION
Judges: JOHN G. VAN LANINGHAM
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: May 27, 2003
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Monday, September 29, 2003.
Latest Update: Dec. 25, 2024
STATE OF FLORIDA
DIVISION OF ADMINISTRATIVE HEARINGS
ELOMAR DRUG CORPORATION, d/b/a fue eons
CARDENAS PHARMACY, Poa,
Petitioner,
CASE NO: 03-1976MPI
C.I. No. 01-1478-000-3
JUDGE: John G. Van Laningham
STATE OF FLORIDA, AGENCY FOR Medicaid Provider No.: 1033417-00
HEALTH CARE ADMINISTRATION,
v.
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.
7
DONE and ORDERED on this the <2> day of PIAL , 2005, in
Tallahassee, Florida.
fr-A¥an Levine, 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:
Ernesto Cespedes
Attorney for Petitioner
12080 SW 127" Ave, #144
Miami, FL 33186
John G. Van Laningham
Administrative Law Judge
Division of Administrative Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, FL 32399
Anthony L. Conticello, Esquire
Agency for Health Care Administration
(Interoffice Mail)
James D. Boyd, Inspector General
Agency for Health Care Administration
(Interoffice Mail)
Timothy Byrnes, Bureau Chief
Medicaid Program Integrity
Agency for Health Care Administration
(Interoffice Mail)
Bureau of 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 a aay of ASE , 2005.
- a
Richard Shoop, Agency Cler’
Agency for Health Care Administration
2727 Mahan Drive, Building #3
Tallahassee, Florida 32308-5403
(850) 922-5873
STATE OF FLORIDA PM ne go,
DIVISION OF ADMINISTRATIVE HEARINGS : Fe
ELOMAR DRUG CORPORATION, d/b/a .
CARDENAS PHARMACY, fe .
Petitioner,
CASE NO: 04-1079MPI
Vv.
JUDGE: John G. Van Laningham
STATE OF FLORIDA, AGENCY FOR
HEALTH CARE ADMINISTRATION,
Respondent.
/
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
(SAHCA” or “the Agency”), and Elomar Drug Corporation d/b/a Cardenas Pharmacy
(“PROVIDER”). by and through the undersigned. hereby stipulate and apree as follows:
I. This Agreement is entered into between the parties for the purpose ot
memorializing the resolution to this matter.
2. PROVIDER is a Medicaid provider in the State of Florida, and has been issied
the following Medicaid Provider Number: 1033417-00.
3. in its Final Agency Audii Report issued on April 7, 7093 (the “Audit borter™
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 S41.661.47 tthe “Overpayrnaent
Amount”). In response to the Audit Letter, PROVIDER disputed the Agency’s findings and
filed a petition for a formal administrative hearing that was assigned DOAH Case No, 94-
1079MPI (formerly 03-1976MPI).
4. In order to resolve this matter without further administrative proceedings.
PROVIDER and AHCA expressly agree as follows:
(a)
(b)
(c)
(d)
(e)
AHCA agrees to accept the payment set forth herein in settlement of the
overpayment issues arising from the MPI review.
PROVIDER, as complete settlement of all claims in the proceedings
before the Division of Administrative Hearings, agrees to pay to AHCA
$42.661.47, broken down as follows: the Overpayment Amount of
$41,661.47; plus an additional 1.600 in attorneys tees and cosis
reimbursable to AHCA. Provider agrees to pay this amount in one lump
sum, which shall be due at AHCA thirty (30) days after the entry of the
Final Order.
PROVIDER is responsible for ensuring timely delivery of the payment.
Furthermore, failure to timely make the payment will render the balance
due and payable immediately, with 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.
PROVIDER and AHCA agree that full payment as set forth above will
resolve and settle this case completely and release all parties from all
liabilities arising from the findings in the audit referenced as: C1. No. 01-
1478-000-3.
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.
bo
a)
Payment shall be made to:
AGENCY FOR HEALTHCARE ADMINISTRATION
Medicaid Accounts Receivable
Post Office Box 13749
Tallahassee, Florida 32317-3749
And payment shall clearly indicate that it is per a settlement agreement, shall
reference the DOAH Case Number (No. 04-1079MPI. formerly 03-1976MP]). and shall
reference the C.I. Number (C.1. No. 01-1478-000-3).
6. 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.
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. The parties agree to bear their own attorney’s 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.
Furthermorc, PROVIDER agrees that its signature alone binds PROVIDER to make the parmen!
as set forth in this agreement. PROVIDER shall furnish the actual signed Settlement Agreement
to AHCA, however a facsimile copy shall be sufficient to enable AHCA to cancel the final
hearing and have the Division of Administrative Hearings relinquish jurisdiction back to the
Agency.
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.
ae
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.
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 lacts
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 and AHCA expressly waive. in this matter, their 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 they may be
entitled by Jaw or rules of the Agency regarding this proceeding and any and all issues raised
herein. PROVIDER and the Agency further agree that the Agency should issue a Final Order
which is consistent with the terms of this settlement, that adopts this agreement and closes this
matter.
14. PROVIDER, does hereby discharge the State of Florida, Agency for Health Care
Administration, and its agents, representatives. and attorneys of and from all claims. demands.
actions. causes of action, suits. damages, losses and expenses. of any and every nature
whatsoever, arising out of or in any way specifically related to this matter - DOAH Case No. 64-
1079MPI (formerly 03-1976MPI), C.1. No. No. 01-1478-000-3. and AHCA’s actions herein.
including, but not limited to. any claims that were or may be asserted in any federal or state cout
or administrative forum, including any claims arising out of this agreement. by or on behalf of
Facility. The Agency for Health Care Administration. does hereby discharge PROVIDER. and
its agents, representatives, and attorneys of and from all claims. demands. actions, causes of
action, suits, damages, losses and expenses, of any and every nature whatsoever. arising out of or
in any way specifically related to this matter - DOAH Case No. 04-1079MPI (formerly 03-
1976MPI), C.1. No. 01-1478-000-3, and PROVIDER’s actions herein. including. but not limited
to, any claims that were or may be asserted in any federal or state court or administrative forum,
including any claims arising out of this agreement, by or on behalf of the Agency. with the
specific exception that the Agency’s discharge does not include any future actions by the
Provider that relate to Medicaid Fraud. Notwithstanding the foregoing, nothing herein prohibits
the Agency from pursuing an action to enforce the settlement agreement or final order.
18. This Agreement is and shall be deemed jointly drafted and written by all parties te
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.
nN
PETITIONER:
ELOMAR DRUG CORPORATION, d/b/a
CARDENAS PHARMACY,
WS A_- ated: Peer 2 2004,
Dated: CocXdo ev DO. 2004.
Attorney(for Petitipner
12080 S Ave, #144
Miami. FL 33186
PLACE CORPORATE SEAL ABOVE
AGENCY FOR HEALTH CARE
ADMINISTRATION
2727 Mahan Drive, Mail Stop #3
Tallahassee, FL 32308-5403
Space DOGy | Dated: SAS , 2005.
JAMES D. BOYD oP
Inspector General
4 LO _
J LAE — 5 fe
; j LL Ker Dated: BLY , 2005.
WILLIAM ROBERTS
Acting Gener’) Counsel
/ ~
(2 (< Spel J —
— Dated: yy rl od , 2005.
ANTHONY L. CONTICELLO
Assistant General Counsel
Docket for Case No: 03-001976MPI
Issue Date |
Proceedings |
Jun. 02, 2005 |
Final Order filed.
|
Sep. 29, 2003 |
Order Closing File. CASE CLOSED.
|
Sep. 26, 2003 |
Agreed Motion for Continuance (filed via facsimile).
|
Aug. 12, 2003 |
Responses to Petitioner`s Request to Produce (filed by Respondent via facsimile).
|
Aug. 12, 2003 |
Respondent`s Responses to Interrogatories (filed via facsimile).
|
Aug. 12, 2003 |
Notice of Filing Respondent`s Responses to Interrogatories and Responses to Petitioner`s Request to Produce (filed via facsimile).
|
Aug. 04, 2003 |
Notice of Service of Petitioner`s Answers to Repsondent`s First Interrogatories filed.
|
Jul. 21, 2003 |
Order Granting Continuance and Re-scheduling Hearing (hearing set for October 1 and 2, 2003; 9:00 a.m.; Tallahassee, FL).
|
Jul. 18, 2003 |
Response to Motion for Continuance of Final Hearing (filed by Respondent via facsimile).
|
Jul. 09, 2003 |
Motion for Continuance of Final Hearing (filed by Petitioner via facsimile).
|
Jul. 09, 2003 |
Order Denying Petitioner`s Motion for Change of Venue.
|
Jul. 08, 2003 |
Petitioner`s Response to Respondent`s First Request for Admissions filed.
|
Jul. 08, 2003 |
Petitioner`s First Request for Production to Respondent filed.
|
Jul. 08, 2003 |
Petitioner`s Motion for Change of Venue filed.
|
Jun. 23, 2003 |
Petitioner`s Notice of Service of First Interrogatories to Respondent (filed via facsimile).
|
Jun. 19, 2003 |
Respondent`s First Request for Production of Documents (filed via facsimile).
|
Jun. 19, 2003 |
Respondent`s First Request for Admissions (filed via facsimile).
|
Jun. 19, 2003 |
Notice of Service of Respondent`s First Interrogatories to Petitioner; Respondent`s First Request for Admissions; and Respondent`s First Request to Produce (filed via facsimile).
|
Jun. 10, 2003 |
Order of Pre-hearing Instructions.
|
Jun. 10, 2003 |
Notice of Hearing (hearing set for August 5 and 6, 2003; 9:00 a.m.; Tallahassee, FL).
|
Jun. 04, 2003 |
Joint Response to Initial Order (filed by Respondent via facsimile).
|
May 28, 2003 |
Initial Order issued.
|
May 27, 2003 |
Pharmacy Audit-Final Report filed.
|
May 27, 2003 |
Final Agency Audit Report filed.
|
May 27, 2003 |
Request for Administrative Hearing filed.
|
May 27, 2003 |
Notice (of Agency referral) filed.
|