STATE OF FLORIDA ree ED AGENCY FOR HEALTH CARE ADMINISTRATION PRESCRIPTION CENTERS, INC., Ds closed Case No. 03-2373MPI . Petitioner, Provider no. 106416200 vs. Audit no. C.I. 00- 02 Qa 000-3 “ STATE OF FLORIDA, AGENCY FOR wr HEALTH CARE ADMINISTRATION, Respondent. _ _/ aa FINAL ORDER The Agency for Health Care Administration, having entered into a Joint Stipulation and Settlement Agreement with the parties to these proceedings, and being otherwise well advised in the premises, decides as follows: The attached Joint Stipulation and Settlement Agreement is approved and adopted as a part of this Final Order and the parties are directed to comply with the terms of the Joint Stipulation and Settlement Agreement. PLEASE SUBMIT PAYMENT TO: Jean Lombardi Accountant Supervisor I- SES Agency for Health Care Administration Finance and Accounting Department 2727 Mahan Drive, Mail Stop #14 Tallahassee, FL 32308 THEREFORE, it is ORDERED and ADJUDGED that the parties hereto are directed to comply with terms of the Joint Stipulation and Settlement Agreement. toed Nw p00, ~ aed _ fe) DONE and ORDERED this |O_day of _Qebvbe , 2003, in Tallahassee, Leon County, Florida. honda/M\ Medows, MD, Secretary Agency fér Health Care Administration 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 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: Jeffries H. Duvall, Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop Code #5 Tallahassee, Florida 32308-5403 (Interoffice Mail) Judith E. Hefren, Inspector General Agency for Health Care Administration 2727 Mahan Drive, Mail Stop Code #5 Tallahassee, Florida 32308 (Interoffice Mail) Timothy Byrnes Bureau Chief of MPI 2002 Old St. Augustine Road Bldg. D Tallahassee, Florida 32301 (Interoffice Mail) Dilip Patel Smita Amin 155 East New England Avenue Winter Park, Florida 32789 (by U.S. Mail) Jean Lombardi Finance & Accounting Agency for Health Care Administration 2727 Mahan Drive Mail Stop Code #14 Tallahassee, Florida 32308 (Interoffice Mail) Danie! Manry Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 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 GY day of , 2003. “oe Lealand McCharen, Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5865 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION PRESCRIPTION CENTERS, INC., Petitioner, CASE NO: 03-2373 MPI vy. JUDGE: D. MANRY AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and PRESCRIPTION CENTERS, INC. (“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 October 16, 2001, 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 $25,685.10 with which the Petitioner now agrees. In response to the audit letter dated October 16, 2001, PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH Case No. 03-2373 MPI. 4. In order to resolve this matter without further administrative proceedings, PROVIDER and the 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 single payment of Five Thousand Six Hundred Eighty-Five and 10/100. The balance of $20,000.00 shall be paid to the Agency in twelve equal installments. All unpaid amounts shall incur interest at the statutory rate as provided in Section 409.913, Florida Statutes. | Payment of these amounts shall constitute full and complete settlement of the matter now before the Division of Administrative Hearings (DOAH Case No. 03-2373 MPI). (C) 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. 00-0267-000-3/JDJ. (D) PROVIDER agrees that it will not re-bill 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 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. 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. 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. 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 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, 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. PTION CENTERS, INC. on Dated: Set b , 2003 BY: Db ‘ (Print nam ATCUe FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 L, Lik Valda Christian General Counsel O32 5757U/L Kim Kellum Chief Medicaid Counsel Dated: , 2003 Dated: (2X 2003 Dated: , 2003 Dated: Qctrtxr lo , 2003 Dated: ‘ Bd , 2003

Docket for Case No: 03-002373MPI