STATE OF FLORIDAQ; weg h AGENCY FOR HEATH CARE ADMIN( RYTON f LER CEDARS MEDICAL CENTER, Petitioner, sm iS Chesed Vs. CASE NO. 03-2816MPI AHCA Provider No. 0100366-00 _CINo. 01-1040-00 a AGENCY FOR HEALTH CARE Rerdithon nla: AHCA-O4- Olu MBO ADMINISTRATION, 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 “settlement agreement”. Based on the foregoing, this proceeding is CLOSED. DONE AND ORDERED on this the day of , 2004, in Tallahassee, Florida. pow Mary Pat Moore, Iiterim Secrétary Agency for Health Care Administration 204 APRA PE 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: Debora Fridie, Esquire Attorney for Agency AGENCY FOR HEALTH CARE ADMINISTRATION Stuart M. Lerner Administrative Law Judge Division of Administrative Hearings The Desoto Building 1230 Apalachee Parkway Tallahassee, Fl 32399 L.A. Perkins, Esq. Buckingham, Doolittle & Burrough, LLP 2500 North Military Trail, Suite #480 Boca Raton, Fl 33431 Rufus Noble, Inspector General Agency for Healthcare Administration Art Williams, Medicaid Program Integrity Agency for Healthcare Administration Willie Bivens, Finance and Accounting Agency for Healthcare Administration CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing has been Lod “ above named addressees by U.S. Mail on this the /F day of , 2004. Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3, Mail Stop 3 Tallahassee, Florida 32308-5403 vel 2% ZU) 4 4urm u ins wl ! BUULALNUHAM DUULITILE & BUKKOUGHS NO. 0322 P. 2 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION CEDARS MEDICAL CENTER Petitioner, vs. D.O.A.B. CASE NO. 03-2816MPI CI. No. 01-1040-00 AGENCY FOR HEALTH CARE PROVIDER # 0100366-00 ADMINISTRATION, Respondent. _/ SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, (“AHCA” or “the Agency”), and CEDARS MEDICAL CENTER (“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 number 0100366-00. 3. In its final agency audit report dated May 15, 2002, AHCA notified PROVIDER fone Per Reine Orgen2 chor (Ke Peo *) that a review of Medicaid claims, performed by MLL coracen etetany MED, 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 $129,057.31. In response to the final agency audit report, on June 5, 2002 PROVIDER filed 2 petition for a formal administrative hearing. UI. ZY 2005 4:40 FM BUCKINGHAM DUOLIIFLE & BURROUGHS NO, 0322 P. 3 Cedars Medical Center. DOAH Case No. 03-2816MPI Settlement Agreement Page 2 of 5 4. The matter was referred to the Division of Administrative Hearings (DOAH) and assigned DOAH Case No. 03-2816 M.P. I. Subsequently, AHCA agreed to accept $55,000.00 for the purpose of settlement. 5. In order to resolve this matter without further administrative proceedings, PROVIDER and AHCA expressly agree as follows: (a) 0) (c) (¢) () AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. Within thirty (30) days of receipt of the Agency for Health Care Administration Final Order incorporating by reference this Settlement Agreement, PROVIDER agrees to make a single payment in the total amount of FIFTY-FIVE THOUSAND DOLLARS ($55,000.00). The payment of $55,000.00 shall be made payable and remitted to: Agency for Health Care Administration Attn. Medicaid Accounts Receivable P. O. Box 13749 Tallahassee, FL 32317-3749 in full and complete settlement of all claims in the audit referenced as C.J. No. 01-1040-00. Payment shall clearly indicate that it is pursuant to a settlement agreement and shall reference Audit C.J. No. 01-1040-00. 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 ansing from the findings in the audit referenced as C.I. No. 01-1040-00. PROVIDER is responsible for ensuring timely delivery of the payment 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 seek enforcement of this agreement by any legal means. (UWE LY AUN FS 4M BUCKINGHAM DUULITILE & BURKOUGHS NO. 0322 PF. 4 Cedars Medical Center. DOAH Case No. 03-2816MPI Settlement Agreement Page 3 of 5 ® 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. 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 intentional or unintentional wrongdoing, violation of any order, law, statute, regulation, duty or contract, or error by either party with respect to this case or any other matter. Compliance with this Agreement shall not be construed as an admission by PROVIDER of any liability whatsoever. 8. The parties agree tc bear their own attorney’s fees and costs, if any, except as hereinabove stated. 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 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 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. . UL 29. 2005 44M BUCKINGHAM DOULITTLE & BURROUGHS NO.0322 PF. 5 Cedars Medical Center. DOAH Case No. 03-2816MPI Settlement Agreement Page 4 of 5 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 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 that is consistent with the terms of this settlement in apy 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. aoe OCT. 29.2003 4:41PM BUCKINGHAM DOOLITTLE & BURROUGHS NO. 0322 =P. 6 Cedars Medical Center. DOAH Case No. 03-2816MPI . Settlement Agreement Page 5 of 5 18. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. PROVIDER: - . ; j Ch whl _ Dated: 1/13/03. __, 2003. Authorized représtntative for Cedars Medical Center THE AGENCY: Dated: 2} vo > noih BOB SHARPE Deputy Secretary for Medicaid Lud fo Dated: Bie aA , 20936 | , VALDA CLARK CHRISTIAN General Counsel

Docket for Case No: 03-002816MPI