STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION.” CYSTIC FIBROSIS PHARMACY, INC., Petitioner, VS. DOAH CASE NO.: 03-3316MPI ‘ C.L. No.: 02-0505-000-3/H/RDS AGENCY FOR HEALTHCARE ADMINISTRATION, Wav \G Respondent. ¥ iSIA aH S\HI / sould wal 40 8 FINAL ORDER SA This cause came before me for issuance of a Final Order. In a Final Agency Audit Report dated July 30, 2003 (audit number C.J. 02-0505-000-3/H/RDS), Petitioner, Cystic Fibrosis Pharmacy, Inc. was informed that the Agency was seeking to recover Medicaid overpayments of $7,742.70. The report was sent certified mail, return receipt requested to Cystic Fibrosis Pharmacy, Inc. (hereinafter “PROVIDER”), who signed for it. The report contained full disclosure and notice regarding the PROVIDER’S administrative hearing and due process rights. The PROVIDER filed a petition for hearing. The PROVIDER through counsel withdrew the petition. Jurisdiction was relinquished by the Division of Administrative Hearings to the Agency for Health Care Administration. FINDINGS OF FACTS The PROVIDER received the Final Agency Audit Report and that report disclosed to the provider its administrative and due process rights. The PROVIDER filed a petition and later through counsel withdrew the petition. Therefore, petitioner has chosen not to dispute the facts set forth in the Final Agency Audit Report dated July 30, 2003. Therefore, those facts are hereby deemed admitted, additionally the total overpayment amount of $7,742.70 is deemed admitted, and these form the factual basis for the existence of an overpayment owed by the PROVIDER, in the amount of $7,742.70. The facts set forth in the Final Agency Report are hereby adopted. That amount is now due and owing. " CONCLUSIONS OF LAW ‘The Agency incorporates and adopts the statements and conclusions of law as set forth in the report dated July 30, 2003. The admitted facts and facts support the conclusion that the overpayment is due and owing, under the law generally set forth in the final audit report. ' Based on the foregoing, it is ORDERED AND ADJUDGED that Petitioner refund immediately if not previously paid, forthwith, the sum of $7,742.70, under the conditions set forth in Section 409.913 Florida Statutes.. Te DONE AND ORDERED this /4 = day of #e/&7#4¥, 2005, in Tallahassee, t » Florida. we im 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: William M. Furlow, Esquire Akerman Senterfitt 106 East College Avenue, Suite 1200 Tallahassee, FL 32301 Grant P. Dearborn, Assistant General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #3 Tallahassee, Florida 32308-5403 (Interoffice) Timothy Byrnes, Chief Medicaid Program Integrity Agency for Health Care Administration ; ' 2727 Mahan Drive, MS #5 Tallahassee, Florida 32308 (Interoffice) Finance & Accounting Medicaid Accounts Receivables Agency for Health Care Administration (Interoffice) Daniel M. Kilbride Administrative Law Judge DOAH (Interoffice) Ra Stewart, Analyst : CERTIFICATE OF SERVICE J HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished by U.S. or interoffice mail to the persons named above on this gee day of Bote bet, 2005. RICHARD J. SHOOP, Agency Clérk Agency for Health Care Administration 2727 Mahan Drive, MS#3 Tallahassee, Florida 32308 (850) 922-5873 STATE OF FLORIDA 4 DIVISION OF ADMINISTRATIVE HEARINGSGENERAL COUNSEL 4) APT 49 205 CYSTIC FIBROSIS PHARMACY, INC., Agency for Heaith Care Administration Case No. 03-3316MPI Petitioner, Vs. AGENCY FOR HEALTH CARE ADMINISTRATION, ) ) ) ) ) ) ) ) ) Respondent. ) ) ORDER CLOSING FILE This cause having come before the undersigned on Petitioner's Withdrawal of Petition for Administrative Hearing filed on October 7, 2005, and the undersigned being fully advised, it is, therefore, ORDERED that: 1. The final hearing in this cause scheduled for October 18, 2005, is hereby cancelled. 2. The file of the Division of Administrative Hearings in the above-captioned matter is hereby closed. DONE AND ORDERED this 11th day of October, 2005, in Tallahassee, Leon County, Florida. DANIEL M. KILBRIDE Administrative Law Judge Division of Administrative Hearings © The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 11th day of October, 2005. COPIES FURNISHED: Grant P. Dearborn, Esquire Agency for Health Care Administration Fort Knox Building III, Suite 3431 2727 Mahan Drive Tallahassee, Florida. 32308 William. M. Furlow, III, Esquire Akerman Senterfitt 106 East College Avenue, Suite 1200 Tallahassee, Florida 32301 nye 1

Docket for Case No: 03-003316MPI

Orders for Case No: 03-003316MPI