STATE OF FLORIDA AGENCY FOR HEATH CARE ADMINISTRATIONGS, 104A HOWARD BUSCH, D.O., Petitioner, vs. , AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. ee FINAL ORDER THE PARTIES resolved all disputed issues and executed a “settlement agreement”, which is incorporated by oy reference. The parties are directed to comply withthe terns: of the-settlement agreement”, Based. on the _. foregoing, this proceeding is CLOSED. DONE and ORDERED on this the _ 2% gi day of we ¥ , 2004, in Tallahassee, Florida, for Haase laed —— 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. : 1 - Copies furnished to: Terry Swartz," Esq. Sonneborn, Rutter Cooney & Klingensmith, P.A. : - P.O. Box 024486 \ West Palm Beach, Florida 33401 j Debora Fridie, Esquire Attorney for Agency “AGENCY FOR. HEALTH CARE |. ADMINISTRATION “+2727 Mahan Drive “Fort Knox Building 3, Mail Stop 3 Tallahassee, Florida 32308 : J.D. Parrish Administrative Law Judge Division of Administrative Hearings ‘ The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Medicaid Program Integrity CERTIFICATE OF SERVICE I HEREBY CERTIFY that aitrue and correct copy foregoing has been furnished to the above named addressees by U.S. Mail on this the oO _ day of 2004. ; Agency for Health Care Administration 2727 Mahan Drive, Building #3, Mail Stop 3 Tallahassee, Florida 32308-5403 1 HOWARD BUSCH, D.O. j Petitioner, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent. eo : STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS Case No. 03-3317MPL C1.No.: 01-1929-000 / STIPULATION AND AGREEMENT _ STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINIS STRATION _(AHICA” or “the Agency”), and HOWARD BUSCH, D.O. (“PROVIDER® \, bya and thropgh the “| undersigned, hereby stipulate and agree as follows: | Lee ‘The two parties enter into this agreement for the purpose of memorializing the resolution to this matter. \ PROVIDER is a Medicaid provider in the State of Florida, operating under provider number 25389300. . In its Final Agency Audit Report C.I. No. 01-1 929-000/CM-M/VAS (the "Audit Letter") 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 repayment of an overpayment in the amount of $40,092.37. In response, PROVIDER petitioned for a formal administrative hearing with the Division of Administrative Hearings, Case No. 03-3317MPI. After the provider requested a formal hearing, 4 Howard Busch vs. AHCA Case No.: 03-3317MPI \ CL No.: _ Stipulation and Agreement 01-1929-000 AHCA re-reviewed certain claims at issue in this audit. Bas ed upon that review, AHCA adjusted the overpayment to $38, 556. 58. PROVIDER agreed to pay the adjusted overpayment in the amount of $38,556.58. In order to resolve this matter without further administrative proceedings, PROVIDER and AHCA expressly agree as follows: : (a) (b) © (d) AHCA will accept the payment set forth herein as settlement of the overpayment issues arising from the MPI review cited in paragraph 3 above. Within thirty (30) days of issuance of the Final Order, PROVIDER agrees to make a single payment to AHCA of Thirty-Eight Thousand Five Hundred Fifty- -Six and 58/100 Dollars-($38, 556.58). AHCA retains the ~ ri cht to perform a 6-month follow-up review. PROVIDER is responsible for erisuring timely delivery of the payment. 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. 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 C.J. 01-1929- 000. 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. Page 2 of 7 Howard Busch vs. AHCA | Case No.: 03-3317MPI - | 1C.L.No.: 01-1929-000 Stipulation and Agreement | po ; (f) , PROVIDER agrees to fully cooperate with any follow up: conducted by the Agency. 5. 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 stipulation and = shall reference the C.I. Number and the Provider Number. PROVIDER agrees that failure to pay any monies due and owing ifides the terms ’ of this Agreement shall constitute PROVIDER’S authorization for the Agency, without further notice, to withhold the total remaining amount due tinder the ' 7 terms of this agreement from any monies due and owing to PROVIDER for any Medicaid claims. AHCA reserves the right to enforce this Stipulation and Agreement under the laws of the State of Florida, the Rules of the Medicaid Prograra, and all other applicable rules and regulations. The parties agree to bear their own attorney’s fees and other costs, if any. 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. Furthermore, PROVIDER agrees that its signature alone binds PROVIDER to make the payment as set forth in this agreement. PROVIDER shall furnish the actual signed Stipulation and Agreement to AHCA; however a . Howard Busch vs. AHCA -Case No.: 03-3317MPI ‘CI: No.: .01-1929-000 _ Stipulation and Agreement 10. 11. 12. facsimile copy shall be sufficient to enable AHCA to cancel a hearing scheduled in this case. This Agreement shall be construed in accordance with the provisions of the laws . of Florida. Venue for any action arising from this Stipulation and Agreement ‘ shall be in Leon County, Florida. t 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 4 . . _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. This is an Stipulation and Agreement, made in recognition that the parties may have different or incorrect understandings, information and contentions, as to facts and Jaw, 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. This ‘Stipulation and Agreement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. However, the parties believe that this matter should be resolved because the parties have agreed to the terms contained within this Stipulation and Agreement. Howard Busch vs. AHCA ' Case No.: 03-3317MPI \C.LNo.; 01-1929-000 Stipulation and Agreement . 13. PROVIDER expressly waives in this matter its right to any hi §§120.569 or 120.57, Florida Statutes, the making of findings of ic 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 “3 “ ' - uo! any and every nature whatsoever, arising out of or in any way related to this 1 1 . ; coe matter, C.J. No. 01-1929-000, and AHCA’s actions herein, including, but not limited to, any claims that were or may be asserted in.any federal or state court or t administrative forum, including any claims arising out of this agreement, by or on ' behalf of Provider. This Stipulation and Agreement is and shall be deemed jointly drafted and written by all parties to it and shail not be construed or interpreted against the party originating or preparing it. To the extent that any provision of this Stipulation and 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 Stipulation and Agreement. Page 5 of 7 Howard Busch vs. AHCA + _ Case No.:-03-3317MPI , CI. No.: 01-1929-000 Stipulation and Agreement w. 17. . This Stipulation and Agreement shall inure to the benefit of and be binding on , each party’s successors, assigns, heirs, administrators, representatives and This Stipulation and Agreement shall be in full force and effect upon execution by 1 L trustees. 18. All times stated herein are of the essence in this Stipulation and Agreement. 19, re . ( the respective parties in counterpart. 4 PETITIONER nee HOWARD BUSCH, D.O. Petitioner «os Z 7 SONNEBORN RUTTER COONEY & . KLINGENSMITH, P.A. P.O. Box 024486 ' West Palm Beach, FL 33401 To Dated: TERRY S\VARTZ, ESQUIRE Attorney for the Petitioner eff is) , 2004 Howard Busch vs. AHCA ° + Case No.: 03-3317MPI. ‘C.LNo.: 01-1929-000 Stipulation and Agreement ' t AGENCY FOR HEALTH CARE . ADMINISTRATION ‘ 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 ies D. BOYD ze Inspector General EZ Le LL em Dated: PGF, 2004 _ | & VALDA CLARK CHRISTIAN ce , “La a : f v General Counsel is LAD C iol Dated: Tu ly 7 , 2004: DEBORA E. FRIDIE Assistant General Counsel

Docket for Case No: 03-003317MPI