STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION. = 03 18 Oo MSS BIOMEDICAL CORPORATION d/b/a IMMUNECARE INFUSION, Petitioner, CASE NO. 02-3480MPI PROVIDER NO. 106159300 STATE OF FLORIDA, AUDIT C.I. NO. 98-1061-000-3 AGENCY FOR HEALTH CARE CASE NO. 04-3028MPI ADMINISTRATION, AUDIT C.1. NO. 00-0423-000-3 Rendition No. AHCA-05- _ -S-MDP vs. Respondent. / FINAL ORDER THE PARTIES resolved all disputed issues and executed a Settlement Agreement. The parties are directed to comply with the terms of the attached settlement agreement. Based on the foregoing, this file is CLOSED. wz , DONE and ORDERED on this the _7 day of _ ZWwve , 2005, in Tallahassee, Florida. fea 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: L. William Porter II, Esquire Agency for Health Care Administration (Interoffice Mail) Geoffrey D. Smith, Esquire Blank, Meenan & Smith 204 S. Monroe Street Tallahassee, Florida 32301 (U.S. Mail) J.D. Parrish Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Tim Byrnes, Chief, Medicaid Program Integrity Susan WilliamsyMedicaid Program Integrity JoAnn Jacksop;Medicaid Program Integrity John Hoover, Finance and Accounting CERTIFICATE OF SERVICE | 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 F day of Zane , 2005. —— 5 oe au Richard Shoop, Esquire Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA a 36 E VED DIVISION OF ADMINISTRATIVE HEARINGS GENERAL COLINSE! 7 Wik MSS BIOMEDICAL CORPOTATION, d/b/a IMMUNECARE INFUSION, lah 2€ 2005 £48 CUu5 Petitioner, aaAnaA F . Agency for Health vs. CASE NO. 02-3480MPI1 © Administration CL NO. 98-1061-006-3 STATE OF FLORIDA, CASE NO. 04-3028MPI1 AGENCY FOR HEALTH CARE CL NO. 00-0423-000-3 m3 ADMINISTRATION, Ray wo) SS ed Respondent. pes Ee / mene" oO me BD SETTLEMENT AGREEMENT eo STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and MSS Biomedical Corporation d/b/a Immunecare Infusion (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. The two parties enter into this agreement for the purpose of memorializing the resolution to this matter. 2. PROVIDER was a Medicaid provider in the State of Florida, provider number 106159300 and was a provider during the audit period. 3. In its Final Agency Audit Reports (final agency action) dated April 14, 2000 (02- 3480) and August 2, 2004 (04-3028), AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity (MPI), Office of the AHCA Inspector General, indicated certain claims, in whole or in part, has been inappropriately paic by Medicaid. The Agency sought recoupment of these overpayments, in the amounts of $1,650,373.36 and $460,601.30 respectfully, for a total overpayment of $2,110,974.66. In response to the audit letters dated April 14, 2000 and August 2, 2004, PROVIDER filed petitions for formal IMMUNECARE INFUSION SETTLEMENT AGREEMENT administrative hearings, which were assigned DOAH Case Nos. 02-3480 and 04-3028. The matters were consolidated for trial. The investigation and exchange of data continued during discovery and trial preparation. 4. In reference to CI 98-1061-000, based upon all of the documentation and information available to MPI, the overpayment was adjusted to $483,046.28 (invoice review). In reference to CI 00-0423-000 the overpayment was adjusted to $83,860 (prescription review) for a total overpayment of $566,906.28. 5, The Agency agrees to accept a lump sum payment of six hundred thousand dollars ($600,000.00) (the established value of claims in pre-payment review, see § 6), which represents the combined adjusted overpayments of $566,906.28 plus $33,092.72 in investigative costs. 6. During the audits the PROVIDER was involved in a prepayment review of $759,523.60 in intercepted claim payments. Using standard adjustment parameters, the Agency agrees that the PROVIDER would be entitled to payment of at least $600,C00 from the claims that were the subject of those now-voided warrants. The Agency agrees to a final resolution that absolves the Agency of any obligation to pay the claims that were the subject of those now- voided warrants, and uses the value therein, at 100%, to settle the matters herein. No further payments are due to the PROVIDER. No further payments, beyond this agreement, are due from the PROVIDER. IMMUNECARE INFUSION SETTLEMENT AGREEMENT 7. In order to resolve this matter without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: q) (2) (3) AHCA agrees to accept the payment set forth herein :n settlement of the overpayment issues arising from the MPI review. Such payment by offset or use of the voided warrants or suspended payments shall be made within 30 days, or at a time, which is convenient for the Agency. 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 audits referenced as C.J. 98- 1061-000-3 and 00-0423-000-3. No further payments on the claims of this audit are due from or to either party. 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. 8. 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. 9. 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. 10. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. 11. Each party shall bear its own attorneys’ fees and costs, if any. IMMUNECARE INFUSION SETTLEMENT AGREEMENT 12, 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. 13. 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. 14. 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. 15. 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. 16. 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. IMMUNECARE INFUSION SETTLEMENT AGREEMENT 17. 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. 18. 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. 19. | This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 20. All times stated herein are of the essence of this Agreement. a 21. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. MSS BIOMEDICAL CORPORATION d/b/a IMMUNECARE INFUSION whhn L LL Me Dated: Mav ch 25, 2005 BY: | SUITE SA Ac (Print name) ws: FRI /MENT_ AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-54f}3 Dated: b- 7 2005 Jafies D. Boyd Inspector General = || Ze _— Zhe ld ; i Dated: x [3 . 2005 Dated: Bb - YEG , 2005

Docket for Case No: 04-003028MPI