Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: ROLANDO B. PADRO, M.D.
Judges: STUART M. LERNER
Agency: Agency for Health Care Administration
Locations: Miami, Florida
Filed: Jan. 11, 2006
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Monday, May 8, 2006.
Latest Update: Dec. 24, 2024
STATE OF FLORIDA il
AGENCY FOR HEALTH CARE ADMINISTRATION ! .. !°
my Pet ca
ROLANDO B. PADRO, M.D., 2008 OCT 27 Alt: 23.
Petitioner, _ GIVISION OF
ADMINISTRATIVE
vs. CASE NO. 06-0144MPRRINGS
JUDGE: Stuart M. Lerner
AGENCY FOR HEALTH CARE C.I. NO. 04-2124-000
ADMINISTRATION, RENDITION NO.: AHCA-06- 2374 -s-MDO
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.
DONE and ORDERED on this the ay ray of eCreser___, 2006, in
Tallahassee, Florida.
foe
/ Christa Calamas, Secretary
Agency for Health Care Administration
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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:
Jeffries H. Duvall, Esquire
Agency for Health Care Administration
(Interoffice Mail)
Rolando B. Padro, M.D.
15439 SW 137" Avenue
Miami, FL 33177
(U.S. Mail)
The Honorable Stuart M. Lerner
Administrative Law Judge
Division of Administrative Hearings
The DeSoto Building
1230 Apalachee Parkway
Tallahassee, Florida 32399-3060
(U.S. Mail)
Tim Byrnes, Bureau Chief, Medicaid Program Integrity, MS 6
Agency for Health Care Administration
(Interoffice Mail)
James Boyd, Inspector General, MS 4
Agency for Health Care Administration
(Interoffice Mail)
Finance and Accounting, MS 14
Agency for Health Care Administration
(Interoffice Mail)
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 and/or Interoffice Mail on this
he Bday of Coetinger— , 2006.
Richard Ion Esquire
Agency Clerk
Agency for Health Care Administration
2727 Mahan Drive, Mail Stop 3
Tallahassee, Florida 32308-5403
Tel: (850) 922-5873
Fax: (850) 921-0158
STATE OF FLORIDA f= ak
AGENCY FOR HEALTH CARE ADMINISTRATION
ROLANDO B. PADRO, M.D., 200b OCT 27 A Hh: 23
Petitioner,
VISION OF
vs Case No. os-0f44NHb1 RATIVE
Judge: Stuart Mi terneres
AGENCY FOR HEALTH CARE G.I. No. 04-2124-000
ADMINISTRATION,
Respondent.
/
SETTLEMENT AGREEMENT
STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION
("AHCA’ or “the Agency”), and Rolando B. Padro, M.D., ("PROVIDER"), by and through
the undersigned, hereby stipulate and agree as follows:
1. This Agreement is entered into for the purpose of memorializing the final
resolution of the matters set forth in this Agreement.
2. PROVIDER is a Medicaid provider (Medicaid provider no. 3759873-00) in
the State of Florida,
3. In its final agency audit report dated September 27, 2005, 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 $16, 4633 32> In response
to the audit letter dated September 27, 2005, PROVIDER: filed a petition for a formal
administrative hearing. Subsequently and after additional information was provided,
AHCA reviewed the disputed claims and determined the outstanding amount of
overpayment should be adjusted to $760.75 plus $2, 500.00 in sanctions. The provider
was also sanctioned with the requirement of a Corrective Action Plan in the form of_an
acknowledgement statement.
4. In order to resolve this matter without further administrative proceedings,
PROVIDER and the AHCA expressly agree as follows:
(1)
(2)
(3)
AHCA agrees to accept the payment set forth herein in settlement
of the overpayment issues arising from the MPI review.
Within thirty days of receipt of the final order, PROVIDER agrees to
make a single payment of three thousand two hundred sixty dollars
and seventy-five cents ($3, 260.75) in full and complete settlement
of all claims in this matter.
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.|. No. 04-2124-000.
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.
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, except as
set forth herein.
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. This is an Agreement of setilement 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.
14. 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.
15. 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.
16. 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.
17. This Agreement shall inure to the benefit of and be binding on each party's
successors, assigns, heirs, administrators, representatives and trustees.
18. All times stated herein are of the essence of this Agreement.
19. This Agreement shall be in full force and effect upon execution by the
respective parties in counterpart.
20. ‘In the event either party breaches this Agreement, the costs and attorney
fees incurred by the non-breaching party associated with enforcement or collection
activity pertaining to this Agreement shall be paid by the party breaching this Agreement
to the non-breaching party.
Rolando B. Padro, M.D.
Kolauce (2. f5 bb Dated: 7-2 / - eee 2006
Printed Representative’s Name
BY: