STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION Lachy Mh eI BP A Ob STATE OF FLORIDA, = AGENCY FOR HEALTH CARE z= aT ADMINISTRATION, x23 5 oo Ban wy IT Petitioner, 2319 = TA Bro U Fy vs. CASE NO. 06-0145MPIZ "= PROVIDER NO. 045130401 = CHATOOR B. SINGH, M.D., P.A. AUDIT C.1. NO. 02-0463-000 Rendition No. AHCA-06- -S-MDP 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. yi? DONE and ORDERED on this the LF” aay of AE , 2006, in Tallahassee, Florida. nl aa via / MlariLevine, 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: Karen Dexter, Esquire Agency for Health Care Administration (Interoffice Mail) Chatoor B. Singh, M.D. 2620 N. Andrews Avenue, Suite 100 Ft. Lauderdale, Florida 33311 (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 Jill Smith, Medicaid Program Integrity Maryann Alliegood, Finance and Accounting CERTIFICATE OF SERVICE I 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 “day of az , 2006. 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 FILED STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS 2008 APA 24 P}: "2 STATE OF FLORIDA, DIVISION oF AGENCY FOR HEALTH CARE ADMINISTR ATIVE ADMINISTRATION, HEARINGS Petitioner, vs. CASE NO. 06-0145MPI PROVIDER NO. 045130401 CHATOOR B. SINGH, M.D., P.A., Respondent. / SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and Chatoor B. Singh, M.D., P.A. (“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 is a Medicaid provider in the State of Florida, provider number 045130401 and was a provider during the audit period. 3. In its Final Agency Audit Report (final agency action) dated January 31, 2005, AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity (MPD), Office of the AHCA Inspector General, indicated that certain claims, in whole or in part, has been inappropriately paid by Medicaid. The Agency sought recoupment of this overpayment, in the amount of $28,546.29. In response to the audit letter dated January 31, 2005, PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH Case No. 06-0145MPI. Chatoor B. Singh, M.D., P.A. Settlement Agreement 4, Subsequent to the original audit that took place in this matter and in preparation for trial, AHCA re-reviewed the PROVIDER’s claims and evaluated additional documentation submitted by the PROVIDER. As a result, AHCA determined that the overpayment was adjusted to $26,348.77. 5. 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 entry of the final order, PROVIDER agrees to pay the Agency twenty six thousand three hundred forty eight dollars and seventy seven cents ($26,348.77) plus five hundred dollars ($500.00) in investigative costs, for a total of twenty six thousand eight hundred forty eight dollars and seventy seven cents ($26,848.77) plus 10% interest per year to be made in six (6) equal monthly payments in full and complete settlement of all claims in the proceedings before the Division of Administrative Hearings (DOAH Case No. 06-0145MPI). AHCA retains the right to perform a 6 month follow-up review. 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.1. 02-0463- 000. Chatoor B. Singh, M.D., P.A. Settlement Agreement (4) 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. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 7. 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. 8. 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. 9. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. 10.‘ Each party shall bear its own attorneys’ fees and costs, if any, with the exception that the Respondent shall reimburse, as part of this settlement, $500.00 in Agency costs of action. This amount is included in the calculations and demand of paragraph 5(2). 11.‘ 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. 12. 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. 13. This Agreement constitutes the entire agreement between PROVIDER and the AHCA, including anyone acting for, associated with or employed by them, concerning all Chatoor B. Singh, M.D., P.A. Settlement Agreement 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. 14. 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 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. 15. 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 agreés 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. 16. | 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. 17. 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. Chatoor B. Singh, M.D., P.A. Settlement Agreement 18. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 19. All times stated herein are of the essence of this Agreement. 20. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. CHATOOR B. SINGH, M.D., P.A. Chills n—) pate: 3 -6- ob , 2006 py. Ciintooh Bb. fingh nD. (Print name) ITS: AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 Pecantrl Spl Dated: a , 2006 Jarxés D. Boyd Inspector General ( tes “fae lewod Dated: +t ly , 2006 Christa Calamas General Counsel Dated: 3/8 , 2006 Assistant General Counsel age-1 of 9) ) yt “a, 2 b, hs 4nd, “7 “y ek By ke th, ap “BNI Oy PA “hy Re JEG BUSH, GOVERN ALAN LEVINE, BEGRETARY “1 eget § 4m “> ; , WT, CERTINIED ~ RETURN RECEIPT No. 7001 0360 0003 3823 0732 January 31, 2005 Provider Na: 0451304-01 Chatoor Singh, . : 2620 N. Andrewg Avenue _ Ft. Lauderdale, FL 33311 Olo- O) US MeL In Reply Refer t ™ FINAL AGENCY AUDIT REPORT C.L No. 02-04634000 Dear Provider: The Agency for Health Care Administration, Office of Medicaid Program Integrity has completed a review of claims for Medicaid reimbursement for dates of service during the period January 1, 2001, jhrough December 31, 2002. A provisional agency audit report dated September 2, 200 was sent to you indicating that we had determined you were overpaid $36,148.50, Basdd upon a review of all documentation submitted, we have determined that you ‘= were overpaid $28,546.29 for services that in-whole or in part are not covered by Medicaid, Be = advised that pursitant to Section 409.913(23)(a), Florida Statutes (F.S.), the Agency is entitled to recover all investigative, Iggal, and expert witness costs. Additionally, pursuant to Section 409,913, Florida statutes (F.S.), this letter shall serve as notice of the following sanction(s): The provider is subject to a corrective action plan in the form of a provider acknowledgement statement addressing the findings of this case, Please see the attachment regarding the requirements for thi This review and the determination of overpayment were made in accordance with the provisions of Section 409.914, F.S. In determining the appropriateness of Medicaid payment pursuant to Medicaid policy, he Medicaid program utilizes procedure codes, descriptions, policies, limitations and requirements found in the Medicaid provider handbooks and Section 409,913, F.8, In applying jor Medicaid reimbursement providers are required to follow the guidelines set forth in the applicable rules and Medicaid fee schedules, as promulgated in the Medicaid policy handbooks, billing bulletins, and the Medicaid provider agreement, Medicaid cannot pay for ~ services that do ngt meet these guidelines, Below is a discussion of the particular guidelines related to our review of your claims, and an explanation of why these claims do not meet Medicaid requirements. The audit work papers are attached, listing the claims that are affected by this determination. Fixit ANCA online at 2727 Mahan Drive 4 Mnif Stop aa wow fihe.stole ff as Tullohagsee, FL J2b08 age-2 of 9} Chatoor Singh, Page 2 REVIEW DETERMINATION(S) Medicaid policy defines the varying levels of care and expertise required for the evaluation and management procedure codes for office visits. The documentation you provided supports a lower level of office visit than the one for which you billed and received payment. The difference betw¢en the amount you were paid and the correct payment for the appropriate level of service is considered an overpayment. Medicaid policy|specifies how medical records must be maintained, A review of your medical records revealed that some services for which you billed and received payment were not documented. Medicaid requires documentation of the services and considers payments made for services not appropriately documented an overpayment. Medicaid policyladdresses specific billing requirements and procedures. You billed and received payment for laboratory services when your facility was licensed to perform waived test only. Payments for th¢se claims are considered overpayment. . Medicaid policy requires that all services be rendered by or supervised by a physician; this is attested to by tha physician’s signature. A review of your medical records revealed that some services, for whibh you billed and received payment, were not signature certified. This information is b¢ing brought to your attention as an educational tool and no overpayment was assessed based on this determination, OVERPA’ f ON ’ Arandom sample of 40 recipients, with respect to whom you submitted claims to Medicaid, was reviewed, For the sample, an overpayment of $4,166,16 was found, as indicated on the accompanying sdhedule, Since you were paid for a total (population) of 1,906 ‘claims for that period, the point estimate of the total overpayment is 1906 x $18.27263158 = $34,827.64. Using a statistical formula, which is generally accepted for this purpose, we have calculated that the overpayment to you is $28,546.29 with a ninety-five percent (95%) probability that it is that amount or more. If you are currently involved in a bankruptcy, you should notify your attorney immediately and provide a copy of this letter forthem. Please advise your attorney that we need the following information immediately: (1) the date of filing of the bankruptcy petition; (2) the case number, (3) the court name and the division in which the petition was filed (e.g., Northern District of Florida, Tallahas¥ee Division); and, (4) the name, address, and telephone number of your attorney. Ifyou are not in Hankruptey and you concur with our findings, remit by certified check in the amount of $28,546.29. The check must be payable to the Florida Agency for Health Care Administration. | Questions regarding procedures for submitting payment should be directed to Medicaid Accounts Receivable, (850) 488-5869, To ensure proper credit, be certain your provider number and the audit number (C.1. 02-0463-000) are shown on your check. Please mail payment to: hur age3 of B) + Chatoor Singh, M.D. Page 3 gency for Health Care Administration edicaid Accounts Receivable B.0. Box 13749 Tallahassee, Florida 32317-3749 Ef payment is nof received, or arranged for, within 30 days of receipt of this letter, the Agency may withhold Medicaid payments in accordance with the provisions of Chapter 409,913(27), F.S. Furthermore, pursuant to Sections 409.913(25) and 409.913(15), F.S., failure to pay in full, or enter into and] abide by the terms of any repayment schedule set forth by the Agency may result in termination from the Medicaid Program. You have the right to request a formal or informal hearing pursuant to Section 120.569, F.S. Ifa request for a formal hearing is made, the petition must be made in compliance with Section 28- 106.201, Florical Administrative Code (F.A.C,) and mediation may be available. If a request for an informal hearing is made, the petition must be made in compliance with mile Section 28- 106.301, F,A.C.} Additionally, you are hereby informed that if request for a hearing is made, the petition must be received by the Agency within twenty-one (21) days of receipt of this letter. For more information regarding your hearing and mediation rights, please see the attached Notice of Hearing and Mediation Rights, Questions should be directed to: Jil] Smith, Medical/Health Care Program Anniyst, Agency for Health Care Administration, Medicaid Program Integrity, Office of Inspector General, 2727 Mahan Drive, Mail Stop #6, Tallahassee, Florida 32308-5403, telephone (850) 921- 1802. Sincerely, EW/IS/td Enclosure(s) cc: Medicnid [Accounts Receivable Ret AGENCY FOR HEALTH CARE ADMINISTRATION AMORTIZATION SCHEDULE CHATOOR B. SINGH, M. D. /Provider 0451304-01 /C. I. #02-0463-000 LOAN DATA $26,848.77 Table starts at date: 5/1/2006 10.00% or payment number: 4 0.5 Past Due Balance: Annual int rate: Term in years: Payments per year:!12 First payment due:|5/1/2006 CALCULATED PAYMENT Entered payment: Calculated payment:|$4,606.21 AMOUNT USED $4,606.21 1 $26,848.77 Cumulative interest prior to payment 1: $0.00 Monthly Pmt Used: 1st Pmt in Table: Fmt) ayer Beginning Cumulative Due Date Balance Interest Principal Interest 4 5/1/2006 26,848.77 223.74 4,382.47 2 6/1/2008 22,466.30 187.22 4,418.99 3 7/1/2006 18,047.30 150.39 4,455.82 4 8/1/2006 13,591.49 113.26 4,492.95 9,098.54 5 9/1/2006 9,098.54 75,82 4,530.39 4,568.14 6 10/1/2006 4,568.14 38,07 4,568.14 Page 1 of 1

Docket for Case No: 06-000145MPI