“ILEM STATE OF FLORIDA — 08 APR 22 Ru hiQO AC: AGENCY FOR HEALTH CARE ADMINISTRA STaATIVE FAIRPAY SOLUTIONS, BROADSPIRE HEARINGS SERVICES, INC. and CRUM SERVICES, Petitioners, DOAH CASE NO. 06-1584 AHCA NO. 2006003908 v. DETERMINATION NO. 20060306-007 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Respondent, and PALMETTO GENERAL HOSPITAL, Intervenor. FINAL ORDER THIS CAUSE concerns a Petition for Administrative Hearing (“Petition”) that the Petitioners filed on April 24, 2006. On May 3, 2006, the Petition was forwarded to the Division of Administrative Hearings by the Agency and assigned to an Administrative Law Judge (“ALJ”). On February 15, 2007, the Petitioners filed a Notice of Voluntary Dismissal with Prejudice, stating that the Petitioners and the Intervenor had resolved the dispute. On February 16, 2007, the ALJ assigned to the case entered an Order Closing File, relinquishing jurisdiction back to the Agency. Based upon the foregoing, IT IS THEREFORE ORDERED AND ADJUDGED THAT: The Petitioners’ Petition is dismissed with prejudice and the Agency’s April 3, 2006 Determination is hereby upheld. Unless they have already done so, Petitioners shall submit the correct reimbursement amount as stated in the Agency’s April 3, 2006. Determination to Palmetto General Hospital within 30 days of the date that this final order is rendered, and shall submit proof of reimbursement to: Anna Ohlson, R.N., AHCA WC Med Services, Division of Worker’s Compensation, 200 East Gaines Street, Tallahassee, Florida 32399-4229. Petitioners. shall govern themselves accordingly. e DONE and ORDERED thiscY_ day of Clpeut , 2008, in Tallahassee, Florida. HOLLY BENSON, Secretary ow AGENCY FOR HEALTH CARE ADMINIS NOTICE OF RIGHT TO JUDICIAL REVIEW A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW, WHICH SHALL BE INSTITUTED BY FILING THE ORIGINAL NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA, AND A COPY ALONG WITH THE FILING FEE 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 THE RENDITION OF THE ORDER TO BE REVIEWED. 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 below on this 2ZF Sy of Ap cef_, 2008. COPIES FURNISHED TO: Honorable P. Michael Ruff Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Tamela I. Perdue, Esquire Stiles, Taylor & Grace, P.A. Post Office Box 1140 Tallahassee, Florida 32302 Mari H. McCully, Esquire Department of Financial Services Division of Worker’s Compensation 200 East Gaines Street Tallahassee, Florida 32399-4229 Joseph W. May, Esquire Bacen and Jordan, P.A. 2901 Stirling Road, Suite 206 Fort Lauderdale, Florida 33312 Jan Mills Facilities Intake Elizabeth Dudek Health Quality Assurance RICHARD J. SHOOP, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, MS #3 Tallahassee, Florida 32308 (850) 922-5873

Docket for Case No: 06-001584