STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION TALLAHASSEEE MEMORIAL HOSPITAL, INC., Petitioner, vs. a STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, DOAH Case No. 06-2119 AHCA No. 2006004 oF 139 ba % eA B20 BD am gee mo Sao fF en Bro 4 Respondent. 2S _ FINAL ORDER The Agency for Health Care Administration, having entered into a Joint Stipulation and Settlement Agreement with the parties to these proceedings, and being otherwise well advised in the premises, decides as follows: The attached Joint Stipulation and Settlement Agreement is approved and adopted as a part of this Final Order, and the parties are directed to comply with the terms of the Joint Stipulation and Settlement Agreement. THEREFORE, it is ORDERED that: 1. The parties hereto are directed to comply with the terms of the Joint Stipulation and Settiement Agreement. 2. Tallahassee Memorial Hospital, Inc. (hereinafter “TMH”) will be exempt from providing emergency maxillofacial surgery on an emergency basis for ten (10) days out of every thirty-day period. 3. This exemption will remain in place until June 30, 2007. 4h had wy 4. TMH will be available for emergency maxillofacial surgery for the remaining twenty (20) days out of every thirty-day period. 5. The thirty-first (31) day will be the beginning of another thirty-day period. 6. Other than the executory features of this final order, the request for hearing is deemed withdrawn and this case and file deemed closed. te DONE and ORDERED this "day of hear, 2007, in Tallahassee, Leon County, Florida. eA Cc. eee oe LE ary Agency for Health Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY OF A NOTICE OF APPEAL WITH AGENCY CLERK AND A SECOND COPY, ALONG WITH FILING FEE AS PRESCRIBED BY LAW, IN THE DISTRICT COURT OF APPEAL 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 THIRTY (30) DAYS OF RENDITION OF THE ORDER TO BE REVIEWED. Copies furnished to: Michael O. Mathis, Esq. Assistant General Counsel Agency for Health Care Administration 2727 Mahan Dr., Suite 3808-D Tallahassee, Florida (Interoffice Mail) Elizabeth Dudek Deputy Secretary Agency for Health Care Administration 2727 Mahan Drive Bldg #1 Mail Stop Code #9 Tallahassee, Florida 32308 (Interoffice Mail) Jean Lombardi Finance & Accounting Agency for Health Care Administration 2727 Mahan Drive Mail Stop Code #14 Tallahassee, Florida 32308 (Interoffice Mail) Cynthia S. Tunnicliff, Esquire 215 South Monroe Street, 24 P.O. Box 10095 Tallahassee, Florida 32302-2095 (U.S. Mail) Suzanne F. Hood Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (U.S. Mail) Jan Mills (Inter-office Mail) CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true copy of the foregoing was mailed to the above-named addressees on this day of Richard Shoop, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308 (850) 922-5873 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION TALLAHASSEE MEMORIAL HOSPITAL, INC., Petitioner, Case No. 06-2119 vs. AHCA Case no. 2006004139 & P, a as 2o BD ‘ STATE OF FLORIDA, AGENCY FOR <2 ~ = HEALTH CARE ADMINISTRATION, TZ © +t Pie Bus 2 m Re dent. Bet ss | esponden BES s came) 4 / mae SETTLEMENT AGREEMENT Respondent, State of Florida, Agency for Health Care Administration (“hereinafter the “Agency” ) through their undersigned representatives, and Petitioner Tallahassee Memorial Hospital, Inc. (hereinafter “Tallahassee Memorial Hospital, Inc.”), pursuant to Sec. 120.57(4), Fla. Stat. (2005) each individually, a “party”, collectively as “parties,” hereby enter into this Stipulation and Settlement Agreement agree as follows: (“Agreement”) and WHEREAS, Tallahassee Memorial Hospital, Inc. is a hospital facility licensed pursuant to Chapter 395, Part .I, Fla. Stat (2005), and Chapter 59A-3, Fla. Admin. Code (2005), and WHEREAS, the Agency has jurisdiction by virtue of being the regulatory and licensing authority over Tallahassee Memorial Hospital, Inc., Stat. (2005); pursuant to Chapter 120.569 and 120.57, and Fla. WHEREAS, the Agency served Tallahassee Memorial Hospital, Inc. with a “Letter of Denial” on May 15, 2006, notifying the party of its Denial for an emergency services exemption in the area of oral and maxillofacial surgery, pursuant to Section 395.1041(3), Fla. Stat. (2005), and; WHEREAS, the parties have agreed that a fair, efficient, and cost effective resolution of this dispute would avoid the expenditure of substantial sums to litigate the dispute; and WHEREAS, the parties have negotiated and agreed that the best interest of all the parties will be served by a settlement of this proceeding; and NOW THEREFORE, in consideration of the mutual promises and recitals herein, the parties intending to be legally bound, agree as follows: 1. All recitals are true and correct and are expressly incorporated herein. 2. Both parties agree that the “whereas” clauses incorporated herein are binding findings of the parties. 3. Upon full execution of this Agreement, Tallahassee Memorial Hospital, Inc. agrees to a withdrawal of its Petition for a formal administrative proceeding; agrees to waive any and all appeals and proceeding; agrees to waive compliance with the form of the Final Order (findings of fact and conclusions of law) to which it may be entitled including, but not limited to, a informal proceeding under Subsection 120.57(2), Fla. Stat. (2005), a formal proceeding under Subsection 120.57(1), Fla. Stat. (2005), appeals under Section 120.68, Fla. Stat.(2005); and declaratory and all writs of relief in any court or quasi-court (DOAH) of competent jurisdiction. 4. Venue for any action brought to enforce the terms of this Agreement or the Final Order entered pursuant hereto shall lie in the Circuit Court in Leon County, Florida. 5. Tallahassee Memorial Hospital, Inc. will be exempt from providing emergency maxillofacial survey for a period of ten (10) days each month. 6. This exemption will remain in place until June 30, 2007. 7. Tallahassee Memorial Hospital, Inc. will be responsible to provide emergency maxillofacial survey for the remaining twenty (20) days each month. 8. Upon full execution of this Agreement, the Agency shall enter a Final Order adopting and incorporating the terms of this Agreement and dismissing the above-styled case. 9. Each party shall bear its own costs and attorney fees. 10. This Agreement shall become effective on the date upon which it is fully executed by all the parties. 11. Tallahassee Memorial Hospital, Inc. for itself and for its related or resulting organizations, its successors or transferees, attorneys, heirs, and executors or administrators, 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 any and every nature whatsoever, arising out of or in any way related to this matter and the Agency’s actions, including, but not limited to, any claims that were or may be asserted in any federal or state court or administrative forum, including any claims arising out of this agreement, by or on behalf of Tallahassee Memorial Hospital, Inc. or related facilities. 12. This Agreement is binding upon all party’s herein and those identified in the aforementioned paragraph (11) of this Agreement. 13. In the event that Tallahassee Memorial Hospital, Inc. was a Medicaid provider at the subject time of the occurrences alleged in the complaint denial letter herein, this settlement does not prevent the Agency from seeking Medicaid overpayments. 14. The undersigned have read and understand this Agreement and have authority to bind their respective principals to it. 15. This Agreement contains the entire understandings and agreements of the parties. 16. This Agreement supersedes any prior oral or written agreements between the parties. 17. This Agreement may not be amended except in writing. Any attempted assignment of this Agreement shall be void. 18. The following representatives hereby acknowledge that they are duly authorized to enter into this Agreement. DATED: LL 7 DATED: SL/- 30 - CL Elizabeth Dudek nthia S. Tunnicliff, Deputy Secretary, Counsel for Tallahassee Managed Care and Memorial Hospital, Inc. Health Quality Assurance Esq. DATED: fat fa parep:_ /2 OG ee H. Roberts Michael 0. Mathis, Esq. Acting General Counsel Senior Attorney Agency for Health Care Agency for Health Care Administration Administration

Docket for Case No: 06-002119