Apr 22 2009 11:44 APR-22-2889 12:57 AGENCY HEALTH CARE ADMIN 856 921 @1i58 P.@2/15 STATE OF FLORIDA BHCA AGENCY CLERK AGENCY FOR HEALTH CARE ADMINISTRATION 100) APR 22 AIO 11: AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, CASE NO. 06+2669MPI C.I. NO: 05-3896-000 PROVIDER NO: 066678500 ve. RENDITION NO.: AHCA-09- ZSie -S-MOO WILLIAM B. KING, M.D, Respondent. / FINAL ORDER THE PARTIES resolved all disputed issues and executed a Stipulation and Agreement, which is attached and incorporated by reference. The parties are directed to comply with the terms of the attached Stipulation and Agreement. Based on the foregoing, this file is CLOSED. DONE AND ORDERED this Qaok day of hex , 2009, in Tallahassee, Leon County, Florida. ob Holly Benson, Secret Agency for Health Care Administration Apr 22 2009 11:45 APR-22-2089 12:5? AGENCY HEALTH CARE ADMIN 856 921 4158 P4315 AHCA vs. William B. King, M.D. Case NO. 09-91PH Final Order 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: J.D, Parrish, ALJ Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Mark Cullen The Cullen Law Firm Attorney for Petitioner 2090 Palm Beach Lakes Blvd. Suite# 400 Concourse Tower II West. Palm Beach, FL 33409 Debora Fridie, Senior Attorney Agency for Health Care Administration (iInteroffice) Fred Becknell AHCA Administrator, MPI Agency for Health Care Administration 2727 Mahan Drive, Mail Stop #6 (Interoffice) Finance & Accounting (Interoffice) Apr 22 2009 11:45 APR-22-2089 12:58 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@4-15 AHCA vs. William B. King, M.D. Case NO. 09-9LPH Final Order CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct. copy of the foregoing was served to the above named addresses by U.S. Mail and/or interoffice mail on this De day of na , 2009. stonard shee Shoop, Agency Cler Agency for Health Care Administration 2727 Mahan Drive, Bldg.3, Mail Stop #3 Tallahassee, Florida 32308-5403 (850) 922-5873 Apr 22 2009 11:45 APR-22-2089 12:58 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@5715 STATE OF FLORIDA DIVISION OF ADMINISTRATIVE HEARINGS AGENCY FOR HEALTH CARE ADMINISTRATION , Petitioner, Case No, 06-2669MPI Provider No.: 066678500 c.I.No.: 05+39896-000 va. WILLIAM B. KING, M.D. Respondent. / STIPULATION AND AGREEMENT The Petitioner, AGENCY FOR HEALTH CARE ADMINISTRATION (a/k/a and hereinafter “AHCA” OR “Agency”), and the Respondent, William B. King, M.D. (a/k/a and hereinafter “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, operating under provider number 066678500. 3. In its Final Audit Report, C.I. Na 05-3896-000, (the "Audit Latter” or “FAR’) dated April 26, 2006, AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity (MPI) indicated that, in its opinion, some elaims in whole or in part were not covered by Medicaid. The Agency sought repayment of an overpayment in the amount of Page 1 of 10 Apr 22 2009 11:45 APR-22-2889 12:58 AGENCY HEALTH CARE ADMIN 856 921 @158 P.@6715 Case No. 0O6-2669MPI ¢.1. No. 05-3696-000 William B, King, M.D. va. AHCA Stipulation and Agreamant $225,458.70. AHCA also notified PROVIDER an the FAR that it is seeking sanctions in the form of a $3,000,00 fine, and a corrective action plan in the form of a Provider Acknowledgement Statement. The sanctions were determined pursuant to Rule 596-9.070, Florida Administrative Code. In response, PROVIDER petitioned for a formal administrative hearing. After the provider requested a formal administrative hearing, AHCA reviewed documentation that was previously unavailable to them. Based upon that review, AHCA adjusted the overpayment to $52,289.83, PROVIDER has agreed to pay the overpayment amount of $52,289.83; a sanction fine in the amount of $2,000.00 pursuant to Rule 59G-9.070(7) (e), Florida Administrative Code and a sanction fine in the amount of $500.00 pursuant to Code R. 59G-9.070(7) (c) Florida Administrative Code; and $1,000.00 in costs for a total repayment amount of $55,789.83. 4. In order to resolve this matter without further administrative proceedings, PROVIDER and AHCA expressly agree as follows: (a) AHCA will accept the payment set forth herein as a complete resolution of the overpayment issues arising from the MPI review cited in paragraph 3 above. (b) PROVIDER agrees to pay the adjusted overpayment amount of Fifty Two Thousand Two Hundred Eighty-Nine and Page 2 of 11 Apr 22 2009 11:45 APR-22-2089 12:58 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@?/15 Case No. 06=2669MFI c.1. No. 05-3896-000 William B. King, M.D. va. AHCA Stipulation and Agreement 83/100 Dollars ($52,289.83), a sanetion in fine amount of Two Thousand and 00/100 Dollars (92, 06.00), a sanction in the amount of Five Hundred and 00/100 ($500.00), and costs in the amount of One Thousand and 00/100 Dollars ($1,000.00), for a total amount of Fifty Five Thousand Seven Hundred Eighty Nine and 83/100 Dollars ($55,789.83). The adjusted overpayment amount plus fines and costs in the total amount of $55,789.83 shall be paid as follows: Within thirty days of the issuance of the Final Order, the Provider shall pay Sixteen Thousand Seven Hundred Thirty-Six and 95/100 Dollars ($16,736.95). Within thirty (30) days after payment of the $16,736.95 initial payment, PROVIDER agrees to make the first installment payment to AHCA of Four Thousand Eighty Six and 51/100 Dollars ($4,086.51). PROVIDER shall pay each subsequent installment payment on the balance due within thirty (30) days of the due date of the previous payment until the overpayment amount is paid in full, by no jater than eleven (11) months of the date of the issuance of the Final Order. In the event that the PROVIDER pays the balance due early, there is no penalty for early payment. The outstanding balance of Page 3 of il Apr 22 2009 11:45 APR-22-2089 12:59 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@815 Casa No. 06-2669MPI C.1. No. 05~-3696-000 William B. King, M.D. va. AHCA Stipulation and Agreenent $55,789.63 will accrue interest at the rate as set forth in Section 409.913 (25) (¢), Florida Statutes, until the balance is paid in full, AHCA retains the right to perform a 6-month follow-up review. (c) PROVIDER is responsible for ensuring timely delivery of the payment. Failure to timely make the payment will render the balance due and payable immediately, with interest, and interest will continue to accrue until the entire balance is paid. (d) PROVIDER and AHCA agree that full payment as set forth above will resolve and settle this case completely and release all parties from all liabilities arising from the findings in the audit referenced as C.1. Number 05-3896-000. (e) 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. (£) PROVIDER agrees to fully cooperate with any follow up reviews conducted by the Agency. Page 4 of 11 Apr 22 2009 11:45 APR-22-2089 12:59 AGENCY HEALTH CARE ADMIN 856 921 4158 P.@915 Case No. 06-2669MPI G.1,. No, 05-3996-000 William B. King; M.D. vs. AHCA Stipulation and Agreement 5. Payment shali be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-37493 And payment shall clearly indicate that it is per a stipulation and agreement and shall reference the C,.1T. Number and the Provider Number. 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. 2. AHCA reserves the right to enforce this Stipulation and Agreement under the laws of the State of Flerida, the Rules of the Medicaid Program, and all other applicable rules and regulations, 8. the parties agree to bear their own attorney’s fees and other costs, if any. 9, As a part of this Stipulation and Agreement, PROVIDER agrees that AHCA may impose administrative sanctions pursuant to Rule 596-9.070, Florida Administrative Code, as referenced in paragraph 3 above, Page 5 of 11 Apr 22 2009 11:45 APR-22-2889 12:59 AGENCY HEALTH CARE ADMIN 856 921 @158 P.1a15 Case No. 06-2669MPI Gr. Ne, 05-2896-000 William B. King, M.D, va. AHCA Stipulation and Agreement 10. PROVIDER acknowledges that Medicaid policy states as follows: (a) Medicaid Policy defines the varying levels of care and expertise required for the evaluation and management procedure codes for office visits. (b) Medicaid uses the Physician’s Current Procedure Terminology (CPT) book, which contains complete descriptions of the standard codes. (¢) Medical records must state the necessity for and extent of service rendered; history; physical assessment; chief complaint on each visit; diagnostic test and results; diagnostic treatment plan, including prescriptions; medications, supplies, scheduling frequency for follow-up or other services: progress reports; treatment rendered. (d) The author of each (medical record) entry must be identified and must authenticate his or her entry by signature, written initials or computer entry; dates of service; and referrals to other services. ll. The signatoriés 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. Furthermore, PROVIDER agrees that its Signature alone Page 6 of 11 Apr 22 2009 11:47 APR-22-2089 12:59 AGENCY HEALTH CARE ADMIN 856 921 4158 P.11/15 Case No. 06~2669MPI C.I. No. 05-3896-000 Willian B, King, M.D. va, AHCA Stipulation and Agreemant binds PROVIDER to make the payment as set forth in this agreement. PROVIDER shall furnish the actual signed Stipulation and Agreement to AHCA; however a facsimile copy shall be sufficient to enable AHCA to cancel a hearing scheduled in this case. 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 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 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 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 na Page 7 of 11 Apr 22 2009 11:47 APR-22-2089 13:68 AGENCY HEALTH CARE ADMIN 856 921 4158 P.12/15 Casa No. 06-2669MPT C.t. Ne. 05-3896-000 Willian B. King, M.D. va. AHCA Stipulation and Agreement misunderstanding or misinformation shall be a ground for rescission hereof, This Stipulation and Agreement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. However, the parties believe that this matter should be resolved because the parties have agreed to the terms contained within this agreement. 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 agrees that the Agency should issue a Final Order which is consistent with the terms of this Stipulation and Agreement, and which adapts this agreement and closes this matter. 16. PROVIDER 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, C.I. No 05-3896-000, and AHCA’s actions herein, in¢luding, but not limited to, any claims that were or Page § of 11 Apr 22 2009 11:47 APR-22-2089 13:68 AGENCY HEALTH CARE ADMIN 856 921 4158 P.13¢15 Case Ne. 06-2669MPI G.I. No. 05-3696-000 William B. King, M.D. vas. ARCA Stipulation and Agreement 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 Provider. 17. This Stipulation and 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 Stipulation and 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 Stipulation and Agreement. 19. This Stipulation and 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 in this Stipulation and Agreement. 21. This Stipulation and Agreement shall be in full force and effect upon execution by the respective parties in counterpart. Page 9 of li APR-22-28689 13:68 AGENCY HEALTH CARE ADMIN Gacsm No, 06-2669MPr G.1. Ne. 0543196-000 William Tl, King, M.D. va, AHCA Stipulation and Agroament PETITICNER WILLIAM B. KING, M.D, SY: Data: 7 , 2009 COLTER LAW FIRM, FA . fe hi , ; of. G / ff Ay: CZ \ fla ue ULE. re Attorney For Petitioner William B, King, M.D. Apr 22 2009 11:48 856 921 @158 Paga 10 of 11 P.i47i5 APR-22-2889 1a: G41 AGENCY HEALTH CARE ADMIN Case Ne, 06-2669MPI G.I. No. 05-3896-000 William B. King, M.D. va. Stipulation and Agraament AHCA AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Prive, Mail Stop #3 Tallahassee, FL 32308-5403 Age Apr 22 2009 11:48 856 921 4158 P.15/15 BY: PETER H. WILLIAMS Inspector General ) Date: _. AS , 2009 BY: Acting General Counsel Date: Kyril bhi , 2008 ao, o: Che Cro DEBORA E. FRIDIE Assistant General Counsal Date: iy ach CG , 2009 Page 1] of 11 TOTAL P.15

Docket for Case No: 06-002669MPI