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AGENCY FOR HEALTH CARE ADMINISTRATION vs KINDRED HOSPITALS EAST, LLC, D/B/A KINDRED PHARMACY SERVICES JACKSONVILLE, 07-000464MPI (2007)

Court: Division of Administrative Hearings, Florida Number: 07-000464MPI Visitors: 6
Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: KINDRED HOSPITALS EAST, LLC, D/B/A KINDRED PHARMACY SERVICES JACKSONVILLE
Judges: BARBARA J. STAROS
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Jan. 25, 2007
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Tuesday, June 19, 2007.

Latest Update: Jul. 05, 2024
FU em giLeD STATE OF FLORIDA Mee Caf ANC 4 PATCA DIVISION OF ADMINISTRATIVE nearrhebAuy , “NOY CLERK An Slow nm. AGENCY FOR HEALTH CARE " Misre o ADMINISTRATION, BOA RU TAT Ve Ves Petitioner, vs CASE NO. 07-0464MPI CI NO. 02-0325-000-3/H/RDS RENDITION NO.: AHCA“6¥1- 044 3 -S-MDO KINDRED HOSPITALS EAST, L.L.C. d/b/a KINDRED PHARMACY SERVICES f£/k/a VENCOR HOSPITALS EAST, L.L.C., Respondent. FINAL ORDER THE PARTIES resolved all disputed issues and executed a “Stipulation and Agreement,” which is incorporated by reference. The parties are directed to comply with the terms of the “Stipulation and Agreement.” Based on the foregoing, this proceeding is CLOSED. DONE and ORDERED on this the /5_ day of , 2007, in Tallahassee, Leon County, Florida. AndyYew C. Agwunobi, M.D. , Secretary Agency for Health Care Administration CASE NO. 07-04646MPI C.I. NO. 02-0325-000-3/H/RDS 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: Matthew B. Steinberg, Attorney for Respondent Kindred 680 South Fourth Street Louisville, Kentucky 40202-2407 Debora Fridie, Esquire Attorney for Agency Agency for Health Care Administration 2727 Mahan Drive Fort Knox Building 3, Mail Stop 3 Tallahassee, Florida 32308 The Honorable Barbara J. Staros Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Medicaid Program Integrity, MS #6 Finance and Accounting, MS #14 CASE NO. 07-04646MPI C.T. NO. 02-0325-000-3/H/RDS CERTIFICATE OF SERVICE SS VE BERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing Final Order has been furnished to the above named addressees by U.S. Mail on this the LE. day of 74545 , 2007. Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3, Mail Stop 3 Tallahassee, Florida 32308-5403 =H ep a vaso DIVISION OF ADMINISTRATIVE HEARINGS MH AG IT ATE 1b AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, Case No. 07-0464MPI vs. KINDRED HOSPITALS EAST, LLC, d/b/a KINDRED PHARMACY SERVICES JACKSONVILLE, FL Respondent. STIPULATION AND AGREEMENT The Petitioner, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (a/k/a “AHCA” or “Agency”), and the Respondent, KINDRED HOSPITALS EAST, LLC, d/b/a KINDRED PHARMACY SERVICES, a/k/a “PROVIDER” or “KINDRED”), 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 02-15333-00. 3. In its Final Agency Audit Report, C.I. No. 02-0325- 000-3/H/RDS (the "Audit Letter"), 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 Page 1 of 9 Case No: 07-0464MPI C.I. No. 02-0325-000-3/H/RDS AHCA v. Kindred Stipulation and Agreement sought repayment of an overpayment amount of the amount of $68,424.58. In response, PROVIDER petitioned for a formal administrative hearing with the Division of Administrative Hearings, Case No. 07-0464MPI. After the provider requested a formal hearing, AHCA reviewed additional information that was previously unavailable to them. Based upon that review, AHCA adjusted the overpayment amount to $29,393.66. PROVIDER has agreed to pay the adjusted overpayment amount of $29,393.66 plus some of AHCA’s investigative costs in the amount of $506.34, for a total repayment amount of $29,900.00. 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 settlement of the overpayment issues arising from the MPI review cited in paragraph 3 above. (b) Within thirty (30) days of issuance of the Final Order, PROVIDER agrees to make a single payment to AHCA of Twenty~Nine Thousand Nine Hundred and no/100 Dollars ($29,900.00). Of this amount, $29,393.66 is to reimburse the Medicaid Program for the overpayment amount due, and $506.34 is to reimburse Page 2 of 9 Case No: 07~0464MPI C.1I. No. 02-0325-000-3/H/RDS AHCA v. Kindred Stipulation and Agreement (c) (a) (e) (f) AHCA in part for investigative costs. AHCA retains the right to perform a 6-month follow-up review. 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. 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.I. 02-0325-000-3/H/RDS. 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. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 Page 3 of 9 Case No: 07-0464MPI C.I. No. 02-0325-000-3/H/RDS AHCA v. Kindred Stipulation and Agreement And payment shall clearly indicate that it is per a stipulation and agreement and shall reference the C.I. 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. 7. AHCA reserves the right to enforce this Stipulation and Agreement under the laws of the State of Florida, the Rules of the Medicaid Program,- and all other applicable rules and regulations. 8. Except as specifically set forth in Paragraphs 3 and 4(b) above with regard to AHCA’s investigative costs, the parties agree to bear their own attorney’s fees and other costs, if any. 9. The signatories to this Agreement, acting ina 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 binds PROVIDER to make the Payment as set forth in this agreement. PROVIDER shall furnish the actual signed Stipulation Page 4 of 9 Case No: 07-0464MPI C.I. No. 02-0325-000-3/H/RDS AHCA v. Kindred Stipulation and Agreement and Agreement to AHCA; however a facsimile copy shall be sufficient to enable AHCA to cancel a hearing scheduled in this case. 10. 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. li. 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. 12. 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 no misunderstanding or misinformation shall be a ground for rescission hereof. This Stipulation and Agreement does not Page 5 of 9 Case No: 07-0464MPI C.I. No. 02-0325-000-3/H/RDS AHCA v. Kindred Stipulation and Agreement 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. 13. PROVIDER expressly waives in this matter its right to any hearing pursuant to §§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 adopts this agreement and closes this matter. 14, 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. 02-0325-000, and AHCA’s actions herein, including, but not limited to, any claims that were or may be asserted in any federal or state court or administrative Page 6 of 9 Case No: 07-0464MPI C.I. No. 02-0325-000-3/H/RDS AHCA v. Kindred Stipulation and Agreement forum, including any claims arising out of this agreement, by or on behalf of Provider. 15. 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. 16. 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. 17. This Stipulation and 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 in this Stipulation and Agreement. 19. This Stipulation and Agreement shall be in full force and effect upon execution by the respective parties in counterpart. Page 7 of 9 Case No: 07-0464MPI C.I. No. 02-0325-000-3/H/RDS AHCA v. Kindred Stipulation and Agreement RESPONDENT KINDRED PHARMACY SERVICES LL ges Berets “Vomasett ls cro (Printed name and title) Date: Joby = , 2007 KINDRED PHARMACY SERVICES BY: Attorney for Respdndent Kindred Date: July lo , 2007 Page 8 of 9 Case No: 07-0464MPI C.I. No. 02-0325-000-3/H/RDS AHCA v. Kindred Stipulation and Agreement AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 BY: Zo Le. Keen LINDA / KEEN Inspector General Date: fare /S_ , 2007 IG X. SMITH General Counsel Date: Arsvot _| , 2007 + . tI MAL DEBO. E. FRIDIE Assistant General Counsel Date: Ju / / 7 1, 2007 Page 9 of 9

Docket for Case No: 07-000464MPI
Issue Date Proceedings
Aug. 17, 2007 Final Order filed.
Jun. 19, 2007 Order Closing File. CASE CLOSED.
Jun. 18, 2007 Notice of Stipulation in Principle and Joint Motion to Close File filed.
May 30, 2007 Agency`s Notice of Service of Responses and Objections to Kindred`s Discovery Requests filed.
Apr. 26, 2007 Order Re-scheduling Hearing (hearing set for July 24 and 25, 2007; 9:30 a.m.; Tallahassee, FL).
Apr. 24, 2007 Notice of Unavailability of Counsel for the Petitioner Agency filed.
Apr. 12, 2007 Amended Joint Response to Order Granting Continuance filed.
Apr. 12, 2007 Joint Response to Order Granting Continuance filed.
Apr. 10, 2007 Petitioner Agency`s Notice of Service of Second Request for Production of Documents to Respondent Kindred Hospitals East, LLC filed.
Apr. 10, 2007 Petitioner Agency`s Second Request for Production of Documents to Respondent Kindred Pharmacy Services filed.
Apr. 04, 2007 Order Granting Continuance (parties to advise status by April 13, 2007).
Apr. 04, 2007 Order Accepting Qualified Representative.
Apr. 02, 2007 Respondent`s Motion for Continuance filed.
Apr. 02, 2007 Letter to Judge Staros from M. Steinberg regarding request for qualification of representative (Affidavit attached) filed.
Mar. 14, 2007 Petitioner Agency`s Notice of Service of First Interrogatories and First Expert Interrogatories to Respondent Kindred Pharmacy Services filed.
Mar. 14, 2007 Petitioner Agency`s First Request for Production of Documents to Respondent Kindred Pharmacy Services filed.
Mar. 13, 2007 Order on Agency`s Motion to Compel.
Mar. 05, 2007 Agency`s First Request for Admissions filed.
Mar. 01, 2007 Agency`s Motion to Compel Discovery Responses filed.
Feb. 01, 2007 Order of Pre-hearing Instructions.
Feb. 01, 2007 Notice of Hearing (hearing set for April 17 and 18, 2007; 9:30 a.m.; Tallahassee, FL).
Feb. 01, 2007 Joint Response to Initial Order filed.
Jan. 26, 2007 Initial Order.
Jan. 26, 2007 Petitioner Agency`s Notice of Service of First Interrogatories and First Expert Interrogatories and Request for Production of Documents to Respondent Kindred Hospitals East, LLC filed.
Jan. 25, 2007 Pharmacy Audit-Final Report filed.
Jan. 25, 2007 Final Agency Audit Report filed.
Jan. 25, 2007 Request for Administrative Hearing filed.
Jan. 25, 2007 Order filed.
Jan. 25, 2007 Notice (of Agency referral) filed.
Source:  Florida - Division of Administrative Hearings

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