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AGENCY FOR HEALTH CARE ADMINISTRATION vs DR. ANTHONY J. GENTILE, 07-001891MPI (2007)

Court: Division of Administrative Hearings, Florida Number: 07-001891MPI Visitors: 30
Petitioner: AGENCY FOR HEALTH CARE ADMINISTRATION
Respondent: DR. ANTHONY J. GENTILE
Judges: ELEANOR M. HUNTER
Agency: Agency for Health Care Administration
Locations: Tallahassee, Florida
Filed: Apr. 30, 2007
Status: Closed
Settled and/or Dismissed prior to entry of RO/FO on Tuesday, July 24, 2007.

Latest Update: Dec. 22, 2024
Py FILED s ANCA STATE OF FLORIDA Zp Drool Cenk AGENCY FOR HEALTH CARE nip , 4g RMR -2? P04 STATE OF FLORIDA, “0% Tag SlON pm AGENCY FOR HEALTH CARE ie us ip aA ADMINISTRATION, Mig VE Petitioner, DOAH Case No. 07-1891 C.I. NO.: 02-0796-000 PROVIDER NO.: 078406100 VS. , RENDITION NO.: AHCA-09-O 4 -S-MDO DR. ANTHONY J. GENTILE, 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 (Exhibit A). Based on the foregoing, ibis file is CLOSED. in Tallahassee, Florida. i ne HOLLY BENSON Secretary 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 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 I 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 Zz day of Starch, 2009. RICHARD J. SHOOP, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive, MS #3 Tallahassee, FL 32308 (850) 922-5873 Copies furnished to: David W. Nam, Esq. Agency for Health Care Administration (Interoffice Mail) Julie Gallagher, Esq. Greenberg Traurig, P.A. Post Office Drawer 1838 Tallahassee, FL 32302 (U.S. Mail) The Honorable Eleanor M. Hunter Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (U.S. Mail) Kenneth Yon, Bureau Chief, Medicaid Program Integrity, MPI Agency for Health Care Administration (Interoffice Mail) Peter H. Williams, Inspector General Agency for Health Care Administration (interoffice Mail) Finance and Accounting Agency for Health Care Administration (interoffice Mail) STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION | STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, DOAH Case No. 07-1891 C.L NO.: 02-0796-000 PROVIDER NO.: 078406100 vs. : : DR. ANTHONY J. GENTILE, Respondent. / SETTLEMENT AGREEMENT The STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (‘AHCA” or “Agency”), and DR. ANTHONY J. GENTILE (“PROVIDER”), by and through the undersigned, hereby stipulate and agree as follows: 1. The 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, with provider number 0784061-000, and was a Medicaid provider at all times relevant to the audit and this proceeding, 3. In its Final Agency Audit Report, C.L. No. 02-0796-000, (FAR, dated January 12, 2006, AHCA notified PROVIDER, that review. of PROVIDER’s Medicaid claims, performed by the Office of Medicaid Program Integrity (MPI), of the AHCA Inspector General, determined that certain of PROVIDER’S Medicaid claims, in whole or in part, were inappropriately paid by Medicaid. The FAR identified a Medicaid overpayment to the PROVIDER in the amount of $113,351.91. In response to the FAR, the PROVIDER requested an administrative hearing on the alleged Medicaid overpayment. EXHIBIT rn 4. Subsequent to issuance of the FAR, the PROVIDER submitted additional - documentation to AHCA relating to the alleged Medicaid overpayment identified in the FAR. Based on a review of the documentation submitted by PROVIDER, and pursuant to review by the AHCA peer, the AHCA determined that an adjustment of the overpayment amount identified in the FAR was warranted. The AHCA determined based on review of PROVIDER’s documentation that the Medicaid overpayment amount for C.J. No. 02-0796-000 should be adjusted to seventy four thousand nine hundred and one dollars and thirty six cents ($74,901.36) plus a sanction in the amount of two thousand five hundred dollars ($2,500.00), and payment of one thousand dollars ($1,000.00) for AHCA costs. The total amount agreed as due to ANCA from PROVIDER for C.l. No. 02-0796-000 is seventy eight thousand four hundred and one _ dollars and thirty six cents ($78,401.36). The PROVIDER must also submit a corrective action plan in the form of a Provider Acknowledgement Statement. . 5. In order to resolve this matter without further administrative proceedings, the PROVIDER and AHCA expressly agree as follows: . (1) | AHCA agrees to accept, and PROVIDER agrees to pay, the amount of seventy eight thousand four hundred and one dollars and thirty six cents ($78,401.36), as set forth herein, and PROVIDER agrees to return to AHCA the executed Provider Acknowledgement Statement in settlement and resolution of the overpayment issues arising from C.I. 02-0796-000. (2) Upon execution of this setilement agreement by PROVIDER, PROVIDER will remit partial payment to AHCA in the amount of twenty thousand dollars ($20,000.00) and return the execute Provider Acknowledgement Statement. Within ninety (90) days of the date of execution of a Final GB) (4) Order adopting this Settlement Agreement, PROVIDER agrees to remit the balance due to AHCA in the amount of fifty eight thousand four hundred and one dollars and thirty six cents ($58,401.36), in full and complete settlement of all matters pertaining to CI. 02-0796-000. PROVIDER and AHCA agree that full payment as set forth above and retum of the executed Provider Acknowledgement Statement 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. 02-0796-000. 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. Payment shall be made to: AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 PROVIDER agrees that failure to pay any monies due and owing under the terms of this Agreement or return the signed Provider Acknowledgement Statement shall constitute PROVIDER’S authorization for the Agency, without further notice, to withhold the total : remaining amount duc under the terms of this agreement from any monies due and owing to PROVIDER for any Medicaid claims. 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, This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. 3 10. Each party shall bear its own attorneys’ fees. 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 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 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 thisunderstanding 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 -tules of the Agency regarding this proceeding and any and all issues raised herein, PROVIDER further agrees 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. 18. This Agreement shall inure to the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustees. 19. _Alll 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. DR. ANTHONY J. GENTILE (PROVIDER) Dated: 97 //F 2007 Signature BY: Avttiay 9. CenTjLe : (Print name) AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Bldg. 3, Mail Stop #3 nO g us Dated:_3/2/ _ 200%" Dated: 3/2. 200K Dated ZO __,207 David W. Nam Assistant General Counsel aor Kem Dated: _{/9-2 2007 Kim Kellum Chief Medicaid Counsel

Docket for Case No: 07-001891MPI
Issue Date Proceedings
Mar. 03, 2009 Final Order filed.
Jul. 24, 2007 Order Canceling Hearing and Relinquishing Jurisdiction. CASE CLOSED.
Jul. 20, 2007 Motion to Relinquish Jurisdiction to AHCA filed.
Jul. 19, 2007 Notice of Service of Answers to Petitioner`s Expert Interrogatories filed.
Jul. 19, 2007 Notice of Service of Answers to Petitioner`s First Set of Interrogatories filed.
Jul. 19, 2007 Respondent`s Response to Petitioner`s Request for Production of Documents filed.
Jul. 16, 2007 Order Granting Motion to Compel Discovery.
Jul. 11, 2007 AHCA Notice of Compliance with s 409.913(22), Fla. Stat. filed.
Jul. 11, 2007 Motion to Compel Discovery filed.
Jun. 28, 2007 Respondent`s Response to Petitioner`s Request for Admissions filed.
May 30, 2007 Notice of Service of Responses to Interrogatories, Request for Admissions, & Request for Production of Documents filed.
May 09, 2007 Amended Notice of Hearing (hearing set for July 25 and 26, 2007; 9:00 a.m.; Tallahassee, FL; amended as to days of hearing).
May 09, 2007 Order of Pre-hearing Instructions.
May 09, 2007 Notice of Hearing (hearing set for July 25, 2007; 9:00 a.m.; Tallahassee, FL).
May 08, 2007 Response to Initial Order filed.
May 07, 2007 AHCA`s Response to Initial Order filed.
May 07, 2007 Notice of Appearance (filed by D. Nam).
May 01, 2007 Initial Order.
Apr. 30, 2007 Final Audit Report filed.
Apr. 30, 2007 Petition for Formal Administrative Proceedings filed.
Apr. 30, 2007 Notice (of Agency referral) filed.
Source:  Florida - Division of Administrative Hearings

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