A STATE OF F FLORIDA 2 fee DIVISION OF ADMINISTRATIVE HE HEARINGS AGERCY CLERK MOT NEY -8 P 1:03 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, vs. CASE NO. 07-3337MP1 RENDITION NO.: AHCA-07- OWT -S-MDO MAIL ORDER MEDS OF FLORIDA, LLC, o d/b/a MOMS SPECIALTY CARE PHARMACY, 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. Based on the foregoing, this file is CLOSED. DONE and ORDERED on this the 7 day of tbe. , 2007, in Tallahassee, Florida. pe Ges C. AGWUNOBI, M.D., SECRETARY Agency for Health Care Administration A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED TO A JUDICIAL REVIEW WHICH SHALL BE !NSTITUTED 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: Tracie L. Wilks, Esquire Agency for Health Care Administration Mr. Glen Schabel, General Manager Mail Order Meds of Florida, LLC, d/b/a MOMS Specialty Care Pharmacy 4500 Biscayne Boulevard, Suite 104 Miami, Florida 33137 Errol Powell Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Ken Yon, Chief, Medicaid Program Integrity Teveica A. Johnson Medicaid Program Integrity Finance and Accounting CERTIFICATE OF SERVICE ! HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished to the above named addressees by U.S. Mail on this the LF day of Abte~Lr™ , 2007. oop, Esquire Agency Clerk State of Florida Agency for Health Care Administration 2727 Mahan Drive, Building #3 Tallahassee, Florida 32308-5403 (850) 922-5873 STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, Case No.: 07-3337MPI Provider No.: 25716800 vs. C.I. No.: 07-5240-000 Judge: E. H. POWELL MAIL ORDER MEDS OF FLORIDA, LLC, d/b/a MOMS SPECIALTY CARE PHARMACY, Respondent. / SETTLEMENT AGREEMENT The Petitioner, MAIL ORDER MEDS OF FLORIDA, LLC, d/b/a MOMS SPECIALTY CARE PHARMACY, (“PROVIDER”) and Respondent, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), 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, provider number 025716800 and was a provider during the audit period. 3. In its Final Audit Report dated March 9, 2007, AHCA notified PROVIDER that review of Medicaid claims performed by the Office of Medicaid Program Integrity (MPI), of the AHCA Inspector General, indicated that certain claims, in whole or in part, were inappropriately paid by Medicaid. The Agency sought repayment of this overpayment, in the amount of eight thousand, three hundred forty-six dollars and forty-three cents ($8,346.43). In addition, the Case No.: 07-3337MP1 Provider No.: 25716800 C.LNo.: 07-5240-006 Agency applied sanctions in accordance with Sections 409.913(15), (16), and (17), Florida Statutes, and Rule 59G-9.070, Florida Administrative Code. PROVIDER was assessed a fine in the amount of two thousand five hundred three dollars and ninety-three cents ($2,503.93) in accordance with Rule 59G-9-070(7)(n), Florida Administrative Code. In response to the audit report dated March 9, 2007, PROVIDER sent a letter to the Agency requesting an Administrative Hearing. 4. Based on the additional information submitted to AHCA, the overpayment has been adjusted to zero. However, a fine in the amount of five hundred dollars ($500.00) is assessed against PROVIDER for violation of Rule 59G-9-070(7)(c), Florida Administrative Code. Additionally, costs in the amount of seven hundred eighty-eight dollars and fifty cents ($788.50), is assessed against the PROVIDER for costs. The total amount due was one thousand, two hundred eighty-eight dollars and fifty cents ($1,288.50), which is to be paid in one (1) lump sum within thirty (30) days of issuance of the Final Order. 5. On September 25, 2007, the Agency for Health Care Administration received check number 25090 in the amount of one thousand, two hundred eighty-eight dollars and fifty cents ($1,288.50) from Allion Healthcare, Inc. as payment in full for settlement of case number 07-3337MPI, C.I. No.: 07-5240-000. 6. In order to resolve this matter without further administrative proceedings, PROVIDER and AHCA expressly agree as follows: (1) | AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. (2) | AHCA agrees to accept check number 25090 in the amount of one thousand, two hundred eighty-eight dollars and fifty cents ($1,288.50) Page 2 of 6 Case No.: 07-3337MPI Provider No.: 25716800 CA No.: 07-5240-000 from Allion Healthcare, Inc. as payment in full for settlement of case number 07-3337MPI, C.I. No. 07-5240-000. (3) PROVIDER and AHCA agree that such payments as set forth above will resolve and settle this case completely and release both parties from all liabilities arising from the findings in the audit referenced as C.]. Number 07-5240-000. (4) 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. 7. Payment shall be made to: AGENCY FOR HEALTH CARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 8. 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. 9. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. 10. 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. 11. 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. 12. This Agreement constitutes the entire agreement between PROVIDER and AHCA, including anyone acting for, associated with or employed by them, concerning all Page 3 of 6 Case No.: 07-3337MPI Provider No.: 25716800 CL No.: 07-5240-000 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. 13. 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. 14. 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 Jaw 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. 15. | 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. 16. 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. Page 4 of 6 Case No.: 07-3337MPI Provider No.: 25716800 CL. No.: 07-5240-000 17. This 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 of this Agreement. 19. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. Page 5 of 6 Case No.: 07-3337MPI Provider No.: 25716800 C.E.No.: 07-5240-000 MAIL ORDER MEDS OF FLORIDA, LLC, d/b/a MOMS SPECIALTY CARE PHARMACY Col Dated: Lasf 2007 BY: (ead Se clobaf (Print name) AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Bldg. 3, Mail Stop #3 Tallahassee, FL 32308-5403 — Dada Teen Dated: /-7-07 2007 Linda Keen Inspector General Carel Cll Dated: (0/$e , 2007 Taig Brat General Counsel HK Wr KO ctor Dated: /0) Qe , 2007 Kim Kellum Chief Medicaid Counsel Page 6 of 6

Docket for Case No: 07-003337MPI