STATE OF FLORIDA DIVISION OF ADMINISTRATIVE PMN in U0 AUS = 770 (0st, A &53 STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, vs. CASE NO. 07-3467MPI RENDITION NO.: AHCA-08- O%X%<& -S-MDO MED-CARE INFUSION SERVICES, INC., Respondent. / FINAL ORDER THE PARTIES resolved ali 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 AQ day of ene ; 2008, in Tallahassee, Florida. frit BENSON, < Deen for notds for Health Care Administration 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: Bernard P. Coniff, Esquire 760 Ponce De Leon Boulevard Coral Gables, Florida 33134 (U.S. Mail) Patricia M. Hart, Administrative Law Judge Desoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (U.S. Mail) Tim Byres, Chief, Medicaid Program Integrity Debbie Lynn, Medicaid Program Integrity Finance and Accounting CERTIFICATE OF SERVICE I 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 6. day of Alagas C_>2008. Richard Shoop, 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.: 07-3467MPI Provider No.: 102454000 vs. CLI. No.: 07-5717-000/P/AAE Judge: Patricia M. Hart MED-CARE INFUSION SERVICES, INC., Respondent. / SETTLEMENT AGREEMENT Petitioner, STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION, (“AHCA” or “Agency”), and Respondent, MED-CARE INFUSION SERVICES, INC. (“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, provider number 102454000, and was a provider during the audit period. 3. In its Final Audit Report, dated June 21, 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 twenty four thousand, three hundred ninety six dollars and thirty eight cents Med-Care Infusion Services, Inc. Settlement Agreement CL. No.: 07-5717-000/P/AAE Case No.: 07-3467MPI ($24,396.38). In addition, the Agency applied sanctions in accordance with Sections 409.913(15), (16), and (17) Florida Statutes, and Rule 59G-9.070(7)(c) Florida Administrative Code. Provider was assessed a five hundred dollar ($500.00) fine for violation of 59G- 9.070(7)(c) Florida Administrative Code; and a fine of five thousand dollars ($5,000.00) for violation of Rule 59G-9.070(7)(n), Florida Administrative Code. In response to the audit report dated June 21, 2007, PROVIDER sent a letter to the Agency requesting a Formal Hearing. 4. Subsequent to the original audit that took place in this matter and after further documentation review, AHCA determined that the overpayment amount should be adjusted to four thousand, twenty five dollars and thirty cents ($4,025.30). Additionally, a fine in the amount of five hundred dollars ($500.00) was assessed pursuant to Rule 59G-9.070(7)(c), Florida Administrative Code; costs in the amount of two thousand, five hundred dollars ($2,500.00) was assessed pursuant to Section 409.913(23), Florida Statutes; and a Corrective Action Plan in the form of a Provider Acknowledgement Statement. The total amount due is seven thousand, twenty five dollars ($7,025.00). In addition, PROVIDER still owes a Corrective Action Plan in the form of an Acknowledgement Statement. 5. In order to resolve this matter without further administrative proceedings, PROVIDER and AHCA expressly agree as follows: qd) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. (2) Within thirty (30) days of the date of execution of a Final Order adopting this Settlement Agreement, PROVIDER agrees to make a payment of four thousand, twenty five dollars ($4,025.00); plus a sanction in the amount of five hundred dollars ($500.00); plus costs in the amount of two thousand, Page 2 of 6 Med-Care Infusion Services, Inc. Settlement Agreement C1. No.: 07-5717-000/P/AAE Case No.: 07-3467MPI 7. (3) (4) (5) five hundred dollars ($2,500.00). The total amount due is seven thousand, twenty five dollars ($7,025.00). PROVIDER will submit the Corrective Action Plan in the form of an Acknowledgement Statement to the Agency within thirty (30) days of execution of the Final Order adopting this Settlement Agreement. 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.I. Number 07-5717-000. 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 HEALTH CARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 Tallahassee, Florida 32317-3749 Overpayments owed to the agency bear interest at the rate of 10 percent per year from the date of determination of the overpayment by the agency, and payment arrangements must be made at the conclusion of legal proceedings, pursuant to Section 409.913 (25)(c), Florida Statutes. 8. 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 Page 3 of 6 Med-Care Infusion Services, Inc. Settlement Agreement C.I. No.: 07-5717-000/P/AAE Case No.: 07-3467MPI 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. 9. 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. 10. This settlement does not constitute an admission of wrongdoing or error by either party with respect to this case or any other matter. 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 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. Page 4 of 6 Med-Care Infusion Services, Inc. Settlement Agreement CI. No.: 07-5717-000/P/AAE Case No,: 07-3467MPI 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. All 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. Page 5 of 6 Med-Care Infusion Services, Inc. Settlement Agreement CLL. No.: 07-5717-000/P/AAE Case No.: 07-3467MPI MED-CARE INFUSION SERVICES, INC. dif Brccees Dated: 2 “f [2] , 2008 BY: where PrAceras rint name) AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Bldg. 3, Mail Stop #3 Tallahassee, FL 32308-5403 Dende : Teer Dated: Q-/B , 2008 Linda Keen Inspector General ,