FILED “ere AHCA STATE OF FLORIDA AGENCY CLERK DIVISION OF ADMINISTRATIVE HEA’ GS ce 20, FEB 27 A +58. AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, vs. CASE NO. 08-2677MPI |. ITION NO.: AHCA-09- OSS, -S-MDO TRELLES PHARMACY MANAGEMENT, INC. REND - ° Respondent. TRELLES PHARMACY MANAGEMENT, INC. Petitioner, vs. po : CASE NO. 08-3820RX AGENCY FOR HEALTH CARE ADMINISTRATION, 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. a DONE and ORDERED on this the 23. day of Yobuc wy , 2007, in i Tallahassee, Florida. , fo f fin wf. : A ee HOLLY BENSON, 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 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: Karen Dexter, Esquire Agency for Health Care Administration (Laserfiche) James M. Barclay, Esq. Ruden McClosky 215 South Monroe Street Suite 815 Tallahassee, FL 32301 (U.S. Mail) W. F. Quattlebaum Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 Ken Yon, Chief, Medicaid Program Integrity Kathy Herold, 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 theZ To of feZr an > 200” 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 DIVISION OF ADMINISTRATIVE HEARINGS AGENCY FOR HEALTH CARE ADMINISTRATION, Petitioner, v8. CASE NO. 08-2677MPI_ TRELLES PHARMACY MANAGEMENT, INC. Respondent. TRELLES PHARMACY MANAGEMENT, INC. Petitioner, vs. CASE NO. 08-3820RX AGENCY FOR HEALTH CARE ‘ADMINISTRATION, Respondent SETTLEMENT AGREEMENT STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION (“AHCA” or “the Agency”), and Trelles Pharmacy Management, Inc. (“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 of these matters. 2. PROVIDER is a Medicaid provider in the State of Florida, provider number ~ 106362600 / License No. PH0015867, and was a provider during the audit period. 3. In its Final Audit Report (final agency action) dated March 4, 2008, AHCA notified PROVIDER that review of Medicaid claims performed by Medicaid Program Integrity . (MPD), Office of the AHCA Inspector General, indicated that cértain claims, in whole or in part, ‘has been inappropriately paid by Medicaid. The Agency sought recoupment of this overpayment, in the amount of $174,264.07, and imposed a fine sanction of $5,500.00 for violation of Rules 59G-9.070(7)(c) and (7)(n), F.A.C. In response to the Final Audit Report dated March 4, 2008, PROVIDER filed a petition for a formal administrative hearing, which was assigned DOAH Case No. 08-2677MPI. . 4, In addition to the request for formal administrative hearing, on August 4, 2008, PROVIDER filed a Petition for Rule Challenge challenging the validity of certain provisions in the Medicaid Pharmacy Handbook, which was assigned DOAH Case NO. 08-3820RX. The Agency responded by filing a Motion for Summary Final Order. The ALT denied the motion and allowed PROVIDER an opportunity to file an amended petition. On September 26, 2008, PROVIDER filed an Amended Petition for Determination that Agency Statements are Unadopted Rules. . 5. In order to resolve these matters without further administrative proceedings, PROVIDER and the AHCA expressly agree as follows: (1) PROVIDER shall withdraw its Amended: Petition for Determination that Agency Statements are Unadopted Rules with prejudice, on or before December 19, 2008. (2) AHCA agrees to accept the payment set forth herein in settlement of the overpayment issues arising from the MPI review. (3) On or before February 1, 2009, and after issuance of the final order, PROVIDER shall remit payment to the Agency in the amount of one ~ hundred seventy nine thousand seven hundred sixty-four dollars and seven sents ($179,764.07), which includes $5,500.00 in sanctions, in one lump sum. AHCA retains the right to perform a 6 month follow-up review. (4) PROVIDER and AHCA agree that full payment as set forth above will resolve and settle Case No. 08-2677MPI completely and release both parties from all liabilities arising from the findings in the audit referenced as CL. 08-6185-000/P. - (5) PROVIDER agrees that it will not, re-bill the Medicaid Program in any manner for claims that were not covered by Medicaid, which are the subject of the audit in this case. ) 6. Payment shall be made to: AGENCY FOR HEALTH CARE ADMINISTRATION Medicaid Accounts Receivable Post Office Box 13749 . Tallahassee, Florida 32317-3749 7. 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. 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. Each party shall bear its own attorney’s fees and costs, if any. 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. 3 12. This Agreement shall be construed in accordance with the provisions of the Jaws ofFlorida. Verme-for any action arising from this Agreement shall be in Leon County, Florida. 13. 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 . @ written aineridment 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. 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 farther 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. Torthe 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 fo the benefit of and be binding on each party’s successors, assigns, heirs, administrators, representatives and trustee. 19. All times stated herein are of the essence. . 20.-... This Agreement shall be in full force and effect upon execution by the respective parties in counterpart. we RELLES PHARMACY “NT: INC. Wied ua Dated: —/Lji2____., 2008 : (Print wane) ms: Cw how AGENCY FOR HEALTH CARE ADMINISTRATION 2727 Mahan Drive, Mail Stop #3 Tallahassee, FL 32308-5403 ica Dated: Febncesy 25 42 Peter Williams "Fe ww Inspector General ELEY Lak CLM: Z Dated: 2/79 200K on, Justi Senior Acting General Counsel Dated: _ /2//7 __, 2008 CHARUE CRIST . an HOLLY BENSON GOVERNOR SECRETARY December 5, 2008 James M. Barclay, Esq. Akerman Senterfit 106 Bast College Ave., Suite 1200 Tallahassee, FI: 32301 RE: AHCA v. Trelles Pharmacy Management, Inc., Case No. 08-2677MPI Trelles Pharmacy Management, Inc. v. ANCA, Case No. 08-3820RX. Dear Chet: In‘reference to our most recent telephone conversation, enclosed please find settlement doctiments memorializing our agreement. If the Settlement Agreement does not accurately set forth our agreement to settle this matter, you must inform me immediately in writing setting forth any points of disagreement in detail. Otherwise, please have your client execute it and return it to me. Please have the signed settlement agreement back to me no later than December 15, 2008. Payment in compliance with the settlement agreement. must be made payable to “Florida Agency for Health Care Administration” and forwarded fo: ‘(please do not make any payments until the signed settlement agreement and final order is received) AGENCY FOR HEALTHCARE ADMINISTRATION Medicaid Accounts Recéivable Post Office Box 13749 , ‘Tallahassee, Florida 32317-3749 Please note that this agreement requires your client to withdraw its rule challenge by December ‘19, 2008. _ Should you have any questions please feel free to cali me at (850) 414-7670. Thank you ' for your attention to this matter. _ Very truly yours, Visit AHCA ontine at http://ahca.myflorida.com 2727 Mahan Drive, MS#-> Tallahasses, Florida 32308

Docket for Case No: 08-002677MPI