STATE OF FLORIDA,

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

1. GE NC\' CLE RK

   2012 JUN 25 A 8: 33

   AGENCY FOR HEALTH CARE ADMINISTRATION,

   
   

   Petitioner,

   
   

   vs. CASE NO: 11-4003MPI

   AUDIT NO: CI 12-0014-000 PROVIDER NO: 067166500 LICENSE NO: ME37730

   RENDITION NO.: AHCA-12- tJ&& tJ -5-MDO

   
   

   JUAN I. SEGUROLA,

   
   

   Respondent.

                                                                          I

   
   

   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 ./4'!!-day of      .k -1'- ' 2012, m

   f

   Tallahassee, Florida.

   -lizabethDiuik-, Secfeftatry!'.

   Agency for Health Care Administration

   
   

   Filed June 26, 2012 2:36 PM Division of Administrative Hearings

   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:

   
   

   Ignacio J. Segurola, P.A.

   3301 Ponde De Leon Boulevard, 3rd Floor Coral Gables, Florida 33134

   (Via U.S. Mail)

   
   

   Shena Grantham, Esquire

   Agency for Health Care Administration 2727 Mahan Drive

   Building 3, Mail Station 3

   Tallahassee, Florida 32308 (Interoffice Mail)

   Mike Blackbum, Bureau Chief Medicaid Program Integrity 2727 Mahan Drive

   Building 2, Mail Station 6

   Tallahassee, Florida 32308 (Interoffice Mail)

   
   

   Robert E. Meale Administrative Law Judge

   Division of Administrative Hearings The Desoto Building

   1230 Apalachee Parkway

   Tallahassee, Florida 32399-3060 (Via U.S. Mail)

   
   

   Inspector General (Interoffice Mail)

   
   

   Health Quality Assurance (Interoffice Mail)

   Finance & Accounting (Interoffice Mail)

   
   

   Gordon McCleary (Interoffice Mail)

   CERTIFICATE OF SERVICE

   
   

        ,......

   I HEREBY CERTIFY that a true and correct copy of the foregoing document has been furnished to the person(s) named the above by the indicated means of delivery, on thish;,

   of _

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   .,c. :::.

   ,2012.

   bJd·· · - ,,

   Richard Shoop, Esqufre Agency Clerk

   Agency for Health Care Administration 2727 Mahan Drive

   Building 3, Mail Station 3

   Tallahassee, Florida 32308

   Telephone: (850) 412-3630

   Fax: (850) 921-0158

   
   

   STATE OF FLORIDA

   DIVISION OF ADMINISTRATIVE HEARINGS

   
   

   STATE OF FLORIDA, AGENCY FOR HEALTH CARE ADMINISTRATION,

   
   

   
   

   vs.

   Petitioner,

   
   

   CASE NO.: 11-4003 MPI PROVIDER NO.: -67166500

   C.I. NO.: 12-0014-000

   
   

   JUAN I. SEGUROLA, MD ,

   
   

   Respondent.

   ---------------'

   SETTLEMENT AGREEMENT

   
   

   Petitioner, the STATE OF FLORIDA, AGENCY FOR HEALTH CARE

   
   

   ADMINISTRATION, ("AHCA" or "Agency"), and Respondent, JUAN I. SEGUROLA, MD, ("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

      
      

      0671665-00, and was a provider during the audit period.

      
      

   3. In its Sanction Only Final Audit Report, dated July 19, 2011, the Agency notified PROVIDER that the Agency was terminating PROVIDER's participation in the Medicaid program pursuant to Florida Statutes§ 409.913(14), stating:

      (14) If the provider has been suspended or terminated from participation in the Medicaid program or the Medicare program by the Federal Government or any state, the agency must immediately suspend or terminate, as appropriate, the provider's participation in this state's Medicaid program for a period no less than that imposed by the Federal Government or any other state, and may not enroll

      
      

      Agency ror Health Care Administration v. Juan I. Segurola. MD

      (Case No.: 11-4003MPI)

      Settlement Agreement Page 1 of 5

      such provider in this state's Medicaid program while such foreign suspension or termination remains in effect.

      
      

   4. In response to the audit report dated July 19, 2011, PROVIDER filed a

      
      

      Petition for Formal Administrative Hearing.

      
      

   5. Subsequently, on August 15, 2011 and September 19, 2011, PROVIDER submitted documentation to AHCA illustrating that PROVIDER had voluntarily surrendered his medical license in Texas, which led to his exclusion from the Texas Medicaid program. Thus, PROVIDER was not "suspended or terminated" from the Medicaid program, in the manner contemplated by Florida Statutes §409.913(14).

   6. The parties moved to relinquish jurisdiction back to the Agency pending settlement, and the Administrative Judge granted this request on October 5, 2011.

   7. In light of the documentation submitted by PROVIDER, the Secretary has agreed to rescind the sanction that would terminate the PROVIDER from the Florida Medicaid program, pursuant to Florida Statutes §409.913(16)U), stating that "[t]he Secretary of Health Care Administration may make a determination that imposition of a sanction or dis·1ncentive is not in the best interest of the Medicaid program, in which case a sanction or disincentive shall not be imposed."

   8. AHCA, accordingly, hereby rescinds the sanction imposed in the July 19,

      
      

      2011 Sanction Only Audit Report

      
      

   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.

       Agency for Health Care Administration . Juan I. Segurola, MD

       (Case No. 11-4003MPI)

       Settlement Agreement Page 2 of 5

       
       

   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.

   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

       
       

       Agency for Health Care Administration v. Juan I. Segurcla, MD (Case No.· 11-4003MPI)

       Settlement Agreement Page 3 of 5

       
       

       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. 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, 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 forum, including any claims arising out of this agreement.

   17. The parties agree to bear their own attorney's fees and costs, if any.

       
       

   18. 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.

   19. 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.

   20. This Agreement shall inure to the benefit of and be binding on each party's successors, assigns, heirs, administrators, representatives and trustees.

   21. All times stated herein are of the essence of this Agreement.

       
       

   22. This Agreement shall be in full force and effect upon execution by the respective parties in counterpart.

Agency for Health Care Administration v. Juan I Segunola, MD (Case No.. 11-4003MPI)

Setllemen1 Agreement Page4 ol S

JUAN I. SEGUROLA, MD,

   (                 Dated: f O/ j,..-f ( 1 1 , 2011

BY: JL>A. D   T.   S 't. u,L<i Lv-4,  JU. A.

(Print name)

AGENCY FOR HEALTH CARE ADMINISTRATION

2727 Mahan Drive, Bldg. 3, Mail Stop #3

Tallahassee, FL 32308-5403

Dated·.

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111am o erts ·R\

Dated:   t,==-+-(!_/_2---      

, 201-r

General Counsel ( oe.11 uf.y)

Kim Kellum ' Chief Medicaid Counsel

Dated: 9 9

nt General Counsel

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Agency for Health Care Admin1slr<1tion v. Juan I. Segurola. MD

(Case No. 11--4003MPI)

Settlement Agreement Page 5 or 5

Docket for Case No: 11-004003MPI

Orders for Case No: 11-004003MPI