STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

r:·i , - n

• • ·~• t. 1.·"

2014 NOV I Lt P 12: 0 I

AGENCY FOR HEALTH CARE ADMINISTRATION,

CASE NO. 12-3817MPI

vs.

Petitioner,

C.l. NO.: 11-1437-000

PROVIDER NO.: 010042136

NPI NO.: 1174601397

LICENSE NO.: 3998

RENDITION NO.: AHCA- I 4 - oq 17 -S-MDO

JACKSON MEMORIAL HOSPITAL,

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 day  of7;1   ,2014, in Tallahassee,

Florida.

ZABETHDui( SE RY

Agency for Health Care Administration

1

AHCA vs. Jackson Memorial Hospital, C.I. 11-1437-000 Final Order

Filed November 19, 2014 3:21 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:

Monica Galindo Stinson Assistant Attorney General Florida Bar No. 145785

OFFICE OF THE ATTORNEY GENERAL

110 S.E. 6th Street, 10th Floor Fort Lauderdale, FL 33301

John Bajger, Bureau Chief Assistant Attorney General

OFFICE OF THE ATTORNEY GENERAL

110 S.E. 6th Street, 10th Floor Fort Lauderdale, FL 33301

Chris Kokoruda, Esq. Jackson Memorial Hospital

1611 N.W. 12th Ave., West Wing 109 Miami, Florida 33136

Counsel for Respondent

Kelly Bennett, Chief Medicaid Program Integrity

Agency for Health Care Administration (AHCA) Medicaid Program Integrity

2727 Mahan Drive, MS#3 Tallahassee, FL 32308

Shena L. Grantham Assistant General Counsel

Agency for Health Care Administration (AHCA) Medicaid Program Integrity

2727 Mahan Drive, MS#3 Tallahassee, FL 32308

Finance and Accounting Health Quality Assurance

2

AHCA vs. Jackson Memorial Hospital, C.I. 11-1437-000 Final Order

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 or other designated method on this the of

,/J /,0_/2 014.

Agency Clerk State of Florida

Agency for Health Care Administration 2727 Mahan Drive, MS #3

Tallahassee, Florida 32308-5403

(850) 412-3630/FAX (850) 921-0158

3

AI-ICA vs. Jackson Memorial Hospital, C.I. 11-1437-000 Final Order

Docket for Case No: 12-003817MPI

Orders for Case No: 12-003817MPI