STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

AMENDED FINAL ORDER ON REMAND

On November 18, 2020, the First District Court of Appeal issued its opinion in Joseph Pinto Domingo, a minor, by and through his parents and natural guardians, Aurileia Dos Reis Pinto and Nilton Pinto v. State of Florida, Agency for Health Care Administration, Case No. 1D18-2573, in which the Court reversed the Final Order entered in this case on May 22, 2018. In the Final Order, the then presiding Administrative Law Judge ordered Petitioner to reimburse AHCA for the full amount of its Medicaid expenditures for his past medical expenses in the amount of $641,174.03, in satisfaction of AHCA’s Medicaid lien.

The Opinion is dispositive as to the amount Petitioners are required to reimburse AHCA in satisfaction of its Medicaid lien, stating that:

In this case, the appellant presented competent, substantial, and uncontradicted evidence to support the reduction of his Medicaid lien by using a pro rata method. AHCA failed to present any evidence that the appellant’s proposed pro rata methodology was inaccurate or that another method would be more appropriate to apply. As a result, the ALJ erred as a matter of law by concluding that the appellant failed to prove that his Medicaid lien should have been reduced. See Mojica, 285 So. 3d at 396−98. We note that the appellant’s proposed amount that AHCA should recover for its Medicaid lien was mathematically incorrect; however, the appellant presented competent, substantial evidence that the Medicaid lien should be reduced by one-third. Accordingly, we reverse and remand the cause to the Department of Administrative Hearings for the ALJ to reduce AHCA’s Medicaid lien to

$213,724.68.

The Court remanded the case to DOAH for further proceedings consistent with itsOopinion. Mandate was entered on December 9, 2020. The presiding Administrative Law Judge having retired since the entry of the Final Order, the case was assigned to the undersigned.

On January 11, 2021, an Order for Requiring Status Report was entered that required the parties to confer and jointly advise the undersigned of the amount each of them believed to be the correct amount to be reimbursed by Petitioners in satisfaction of the Medicaid lien. On January 13, 2021, the parties filed a joint response in which they agreed that the sum of

$213,724.68 is sufficient, and required, to satisfy the Medicaid lien. Further evidentiary proceedings are not necessary to carry out the direction of the Court.

Based on the foregoing, it is hereby ORDERED that Petitioners, Joseph Pinto Domingo, a minor, by and through his parents and natural guardians, Aurileia Dos Reis Pinto and Nilton Pinto, shall pay to Respondent, Agency for Health Care Administration, the sum of $213,724.68, in satisfaction of the Medicaid Lien.

DONE AND ORDERED this 15th day of January, 2021, in Tallahassee, Leon County, Florida.

S

E. GARY EARLY Administrative Law Judge

Division of Administrative Hearings The DeSoto Building

1230 Apalachee Parkway

Tallahassee, Florida 32399-3060

(850) 488-9675

Fax Filing (850) 921-6847 www.doah.state.fl.us

Filed with the Clerk of the

Division of Administrative Hearings this 15th day of January, 2021.

COPIES FURNISHED:

Alexander R. Boler, Esquire Suite 330

2073 Summit Lake Drive Tallahassee, Florida 32317 (eServed)

Floyd B. Faglie, Esquire Staunton & Faglie, PL 189 East Walnut Street Monticello, Florida 32344 (eServed)

Kim Annette Kellum, Esquire

Agency for Health Care Administration Mail Stop 3

2727 Mahan Drive

Tallahassee, Florida 32308 (eServed)

Shena L. Grantham, Esquire

Agency for Healthcare Administration Building 3, Room 3407B

2727 Mahan Drive

Tallahassee, Florida 32308 (eServed)

Thomas M. Hoeler, Esquire

Agency for Health Care Administration Mail Stop 3

2727 Mahan Drive

Tallahassee, Florida 32308 (eServed)

Richard Shoop, Agency Clerk

Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308 (eServed)

Shevaun L. Harris, Acting Secretary Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 1

Tallahassee, Florida 32308

Bill Roberts, Acting General Counsel Agency for Health Care Administration 2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308 (eServed)

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party who is adversely affected by this Final Order is entitled to judicial review pursuant to section 120.68, Florida Statutes. Review proceedings are governed by the Florida Rules of Appellate Procedure. Such proceedings are commenced by filing the original notice of administrative appeal with the agency clerk of the Division of Administrative Hearings within 30 days of rendition of the order to be reviewed, and a copy of the notice, accompanied by any filing fees prescribed by law, with the clerk of the district court of appeal in the appellate district where the agency maintains its headquarters or where a party resides or as otherwise provided by law.

Docket for Case No: 17-005417MTR

Orders for Case No: 17-005417MTR