Findings Of Fact The Respondent, Howard Newman, is a pharmacist licensed in the State of Florida, holding license number 0014877. The Respondent, Bek-New Chemist, holds community pharmacy permit number 0006282. The Respondent practices pharmacy, and Bek-New Chemist is located, at 3690 Northwest 199th Street, Carol City, Florida 33054. Howard Newman is the owner and operator of Bek-New Chemist. The Petitioner is an agency of the State of Florida charged with administering and enforcing the licensure standards and status of pharmacists and pharmacies in Florida and the regulation and enforcement of their standards of practice. On August 26, 1980, Detective Kenneth Hackett of the Hialeah Police Department, pursuant to information received from a confidential informant, went with that informant to Bek-New Chemist Pharmacy, the Respondent's place of practice. Upon arriving in the parking lot of that establishment, the confidential informant pointed out to Detective Hackett a particular car which he said belonged to a black male by the name of "Howard." The informant told Detective Hackett that Howard would sell controlled drugs without a prescription. Detective Hackett thereupon gave his informant $20 in Hialeah Police Department "investigation funds" and instructed him to go inside and attempt to buy Darvon from the black male previously identified by the informant as "Howard." The informant then proceeded into the pharmacy, followed immediately thereafter by Detective Hackett. The informant identified the black male inside behind the counter as "Howard." Detective Hackett later checked the license number on the car identified as belonging to Howard, the individual in the pharmacy at the time, and identified by the informant, as being registered to the Respondent, Howard Newman. The informant, under the observation of Detective Hackett, engaged the individual identified by that means as the Respondent Howard Newman in a conversation. The Respondent went into the back room area of the pharmacy, returning a few minutes later and again conversing with the police informant. The Respondent then returned to the "back room" and returned with a medication container marked "Valium." The informant thereupon gave the Respondent the subject $20 in cash and the Respondent gave him the container. The container proved, after laboratory tests, the results of which are in evidence, to contain 60 Dextropropoxyphene tablets, commonly known as Darvon. Darvon is a scheduled, controlled drug, the dispensing of which must be accompanied by a prescription. The Respondent thus sold this controlled substance without being furnished a valid prescription or authorized refill therefor while the Respondent was licensed to practice pharmacy in this state.
Recommendation Having considered the foregoing Findings of Fact and Conclusions of Law, the evidence in the record and the candor and demeanor of the witnesses, it is RECOMMENDED: That the license of the Respondent, Howard Newman, and the community pharmacy permit of the Respondent Bek-New Chemist be revoked without prejudice to those Respondents reapplying for licensure and permitting upon a proper show of rehabilitation. DONE and ENTERED this 23rd day of June, 1983, in Tallahassee, Florida. P. MICHAEL RUFF Hearing Officer Division of Administrative Hearings The Oakland Building 2009 Apalachee Parkway Tallahassee, Florida 32301 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 23rd day of June, 1983. COPIES FURNISHED: Bruce D. Lamb, Esquire Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Howard Newman 3690 Northwest 199th Street Carol City, Florida 33054 Wanda Willis, Executive Director Board of Pharmacy Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301 Fred M. Roche, Secretary Department of Professional Regulation 130 North Monroe Street Tallahassee, Florida 32301
The Issue Whether the Petitioner must reimburse the Respondent for Medicaid overpayments as set out in the Final Agency Audit Report dated January 24, 2008, and pay an administrative fine, and, if so, the amount of the fine and the amount to be repaid.
Findings Of Fact Based on the oral and documentary evidence presented at the final hearing and on the entire record of this proceeding, the following findings of fact are made: AHCA is the state agency charged with responsibility for overseeing the Florida Medicaid system, including the recovery of overpayments to Medicaid providers. § 409.913, Fla. Stat. Grand Pharmacy Discount was first issued a pharmacy license by the Department of Health on June 3, 2004; the license number was PH20078, and the owner of Grand Pharmacy Discount was Ana M. Grajales. On or about May 19, 2005, Mr. Mohebbi purchased Grand Pharmacy Discount from Ms. Grajales. At that time and at all times material to this proceeding, Mr. Mohebbi was a licensed pharmacist, license number PS33552. On July 6, 2005, Mr. Mohebbi applied to the Department of Health, Board of Pharmacy, for a new pharmacy license for Grand Pharmacy Discount, based on a change of ownership. A new pharmacy license, number PH21403, was issued. On July 10, 2005, Grand Pharmacy Discount, through Mr. Mohebbi, submitted a Florida Medicaid Provider Enrollment Application to AHCA, together with a signed Non-Institutional Medicaid Provider Agreement ("Provider Agreement"). The Florida Medicaid Provider Enrollment Application was submitted by Mr. Mohebbi because of a change in ownership, and the Grand Pharmacy Discount pharmacy license referenced in the application was numbered PH21403. Among the provisions of the Provider Agreement were the following: (5) Provider Responsibilities. The Medicaid provider shall Possess at the time of the signing of the provider agreement, and maintain in good standing throughout the period of the agreement's effectiveness, a valid professional, occupational, facility or other license appropriate to the services or goods being provided, as required by law. * * * (8) Ownership. The provider agrees to give AHCA sixty (60) days written notice before making any change in ownership of the entity named in the provider agreement as the provider. Grand Pharmacy Discount was assigned Medicaid provider numbers 0309401-00 and 0309401-01. At the times material to this proceeding, Mr. Mohebbi was the pharmacy manager for Grand Pharmacy Discount and dispensed all medications.2 On March 30, 2007, David Santiago filed papers with the Florida Department of State incorporating Grand Pharmacy Discount as a limited liability company. Mr. Santiago and Mr. Mohebbi entered into negotiations for Mr. Santiago to purchase Grand Pharmacy Discount, and Mr. Santiago and Mr. Mohebbi had a verbal agreement that Mr. Santiago would pay Mr. Mohebbi a deposit on the business, with the balance due at the time of the sale. In furtherance of his intention to purchase Grand Pharmacy Discount, Mr. Santiago, with the assistance of Mr. Mohebbi, prepared and signed an Application for Pharmacy requesting a new pharmacy license for Grand Pharmacy Discount. It was indicated on the Application for Pharmacy that the application was based on a change of ownership from Mr. Mohebbi to Mr. Santiago, and Mr. Santiago filed the application with the Department of Health on April 2, 2007. A new pharmacy license, license number PH22661, was issued to Grand Pharmacy Discount on April 19, 2007. Mr. Santiago did not fulfill his promise to pay Mr. Mohebbi a deposit on the purchase of Grand Pharmacy Discount, and the negotiations for the purchase and sale terminated. Mr. Santiago and Mr. Mohebbi did not enter into a purchase and sale agreement, and Mr. Mohebbi at no time relinquished ownership or control of Grand Pharmacy Discount, its assets or liabilities, to Mr. Santiago. On June 5, 2007, Mr. Mohebbi submitted an Application for Pharmacy to the Department of Health, Board of Pharmacy, requesting that a new permit be issued to Grand Pharmacy Discount based on a change of ownership; Mr. Mohebbi was listed as the owner. On August 2, 2007, Grand Pharmacy Discount was issued a new pharmacy license, number PH22843. In a letter dated June 13, 2007, AHCA notified Grand Pharmacy Discount that its Medicaid provider numbers had been terminated effective April 19, 2007, because it had been notified that Grand Pharmacy Discount's license number PH21403 had been "closed." AHCA conducted a review of the claims for Medicaid reimbursement submitted by Grand Pharmacy Discount from April 19, 2007, through September 30, 2007. In a Preliminary Audit Report dated October 30, 2007, AHCA notified Grand Pharmacy Discount that it found that Grand Pharmacy Discount was overpaid $10,655.44. On January 24, 2008, AHCA issued the FAR, in which it notified Grand Pharmacy Discount that it owed AHCA a total of $11,655.44, which included the previously-identified overpayment of $10,655.44 and a penalty in the amount of $1,000.00. The reasoning for finding an overpayment was stated as follows: The audit period for this review was from April 19, 2007, through June 5, 2007. Grand Pharmacy Discount, Florida Pharmacy license number PH0021403, located at 2140 N.W. 36th Street, Miami, Florida 33142 was issued Medicaid provider number 030940100 effective July 25, 2005. The Department of Health, due to a change of owners, issued Florida Pharmacy license number PH0022661 for Grand Pharmacy Discount at the same address effective April 19, 2007, which closed the previous license number, PH0021403. Medicaid requires an active pharmacy license for your Medicaid provider number to be valid. Additionally, Medicaid requires providers to notify the Agency of any proposed change of ownership 60 days prior to the date on which that ownership change will occur, per Section 409.907(6), F.S. Paid claims to your provider number were found with dates of service after April 19, 2007, when your pharmacy license was closed. The paid claims identified for the period when your provider number was invalid due to the closed pharmacy license number and ownership change resulted in an overpayment of $10,655.44. The termination date of the Audit Period was changed in the FAR from September 30, 2007, to June 5, 2007. The Audit Period was changed to June 5, 2007, because no Medicaid claims were submitted by Grand Pharmacy Discount after that date. According to AHCA's Documentation Worksheet for Imposing Administrative Sanctions, the $1,000.00 sanction was imposed because of Grand Pharmacy Discount's alleged failure "to report CHOW [Change of Ownership] & allowed unauthorized use of provider # to submit Rx claims." Grand Pharmacy Discount has never been disciplined by AHCA, and AHCA has never sought to recoup any Medicaid overpayments from Grand Pharmacy Discount.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Agency for Health Care Administration enter a final order withdrawing the Final Audit Report issued January 24, 2008, with respect to both the $10,655.44 overpayment and the $1,000.00 administrative fine. DONE AND ENTERED this 21st day of December, 2009, in Tallahassee, Leon County, Florida. PATRICIA M. HART Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 21st day of December, 2009.
The Issue At issue is whether Respondent committed the offenses set forth in the Administrative Complaint and, if so, what penalty should be imposed.
Findings Of Fact Respondent's license and employment Respondent, Patrick O. Ojo, is now, and was at all times material hereto, licensed as a pharmacist by the State of Florida, having been issued license number PS 0032023. At all times pertinent hereto, Respondent was under contract with Healthcare Consultants of Central Florida, Inc., d/b/a Healthcare Consultants Pharmacy Staffing (Healthcare Consultants) , a corporation engaged in "the business of placing licensed pharmacists on a temporary and permanent basis" with businesses in need of their services. Pursuant to the agreement, Healthcare Consultants would "from time to time during the term of . . . [the] agreement offer [the] pharmacist the right to perform pharmaceutical services at the location of various clients, " which the pharmacist had the option to accept or reject. If accepted, for temporary services provided under the agreement, Healthcare Consultants would pay the pharmacist $25.50 per hour, except for legal holidays when the rate would be $41.25 per hour. Pursuant to a referral from Healthcare Consultants, Respondent accepted a position, on a temporary basis, as pharmacy manager for A & N Discount Pharmacy on June 2, 1997. A & N Discount Pharmacy is a community pharmacy licensed by Petitioner pursuant to Section 465.018, Florida Statutes, and located at 900 Alton Road, Miami Beach, Florida. The pharmacy inspection On June 24, 1997, Harold Gluck, a senior pharmacist employed by the Agency for Health Care Administration (AHCA), entered A & N Discount Pharmacy to conduct a routine community pharmacy inspection. Pertinent to this case, that inspection noted three deficiencies or violations against the pharmacy business, to wit: (1) there was a 2:1 technician to pharmacist ratio, without prior approval of the Board of Pharmacy (a perceived violation of Rule 64B16-27.410, Florida Administrative Code); (2) the two technicians were not wearing identification badges ( a perceived violation of Rule 64B16-27.410, Florida Administrative Code); and (3) the prescription department was only open 24 hours per week, as opposed to 40 hours per week (a perceived violation of Rule 64B16-28.404, Florida Administrative Code). Mr. Gluck's visual observations are supported by compelling proof, and are credited.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that a final order be entered which dismisses Counts I and IV of the Administrative Complaint; finds Respondent guilty of violating Section 465.016(1)(n), Florida Statutes, by failing to comply with Rule 64B16-27.410, Florida Administrative Code, as alleged in Counts II and III of the Administrative Complaint; and, which imposes, as a penalty for such violations, the issuance of a letter of guidance. DONE AND ENTERED this 15th day of September, 1998, in Tallahassee, Leon County, Florida. WILLIAM J. KENDRICK Administrative Law Judge Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 SUNCOM 278-9675 Fax Filing (850) 921-6847 Filed with the Clerk of the Division of Administrative Hearings this 15th day of September, 1998.
The Issue Whether Hospice of Southwest Florida, Inc. has standing to initiate a challenge to the issuance of a license to Hospice of Charlotte, Inc.
Findings Of Fact The facts alleged in the petition, which for purposes of this Motion, are taken as true, are as follows: In a March 10, 1994 letter, the President of HOC notified AHCA that the Board of Directors met that day and decided to dissolve HOC, that the only patient receiving services had been transferred to another provider, and that HOC intended to accept no further referrals. On March 15, 1994, AHCA responded by "terminating the license of Hospice of Charlotte effective March 10, 1994." AHCA requested a copy of the minutes of the March 10th board meeting. On March 25, 1994, the President of HOC wrote to AHCA again, this time requesting review of his letter seeking dissolution, "for the purpose of re- opening our case." He said the Board, on March 10th, intended to restructure the operation and, on March 22nd, met again and approved an agreement to work with another home health agency. Referring in his letter to advice given him in a telephone conversation with agency staff, the President sent HOC licenses number 0046 and 00442 to AHCA. The licenses had April 30, 1994 expiration dates. The letter also stated that HOC and its new partner would re-apply for licensure. In May 1994, HOC requested the return of the renewal license fee sent in on March 3, 1994, for a license that was not pursued. In December, 1994, AHCA investigated an allegation that HOC was continuing to operate without a license and concluded by finding the allegation unconfirmed. HOC had no license after March 1994 until January 31, 1995, when AHCA issued License No. 5015-94 to HOC, effective from May 1, 1994 to April 30, 1995. On April 21, 1995, AHCA notified HOC that its license was void ab initio for failure to first obtain a certificate of need (CON). The following facts are taken from public records at DOAH and from documents submitted by HOC as attachments to the Motion In Opposition: On May 16, 1995, HOC filed a Petition For Formal Administrative Hearing challenging AHCA's April 21, 1995 action voiding its license. On June 1, 1995, the First District Court of Appeal issued an Order to Show Cause by June 7, why a petition to review non-final administrative action should not be granted, and required the agency to specifically address the authority of the agency to revoke HOC's license. On June 7, HOC and AHCA entered into a settlement agreement, pursuant to which HOC voluntarily dismissed its actions at DOAH and in the District Court, and AHCA withdrew its letter of April 21, 1995, and issued HOC a license effective May 1, 1995. There is no evidence in the record of HOC's CON status. Whether HOC has or ever had a CON, or was a grandfathered provider is not know.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Agency For Health Care Administration enter a Final Order dismissing the Petition For Administrative Hearing filed by Hospice of Southwest Florida, Inc. DONE AND ENTERED this 1st day of September, 1995, in Tallahassee, Leon County, Florida. ELEANOR M. HUNTER Hearing Officer Division of Administrative Hearings The DeSoto Building 1230 Apalachee Parkway Tallahassee, Florida 32399-1550 (904) 488-9675 Filed with the Clerk of the Division of Administrative Hearings this 1st day of September, 1995. COPIES FURNISHED: Michael O. Mathis, Esquire Agency for Health Care Administration 2727 Mahan Drive Fort Knox Building 3, Suite 3431 Tallahassee, Florida 32308-5403 J. Robert Griffin, Esquire McFarlain, Wiley, Cassedy & Jones, P.A. 215 South Monroe Street Suite 600 Tallahassee, Florida 32301 Peter A. Lewis, Esquire Goldsmith & Grout, P.A. 307 West Park Avenue Post Office Box 1017 Tallahassee, Florida 32302-1017 R. S. Power, Agency Clerk Agency for Health Care Administration 2727 Mahan Drive Fort Knox Building 3, Suite 3431 Tallahassee, Florida 32308-5403 Tom Wallace Assistant Director Agency For Health Care Administration 2727 Mahan Drive Fort Knox Building 3, Suite 3431 Tallahassee, Florida 32308-5403
