The Issue The issues in these cases are whether two Petitions for Resolution of Reimbursement Dispute (Petitions), filed pursuant to section 440.13(7), Florida Statutes (2018),1/ were untimely; and, if so, whether the untimeliness should be excused under the equitable tolling defense asserted by Petitioners.
Findings Of Fact LRMC is a large hospital in Lakeland that regularly provides hospital care and services to injured workers covered by workers’ compensation insurance. In conformity with the workers’ compensation statutes and rules, LRMC bills workers’ compensation insurance carriers (carriers) for the hospital charges. LRHS is a health system, presumably affiliated with LRMC (though there is no record evidence of the relationship between the two entities). Based on an unspecified relationship with physicians who provide services to injured workers at LRMC, LRHS takes care of billing carriers for those physician charges. The parties stipulated that Petitioners are considered “health care providers” within the meaning of the Workers’ Compensation Law, chapter 440, Florida Statutes. In these cases, Petitioners want the Department to resolve their reimbursement disputes with a carrier. The disputes arose from the carrier’s disallowance or adjustment of payment on bills for hospital and physician services rendered to an injured worker during a single “encounter” (patient stay at LRMC) from October 31, 2017, to November 8, 2017. The Department is the state agency responsible for administering and enforcing the Workers’ Compensation Law. One of its responsibilities is resolving reimbursement disputes between providers and carriers, upon a provider’s timely petition after receiving notice from a carrier that payment of a bill has been disallowed or adjusted. See § 440.13(7), Fla. Stat. Regulatory Context The process by which health care providers bill carriers and carriers review and make determinations on provider bills is highly regulated, with requirements, deadlines, and procedures in the Workers’ Compensation Law and implementing rules.3/ Bill review by carriers under section 440.13(6) and implementing rules culminates in a reimbursement decision by the carrier to either pay the bill or to disallow, adjust, or deny payment. An “Explanation of Bill Review” (EOBR) is “the document used to provide notice of payment or notice of adjustment, disallowance or denial by a claim administrator or any entity acting on behalf of an insurer to a health care provider[.]” Fla. Admin. Code R. 69L-7.710(1)(y). Pursuant to rule 69L-7.740(14), the carrier (or its claim administrator) must use an EOBR detailing the adjudication of the submitted bill by each line item; it is the only authorized means for giving notice to the health care provider of the reimbursement decision. The adjudication (reimbursement decision) must be explained using EOBR reason codes and code descriptors listed in rule 69L-7.740(13)(b) (listing 98 EOBR codes with code descriptors). The carrier must select at least one EOBR code reason, and no more than three EOBR code reasons, for each line item. When more than one EOBR code reason is used for one line item, the codes must be shown in descending order of importance. Fla. Admin. Code R. 69L-7.740(13)(a). EOBR codes must be used, but the carrier may also add internal code reasons for additional explanation. Fla. Admin. Code R. 69L-7.740(14). The EOBR notice is what triggers a health care provider’s option to petition the Department to resolve a reimbursement dispute with the carrier pursuant to section 440.13(7). The EOBR itself must make that clear by including the following statements required by rule 69L-7.740(14): An EOBR shall specifically state that the EOBR constitutes notice of disallowance or adjustment of payment within the meaning of subsection 440.13(7), F.S. An EOBR shall specifically identify the name and mailing address of the entity the carrier designates to receive service on behalf of the “carrier and all affected parties” for the purpose of receiving the petitioner’s service of a copy of a petition for reimbursement dispute resolution by certified mail, pursuant to paragraph 440.13(7)(a), F.S. By statute, a provider has a limited 45-day window after receiving a carrier’s notice of disallowance or adjustment of a bill to petition the Department to resolve a reimbursement dispute with the carrier. § 440.13(7)(a), Fla. Stat. (“Any health care provider who elects to contest the disallowance or adjustment of payment by a carrier under subsection (6) must, within 45 days after receipt of notice of disallowance or adjustment of payment, petition the department to resolve the dispute.”). Since the notice can only be given by means of an EOBR, the 45-day window starts upon receipt of the EOBR. Three EOBRs Adjudicating Two LRHS Bills (Case No. 18-3845) The parties stipulated that in Case No. 18-3845, LRHS received notice of disallowance or adjustment of payment from the carrier on December 5, 2017, and December 11, 2017. As required by rule, notice was given by EOBRs: two EOBRs were received on the first date; a third EOBR was received on the second date.4/ One EOBR received on December 5, 2017, addressed a “treating physician” bill with three line items for physician services rendered on or about November 6 and 8, 2017 (as best the dates can be discerned). The EOBR authorized partial payment of $407.25 for two of the three line items, and identified a check issued in that amount on December 1, 2017. The second EOBR received on December 5, 2017, addressed a different treating physician bill, with line items for three hospital visits, on November 3, 4, and either 5 or 6, 2017 (the date is stated on the EOBR, but is not clear on the reduced copy in evidence). The EOBR authorized partial payment in the amount of $180.00, and identified a check issued in that amount on December 1, 2017. The EOBR received on December 11, 2017, appears to be a reconsideration of the first EOBR described in the preceding paragraph, because it addressed the same three line items. The EOBR authorized additional reimbursement of $2,172.00, and identified a check issued in that amount on December 7, 2017. EOBR codes were assigned in all three EOBRs to explain the reasons for adjusting or disallowing payment for each line item. Additional internal codes were also provided with additional explanation. According to the codes, payment was reduced from the amounts billed based on reimbursement manual provisions and/or a contractual arrangement, and payment on one line item on each bill was disallowed as a billing error. As required by Department rule, each EOBR stated: “This EOBR constitutes notice of disallowance or adjustment of payment within the meaning of Section 440.13(7), Florida Statutes (F.S.). This carrier designates Optum, 2500 Monroe Blvd., Suite 100, Norristown, PA 19430 to receive service of a copy of a petition for reimbursement dispute resolution by certified mail, pursuant to Section 440.13(7)(a), F.S. on behalf of the carrier and all affected parties.” Arlene Cotton, testifying for the Department, said that carriers occasionally issue multiple EOBRs. Usually that is done to address different components of a bill or series of bills. If a carrier issues multiple EOBRs for the same bill, the 45-day deadline to file a reimbursement dispute resolution petition would run from the last EOBR receipt date only if the last EOBR is substantively different from a prior EOBR adjudicating the same line items, i.e., if the last EOBR makes changes to the line-by-line adjudication of the bill. For LRHS, a single EOBR was issued to adjudicate the bill for three physician hospital visits, received on December 5, 2017. The 45-day deadline to file a petition disputing the reimbursement decisions in that EOBR was January 19, 2018. The other LRMC bill, with three line items charging for three types of physician services, was the subject of two EOBRs. The second EOBR, received December 11, 2017, changed the line-by- line adjudication of the submitted bill, changing both the amount of payment authorized and some of the coded reasons assigned to the three line items. The deadline to file a petition to dispute the revised adjudication of that bill was January 25, 2018. On May 4, 2018, counsel for LRHS filed a single Petition to dispute the EOBRs received on December 5 and 11, 2017. The LRHS Petition was, without question, very untimely. One EOBR Adjudicating One LRMC Bill (Case No. 18-3846) The parties stipulated that in Case No. 18-3846, LRMC received notices of disallowance or adjustment of payment on January 12, 2018, and February 16, 2018. As provided by rule, notice was by means of an EOBR. A single EOBR, issued to adjudicate a single LRMC bill with 27 line items, was sent twice, with different fax transmittal pages, first on January 12, 2018, and again on February 16, 2018. The twice-transmitted EOBR, as required by Department rule, stated: “This EOBR constitutes notice of disallowance or adjustment of payment within the meaning of Section 440.13(7), Florida Statutes (F.S.). This carrier designates Optum, 2500 Monroe Blvd., Suite 100, Norristown, PA 19430 to receive service of a copy of a petition for reimbursement dispute resolution by certified mail, pursuant to Section 440.13(7)(a), F.S. on behalf of the carrier and all affected parties.” The Department takes the position that when the same EOBR is transmitted on two different days, transmittal of a second identical EOBR does not start a second 45-day window to file a petition for reimbursement dispute resolution. Under that view, which is found to be the more reasonable position under the circumstances here (where nothing was changed in the EOBR, not even a date, much less an authorized payment or reason code), LRMC was required to file a petition by February 26, 2018. No evidence was offered that would suggest LRMC was operating under a different assumption; Ms. Cobb did not testify that she believed LRMC would have the right to file a petition within 45 days of receiving the same EOBR a second time. It is noted that even if the later receipt date were used to restart the 45-day clock, the petition would have been due April 2, 2018. Counsel for LRMC filed the Petition on May 4, 2018, more than two months late according to the more reasonable position, and more than one month late under the most generous (and unreasonable) interpretation. Under any interpretation, the Petition was untimely; there is no legitimate dispute about that. Equitable Tolling Defense Petitioners raise equitable tolling as a defense, contending the untimeliness of their Petitions should be excused. Gina Cobb was Petitioners’ only witness. She works for LRMC in the denials and appeals department. During the time pertinent to this case, she worked exclusively on workers’ compensation claims for four years at LRMC, billing carriers for LRMC’s hospital charges and following up when payment was denied, disallowed, or adjusted. Before that, she did the same kind of work in the workers’ compensation claims arena at Winter Haven Hospital for an additional four years. Ms. Cobb does not handle billing for LRHS. LRHS takes care of billing carriers for separate physician charges for services to injured workers while at LRMC. When both hospital services and physician services are provided to the same injured worker during a single “encounter” (i.e., a patient stay at LRMC), Ms. Cobb’s only involvement in the LRHC billing process is to provide LRHS with the claim number issued by the carrier or claim administrator, as well as the address to use for billing purposes. Ms. Cobb did not work on the LRHS bill submissions at issue in this case, other than to provide the claim number and address for LRHS to use to submit its bills. Ms. Cobb is not a lawyer. Instead, in keeping with her job duties, she is certified in medical billing and coding. With eight years’ experience handling workers’ compensation billing for two different Florida hospitals, she would have to be very familiar with the regulatory requirements for the billing and payment process under the Workers’ Compensation Law. Indeed, she is quite proud of her track record, saying more than once that she is “usually successful” in getting bills paid. Whether a badge of accomplishment or not, in her eight years of experience, Ms. Cobb has never filed a petition for reimbursement dispute resolution or been involved in a Department proceeding to resolve a reimbursement dispute. Indeed, she did not file a petition this time, either. Instead, at some unknown point, Petitioners retained an attorney who prepared and filed the untimely Petitions; his name, not Ms. Cobb’s, appears on LRMC’s Petition as the LRMC representative. Ms. Cobb’s initial involvement in the October 31 through November 8, 2017, injured worker “encounter” at issue was on November 2, 2017. That is when Ms. Cobb was informed by a hospital social worker that a patient was being reclassified from self-pay to workers’ compensation. The next day, Ms. Cobb called the patient’s employer and learned that the carrier was Lion Insurance Company (Lion or carrier), and that the claim administrator was Packard Claims Administration (Packard or administrator). She called Packard and received a claim number and address to use in submitting bills for the encounter. Ms. Cobb worked on preparing and submitting the LRMC bill to Packard for the hospital charges. She also gave the Packard claim number and address to LRHS so that LRHS could file bills with Packard for physician charges for the encounter. Ms. Cobb’s testimony was limited to addressing the LRMC billing process before and after receiving the EOBR. She was unable to address the LRHS bills because she did not submit them, nor could she address the EOBRs on those bills, because she did not receive them. Ms. Cobb had no communications with Packard or the carrier regarding the LRHS bills or the EOBRs on those bills. With regard to the LRMC bill, Ms. Cobb testified that she prepared the claim (bill with supporting records), which was printed out and mailed to Packard on or about November 29, 2017. She called Packard to check on the claim status and spoke with a representative on January 12, 2018. The EOBR was transmitted to her later that same day. It appears from the EOBR, corroborated by what Ms. Cobb said she was told by the Packard representative, that as of January 12, 2018, the bill had already been reviewed and payment disallowed (on or about December 21, 2017). The EOBR giving notice of that reimbursement decision was not received by LRMC until Ms. Cobb’s inquiry prompted the fax transmittal. Ms. Cobb testified that she reviewed the EOBR, and believed from her review that the reason payment of the entire hospital bill was disallowed was that no medical records were received. That belief is contradicted by the EOBR itself, which is the only non-hearsay record evidence.5/ The impression given from Ms. Cobb’s testimony is that she did not carefully study the EOBR she received on January 12, 2018. The EOBR addressed 27 separate line items on the LRMC bill. All 27 billed line items were disallowed, with code 34 given as the first EOBR code reason for each line item. The reason descriptor for code 34 set forth in the EOBR (consistent with the EOBR coding rule) was: “Payment disallowed: no modification to the information provided on the medical bill.[6/] No payment made pursuant to contractual arrangement.” (all caps in original converted to lower case). A second EOBR code reason related to insufficient documentation was given for only one of the 27 line items, which was a line item charging for an implant. For this single line item, after code 34, EOBR code 47 was added as the second reason for disallowing payment. The reason descriptor for code 47 set forth in the EOBR (consistent with the EOBR coding rule), was: “Payment disallowed: insufficient documentation; invoice or certification not submitted for implant.” (all caps in original converted to lower case). For the same implant line item, two internal code reasons (M127 and MA27) were added: “Missing patient medical record for this service” and “Missing/incomplete/ invalid entitlement number or name shown on this claim.” Following her review of the EOBR received January 12, 2018, Ms. Cobb said that she immediately printed all of the medical records and submitted them to Packard with a request for reconsideration. A reasonably prudent employee with responsibility over a hospital’s workers’ compensation claim denials and appeals department would have, instead, addressed the actual EOBR code reasons given for disallowing payment.7/ Petitioners did not point to any statute or rule that regulates a provider’s request for “reconsideration,” or a carrier’s obligations with respect to such a request, after the carrier disallows or adjusts payment of a bill for reasons set forth in an EOBR sent to the provider. The only official avenue in statute and rule available to a provider who wants to contest a carrier’s disallowance or adjustment of payment, as set forth in an EOBR, is to file a petition with the Department to resolve the reimbursement dispute. It appears that the process of requesting a carrier reconsider its adjudication of a bill as set forth in an EOBR is an informal, unofficial process, akin to other settlement efforts to resolve disputes. As evident by the LRHS December 11, 2017, EOBR, sometimes a carrier will reconsider its adjudication of a bill, revise an EOBR, and authorize additional payment. But within the official statutory and rule framework, there is only the 45-day period for carriers to review and adjudicate a bill by means of an EOBR, followed by a 45-day period after a provider’s receipt of an EOBR for the provider to file a petition with the Department for reimbursement dispute resolution. Ms. Cobb offered testimony about the steps she took beginning on January 12, 2018, to try to get the carrier to reconsider its reimbursement decision that was set forth in the EOBR. Because the total hospital charge on the bill was over $135,000, and the expected reimbursement was just over $100,000, Ms. Cobb said that the claim was considered “high dollar,” and she was expected to “touch” the account more often, which she described as checking on the status. She called Packard periodically and spoke with different persons about the status of the reconsideration request. Ms. Cobb said that when she spoke with someone on February 13, 2018, that person said that no claim was found for that amount. This was a red flag to Ms. Cobb. As she put it: It’s usually a stalling tactic that we deal with -- with carriers, so I felt like it was, but to cover myself I sent everything all over again. Tr. at 42 (emphasis added). As of February 13, 2018, 32 days had elapsed since the EOBR was received on January 12, 2018. Ms. Cobb was experienced enough to understand the possibility that her reconsideration request was not getting attention, but rather, that the carrier was employing stalling tactics while the days counted down. Having “felt like it was” a stalling tactic, Ms. Cobb should have, at that time (instead of months later, well after the 45- day deadline had passed), enlisted the help of the LRMC attorney to prepare and file the Petition. Since that is the only formal avenue in statute and rule available to a provider wanting to contest a carrier’s EOBR adjudication of a bill, it is inconceivable that Ms. Cobb would not have done so. Instead, despite her belief that the carrier was using stalling tactics, Ms. Cobb’s only action was to reprint the bill and supporting documentation, and send the reconsideration request a second time. Although Ms. Cobb testified about several conversations with Packard, she never said that she was misled or lulled into believing that she did not have to file a petition for reimbursement dispute resolution within 45 days after receiving the EOBR on January 12, 2018. She repeatedly acknowledged that nothing prevented her from filing a petition for reimbursement dispute resolution. Instead, it was her choice to pursue informal resolution of the dispute by filing (and refiling) reconsideration requests. That choice was not mutually exclusive with protecting LRMC’s rights by means of a timely filed petition. Given Ms. Cobb’s belief as of February 12, 2018, that the carrier was employing stalling tactics with regard to her reconsideration requests, it was unreasonable for her to pursue only this avenue for this high dollar unpaid bill. In light of her concerns, she failed to act with reasonably prudent regard for LRMC’s rights, when she did not file a petition then (with 13 days remaining) or enlist counsel (as was later done) to file a petition for reimbursement dispute resolution. Three days later, on February 16, 2018, Ms. Cobb received a fax transmittal from Packard, transmitting the same EOBR that had previously been transmitted on January 12, 2018. Ms. Cobb’s concerns should have been heightened by this second red flag. The failure to act with reasonably prudent regard for LRMC’s rights was compounded by letting this second red flag go. Although there were still ten days left to file a petition for reimbursement dispute resolution based on the first EOBR transmittal, Ms. Cobb still took no action to contact the LRMC attorney or seek authorization to retain an attorney to prepare a petition (as was done much later, after any conceivable 45-day window had long passed). A reasonably prudent employee in her position would have been spurred to action by filing a petition or enlisting counsel then, with 10 days remaining to timely dispute the EOBR. Instead, Ms. Cobb said that she did two things when she received the identical EOBR a second time. She said at that point, she gave the EOBR to the “cash apps department” to post zero as the money received on the bill. In addition, she said that upon receiving the EOBR a second time (five weeks after she first received the EOBR notifying LRMC that payment on the entire bill was disallowed), she “did a more thorough check,” for the purpose of “looking for the denial reasons to -- I was looking for the denial reasons that I could’ve rectified.” Tr. at 47. She admitted that when she looked more closely at the EOBR, “I did see that I missed [the] implant invoices.” Id. Reasonable regard for her employer’s rights would have compelled this careful attention immediately upon first receipt of the EOBR. That was her job. Ms. Cobb said she assumed that since payment was disallowed for the whole bill, the EOBR’s reference to missing implant invoices on one line item must have meant that the carrier was missing everything. This explanation does not square with the actual EOBR code reasons given for disallowing payment on the other 26 line items. But Ms. Cobb said that “just to be thorough this time,” she sent everything one more time. In addition, this time she included the implant invoices that she had never previously submitted. On March 27, 2018, Ms. Cobb called Packard to check on the status of the reconsideration request. Following the conversation, she received a fax from Packard. With regard to that communication, the parties stipulated that on March 27, 2018, Ms. Cobb “received correspondence from Packard stating that the bill was being audited by an attorney, and that ‘it is still processing.’” Ms. Cobb acknowledged that the March 27, 2018, fax was not an EOBR.8/ Ms. Cobb testified that it was her expectation that another EOBR would be sent after the carrier or administrator completed review of the reconsideration request. Her expectation was based on hearsay, and was not proven to be a reasonable expectation. Petitioners did not offer any statutory or rule authority that would have required the carrier to proceed in a certain fashion on the reconsideration request, or to give notice in any particular form of the culmination of that process. Moreover, having already been sent the same EOBR twice, Ms. Cobb had no basis for assuming or expecting that any subsequent EOBR transmittal would not have been of the same EOBR, a third time, to signify denial of the request for reconsideration. Ms. Cobb testified that she followed up on April 13, 2018, by calling the attorney who had been auditing the reconsideration request. There was no non-hearsay evidence as to what she was told. She indicated that she perceived what she was told to be a red flag. This was not the first red flag, though, as Ms. Cobb believed two months earlier that the carrier was employing stalling tactics. Petitioners apparently contend that as of March 27, 2018, it was reasonable for Ms. Cobb to believe not only that the carrier would review the multiple reconsideration requests she had sent by then, but also, that the carrier would revise the EOBR to change its prior adjudication of the bill. Petitioners essentially concede that that expectation was rendered unreasonable as of April 13, 2018, when it became clear to Ms. Cobb that the carrier was not going to reconsider its decision to disallow payment of the LRMC bill. Ms. Cobb did not say that she ever informed the carrier or administrator that LRMC was planning to file a petition with the Department to resolve the dispute over the carrier’s disallowance of payment. Ms. Cobb did not testify that she was ever led to believe by the carrier or administrator that the time for LRMC to file a petition for reimbursement dispute resolution would be extended by her reconsideration request. Ms. Cobb did not say that the subject of a dispute resolution petition was ever raised in any of her communications with the carrier and administrator. Petitioners admit that they had no communications with the Department regarding whether or when to file a petition for resolution of the reimbursement dispute. There is no evidence that a Department employee said or did anything to mislead or lull Petitioners into inaction that prevented the timely filing of the Petitions. At the point that even Petitioners acknowledge it was no longer reasonable to expect reconsideration by the carrier of its reimbursement decision, the Petitions were not immediately filed. No explanation was given for waiting three more weeks before filing the Petitions on May 4, 2018.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Financial Services, Division of Workers’ Compensation, issue a final order dismissing the untimely Petitions filed by Petitioners LRHS and LRMC. DONE AND ENTERED this 26th day of November, 2018, in Tallahassee, Leon County, Florida. S ELIZABETH W. MCARTHUR 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 26th day of November, 2018.
The Issue Whether Petitioner ADCO Billing Solutions, L.P.’s (ADCO), Petition for Resolution of Reimbursement Dispute is entitled to be considered on the merits, or whether it should be dismissed.
Findings Of Fact The Department is the state agency with jurisdiction to resolve reimbursement disputes between health care providers and carriers, pursuant to section 440.13(7), Florida Statutes. Chapter 440 is known as the Florida’s Workers’ Compensation Law. See § 440.01, Fla. Stat. Michael S. Schurdell, M.D., a physician (Dr. Schurdell), is a “health care provider” as defined in section 440.13(1)(g). ADCO is an agent for Dr. Schurdell, responsible for preparing, processing, and submitting workers’ compensation bills for repackaged prescription medication to insurers and carriers on Dr. Schurdell’s behalf. Zenith Insurance Company (Zenith), a nonparty to this proceeding, is considered a “carrier” as defined in section 440.13(1)(c). The Florida’s Workers’ Compensation Law, and its implementing rules, govern the process through which health care providers and carriers review and make determinations on health care provider bills. A carrier’s bill review, under section 440.13(6), and implementing rules, culminates in a reimbursement decision to either pay the bill, or to disallow, adjust, or deny payment. An Explanation of Bill Review (EOBR) is “the document used to provide notice of payment or notice of adjustment, disallowance or denial by a claim administrator or any entity acting on behalf of an insurer to a health care provider[.]” Fla. Admin. Code R. 69L-7.710(y). Pursuant to Florida Administrative Law Rule 69L-7.740(14), a carrier (or its claim administrator) must use an EOBR that details the reasons for a reimbursement decision for each line item. The EOBR must reflect EOBR codes (up to three for each line item billed), which are reasons for the reimbursement decision. The EOBR is what triggers a health care provider’s option to submit a petition for resolution of reimbursement dispute with the Department, pursuant to section 440.13(7). Section 440.13(7) provides, in pertinent part: (7) UTILIZATION AND REIMBURSEMENT DISPUTES.— (a) Any health care provider who elects to contest the disallowance or adjustment of payment by a carrier under subsection (6) must, within 45 days after receipt of notice of disallowance or adjustment of payment, petition the department to resolve the dispute. The petitioner must serve a copy of the petition on the carrier and on all affected parties by certified mail. The petition must be accompanied by all documents and records that support the allegations contained in the petition. Failure of a petition to submit such documentation to the department results in dismissal of the petition. Melissa Malarae, a nonparty to this proceeding, sought medical treatment from Dr. Schurdell, as a result of a workplace injury that occurred on August 31, 1998. Ms. Malarae subsequently filed a Petition for Workers’ Compensation Benefits on August 29, 2002, with the Office of the Judges of Compensation Claims (OJCC), in a matter styled Melissa Malarae v. TLC Child Care Center of Sarasota and Zenith Insurance Company, OJCC Case Number 02- 034031RLD. Dr. Schurdell provided medical care related to the 1998 workplace injury and dispensed prescription medications to Ms. Malarae on August 8, 2019. Notably, two of the prescription medications that Dr. Schurdell prescribed and dispensed were “Lidocaine Ointment 5%” and “Diclofenac Sodium Solution 1.5%.” On August 8, 2019, ADCO, on behalf of Dr. Schurdell, submitted a “Health Insurance Claim Form” for prescription medications he had prescribed and dispensed, to Zenith, Ms. Malarae’s employer’s workers’ compensation carrier, for payment. As Zenith had not paid for those prescription medications, on February 18, 2020, Ms. Malarae (through her attorney, Ronald S. Fanaro, Esquire) filed another Petition for Workers’ Compensation Benefits, in OJCC Case No. 02-034031RLD, seeking payment for prescription medications that ADCO, on behalf of Dr. Schurdell, submitted to Zenith. On March 11, 2020, Zenith filed a Response to Petition for Benefits in OJCC Case No. 02-034031RLD. In the portion of the Response to Petition for Benefits entitled “Response to Each Benefit Requested,” Zenith stated: Petition(s) 02/18/2020(9) are covered by this response. Payment in the amount of $29,942.34 to ADCO Billing Solutions. Attorney Fees and Costs. Response: The EC denies entitlement to attorney fees as the requested benefits are being paid within 30 days of the Petition. The EC agrees to reimburse taxable costs associated with obtaining benefits in the Petition. However, also on March 11, 2020, Zenith issued an EOBR that adjusted the August 8, 2019, payment for medications listed on the Health Insurance Claim Form. The March 11, 2020, EOBR indicated a significant downward adjustment of payment for the “Lidocaine Ointment 5%” and “Diclofenac Sodium Solution 1.5%” that ADCO requested. Mr. Chenchick, the collections manager for ADCO that sought reimbursement for the multiple medications Dr. Schurdell dispensed to Ms. Malarae (including the Lidocaine Ointment and Diclofenac Sodium Solution), testified that he worked with Mr. Fanaro in the filing of the February 18, 2020, Petition for Workers’ Compensation Benefits, to seek reimbursement in the amount of $29,942.34. Mr. Chenchick testified that, following receipt of Ms. Malarae’s Petition for Workers’ Compensation Benefits: [T]hey [Zenith] rescinded their denial. That was the response from Zenith. It was from the adjuster, Katy Lamb. It was another document that said we rescind, and, you know, there was a guarantee of payment of that [$]29,942.34. Mr. Chenchick testified that he considered Zenith’s March 11, 2020, response to the February 18, 2020, Petition for Workers’ Compensation Benefits a “guarantee of payment[,]” and that he believed that Zenith would make full payment for the multiple medications at issue. Mr. Chenchick testified that on March 17, 2020—after he received Zenith’s March 11, 2020, response to the Petition for Workers’ Compensation Benefits—he received the EOBR, dated March 11, 2020, and payment from Zenith. Mr. Chenchick testified: So the other dates of service were reimbursed properly. This was the only date of service that was – that we were taking issue with, this date of service of 8/8/2019, and the billed amount was, yeah, $13,536.43, and for that date of service, we were only reimbursed $349.67. After receiving the March 11, 2020, EOBR, which Mr. Chenchick considered a “short pay,” Mr. Chenchick contacted Zenith’s bill review department on March 27, 2020, to discuss this discrepancy. Mr. Chenchick testified that a “short pay” error was common, and that ADCO regularly addressed such an error with carriers directly, as opposed to utilizing the dispute resolution process with the Department, pursuant to section 440.13(7). Mr. Chenchick further testified concerning the alleged “short pay” of the two prescription medications: What we had in this one, which typically we don’t, was the – a guarantee of payment is what I considered it where they rescinded and said they would be paying the bills. So when I had that in my hand saying we are rescinding the denial, we will pay this amount, and then an amount comes in that’s lower than that. . . . I didn’t feel at that time that I needed to submit anything to the State because it was still under review. It had not hit a hard denial. ADCO did not contest the March 11, 2020, EOBR, pursuant to the procedure set forth in section 440.13(7), and, therefore, did not petition the Department within the 45-day requirement contained in this provision. Nor did ADCO and Zenith submit a Joint Stipulation of the Parties to the Department, pursuant to rule 69L-31.012, which would have allowed the parties to “mutually stipulat[e] in writing that the reimbursement dispute be held in abeyance for a specified time period, not to exceed sixty (60) calendar days, for the parties to seek a resolution of the reimbursement dispute without the need for a determination by the Department.” Instead, Mr. Chenchick testified that he continued to negotiate with Zenith concerning the payment discrepancy through May 2020. On May 20, 2020, Mr. Chenchick, on behalf of ADCO, sent Zenith an “Appeal for Reconsideration,” that explained ADCO’s position that Zenith had short-paid the two prescription medications. On May 27, 2020, Zenith issued a second, separate EOBR, that ADCO received on June 3, 2020 (Second EOBR). The Second EOBR differed from the March 11, 2020, EOBR, in that it only concerned the two prescription medications at issue here, and that Zenith completely disallowed payment ($13,536.43) for them. ADCO filed a Petition for Resolution of Reimbursement Dispute with the Department on June 19, 2020, which the Department received on June 30, 2020, 27 days after ADCO received the Second EOBR. At the time Zenith issued the Second EOBR, the August 8, 2019, billing remained at issue in OJCC Case No. 02-034031RLD. A June 10, 2020, mediation agreement, signed by Ms. Malarae, Mr. Fanaro, and a representative from Zenith, states, in part: Parties agree as follows: Regarding PFB of 2/18/20, the outstanding bills submitted by ADCO Billing Solutions have been paid and accepted by E/C, with the exception of prescriptions for Date of Service 8/8/19 for Diclofenac and Lidocaine ointment. E/C made a payment for the 8/8/19 prescriptions, but the provider is disputing the amount paid. This dispute between the E/C and the billing provider is not within the purview of the JCC, who is without jurisdiction to address such billing disputes, and must be handled administratively. The Department assigned Ms. Paulk, a registered nurse consultant with the Department’s Bureau of Monitoring and Audit within its Medical Services Section, to review ADCO’s Petition for Resolution of Reimbursement Dispute. Her job duties include reviewing petitions for resolution reimbursement disputes for deficiencies, under section 440.13(7) and rules 69L-31 and 69L-7. Ms. Paulk reviewed ADCO’s Petition for Resolution of Reimbursement Dispute, dated June 19, 2020, and compared it to the date ADCO received an EOBR that would trigger section 440.13(7)’s 45-day deadline for this process. Ms. Paulk testified that she reviewed the two EOBRs, and noted that both indicated a “disallowance or adjustment of payment” for the two prescription medications. Under this circumstance, Ms. Paulk testified that the Department used the earlier, March 11, 2020, EOBR for purposes of calculating the deadline for a petition for resolution of reimbursement dispute. As ADCO’s Petition for Resolution of Reimbursement Dispute was filed more than 45 days after the March 11, 2020, EOBR, the Department dismissed it as untimely served on the Department, pursuant to section 440.13(7). Ms. Paulk admitted, on cross-examination, that when she made the decision to dismiss ADCO’s Petition for Resolution of Reimbursement Dispute, she was unaware of OJCC Case No. 02-034031RLD, had no contact with either ADCO or Zenith, and that the March 11, 2020, EOBR and the Second EOBR were not identical, as the March 11, 2020, EOBR actually reflected an adjustment of the amounts for reimbursement for the two prescription medications (i.e., Zenith would pay an amount for the two prescriptions totaling $349.67), while the Second EOBR reflected that Zenith completely disallowed payment in full for the two prescriptions. The undersigned finds that the March 11, 2020, EOBR differs from the Second EOBR. The March 11, 2020, EOBR reflected a downward adjustment for the two prescription medications. The Second EOBR reflects that Zenith completely disallowed payment for these two prescriptions. Additionally, the March 11, 2020, EOBR considered additional dates of service, which were not at issue in the Second EOBR. With respect to the payment for the two prescription medications at issue between ADCO and Zenith, the March 11, 2020, EOBR also conflicts with Zenith’s Response to Petition for Benefits in OJCC Case No. 02- 034031RLD, in which Zenith admitted that it would pay for all of the medications (including the two prescription medications at issue) listed in ADCO’s August 8, 2019, Health Insurance Claim Form. The OJCC was the wrong forum for Ms. Malarae to seek payment for these two medications. See § 440.13(7), Fla. Stat. However, Zenith’s response, and Mr. Chenchick’s testimony that ADCO considered it a “guarantee of payment,” establishes that ADCO had been lulled or misled into inaction, as ADCO relied on Zenith’s response, and reasonably believed that the adjustment reflected in the March 11, 2020, EOBR was erroneous. Mr. Chenchick’s additional testimony concerning ADCO’s attempt to reconcile what he believed to be a common error known as “short pay,” reflected in the March 11, 2020, EOBR (which he received after Zenith filed its Response to Petition for Benefits), is further evidence that ADCO reasonably believed that Zenith intended to pay, in full, the amount of the two prescription medications at issue.
Recommendation Based upon the foregoing Findings of Fact and Conclusions of Law, the undersigned hereby RECOMMENDS that the Department of Financial Services, Division of Workers’ Compensation, enter an Order that reinstates the Petition for Resolution of Reimbursement Dispute filed by ADCO Billing Solutions. DONE AND ENTERED this 2nd day of February, 2021, in Tallahassee, Leon County, Florida. COPIES FURNISHED: Keith C. Humphrey, Esquire Department of Financial Services 200 East Gaines Street Tallahassee, Florida 32399-4229 Ralph Paul Douglas, Esquire McConnaughhay, Coonrod, Pope, Weaver & Stern, P.A. Suite 200 1709 Hermitage Boulevard Tallahassee, Florida 32308 S ROBERT J. TELFER III Administrative Law Judge 1230 Apalachee Parkway Tallahassee, Florida 32399-3060 (850) 488-9675 www.doah.state.fl.us Filed with the Clerk of the Division of Administrative Hearings this 2nd day of February, 2021. Marc J. Semago, Esquire FL Legal Group Suite 400 2700 West Dr. MLK Jr Boulevard Tampa, Florida 33607 Diane Wint, Agency Clerk Division of Legal Services Department of Financial Services Room 612.17, Larson Building 200 East Gaines Street Tallahassee, Florida 32399-0390
The Issue Whether the Petitioners are entitled to an award of attorneys' fees and costs pursuant to Sections 120.569(2)(e) and 120.595(1), Florida Statutes, and, if so, in what amounts.
Findings Of Fact On October 3, 2001, AHCA served three Administrative Complaints on HHCI, apparently intending to revoke HHCI's licenses to operate nursing homes on the basis of a retroactive application of Section 400.121(3)(d), Florida Statutes (2001). The statute states in pertinent part: (3) The agency shall revoke or deny a nursing home license if the licensee or controlling interest operates a facility in this state that: * * * (d) Is cited for two class I deficiencies arising from separate surveys or investigations within a 30-month period. HHCI filed petitions challenging AHCA's allegations in the Administrative Complaints. On October 12, 2001, HHCI filed a challenge to the non- rule policy of retroactive application (DOAH Case No. 01-3935RU) and a hearing was scheduled for October 23, 2001. The Petitions in the Administrative Complaint cases were forwarded by AHCA to DOAH on October 19, 2001, and were consolidated under DOAH Case No. 01-4124. The Final Order in Case No. 01-3935 RU, declaring AHCA's policy of retroactive application invalid, was issued on October 31, 2001. HHCI filed a Motion for Award of Attorney's fees in DOAH Case No. 01-4124 on November 2, 2001. That motion forms the basis for the instant case. At the time the Administrative Complaints were filed, the three HHCI facilities held standard licenses and were apparently operating in compliance with applicable law, with no unresolved survey violations pending. The day after the Administrative Complaints were served, AHCA issued a press release and scheduled a telephonic "media call-in" to reply to questions from interested press representatives. The result of the media attention was to cause great concern to both HHCI and the residents of their facilities as to the proposed closure of the facilities. AHCA distributed a letter to residents indicating that unless HHCI challenged the action, the facility would be closed in approximately 60 days. The AHCA letter advised residents that if HHCI challenged the proposed action, the proposed action "may be delayed." The AHCA letter did not indicate that any resolution of the dispute other than facility closure was possible. The result of the attention and statements by AHCA's representative was to cause great concern among residents and their families as to what living arrangements would be available for residents of the facilities. AHCA also placed monitors in each facility to discuss the pending action with residents and their families, as well as to observe the facility operations. There is no evidence that the placement of monitors in the facilities offered any level of comfort to residents or families. The monitors also apparently began citing the facilities for alleged additional violations of various regulations. In response, HHCI officials immediately sought legal counsel to address the situation. Counsel at the Washington, D.C., law firm, Proskauer Rose, became involved in representing HHCI. HHCI also retained Counsel in the Tallahassee office of the Broad and Cassel law firm, with whom it had no prior relationship. HHCI directed its legal team to review all possible options to resolving the matter expeditiously. Counsel considered both federal and state court action and filed a request for injunction in state court. HHCI also attempted to resolve the matter informally. On October 8, 2001, HHCI obtained an opinion from the Joint Administrative Procedures Committee (JAPC), a standing committee of the Florida Legislature, which concluded that "a strong legal argument" could be made that the retroactive application of the statute was improper. There is no evidence that AHCA considered the JAPC opinion. In any event, because informal attempts to resolve the matter were unsuccessful, HHCI legal counsel began an intensive effort to defend the company against the AHCA action. The Final Order in Case No. 01-3935RU held that there was an absence of legal authority to apply the new law retroactively. There was no appeal of the Final Order. After the Final Order was issued, AHCA abandoned the Administrative Complaints that sought to revoke HHCI's licenses and close the facilities. In this proceeding, HHCI seeks fees it incurred for the Broad and Cassel and the Proskauer Rose law firms and for presentation of the testimony of Al Clark at the fee hearing. HHCI presented nine invoices from Broad and Cassel that were admitted as HHCI Exhibit 1. The invoices submitted in this case do not duplicate time that was invoiced as part of the rule challenge-related fee case. Invoice #469914 dated November 1, 2001, is for a total of $23,835.87, including fees of $23,565 and costs of $270.87. The majority of the work in these cases was performed in October. The invoice indicates time spent considering several theories of defense to the complaints. Invoice #474211 dated December 1, 2001, is for a total of $2,282.02, including fees of $1,981.50 and costs of $300.52. Invoice #479185 dated January 2, 2002, is for a total of $257.59, including fees of $245 and costs of $12.59. Invoice #491866 dated February 9, 2002, is for a total of $5,463.05, including fees of $5,116.50 and costs of $346.55. Invoice #496833 dated April 3, 2002, is for a total of $161.74, including fees of $147 and costs of $14.74. Invoice #505207 dated June 7, 2002, is for a total of $738.68, including fees of $735 and costs of $3.68. Invoice #507485 dated July 2, 2002, is for a total of $296.17, including fees of $294 and costs of $2.17. Invoice #515997 dated October 2, 2002, is for a total of $1,625.93, including fees of $1586 and costs of $39.93. Invoice #516952 dated October 16, 2002, is for a total of $2,903.35, including fees of $2878 and costs of $25.35. HHCI presented the testimony of Al Clark, who was accepted as an expert on the issue of attorney fees. Mr. Clark testified as to the reasonableness of the fees and costs charged to HHCI by the Broad and Cassel law firm. Mr. Clark's testimony was not contradicted and is credited. The time and labor expended by employees of the Broad and Cassel law firm were reasonable in light of the legal issues presented by the administrative actions proposed by AHCA. The presumed goal of AHCA's action was to revoke the licensure of HHCI's three nursing homes. Broad and Cassel provided the substantial skill and expertise required to supply the necessary legal services. Broad and Cassel billed HHCI at an hourly rate. The hourly rates charged by Broad and Cassel personnel are reasonable. The rates ranged from $245 per hour for lead counsel to $90 per hour for support counsel. There was no prior business relationship between Broad and Cassel and HHCI. Broad and Cassel counsel has significant experience and skill in health care law and provided their services efficiently throughout the dispute. Because the proposed sanction was severe, and because the agency publicized its legal action, HHCI required an immediate legal response resulting in an intense initial amount of work by Broad and Cassel. Broad and Cassel personnel represented HHCI legal interests throughout the administrative proceedings and prevailed in defending against the proposed administrative action. Subsequent to the hearing, HHCI submitted Mr. Clark's invoice for $1,012.50. Mr. Clark's invoice reflects a reasonable effort expended in addressing the costs and fees at issue in this case. At the hearing, Mr. Clark further testified that an amount up to $10,000 would be possible for the resolution of this fee case. At this time, none of this expense has been incurred and is not properly awarded. Based on the foregoing, HHCI has satisfied the factors set forth in Florida Bar Rule 4-1.5(b) related to awards of fees and costs in this case, and is entitled to an award of fees and costs for the Broad and Cassel billing and for Al Clark's invoice. Mr. Clark was not asked for, and did not offer, an opinion about the reasonableness of the Proskauer Rose fees. There is no credible evidence supporting an award of fees for work performed by the Proskauer Rose firm. Based on the testimony presented during the hearing, the evidence fails to establish that the charges by the Proskauer Rose firm as set forth on the exhibit are reasonable. Billing records admitted into evidence as HHCI Exhibit 3 contain references to regulatory matters not directly at issue in the proceedings giving rise to this request for fees. Such additional matters include nursing home surveys performed in October 2001, preparations for informal dispute resolution (IDR) meeting related to survey issues, and regulatory matters occurring in other states. The IDR preparations, although apparently prompted by alleged problems identified by the monitors, were not at issue in the Administrative Complaints that form the basis for this fee request. Although HHCI asserts that an Administrative Law Judge, hearing the Administrative Complaints seeking license revocation, could have considered the alleged problems, such allegations would have required amendment of the pending Administrative Complaints. More likely, the allegations would have been the subject of new Administrative Complaints that would have been litigated separately, and, as such, costs related to IDR preparation are not properly awarded in the instant case. Further, the Proskauer Rose invoices indicate that hours billed on one invoice in "File #84028.0014" for October 12 (description beginning with "review faxed 256") and October 22 (description beginning with "Meeting with S. Davis and C. Schessler re preparation for IDR") were also billed on another invoice in "File #84028.0015." Duplicate billings would not support an award of attorney fees. AHCA'S MOTION FOR SUMMARY JUDGMENT On April 9, 2002, HHCI, a foreign limited partnership operating in the State of Florida, canceled the registration of HHCI Limited Partnership with the Florida Department of State. HHCI Limited Partnership continues to operate in other states and is registered in Massachusetts.
The Issue The issue to be determined is whether the doctrine of equitable tolling should excuse the late filing of a Petition for Administrative Hearing filed with Respondent by Petitioner Florists Mutual Insurance Company.
Findings Of Fact Respondent, the Department, is the state agency charged with resolving disputes over reimbursement for costs of medical services provided to injured workers under workers? compensation law. Petitioner Florists was in a reimbursement dispute with Kendall. The Department issued a Determination that Florists should reimburse Kendall the sum of $100,894.54. Florists received notice of the Reimbursement Dispute Determination on April 8, 2013, via United States Postal Service certified mail. The Reimbursement Dispute Determination included a Notice of Rights advising Florists that a request for an administrative hearing on the Determination had to be received by the Department within 21 days of Florists? receipt of the Determination. It noted in bold print that failure to file a petition within that time period constituted waiver of the right to a hearing. Florists? Initial Petition was sent via certified mail from the Tallahassee office of Petitioner?s counsel located at 1701 Hermitage Boulevard, Suite 103, Tallahassee, Florida, on or about Thursday, April 25, 2013. The filing deadline was the following Monday. The Initial Petition was appropriately addressed to “Julie Jones, CP, FRP, DFS Agency Clerk, Department of Financial Services, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida.” The Initial Petition was received by the Department on Wednesday, May 1, 2013, at 10:11 a.m. The Department determined that the Initial Petition was untimely, as it was received on the twenty-third day after Florists received notice, making it two days late. Petitioner is a workers? compensation insurance carrier whose substantial interests are affected by Respondent?s Reimbursement Dispute Determination that it must reimburse health care provider Kendall $100,894.54. That determination will become final if Petitioner is determined to have waived its right to a hearing. The distance between the Tallahassee office of Petitioner?s counsel and the office of the Department is approximately four miles. From review of the United States Postal Service tracking information, it appears that after the Initial Petition was mailed, it was processed in Louisville, Kentucky, before it returned to Tallahassee, Florida, for delivery, indicating a journey of some 1,050 miles over the course of six days. Late delivery of the Petition by the United States Postal Service did not prevent Florists from asserting its rights.
The Issue Did Respondent, Tarpon Liquors LLC (Tarpon Liquors), timely request a hearing to contest the Amended Order of Penalty Assessment issued by Petitioner, Department of Financial Services, Division of Workers' Compensation (Division)?
Findings Of Fact The Division is the state agency responsible for enforcing the statutory requirement that employers secure payment of workers' compensation for the benefit of their employees. § 440.107(3), Fla. Stat. (2019). Christina Brigantty is a Division compliance investigator. She checks employers for compliance with Florida's workers' compensation law. If an investigator concludes that an employer is not in compliance, she issues a Stop-Work Order along with a penalty assessment for the asserted periods of non- compliance. The Division determines periods of non-compliance by examining a business's records obtained from the business through a business records request. Investigator Brigantty performed a compliance check of Tarpon Liquors on July 31, 2018. As a result of that check, the Division issued Tarpon Liquors a Stop-Work Order and Order of Penalty Assessment. Subsequently the Division issued an Amended Order of Penalty Assessment dated December 13, 2018. It included a Stop- Work Order and Notice of Rights advising that Tarpon Liquors had 21 days from receipt of the Amended Order to file a petition for a hearing challenging the assessment. The Notice of Rights also stated that failure to request a hearing during that period waived the right to challenge the assessment. The Division transmitted the Amended Order to Tarpon Liquors, attention Ronald J. Maniscalco, registered agent, at 907 Narragansett Lane, Key Largo, Florida, by certified mail. The Narragansett Lane address was the residence of Mr. Maniscalco and Tarpon Liquors' managing member, Mr. Maniscalco's wife, Lorraine Maniscalco. The Division received the certified mail receipt from the postal service with the name Lorraine Maniscalco signed in the box for "Agent", and December 28, 2018, indicated as the date of delivery. Tarpon Liquors maintains that the signature on the certified mail receipt for the Amended Order is not Ms. Maniscalco's signature. Mr. Maniscalco believed that the mail carrier forged the signature. Mr. Maniscalco thought the signature was a forgery because Lorraine Maniscalco always signs her signature the same way and her signature does not match the signature on the certified mail receipt. Mr. Maniscalco filed a complaint with the United States Postal Service, which investigated the matter. The investigation included questioning the mail carrier who could not remember the certified mail document in question. The postal service reached no conclusions. During December 2018, Mr. and Ms. Maniscalco were in the process of moving. They were traveling between Tampa, Punta Gorda, and Key Largo frequently. Mr. and Ms. Maniscalco are unsure whether they were home December 28, 2018, and if they were, when they may have been there. In addition, their Narragansett Lane house was for sale. Consequently, they had to vacate the house frequently when the realtor was showing the house to potential buyers. There is a possibility the realtor signed in an effort to be helpful. Mr. Maniscalco, Ms. Maniscalco, and Ms. Shea, their daughter and also a manager of Tarpon Liquors, are all confident that the signature on the certified mail receipt is not Ms. Maniscalco's signature. There are significant differences between the signature on the receipt and Ms. Maniscalco's signature on her driver's license and on the sample signature admitted into evidence. The bottom loop of the "L" is notably different. The angle of the "M" is different. In addition, Ms. Maniscalco's "M" drops below the signature line while the "M" on the receipt does not. The evidence does not prove who signed the receipt. The weight of the credible, persuasive evidence, however, proves that Ms. Maniscalco did not sign it. In June 2019, Ms. Shea learned of the Amended Order in conversations with Investigator Brigantty. On July 3, 2019, Ms. Brigantty provided Ms. Shea a copy of the Amended Order, including the Notice of Rights. This was the first time that Tarpon Liquors received written notice of the Amended Order and the right to request a hearing. On July 9, 2019, the Division received a request for hearing dated July 5, 2019, from Mr. Maniscalco, challenging the Amended Order. This is more than 21 days after the December 28, 2018, date on the receipt for certified mail. The request for hearing stated: I never received notice of the Amended Order of Penalty Assessment that was sent on 12/12 and signed for on 12/28. The signature on the Return Receipt is not Lorraine Maniscalco's signature. Please see attached Drivers licenses for verification of Lorraine Maniscalco's actual signature for comparative purposes.
Recommendation Based on the foregoing Findings of Fact and Conclusions of Law, it is RECOMMENDED that the Department of Financial Services, Division of Workers' Compensation, accept the request for hearing of Tarpon Liquors LLC as timely. DONE AND ENTERED this 3rd day of January, 2020, in Tallahassee, Leon County, Florida. S JOHN D. C. NEWTON, II 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 3rd day of January, 2020. COPIES FURNISHED: Leon Melnicoff, Esquire Department of Financial Services 200 East Gaines Street Tallahassee, Florida 32399-4229 (eServed) Ronald Maniscalco Tarpon Liquors LLC 1421 Pine Island Court Punta Gorda, Florida 33950 Lena Marie Shea, Manager Tarpon Liquors LLC 4978 Edgewater Lane Oldsmar, Florida 34677-6342 Rean Knopke, Esquire Department of Financial Services 200 East Gaines Street Tallahassee, Florida 32399 (eServed) Julie Jones, CP, FRP, Agency Clerk Division of Legal Services Department of Financial Services 200 East Gaines Street Tallahassee, Florida 32399-0390 (eServed)
