09-003177 Center For Dermatology, P.A., A/K/A Peter M. Wallach And Shari F. Topper, M.D.S, P.A. vs. Agency For Health Care Administration Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Tuesday, June 23, 2009.

STATE OF FLORIDA 11L A44 C A L

AGENCY FOR HEALTH CARE ADMINISTRATION AGEE FCY CLERK

2004 JUL 8 P 3 0 S

CENTER FOR DERMATOLOGY P A

Petitioner

DOAH No 09 3177

VS FRAES No 2009005482

RENDITION NO AHCA 09 590 S OLC

STATE OF FLORIDA AGENCY FOR

HEALTH CARE ADMINISTRATION

Respondent

FINAL ORDER

Having reviewed the Notice of Intent to Deem Application Incomplete

and Withdrawn from Further Review dated May 12 2009 attached hereto

and incorporated herein Ex 1 and all other matters of record the Agency

for Health Care Administration Agency has entered into a Settlement

Agreement Ex 2 with the other party to these proceedings and being

otherwise well advised in the premises finds and concludes as follows

ORDERED

1 The attached Settlement Agreement is approved and adopted as

part of this Final Order and the parties are directed to comply with the

terms of the Settlement Agreement

2 Each party shall bear its own costs and attorney s fees

3 The above styled case is hereby closed

DONE and ORDERED this day of 2c

in Tallahassee Leon County Florida

Holly Benson ecretary

Agency for He th Care Administration

A PARTY WHO IS ADVERSELY AFFECTED BY THIS FINAL ORDER IS ENTITLED

TO 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 OF 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

Conies furnished to

Stephen T Maher Jamie L Jackson

Shutts Bowen LLP Assistant General Counsel

201 South Biscayne Boulevard Agency for Health Care Administration

Suite 1500 Miami Center 2727 Mahan Drive Bldg 3 MS 3

Miami Florida 33131 Tallahassee Florida 32308

Interoffice Mail

Jan Mills Karen Rivera

Agency for Health Care Administration Laboratory Unit Manager

2727 Mahan Drive Bldg 3 MS 3 Agency for Health Care Administration

Tallahassee Florida 32308 2727 Mahan Drive MS 28

Interoffice Mail Tallahassee Florida 32308

Interoffice Mail

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy of this Final Order was

served on the above named person s and entities by U S Mail or the

J

method designated on this the day of 204

Richard Shoop Agency Clerk

Agency for Health Care Administration

2727 Mahan Drive Building 3

Tallahassee Florida 32308 5403

850 5873 922

JUN Wb eW61j 1b 40 From To R509210156 P 15 17

a3tAa RI CMINQ eAM 4R NAll N

GIdARI IF CR1ST 9ettsr Health Carr ear aft Flcrldlena Mpi t Y BENSON

GOVERNOR SECRETARY

May 12 2009 CuicrIFIED MAR RETURN XECEI P r RI QUr STFD

ADMTNTSTRATOR

P715 11 M WALLACH AND ST TART F TOPPB R MpS PA LICENSE N1UM8ER 00004917

1480 N UNIVEMITY DRIVE

CORAL SPRINGS FL 33071 CASE 9 2009005492

N tip jNT TO R99biA rTJ CA f Q0MCPPTXTF A av l aivt

Frmt 1Tim r ymm

Your ppliontion for license is deemed Incomplete and withdrawn from further consideration pursuant to

Sootion 408 806 3 b Florida Statutea which stator that Requeswd information omitted from an

application for licensum license renewal or change of ownership other than an Inspection must be Mod

wil h the agency within 21 days oftar the agency s requost fbr omitted information or the application shall

bo deemed Incomplete and shall be withdrawn from further eonsidomtion and the frob shall bas forfoitod

You were notified by correspondenco dated February 29 2009 to provide further information nddroming

identified apparent orrore or cimissions within twenty one days from the reoeipt of the Agency s

correspondence Our records indicate was you received this cormspondence by certified mail on Munch 09

2009 As this requested informarion not timely received by tho Agency your application is dccmod

incomplete and withdrawn Crorri Rather uonsideiWion The outetandlog issues rornaining for liconsure are

Corrected List of Tests Perforated This Proficiency Testing Company listed 1e not CILIA

npproved

EXPLANA Ej0P Of IIYC ATS

Pursuani to Section 569 120 F S you have tho right to rcquost an a roiniAmlivc hcnring n order to

obtain a formal proceeding Wore the Division of Administrative Hearings under Section 1 120 57 F S

your requestfor an administrative hearing must c onforrn to thc requirements in Section 29 106 201

Florida Administr tivc Cads F A C and must state the material facts you dispute

SIT ATTACHE L ION AND LrVLANATION OF RICHTS FORMS

a

Karen Rivera Manager

Laboratory Lim mdurc Unit 711613 3901 4110

9446 8737

ace Agency C lurk Mail Stop I I 1 16mcil e a

Legal tntako Unit Mail Stop 3

I

2721 Motion Drivar M9il3a Visit AMCA onllne at

Tanshassoo Florida 32306 tlttp flaha a myflorlda com

EXHIBIT

JUN 05 2009 16 40 From To 9509210158 P 16 17

STATE OF FLOIUDA

AGENCY FOR ITIZALTR CARE ADMINISTRATION

R Pater M Wallach And Shari F Topper Mds Pa

CASE NO 2009005482

ELKCTTON OF RIGHTS

This Ul ction of Rights form is attached to a proposed Notiao of intent to Deein Incompioto and

Withdrow font Further Review of the Agency for Hatith Care Administration AI1CA The title may be

Notice of Intent to Doom Incomplete and Withdraw front Farther Review or some other notice of

Intondcd notion by AMC

N an Fteetian Rights with your salected option is not received by AFICA within twenty one 21

days from the date you received diis notice of proposed will action be issued you will have givott up your right to

contest the Agency s proposed action and a Cppl order

Pivtui reply using this Flection of Rights Statutes form unless you and your attorney or your roprooentativv prcrer to

reply according to Chapter 120 Fldrlda 2006 Rule 28 Florida Administrative Cods

Please return your E U rJ N F it3 GHTS to

Agency ibr Health Care Clerk Administmdon

Ationtion Agency

2727 Mahan Drive Mail Stop 43

Tallahassee Florida 32308

Phone [phone] P 850 921 0158

AL M i 6 JRt ONLY 1 OP nJ EJ 1 OPrONS

OPTION ONE i I admit to the aliegettions of facto and law contained In the Notice sedon of Intent AHCA to

Deem lucomplato and Withdraw from Further Review or other notice of Intended by to a

and I waive my right to object and have a hearing I understand that by giving up my right

hearing a final order will be ittus d that adopts the proposed agency action and imposes the proposed

penalty fine or actia

OPTION TWO 2 I admit to the alicUstions of facts contained In the Notice of Intent but to I

Droom Incomplete and Withdraw from Further Review or other proposed Florida action by AI CA where T

wish to be heard at an informal proceeding pursuant to Section 12037 2 Statutes action

may submit testimony or that the and floc written evidence by roduced to the Agency to show that the proposed administrative

is too severe should

ornoN Z7 litEE 3 I di putc the allegations of fact contained in the Notice of Intent to

Ocem Incompleto and Withdraw farm Further Review or other proposed action by AHCA

2nd I requ t a formal hetlring pursuant to 5crtitm 120 57 2 Florida Statutes before an

Administrative Low Judge appointed by the Division of Administrative Ilourings

1 it tile N T Choosing OPTIOK THREE 3 by it is HQTT suMelcat to t111 013 before n formml the

hearing A You w also must the e u a written A petition Q J an rinn in order 17f1 to 5711 obtnin rinrldn it formal quitutea hearing It must be

JUN 05 2009 15 41 From To 9509210158 PA7 17

received by the Agency Clerk ut the address above within 21 days of receipt of this proposed

administrative action The raquost for f4rertal h4aring must eonfarm tv the requirements of Rule 28

106 201 Florida Administrative Code which mouilal that it eor tain

1 The nnmo and address of each agency affected and each agency s idle Qr

id antillcatlon number if known

2 Your name address and telephone number and the name address and telephone

number of your representative or lawyor if any

3 An Explanation of how your subsrantlal Interests will be affected by the Agency s

proposed action

4 A statement of when and how you received notice of 0 ic s Agency proposed action

5 A statement of all disputed issues of material fact If there are nu c you must state

that these arc none

6 A concise statement of the ultimate facia alleged Including the specific facts you

contend warrn nt rovcrul or modification of the Agency s proposed action

7 A statement of the specific rules or statutes you claim require rovorsal or modifiaarlon

of the Agcttcy e proposed action and

8 A statement of the repel you arc seeking stating exactly what action you wish the

Agency to take with respect to its proposed action

Mediation under Section 120 573 Florida Statutes may be available in thia matter if the Agency

agrees

License type clinical laboratory License number 800004917

Licens ce Name Peter M Wallach And Shari F Topper Mda Pn

Contact person

Name Title

Address M

Stract and number city Zip Code

Telephone No Fax Email optional

1 hereby certify that 1 tun duly authorized to submit this Notice of Election of Rights to the

Agency for Health Care Administration on behaiFof tbo licensee referred to above

Print Name Title

USPS Track Confirm Page I of 1

Home I Help I Sian In

Track Confirms

Track Confirm

Search Results

Label Receipt Number 7160 39019848 1045 5162 Track Confirm MEN

Service s Certified Mall Enter Number

Status Delivered Label Receipt

Your item was delivered at 12 27 PM on May 18 2009 in MIAMI FL

33144

Detailed Results

Delivered May 18 2009 12 27 pm MIAMI FL 33144

Notice Left May 15 2009 11 22 am MIAMI FL 33144

NgtifiCBtigq tlptitatts

Track Confirm by email

Get current event information or updates for your Item sent to you or others by email 0a

Return Receipt Electronic

Verify who signed for your item by email ttv

site 1 alwyle rar vi Foftm t Gov 3 w q Careers Prlvam v Polk Teum of Usg @uslness customer 0atewav

zTrti

CopyrightO 2009 USPS All Rights Reserved No FEAR Act EEO Data FOIA tie tT Sii t iY n fb meo l t rer d Ie t tit y l S ut Y f ren ar kET p

http trkcnfrml smi usps com PTSIntemetWeb InterLabelInquiry do 05 19 2009

STATE OF FLORIDA

AGENCY FOR HEALTH CARE ADMINISTRATION

CENTER FOR DERMATOLOGY P A

Petitioner

VS DOAH No 09 3177

FRAES No 2009005482

STATE OF FLORIDA AGENCY FOR

HEALTH CARE ADMINISTRATION

Respondent

SETTLEMENT AGREEMENT

Respondent State of Florida Agency for Health Care Administration

hereinafter the Agency through its undersigned representatives and

Petitioner Center for Dermatology P A hereinafter Petitioner pursuant

to Section 120 57 4 Florida Statutes each individually a party

collectively as parties hereby enter into this Settlement Agreement

Agreement and agree as follows

WHEREAS the Petitioner seeks clinical laboratory licensure pursuant

to Chapter 483 Part I Florida Statutes and Chapter 59A 7 Florida

Administrative Code and

WHEREAS the Agency has jurisdiction by virtue of being the

regulatory and licensing authority over licensure sought by Petitioner and

s jamie settlement agreements center for dermatology center for dermatology sa docX EXHIBIT r

It I

WHEREAS the Agency served the Petitioner with a Notice of Intent to

Deem Application Incomplete and Withdrawn from Further Review Notice of

Intent dated May 12 2009 and

WHEREAS the Petitioner requested a formal administrative hearing

by filing an election of rights form or by petition and

WHEREAS the parties have agreed that a fair efficient and cost

effective resolution of this dispute would avoid the expenditure of substantial

sums to litigate the dispute and

WHEREAS the parties stipulate to the adequacy of considerations

exchanged and

WHEREAS the parties have negotiated in good faith and agreed that

the best interest of all the parties will be served by a settlement of this

proceeding and

NOW THEREFORE in consideration of the mutual promises and

recitals herein the parties intending to be legally bound agree as follows

1 All recitals are true and correct and are expressly incorporated

herein

2 Both parties agree that the whereas clauses incorporated

herein are binding findings of the parties

3 Upon full execution of this Agreement Petitioner agrees to waive

any and all proceedings and appeals to which it may be entitled including

but not limited to an informal proceeding under Subsection 120 57 2 a

formal proceeding under Subsection 120 57 1 appeals under Section

120 68 Florida Statutes and declaratory and all writs of relief in any court

or quasi court DOAH of competent jurisdiction and further agrees to waive

compliance with the form of the Final Order findings of fact and conclusions

of law to which it may be entitled Provided however that no agreement

herein shall be deemed a waiver by either party of its right to judicial

enforcement of this Agreement

4 Upon full execution of this Agreement the parties agree to the

following

a The Notice of Intent to Deem Application Incomplete and

Withdrawn from Further Review dated May 12 2009 is

deemed superseded

b The Petitioner s request for formal administrative

proceedings is withdrawn

C Upon the full execution of this Agreement the Agency shall

begin processing Petitioner s application

d Nothing in this Agreement shall prohibit the Agency from

denying Petitioner s application for licensure based upon

any statutory and or regulatory provision including but

not limited to the failure of Petitioner to satisfactorily

complete a survey reflecting compliance with all statutory

and rule provisions as required by law

5 Venue for any action brought to interpret challenge or enforce

the terms of this Agreement or the Final Order entered pursuant hereto shall

lie solely in the Circuit Court in Leon County Florida

6 By executing this Agreement the Petitioner neither admits nor

denies the allegations raised in the Notice of Intent referenced herein

7 Upon full execution of this Agreement the Agency shall enter a

Final Order adopting and incorporating the terms of this Agreement and

closing the above styled case s

8 Each party shall bear its own costs and attorney s fees

9 This Agreement shall become effective on the date upon which it

is fully executed by all the parties

10 The Petitioner for itself and for its related or resulting

organizations its successors or transferees attorneys heirs and executors

or administrators does hereby discharge the Agency and its agents

representatives and attorneys of 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 and the

Agency s actions 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 by or on behalf of the Petitioner or

related or resulting organizations

11 This Agreement is binding upon all parties herein and those

identified in the aforementioned paragraph of this Agreement

12 In the event that Petitioner is or was a Medicaid provider this

settlement does not prevent the Agency from seeking Medicaid

overpayments or from imposing any sanctions pursuant to Rule 59G 9 070

Florida Administrative Code

13 The undersigned have read and understand this Agreement and

have authority to bind their respective principals to it

14 This Agreement contains the entire understandings and

agreements of the parties

15 This Agreement supersedes any prior oral or written agreements

between the parties This Agreement may not be amended except in

writing Any attempted assignment of this Agreement shall be void

16 All parties agree that a facsimile signature suffices for an original

signature

Elizabet Dudek Stikn r Maher

HQA Dep ty Secretary ShuttsQ Bowen LLP

Agency Mr Health Care Administration Counsel for Petitioner

2727 Mahan Drive Bldg 1 201 South Biscayne Boulevard

Tallahassee Florida 32308 Suite 1500 Miami Center

Miami Florida 33131

DATED Y2 DATED Z 0

s

L Nwwbxmw

k3ustin M Senior U a stant ie L Jac s

General Counsel General Counsel

Agency for Health Care Administration Agency for Health Care Administration

2727 Mahan Drive MS 3 2727 Mahan Drive MS 3

Tallahassee Florida 32308 Tallahassee Florida 32308

DATED 1 le 4 Ito DATED Q f d4 7 I