09-004199MPI Agency For Health Care Administration vs. Christine Edwards, M.D. Status: Closed Settled and/or Dismissed prior to entry of RO/FO on Friday, October 2, 2009.

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STATE OF FLORIDA f r CU H 1 l n

DIVISION OF ADMINISTRATIVE HEARINGS r l v I LEPK

20M OCT 28 A 10 3

STATE OF FLORIDA AGENCY FOR

HEALTH CARE ADMINISTRATION

Petitioner

DOAH Case No 09 4199MPI

vs PROVIDER NO 273867800

AHCA C I No 08 7614 000

CHRISTINE EDWARDS M D RENDITION NO AHCA 09 1119 S MDO

Respondent

STATE OF FLORIDA AGENCY FOR

HEATLH CARE ADMINISTRATION

Petitioner

vs DOAH Case No 09 4198MPI

PROVIDER NO 255787800

CHRISTINE EDWARDS M D AHCA C I No 08 7613 000

Respondent

FINAL ORDER

THE PARTIES resolved all disputed issues and executed a settlement agreement which

is attached and incorporated by reference The parties are directed to comply with the terms of

the attached settlement agreement Based on the foregoing these files are CLOSED

DONE AND ORDERED on this the G 1l day of C 2009 in

Tallahassee Florida

HOll Y

Agency for Health Care Administration

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

TO A JUDICIAL REVIEW WHICH SHALL BE INSTITUTED BY FILING ONE COPY

OF A NOTICE OF APPEAL WITH THE AGENCY CLERK OF AHCA AND A

SECOND COpy ALONG WITH FILING FEE AS PRESCRIBED BY LAW WITH THE

DISTRICT COURT OF APPEAL IN THE APPELLATE DISTRICT WHERE THE

AGENCY MAINTAINS ITS HEADQUARTERS OR WHERE A PARTY RESIDES

REVIEW PROCEEDINGS SHALL BE CONDUCTED IN ACCORDANCE WITH THE

FLORIDA APPELLATE RULES THE NOTICE OF APPEAL MUST BE FILED

WITHIN 30 DAYS OF RENDITION OF THE ORDER TO BE REVIEWED

Copies Furnished to

Lester J Perling Esq

Broad and Cassel

One Financial Plaza Suite 2700

Fort Lauderdale Florida 33394

Karen Dexter Assistant General Counsel

Agency for Health Care Administration

Interoffice

Peter Williams Inspector General

Agency for Health Care Administration

Interoffice

D Kenneth Yon Bureau Chief

Medicaid Program Integrity

Interoffice

Finance Accounting

Interoffice

CERTIFICATE OF SERVICE

I HEREBY CERTIFY that a true and correct copy ofthe foregoing was served to the

above named addresses by mail or interoffice mail this Zr r day of

2009

c S

Richard Shoop Agency Clerk

Agency for Health Care Administration

2727 Mahan Drive Bldg 3 Mail Stop 3

Tallahassee Florida 32308 5403

850 922 5873

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

STATE OF FLORIDA AGENCY FOR

HEALTH CARE ADMINISTRATION

Petitioner

vs Case No 094199MPI

273867800

CHRISTINE EDWARDS M D 08 7614 000

Respondent

I

STATE OF FLORIDA AGENCY FOR

HEALTH CARE ADMlNISTRA nON

Petitioner

vs Case No 094198MPI

255787800

CHRISTINE EDWARDS M D 08 7613 000

Respondent

I

SETTLEMENT AGREEMENT

STATE OF FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATION

AHCN or the Agency and CHRISTINE EDWARDS M D PROVIDER by and

through the undersigned hereby tipulate and agree as follows

1 The two parties enter into this agreement for the purpose of memorializing the

resolution to this matter

2 PROVIDER is a Medicaid provider in the State of Florida with provider numbers

2738678 00 and 2557878 OO and was a provider during the audit period

3 In its Final Audit Reports final agency action dated June 7 2009 AReA

notified PROVIDER that review of Medicaid claims perfonned by Medicaid Program Integrity

Christine Edwards M D

C I Nos 08 7613 000 08 7614 000

Provider Nos 255787800 273867800

MPD Office of the AHCA Inspector General indicated that certain claims in whole or in part

has been inappropriately paid by Medicaid The Agency sought recoupment of these

overpayments in the amount of 2 266 28 plus a fine in the amount of 500 00 for violation s

of Rule Section 59G 9 070 7 e F A C for C I No 08 7614 000 and in the amount of

4 085 66 plus a fine of 1 000 00 for violation s of Rule Section 59G 9 070 7 e F A C for

I C No 08 7613 000 In response to the audit letters dated June 7 2009 PROVIDER filed a

petition for a formal administrative hearing which was assigned DOAH Case Nos 09 4198 and

09 4199 respectively

4 In order to resolve this matter without further administrative proceedings

PROVIDER and the AHCA expressly agree as follows

1 AHCA agrees to accept the payment set forth herein in settlement of the

overpayment issues arising from the MPI review

2 Within thirty days of entry of the final order PROVIDER agrees to pay

the Agency seven thousand eight hundred fifty one dollars and ninety four

cents 7 851 94 which includes 1 500 in fines in six 6 equal monthly

installments including 10 mandatory statutory interest PROVIDER

agrees to submit a Corrective Action Plan in the form of a Provider

Acknowledgement Statement AHCA retains the right to perform a 6

month follow up review

3 PROVIDER and AHCA agree that full payment as set forth above will

resolve and settle these cases completely and release both parties from all

liabilities arising from the findings in the audits referenced as C I Nos

08 7614 000 and 08 7613 000

Christine Edwards M D

C I Nos 08 7613 000 08 7614 000

Provider Nos 255787800 273867800

4 PROVIDER agrees that it will not rebill the Medicaid Program in any

manner for claims that were not covered by Medicaid which are the

subject of the audit in this case

5 Payment shall be made to

AGENCY FOR HEALTHCARE ADMINISTRATION

Medicaid Accounts Receivable

Post Office Box 13749

Tallahassee Florida 32317 3749

6 PROVIDER agrees that failure to pay any monies due and owing under the terms

of this Agreement shall constitute PROVIDER S authorization for the Agency without further

notice to withhold the total remaining amount due under the terms of this agreement from any

monies due and owing to PROVIDER for any Medicaid claims

7 AHCA reserves the right to enforce this Agreement under the laws of the State of

Florida the Rules of the Medicaid Program and all other applicable rules and regulations

8 This settlement does not constitute an admission of wrongdoing or error by either

party with respect to this case or any other matter

9 Each party shall bear its own attorneys fees and costs ifany

10 The signatories to this Agreement acting in a representative capacity represent

that they are duly authorized to enter into this Agreement on behalf of the respective parties

11 This Agreement shall be construed in accordance with the provisions of the laws

of Florida Venue for any action arising from this Agreement shall be in Leon County Florida

12 This Agreement constitutes the entire agreement between PROVIDER and the

AHCA including anyone acting for associated with or employed by them concerning all

matters and supersedes any prior discussions agreements or understandings there are no

Christine Edwards M D

C Nos 08 7613 000 08 7614 000

Provider Nos 255787800 273867800

promises representations or agreements between PROVIDER and the AHCA other than as set

forth herein No modification or waiver of y provision shall be valid unless a written

amendment to the Agreement is completed and properly executed by the parties

13 This is an Agreement of settlement and compromise made in recognition that the

parties may have different or incorrect understandings infonnation and contentions as to facts

and law and with each party compromising and settling any potential correctness or

incorrectness of its understandings infonmition and contentions as to facts and law so that no

misunderstanding or misinformation shall be a ground for rescission hereof

14 PROVIDER expressly waives in this matter its right to any hearing pursuant to

sections 120 569 or 120 57 Florida Statutes the making of findings of fact and conclusions of

law by the Agency and all further and other proceedings to which it may be entitled by law or

rules of the Agency regarding this proceeding and any and all issues raised herein PROVIDER

further agrees that it shall not challenge or contest any Final Order entered in this matter which is

consistent with the terms of this settlement agreement in any forum now or in the future available

to it including the right to any administrative proceeding circuit or federal court action or any

appeal

15 This Agreement is and shall be deemed jointly drafted and written by all parties to

it and shall not be construed or interpreted against the party originating or preparing it

16 To the extent that any provision of this Agreement is prohibited by law for any

reason such provision shall be effective to the extent not so prohibited and such prohibition

shall not affect any other provision of this Agreement

17 This Agreement shall inure to the benefit of and be binding on each party s

successors assigns heirs administrators representatives and trustees

Christine Edwards M D

C Nos 08 7613 000 08 7614 000

Provider Nos 255787 00 273867800

18 All times stated herein are of the essence of this Agreement

19 This Agreement shall be in full force and effect upon execution by the respective

parties in counterpart

CHRISTINE EDWARDS M D

r Dated 1 2 2009

BY C hc S4 rL Z o

print name

f A

ITS C T d I

AGENCY FOR HEALTH CARE

ADMINISTRATION

2727 Mahan Drive Mail Stop 3

Tallahassee FL 32308 5403

Dated to ZG 2009

Peter Williams I

Inspector General

f1 L Dated 0 J 2009

J M Se r

Acting General Counsel

Dated tj 3 2009