13-004951MTR Glenn Allen Holland vs. Agency For Health Care Administration Status: Closed DOAH Final Order on Friday, May 2, 2014.

Summary: Petitioner did not prove that AHCA should recover less than the amount of its Medicaid lien claim.

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

GLENN ALLEN HOLLAND,

Petitioner,

vs. Case No. 13 - 4951MTR

AGENCY FOR HEALTH CARE

ADMINISTRATION,

Respondent.

_______________________________/

FINAL ORDER

Pursuant to notice, a final hearing was held in this matter

on February 27, 2014, in Tallahassee, before W. David Watkins,

the assigned administrative law judge of the Florida Division of

Administrative Hearings (DOAH) .

APPEARANCES

For Petitioner: Richard Lantinberg, Esq uire

The Wilner Firm

444 E ast Duval Street

Jacksonville, F lorida 32202

For Respondent: Adam Stallard, Esquire

Xerox Recovery Services, Inc.

2316 Killearn Center B oulevard

Tallahassee, F lorida 32309

STATEMENT OF THE ISSUE

The issue in this case is the amount of Petitioner Ó s

personal injury settlement required to be paid to the Agency for

Health Care Administration (AHCA) to satisfy its

Medicaid reimbursement cl aim under section 409.910, Florida

Statutes. 1 /

PRELIMINARY STATEMENT

On December 20, 2013, Petitioner filed with DOAH a Petition

for Equitable Apportionment of Personal Injury Settl ement to

Satisfy Medicaid Lien (Petition) pursuant to section

409.910(17)( b), Florida Statutes. Thereafter, the matter was

assigned to the undersigned administrative law judge to conduct

a formal administrative hearing and enter a final order. The

matter was set for hearing on February 27, 2014, and prior to

hearing the partie s filed a Joint Prehearing Stipulation, as

well as a supplemental stipulation.

The hearing proceeded as scheduled, with the Petitioner

calling one witness, Christopher Shakib, Esquire. At

PetitionerÓs request, several legal authorities were officially

re cognized. Respondent called no witnesses and offered no

documentary evidence.

The T ranscript of the hearing was filed with DOAH on

March 27, 2014, and both parties tim ely filed P roposed F inal

O rders 2 / which have been carefully considered in the preparatio n

of this Final Order.

On April 14, 2014, Respondent filed a Motion for Official

Recognition of the Final Order in Debra L. Savasuk v. Agency for

Health Care Administration , Case No. 13 - 4130MTR (Fla. DOAH Jan.

29, 2014). Petitioner did not file a res ponse in opposition to

the motion. Accordingly, the motion is granted and the

undersigned has considered the cited Final Order.

FINDINGS OF FACT

Based on the evidence adduced at hearing, and the record as

a whole, the following findings of fact are made:

Background

1 . On April 9, 2009, Petitioner, Glenn Holland, came into

contact with an energized overhead electric power li ne owned by

the local utility company . At the t ime of the incident,

Mr. Holland was working as a professional tree trimmer. As a

re sult of his contact with the wire, he was shocked, lost his

balance and grip and fell approximately 30 feet to the ground ,

and sustained catastrophic bodily injuries which render ed him a

wheelchair - bound paraplegic.

2 . PetitionerÓs emergency and other med ical expenses were

paid by Medicaid . The parties stipulated that Medicaid has paid

a total of $219,908 to treat Petitioner for his injuries.

3 . Petitioner commenced a civil action against the utility

company , alleging negligence in the maintenance of th e power

line and adjacent pole and structures . The utility company

defended, claiming comparative negligence on the part of

Mr. Holland. Ultimately , Petitioner settled the lawsuit for

$500,000. The costs incurred by Petitioner in the underlying

action w ere stipulated to be $ 65,183.49. Thereafter, AHCA ,

pursuant to the formula set forth at section 409.910(11)(f) ,

Florida Statutes, asserted an entitlement to be paid $154,908.25

from the proceeds of the $500,000 settlement.

4 . Petitioner objected to the AgencyÓs demand for

$154,908.25 and timely commenced this action.

Evidence Relating to Damages

5 . On February 24, 2014, the parties filed with DOAH a

document entitled ÐStipulation #1 . Ñ Through the document, the

parties stipulated to the following:

1. T he Petitioner, had the underlying

matter gone to trial, would have presented

and sought to prove - up the damage figures

that appear on page 10 of 10 of Dr. J. Rody

BorgÓs report as Mr. Glenn Holland, III's

economic damages. These figures appear on

page 3 of the PetitionerÓs Petition in the

instant case at the Division of

Administrative Hearings.

2. The figures in Dr. Borg's Report were

calculated by Rody Borg, Ph.D., in

consultation with the life care report of

Dr. Craig Lichtblau, MD.

3. T he Responde nt agree s to not object to

testimony from Petitioner's expert witnesses

(i.e. Chris Shakib) at final hearing

regarding the economic damages figures

contained in Dr. Borg's report, including,

by way of example , that Dr. Borg opined that

the amount of lost p ast earnings was

$297,741; future earnings lost were

$1,139,070, that lost benefits were $113,907

and the low present value amount of future

life care expenses total $4,656,614, for a

total calculated economic loss (assuming low

estimated figures) of $6,20 7,333.

4. Petitioner stipulates that he will not

seek to admit into evidence Dr. BorgÓs

report nor the Dr. Lichblau report.

6 . Page 3 of the Petition referenced in the first

stipulation above sets forth estimated (past) and projected

(future) economic damages suffered by Petitioner, as follows:

8. At hearing on this matter, plaintiff

will submit proof of:

i. t he amount of MedicaidÓs lien

$219,108.80 Ï by reference to

MedicaidÓs lien demand amount.

ii. Mr. HollandÓs total injuries,

medical and otherwi se, by reference

to Craig H. Lichtblau, M.D.Ós life

care plan pertai n in g to medical

damages and a summary of medical

bills.

iii. The present dollar value of

Mr. HollandÓs injuries by reference

to Dr. BorgÓs expert report. Total

future medical damages, t hose not

paid by AHCA exceed $4.65 million

on a present value basis. ( See

e.g. table below from Dr. BorgÓs

Economic Damages Report.)

LIFE CARE PLAN TOTALS

LOW MID HIGH

Actual Future Expected $16,708,080.52 $19,121,210.31 $21,534 ,340.10

Present Value $4,656,614.47 $5,388,683.20 $6,120,751.93

ECONOMIC DAMAGES SUMMARY

Glenn Holland III

OVERALL LOSS TOTALS

LOW MID HIGH

Past Earnings $297,741.27 $297,741.27 $297,741.27

Future Earnings $1,139,070.35 $1,518,760.47 $1,898,450.59

Future Benefits $ 113,907.04 $227,814.07 $379,690.12

Future Life Care $4,656,614.47 $5,388,683.20 $6,120,751.93

OVERALL TOTALS $6,207,333.14 $7,432,999.02 $8,696,633.91

7 . Dr. Craig Lichtblau is a physiatrist (a physician

specializing in physical medicine) retained by Mr. Holland in

the underlying action to evaluate his condition and to render an

opinion re garding the future care and treatment need s of

Mr. Holland as a result of injuries. Dr . Lichtblau prepared a

report of his findings and projections, referred to as t he Life

Care Plan.

8 . Rody Borg , Ph.D., is an economist and professor at

Jacksonville University . He was retained by Petitioner to

evaluate the Life Care Plan and to calculate what it would cost

to provide the services outl ined in the plan. Dr. Borg pre pared

a n ÐEconomic Damages ReportÑ that reduc ed to present value the

cost of future medical expenses and other damages sustained by

Mr. Holland , as outlined by Dr. Lichtblau.

9 . Christopher Shakib, Esq u ire , was called as Petitioner Ós

only witness . Mr. Sh akib has practiced law for more than 20

years , and has experience in personal injury, civil trial , and

catastrophic injury cases. Prior to testifying, Mr. Shakib

reviewed the pleadings in the underlying tort action, discovery,

deposition testimony , and th e expert reports prepared by

Dr. Lichtblau and Dr. Borg .

10 . Mr. Shakib first discussed the economic damages that

Petitioner has, and will, continue to suffer as a result of the

accident. Those categories of economic losses include past

earnings, future earnings, future benefits, and future life care

(medical) expenses .

11 . Consistent with the figures appearing on page 3 of the

Petition, Mr. Shakib testified that in his opinion, the amount

of economic damages sustained by Mr. Holland ranged in present

va lue, from a low of approximately $6. 2 million to a high of

approximately $8.7 million. Subsumed within these projections

were projected future medical expenses ranging from a low of

approximately $4.6 million to a high of approximately $6.1

million.

12 . Mr. Shakib further opined that in addition to economic

losses, Petitioner has, and will, suffer non - economic losses.

These include pain and suffering, loss of enjoyment of life,

inconvenience, and mental anguish. In his opinion, the non -

economic damages sustained by Mr. Holland would range from $8. 7

million to $20 million.

13 . Mr. Shakib explained the approach he followed to come

up with his projection of non - economic losses, as follows:

A. Right. There are different ways to

do it. Some people will amortize it and

come up with a daily rate for pain and

suffering. And, you know, in my opinion

sometimes that ends up making the numbers

too high , higher than I think are

reasonable. What I do in my practice, and

IÓve done this for many years, is wh en

trying to evaluate what a case is worth, I

will take all of the economic losses and

IÓll add one extra component for the

medicals in the past that were billed; I

wonÓt just use the amount that was paid but

I will use the actual amount that was billed

to come up with the total economics, as a

rule of thumb that I use.

And I think it was closer to a million

and the amount that was actually billed

versus the $219,000 or so that was actually

paid. And so IÓll add the difference

between the billed amo unt and the paid

amount back in, and then I will double the

economics to get my low range value of a

case like this ; and IÓll triple the

economics, and that will give me the high

range for what I think the case is worth.

14 . Although the Medicaid program paid $219 , 108.80 for

medical services provided to Petitioner, a total of

$1,140,386.80 was billed to Medicaid for PetitionerÓs medical

care. The remaining $921,278.00 represented the Ðwrite - offÑ

taken by medical services providers.

15 . Mr. Shakib has ne ver met Mr. Holland, or personally

evaluated his physical condition. Mr. Shakib testified that in

catastrophic injury cases , he typically interviews the treating

physicians, yet there is no evidence in this record that he did

so in preparing to render tes timony in this case. Nor did

Mr. Shakib offer testimony regarding the actual degrees of pain

and suffering, loss of enjoyment of life, inconvenience, and

mental anguish that has been suffered , or will be suffered in

the future, by Mr. Holland.

16 . Mr. Sh akib conducted no jury verdict research and did

not compare this case to any case tried to verdict.

17 . Mr. ShakibÓs testimony regarding PetitionerÓs non -

economic damages was lacking in detail, and was unpersuasive.

The imprecision of Mr. ShakibÓs projec tions was undersc ored by

his projected range of non - economic damages, from $8.7 million

to $20 million, a swing of more than $11 million.

18 . According to Mr. Shakib , the total economic and non -

economic damages sustained by Mr. Holland were in the range of

$15 million to $29 .5 million . 3 / Mr. Shakib opined that

Ðregardless of any issues of liability; if 100 percent liability

could be proved with no comparative fault and there was someone

who could pay these damages, this case is worth between 15

million a nd a little less than 30 million, and I think that

because of his age at the time that he became a quadriplegic ,

that his actual damages are more on the higher side of that than

the lower side of that.Ñ

19 . Mr. ShakibÓs testimony regarding the total damag es

suffered by Petitioner is rejected, since the largest component

of the total damages estimate are the non - economic damages,

which are non - credible.

20 . Mr. Shakib thereafter calculated the proportion that

the amount of past medical expenses ($219,108.8 0) bore to the

full value of the case. He calculated the proportion as a range

of between 1.46 % 4 / and 0.742% . 5 / In other words, according to

Mr. Shakib , the AgencyÓs recovery should be limited to between

1.46% and 0.742% of the settlement amount. Mr. Sh akib then

applied these ratios to the settlement and the amount sought by

the Agency . In this regard , he testified , Ð[ M ] y opinion is that

the lien recovery by the agency should be between $3700 and

$7300, and my opinion would be it should really be more t owards

the lower end of that because of the value of the case given the

fact that this is a 22 - year - old who becomes a quadriplegic.Ñ

21 . As noted, Mr. Shakib did not include the projected

future medical expenses in his calculation of the proportion

that m edical expenses bore to the full value of the case. Had

he done so, the following chart illustrates the impact the

inclusion of future medical expenses would have on the

calculation of the Medicaid lien recovery amount:

CA L CULATION OF LIEN RECOVERY AMOUNT USING PETITIONERÓS

METHODOLOGY WITH INCLUSION OF FUTURE MEDICAL EXPENSES

LOW HIGH

PAST MEDICALS PAID $219,108.80 $219,108.80

BY AHCA

FUTURE MEDICALS $4,656,614.00 $6,120,752.00

TOTAL MEDICALS $4,875,722.80 $6,339,860.80

TOTAL DAMAGES $15,000,000.00 $29,511,063.33

PROPORTION OF 32.505% 21.483%

MEDICAL EXPENSES TO

TOTAL DAMAGES

SETTLEMENT AMOUNT X $500,000 X $500,000

LIEN RECOVERY AMOUNT $162,524.09 $107,414.98

CONCLUSIONS OF LAW

22 . DOAH has jurisdiction over the parties and the subject

matter of this proceeding , and F inal O rder authority, pursuant

to s ection 409. 910(17), Florida Statutes .

23 . The Florida Legislature has codified a formula for

determining the maximum amount that may be recovered by AHCA

from the proceeds of a tort action broug ht by a Medicaid

recipient. Section 409.910(11)(f), provides:

(f) Notwithstanding any provision in this

section to the contrary, in the event of an

action in tort against a third party in

which the recipient or his or her legal

representative is a party which results in a

judgment, award, or settlement from a third

party, the amount recovered shall be

distributed as follows:

1. After attorneyÓs fees and taxable costs

as defined by the Florida Rules of Civil

Procedure, one - half of the remaining

recovery shall be paid to the agency up to

the total amount of medical assistance

provided by Medicaid.

2. The remaining amount of the recovery

shall be paid to the recipient.

3. For purposes of calculating the agencyÓs

recovery of medical assistance benefits

p aid, the fee for services of an attorney

retained by the recipient or his or her

legal representative shall be calculated at

25 percent of the judgment, award, or

settlement.

4. Notwithstanding any provision of this

section to the contrary, the agency sh all be

entitled to all medical coverage benefits up

to the total amount of medical assistance

provided by Medicaid. For purposes of this

paragraph, Ðmedical coverageÑ means any

benefits under health insurance, a health

maintenance organization, a preferre d

provider arrangement, or a prepaid health

clinic, and the portion of benefits

designated for medical payments under

coverage for workersÓ compensation, personal

injury protection, and casualty.

24 . Pursuant to the above formula, AHCA is entitled to

pa yment for all medical assistance it provides for a Medicaid

recipient who suffers a tort injury, up to 37.5% of the amounts

recovered from third parties.

25 . While the s tate of Florida , after providing Medicaid

benefits, may seek reimbursement for Ð such health care items or

services, Ñ there are limitations on the s tate Ó s recovery that

protect the Medicaid recipient's property interest.

Specifically, the federal anti - lien statute at 42 U.S.C.

§ 1396p( a )(1) states Ð [n]o lien may be imposed against the

prop erty of any individual prior to his death on account of

medical assistance paid, Ñ and the federal anti - recovery statute

at § 1396p(b)(1) states Ð [n]o adjustment or recovery of any

medical assistance correctly paid on behalf of an individual

under the State plan may be made. Ñ Pursuant to these federal

directives, Florida enacted the Ð Medicaid Third - Party Liability

Act Ñ (F TPLA). See § 409.910, Fla. Stat.

26 . Citing Arkansas Department of Health and Human

Services v. Ahlborn , 547 U.S. 268, 126 S. Ct. 1752 (2006) , and

Wos v. E.M.A. ex Rel. Johnson , 133 S. Ct. 1391 (2013),

Petitioner contends that unless the Florida Statutes are

interpreted and applied so as to reduce AHCAÓs Medicaid lien

claim in accordance with its theory, those statutes are

preempted by fe deral law that prohibits states from imposing a

lien against the property of a Medicaid recipient prior to the

death of the recipient. Specifically, Petitioner argues that

Florida has established an arbitrary sum due to AHCA regardless

of the proportion t hat medical expenses paid by AHCA bears to

the total damages sustained.

27 . As an alternative to the formula set forth in section

409.910(11)(f), Petitioner urges the application of a formula

which compares the amount of past medical expenses (here , th e

amount of Medicaid's lien) to the total damages , and then an

application of that same proportion to the settlement amount , to

determine the amount to be reimbursed to the Agency. As

authority for its proposed formula, Petitioner cites Smith v.

Agency fo r Health Care Admin istration , 24 So. 3d 590, 590 (Fla.

5th DCA 2009) ( at n . 1 and dissent at 593 explaining formula to

determine ratio of medical expenses to total damages for

purposes of complying with Ahlborn ) . Petitioner also cites

several Florida circu it court decisions which have applied a

past - medical - expense - to - total - damages ratio to calculate the

Medicaid lien recovery amount.

28 . PetitionerÓs argument ignores the fact that the 2013

Florida Legislature amended section 409.910 to specifically

addres s the concerns voiced by the Court in Ahlborn and Wos .

T he Staff Analysis on CS/CS/HB 939 prepared by the Health and

Human Services Committee of the Florida House of Representatives

on April 12, 2013, clearly indicates that the intended effect of

the stat utory changes was to address the U.S. Supreme Court

decision in Wos .

Section 409.910, F.S. , creates an

irrebuttable presumption that the amount

that the A H CA is entitled to from a Medicaid

recipientÓs judgment, award or settlement in

a tort action is the lesser of 37.5% of the

total recovery or the total amount of

medical assistance paid by Medicaid. This

provision is similar to the North Carolina

provision recently struck down by the

Supreme Court in Wos v. E.M.A. To ensure

compliance with federal law, the bill amends

this section to create a presumption of

accuracy as to the A H CAÓs determination of

the reimbursement amount but allows this

determination to be rebutted by clear and

convincing evidence. The bill establishes

the mechanism for these challe nges by

providing Medicaid recipients with the right

to an administrative hearing at DOAH to

contest the amount of AHCAÓs recoupment.

The bill establishes Leon County as venue

for these hearings and the First District

Court of Appeal as venue for any rela ted

appeals. The bill also provides that each

party is to bear its own attorney fees and

costs.

29 . Effective July 1, 2013, section 409.910(17(b),

provides in relevant part :

(b) A recipient may contest the amount

designated as recovered medical expens e

damages payable to the agency pursuant to

the formula specified in paragraph (11)(f)

by filing a petition under chapter 120

within 21 days after the date of payment of

funds to the agency or after the date of

placing the full amount of the third - party

be nefits in the trust account for the

benefit of the agency pursuant to paragraph

(a). The petition shall be filed with the

Division of Administrative Hearings. For

purposes of chapter 120, the payment of

funds to the agency or the placement of the

full a mount of the third - party benefits in

the trust account for the benefit of the

agency constitutes final agency action and

notice thereof. Final order authority for

the proceedings specified in this subsection

rests with the Division of Administrative

Heari ngs. This procedure is the exclusive

method for challenging the amount of third -

party benefits payable to the agency.

(footnote omitted).

30 . S ection (17)(b) of the 2013 amendment also establishes

the evidentiary burden that must be satisfied by a cha llenger to

the statutory formula:

In order to successfully challenge the

amount payable to the agency, the recipient

must prove, by clear and convincing

evidence, that a lesser portion of the total

recovery should be allocated as

reimbursement for past and future medical

expenses than the amount calculated by the

agency pursuant to the formula set forth in

paragraph (11)(f) or that Medicaid provided

a lesser amount of medical assistance than

that asserted by the agency. (footnote

omitted).

31 . None of t he cases cited by Petitioner address ed the

newly amended version of s ection 409.910 . Rather, those cases

addressed the old version of s ection 409.910, which included no

provision or procedure by which a recipient could challenge

s ection 409.910(11)(f)Ós d etermination as to the medical expense

portion of a recipientÓs settlement. The most recent Florida

appellate case cited by Petitioner , Davis v. Roberts , 130 So. 3d

264 (Fla. 5 th DCA 2013), makes this perfectly clear . At

f o otnote 8 of that decision , the c ourt specifically mentions the

new, amended version of section 409.910 . This footnote is

prece ded by a lengthy discussion of the flaw in the appelleeÓs

position in that case , to wit , AHCA Ós assertion that Medicaid

recipients have no right to attempt to r ebut the Medicaid

reimbursement determination made by the formula at s ection

409.910(11)(f). Id . at 269. The flaw noted by the court in

Davis has been remedied by the addition of section

409.910(17)(b).

32 . Pursuant to section 409.910(17)(b), a challen ger must

prove Ð by clear and convincing evidence, that a lesser portion

of the total recovery should be allocated as reimbursement for

past and future medical expenses than the amount calculated by

the agency pursuant to the formula . Ñ

33 . Clear and conv incing evidence is an Ð intermediate

standard, Ñ Ð requir[ing] more proof than a 'preponderance of the

evidence' but less than 'beyond and to the exclusion of a

reasonable doubt.' Ñ In re Graziano , 696 So. 2d 744, 753 (Fla.

1997). For proof to be considered Ð 'clear and convincing' Ñ

T he evidence must be found to be credible;

the facts to which the witnesses testify

must be distinctly remembered; the testimony

must be precise and explicit and the

witnesses must be lacking in confusion as to

the facts in issue. The evidence must be of

such weight that it produces in the mind of

the trier of fact a firm belief or

conviction, without hesitancy, as to the

truth of the allegations sought to be

established.

In re Davey , 645 So. 2d 398, 404 (Fla. 1994) (quoting, with

approval, from Slomowitz v. Walker , 429 So. 2d 797, 800 (Fla.

4th DCA 1983)); see also In re Adoption of Baby E.A.W. , 658 So.

2d 961, 967 (Fla. 1995) ( Ð The evidence [in order to be clear and

convincing] must be sufficient to convince the trier of fact

wit hout hesitancy. Ñ ). Ð Although this standard of proof may be

met where the evidence is in conflict, . . . it seems to

preclude evidence that is ambiguous. Ñ Westinghouse Electric

Corp. v. Shuler Bros. , 590 So. 2d 986, 989 (Fla. 1st DCA 1991).

In this insta nce, Petitioner failed to carry its burden of

proof.

34 . At the outset, the undersigned notes that the

projections of non - economic damages (which were factored into

total damages for purposes of applying PetitionerÓs formula) did

not rise to the level of Ðclear and convincingÑ evidence. While

the undersigned is aware that the valuation methods used by

counsel in personal injury and wrongful death cases may vary,

and are not an exact science, in this instance , the high and low

end valuations provided by P etitionerÓs witness were imprecise,

lacked an adequate foundation, and were so widely disparate as

to be rendered non - credible.

35 . The second fatal shortcoming in PetitionerÓs case was

the failure to include both past and future medical expenses in

the application of its alternative formula. As the chart at

Finding of Fact No. 21 illustrates, in a case where the injuries

are catastrophic, and are suffered by a young person, future

medical expenses will be significant and will radically alter

the product of PetitionerÓs formula .

36 . If the language of a statute Ð is clear and unambiguous

and conveys a clear and definite meaning, the statute should be

given its plain meaning. Ñ Fla. Hosp. v. Ag . for Health Care

Admin. , 823 So. 2d 844, 848 (Fla. 1st DCA 20 02).

37 . Here, a plain reading of Ð past and future medical

expenses Ñ cannot, as Petitioner asserts, limit the term to Ð past

medical expenses . Ñ See Debra L. Savasuk v. Ag . for Health Care

Admin. , Case No. 13 - 4130MTR (Fla. DOAH Jan. 29, 2014) .

Accordingly , the undersigned is obliged to apply the statute as

written.

38 . When future medical expenses are factored into

PetitionerÓs formula (and assuming, arguendo, that PetitionerÓs

projections of total damages are credible) , the result is not

appreciably diff erent than the result rendered when the

statutory formula is applied. As stipulated by the parties,

application of the section 409.910(11) (f) formula renders a

Medicaid lien recovery of $154,908.25, while PetitionerÓs

alternative formula renders a lien re covery amount of between

$107,414.98 and $162,524.09. Thus, the statutory lien recovery

amount falls within the range determined using PetitionerÓs

formula, when future medical expenses are included.

39 . Petitioner has failed t o prove by clear and convin cing

evidence that a lesser portion of the total recovery should be

allocated as reimbursement for past and future medical expenses

than the amount calculated by the agency pursuant to the formula

set forth in paragraph (11)(f) , or that Medicaid provided a

lesser amount of medical assistance than that asserted by the

agency.

DISPOSITION

Based on the foregoing Findings of Fact and Conclusions of

Law, it is DETERMINED that the amount of AHCAÓs Medicaid lien

payable from the PetitionerÓs $500,000.00 settlement is fixed at

$154,908.25, as claimed by AHCA.

DONE AND ORDERED this 2nd day of May , 2014 , in Tallahassee,

Leon County, Florida.

S

W. DAVID WATKINS

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 2nd day of May , 2014 .

ENDNOTES

1 / Unless otherwise indic ated, all references are to the 2013

version of the Florida Statutes.

2 / While denominated a Proposed Recommended Order, the

undersigned considered PetitionerÓs filing to be a Proposed

Final Order.

3 / The exact figure calculated by Mr. Sh akib was $29,5 11,063.33.

4/ $219,108.80 divided by $15,000,000.00=0.0146 (1.46 percent) .

5 / $219,108.80 divided by $ 29,511,063.33 =0. 0 0 742 ( 0 . 742

percent) .

COPIES FURNISHED :

Frank Dichio

Agency for Health Care Administration

2727 Mahan Drive , Mail Stop 19

Tallahas see, Florida 32308

Adam James Stallard, Esquire

Xerox Recovery Services Group

2316 Killearn Center Boulevard

Tallahassee, Florida 32309

Richard J. Lantinberg, Esquire

The Wilner Firm

444 East Duval Street

Jacksonville, Florida 32202

Stuart F. William s, General Counsel

Agency for Health Care Administration

2727 Mahan Drive , Mail Stop 3

Tallahassee, Florida 32308

Richard J. Shoop, Agency Clerk

Agency for Health Care Administration

2727 Mahan Drive , Mail Stop 3

Tallahassee, Florida 32308

Elizabeth Du dek, Secretary

Agency for Health Care Administration

2727 Mahan Drive , Mail Stop 1

Tallahassee, Florida 32308

NOTICE OF RIGHT TO JUDICIAL REVIEW

A party who is adversely affected by this Final Order is

entitled to judicial review pursuant to s ection 120.68, Florida

Statutes. Review proceedings are governed by the Florida Rules

of Appellate Procedure. Such proceedings are commenced by

filing one copy of a Notice of Appeal with the agency clerk of

the Division of Administrative Hearings and a second copy,

accompanied by filing fees prescribed by law, with the District

Court of Appeal, First District, or with the District Court of

Appeal in the appellate district where the party resides. The

Notice of Appeal must be filed within 30 days of rendition o f

the order to be reviewed.