17-001966MTR Angela Mojica, A Minor, By And Through Her Mother And Natural Guardian, Glexys Mojica vs. Agency For Health Care Administration Status: Closed DOAH Final Order on Tuesday, March 3, 2020.

Summary: On remand from the First District Court of Appeal, Respondent's Lien shall be reduced to $113,112.33.

the amended final order and remand for further

proceedings consistent with this opinion.

That opinion became final and the court’s mandate directed to the

undersigned was issued on January 9, 2019.

The undersigned conducted a telephonic status conference with the

parties to discuss further proceedings before the Division of Administrative

Hearings. During the status conference, Respondent requested tim e to

submit a brief to the undersigned regarding the amount by which its lien

should be reduced given the First District Court’s opinion.

On January 28, 2020, the undersigned entered an Order Granting Leave

for Respondent to Submit Memorandum of Law, requ iring Respondent’s

memorandum to be filed within ten days of the date of the Order, and

requiring Petitioner’s response, if any, to be filed within 15 days of

Respondent’s memorandum. The parties timely filed their memoranda, which have been taken into con sideration in preparing this Amended Final Order

on Remand.

In its memorandum, Respondent argues that it is entitled to the full

amount allocable to Petitioner’s past medical expenses: $209,476.26.

However, the parties stipulated for final hearing that Pe titioner’s past

medical expenses were paid by three different Medicaid programs:

Respondent ; Department of Health ; and Amerigroup Community Care.

Respondent is only entitled to the portion of past medical expenses actually paid by Respondent. See Baker v. Ag. for Health Care Admin. , Case No. 18 -

3847 (Fla. DOAH May 21, 2019); Lamendola v. Ag. for Health Care Admin. ,

Case No. 17 - 3908 (Fla. DOAH Jan. 5, 2018). To accept Respondent’s

argument — that it is entitled to reimbursement of the full amount allocable

to past medical expenses — would require Petitioner to pay, in satisfaction of

all three Medicaid providers’ liens, more than the total amount allocable to

past medical expenses. 1 Respondent paid 54 percent of the $209,476.26

allocated to Petitioner’s past medi cal expenses, thus, Respondent’s lien

should be reduced to 54 percent of that total amount.

Accordingly, as directed, it is found and concluded that the Agency for

Health Care Administration’s lien in this case shall be reduced to 54 percent

of $209,426. 26, or $113,112.33.

Based on the foregoing, it is,

O RDERED that:

1. The Agency for Health Care Administration’s lien in the case is reduced

to $113,112.33; and

2. Petitioner is awarded the unopposed requested taxing costs of $469.00. 2

D ONE A ND O RDERED t his 3rd day of March , 2020 , in Tallahassee, Leon

County, Florida.

S UZANNE V AN W YK

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

1 The other two Medic aid providers, Department of Health and Amerigroup, settled their

claims for reimbursement of past medical expenses for a total of $99,915.28 , which Petitioner

has previously paid .

2 ie, PL.” The check for the taxing costs shall be made payable to “Staunton & Fagl

Filed with the Clerk of the

Division of Administrative Hearings

this 3rd day of March , 2020 .

C OPIES F URNISHED :

Alexander R. Boler, Esquire

Suite 300

2073 Summit Lake Drive

Tallahassee, Fl orida 32317

(eServed)

Floyd B. Faglie, Esquire

Staunton and Faglie, P.L.

189 East Walnut Street

Monticello, Florida 32344

(eServed)

Kim Annette Kellum, Esquire

Agency for Health Care Administration

Mail Stop 3

2727 Mahan Drive

Tallahassee, Florida 323 08

(eServed)

Ashley E. Davis, Esquire

Office of the Attorney General

The Capitol, Plaza Level 01

Tallahassee, Florida 32399

(eServed)

Jonathan Alan Glogau, Esquire

Office of the Attorney General

The Capitol, Plaza Level 01

Tallahassee, Florida 32399

(e Served)

Elizabeth A. Teegen, Esquire

Office of the Attorney General

The Capitol, Plaza Level 01

Tallahassee, Florida 32399

(eServed)

Patrick John Murphy, Esquire

Office of the Attorney General

The Capitol, Plaza Level 01

Tallahassee, Florida 32399

(eSe rved)

Shena Grantham, Esquire

Agency for Health Care Administration

Building 3, Room 3407B

2727 Mahan Drive

Tallahassee, Florida 32308

(eServed)

Thomas M. Hoeler, Esquire

Agency for Health Care Administration

Mail Stop 3

2727 Mahan Drive

Tallahassee, Fl orida 32308

(eServed)

Timothy L. Newhall, Esquire

Office of Attorney General

Plaza Level - 1

The Capitol

Tallahassee, Florida 32399 - 1050

(eServed)

Richard J. Shoop, Agency Clerk

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahas see, Florida 32308

(eServed)

Mary C. Mayhew, Secretary

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 1

Tallahassee, Florida 32308

(eServed)

Stefan Grow, General Counsel

Agency for Health Care Administration

2727 Mahan Drive, Mail St op 3

Tallahassee, Florida 32308

(eServed)

N OTICE O F R IGHT T O J UDICIAL R EVIEW

A party who is adversely affected by this Final Order is entitled to judicial

review pursuant to section 120.68, Florida Statutes. Review proceedings are

governed by the Florida Rules of Appellate Procedure. Such proceedings are commenced by filing the original notice of administrative appeal with the agency clerk of the Division of Administrative Hearings within 30 days of rendition of the order to be reviewed, and a copy of the notice, accompanied

by any filing fees prescribed by law, with the clerk of the d istrict c ourt of

a ppeal in the appellate district where the agency maintains its headquarters

or where a party resides or as otherwise provided by law.