17-004556MTR Amanda Soto vs. Agency For Health Care Administration Status: Closed DOAH Final Order on Friday, January 15, 2021.

Summary: Petitioner proved that reimbursement of medicaid expenses in an amount less than the full amount set by the (11)(f) formula was appropriate.

S TATE OF F LORIDA

D IVISION OF A DMINISTRATIVE H EARINGS

A MANDA S OTO ,

Petitioner ,

vs. Case No. 17 - 4556MTR

A GENCY F OR H EALTH C ARE

A DMINISTRATION ,

Respondent .

/

A MENDED F IN AL O RDER O N R EMAND

On November 18, 2020 , the First District Court of Appeal issued its

opinion in Amanda Soto v. State of Florida, Agency for Health Care

Administration , Case No. 1D1 7 - 5387 , in which the Court reversed the Final

Order entered in this case o n November 28, 2017 . In the Final Order, the

then presiding Administrative Law Judge ordered Petitioner to reimburse

AHCA for the full amount of its Medicaid expenditures for her past medical

expenses in the amount of $ 231,666.01 , in satisfaction of AHCAÔs Medicaid

lien.

The O pinion is dispositive as to the amount Petitioner is required to

reimburse AHCA in satisfaction of its Medicaid lien, stating that:

The record shows that the appellant presented

competent, substantial, and uncontradicted

evidence to support the reduction of her Medicaid

lien by using a pro rata method. AHCA failed to

present any evidence that the appellantÔs proposed

pro rata methodology was inaccurate or that

another method would be more appropriate to

apply. For those reasons, the A LJ erred as a matter

of law by concluding that the appellant failed to

prove that her Medical lien should have been

reduced. See Mojica , 285 So. 3d at 396Č98.

Accordingly, we reverse and remand the cause to

the Department of Administrative Hearings for the

ALJ to reduce AHCAÔs Medicaid lien to $26,641.59.

The Court remanded the case to DOAH for further proceedings consistent

with its O pinion. Mandate was entered on December 9, 2020 . The presiding

Administrative Law Judge having retired since the entry of the Final Order,

the case was assigned to the undersigned.

On January 11, 2021 , an Order for Requiring Status Report was entered

that required the parties to confer and jointly advise the undersigned of the

amount each of them believed to be the correct amount to be reimbursed by

Petitioner in satisfaction of the Medicaid lien. On January 13, 2021 , the

parties filed a joint response in which the y agreed that the sum of $ 26,641.59

is sufficient , and required, to satisfy the Medicaid lien . Furt her evidentiary

proceedings are not necessary to carry out the direction of the Court.

Based on the foregoing, it is hereby O RDERED that Petitioner, Amanda

S oto , shall pay to Respondent, Agency for Health Care Administration, the

sum of $ 26,641.59 , in satisfaction of the Medicaid Lien.

D ONE A ND O RDERED this 15th day of January , 202 1 , in Tallahassee, Leon

County, Florida.

S

E. G ARY E ARLY

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 A dministrative Hearings

this 15th day of January , 202 1 .

C OPIES F URNISHED :

Kevin A. Joyce, Esquire

Cole, Scott & Kissane, P.A.

Suite 400

4301 West Boy Scout Boulevard

Tampa, Florida 33607

(eServed)

David N. Perry, Esquire

Xerox Recovery Services, Inc.

S uite 300

2073 Summit Lake Drive

Tallahassee, Florida 32317

(eServed)

Floyd B. Faglie, Esquire

Staunton & Faglie, PL

189 East Walnut Street

Monticello, Florida 32344

(eServed)

Alexander R. Boler, Esquire

Suite 330

2073 Summit Lake Drive

Tallahassee, F lorida 32317

(eServed)

Shena L. Grantham, Esquire

Agency for Healthcare 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 D rive

Tallahassee, Florida 32308

(eServed)

Kim Annette Kellum, Esquire

Agency for Health Care Administration

Mail Stop 3

2727 Mahan Drive

Tallahassee, Florida 32308

(eServed)

Richard J. Shoop, Agency Clerk

Agency for Health Care Administration

2727 Maha n Drive, Mail Stop 3

Tallahassee, Florida 32308

(eServed)

Shevaun L. Harris, Acting Secretary

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 1

Tallahassee, Florida 32308

Bill Roberts, Acting General Counsel

Agency for Health Care Adm inistration

2727 Mahan Drive, Mail Stop 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 pr oceedings 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 cop y 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.