18-005813MTR Grace Provvedi, Deceased, By And Through Timothy Provvedi As Personal Representative Of The Estate Of Grace Provvedi; Timothy Provvedi, As Surviving Spouse Of Grace Provvedi; B.P. Surviving Minor Child Of Grace Provvedi; And Kyle Lima Surviving Child Of Grace Provvedi vs. Agency For Health Care Administration Status: Closed DOAH Final Order on Tuesday, April 9, 2019.

Summary: Petitioner proved by a prepondersance of the evidence that AHCA's Medicaid lien should be reduced by the same ratio as the settlement is to the value of the claim.

STATE OF FLORIDA

DIVISION OF ADMINISTRATIVE HEARINGS

GRACE PROVVEDI, deceased, by and

through TIMOTHY PROVVEDI as

Personal Representative of the

Estate of GRACE PROVVEDI;

TIMOTHY PROVVEDI, as surviving

spouse of GRACE PROVVEDI; B.P. ,

surviving minor chi ld of GRACE

PROVVEDI; and KYLE LIMA ,

surviving child of GRACE

PROVVEDI,

Petitioners,

vs. Case No. 18 - 5813MTR

AGENCY FOR HEALTH CARE

ADMINISTRATION,

Respondent.

_______________________________/

FINAL ORDER

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

in Tallahassee , Florida, on January 17, 2019 , before Linzie F.

Bogan, Administrative Law Judge of the Division of Administrative

Hearings.

APPEARANCES

For Petitioner s : Floyd B. Faglie, Esquire

Stau nton and Faglie, P.L.

189 East Walnut Street

Monticello, Florida 32344

For Respondent: Alexander R. Boler, Esquire

2073 Summit Lake Drive , Suite 300

Tallahassee, Florida 32317

ST ATEMENT OF THE ISSUE

What amount from Petitioners Ó settlement proceeds should be

paid to satisfy Respondent Ó s Medicaid lien under section 409.910,

Florida Statutes (2018)? 1/

PRELIMINARY STATEMENT

On November 2, 2018, Grace Provvedi, deceased, by and

throug h Timothy Provvedi as personal representative of the Estate

of Grace Provvedi ; Timothy Provvedi, as surviving spouse of Grace

Provvedi ; B.P. , as surviving minor child of Grace Provvedi, and

Kyle Lima , as surviving child of Grace Provvedi (Petitioners),

fil ed with the Division of Administrative Hearings (DOAH) a

Petition to Determine Amount Payable to Agency for Health Care

Administration in Satisfaction of Medicaid Lien. At the final

hearing , Petitioners offered testimony from John Pate, Esquire.

The Agen cy for Health Care Administration (Respondent or AHCA)

did not call any witnesses to testify on its behalf.

Petitioners Ó Exhibits 1 through 10 were admitted into

evidence. Respondent did not offer any exhibits into evidence.

A Transcript of the final he aring was filed with DOAH on

February 22, 2019. On March 11, 2019, each party filed a

proposed order, and the same have been considered in the

preparation of this Final Order.

FINDING S OF FACT

A. Stipulated Facts ( near - verbatim)

1. On February 13, 201 7, Grace Provvedi (Mrs. Provvedi)

underwent an outpatient surgical procedure. Post - surgery, a

F entanyl patch was applied to Mrs. Provvedi Ó s body for the

management of pain. Additionally, she was discharged home with a

prescription for the oral pain medic ines, Lorazepam and Robaxin.

Mrs. Provvedi returned for a follow - up doctor Ó s visit on

February 15, 2017. That same day, February 15, 2017,

Mrs. Provvedi went into cardiopulmonary arrest at home. She was

transported to the hospital where she was ultima tely diagnosed

with anoxic brain injury due to pain medicine overdose.

Mrs. Provvedi remained in a vegetative state until her death on

March 24, 2017.

2. Mrs. Provvedi was survived by her husband Timothy

Provvedi, their four - year - old child, B.P. and an adult child, Kyle

Lima.

3. Mrs. Provvedi Ó s medical care related to her injury was

paid by Medicaid, and AHCA through the Medicaid program provided

$54,071.79 in benefits associated with Mrs. Provvedi Ó s injury.

This $54,071.79 represented the entire claim for past medical

expenses.

4. Mrs. Provvedi Ó s funeral bill totaled $11,422.97 and was

paid by her surviving husband.

5. Timothy Provvedi was appointed the p ersonal

r epresentative of the Estate of Grace Provvedi.

6. Timothy Provvedi , as the p ersonal r epr esentative of the

Estate of Grace Provvedi , brought a wrongful death claim to

recover both the individual statutory damages of Mrs. Provvedi Ó s

surviving spouse and two surviving children, as well as the

individual statutory damages of the Estate of Grace P rovvedi

against the doctor and physician Ó s group (Defendants) who

prescribed the deadly combination of the Fentanyl patch and oral

pain medication .

7. Timothy Provvedi , as the p ersonal r epresentative of the

Estate of Grace Provvedi , on behalf of Mrs. Prov vedi Ó s surviving

husband and two children, as well as on behalf of the Estate of

Grace Provvedi, compromised and settled the wrongful death claim

with the Defendants for the unallocated lump sum amount of

$225,000.

8. During the pendency of the wrongful d eath claim, AHCA was

notified of the action and AHCA asserted a $54,071.79 Medicaid

lien against the Estate of Grace Provvedi Ó s cause of action and

settlement of that action.

9. By letter, the attorney handling the wrongful death claim

notified AHCA of th e settlement. This letter requested AHCA to

advise as to the amount AHCA would accept in satisfaction of the

$54,071.79 Medicaid lien.

10. AHCA has not filed an action to set aside, void, or

otherwise dispute the wrongful death settlement.

11. AHCA has not commenced a civil action to enforce its

rights under section 409.910.

12. AHCA, through the Medicaid program, spent $54,071.79 on

behalf of Mrs. Provvedi, all of which represents expenditures paid

for Mrs. Provvedi Ó s past medical expenses.

13. No por tion of the $225,000 settlement represents

reimbursement for future medical expenses.

14. The formula at section 409.910(11)(f), as applied to the

entire $225,000 settlement, requires payment of the full

$54,071.79 Medicaid lien and AHCA is demanding paym ent of

$54,071.79 from the $225,000 settlement.

15. The Petitioners have deposited the full Medicaid lien

amount in an interest - bearing account for the benefit of AHCA

pending an administrative determination of AHCA Ó s rights, and this

constitutes Ð final a gency action Ñ for purposes of chapter 120,

Florida Statutues, pursuant to section 409.910(17).

B. Additional Findings of Fact

16. Mr. Provvedi, as surviving husband, and the two children

of Mrs. Provvedi, suffered economic and non - economic damages. The

Estate of Mrs. Provvedi suffered economic damages in the form of

medical expenses resulting from the Defendant Ó s alleged

negligence. Mrs. Provvedi Ó s funeral bill was paid by

Mr. Provvedi. Pursuant to the Florida Wrongful Death Act, burial

expenses are g enerally charged to the estate, unless, as in the

present case, such expenses are paid by a surviving spouse and

reimbursement of the same is not sought from the estate.

17. Mrs. Provvedi, as a condition of eligibility for

Medicaid, assigned to AHCA her r ight to recover medical expenses

paid by Medicaid from liable third parties.

18. Petitioners presented the testimony of Mr. John W. Pate,

a trial attorney with the law firm of Haygood, Orr & Pearson in

Irving, Texas. Mr. Pate has been a trial attorney f or 14 years

and he specializes in representing individuals in personal injury,

medical malpractice , and wrongful death cases.

19. Mr. Pate testified that during the last several years,

his practice has focused extensively on litigating medical

malpracti ce cases involving the wrongful administration of

prescription medications, including opioids like Fentanyl,

Oxycodone, Hydrocodone , and other drugs which impact an

individual Ó s central nervous system (CNS). Such drugs are often

referred to as CNS depress ant drugs.

20. Mr. Pate routinely conducts civil jury trials, and as a

consequence thereof, he stays abreast of jury verdicts by

reviewing jury verdict reporters and discussing cases with other

trial attorneys. Although Mr. Pate is not a member of the Fl orida

Bar, he represents injured parties in Florida which necessitates

that he stays up - to - date with civil jury verdicts from the State

of Florida. Mr. Pate testified that as a routine part of his

practice , he makes assessments concerning the value of dam ages

suffered by injured parties and credibly explained his process for

making such assessments.

21. Without objection, Mr. Pate was recognized as an expert

in the valuation of damages suffered by injured parties.

22. Mr. Pate served as lead attorney in the litigation

against the medical providers who treated Mrs. Provvedi. In his

capacity as lead attorney, Mr. Pate reviewed Mrs. Provvedi Ó s

medical records, consulted with an anesthesiology and pain

management expert in North Carolina, consulted with a plastic

surgery expert in Miami, met personally with Mr. Provvedi, and

spoke with Mrs. Provvedi Ó s children.

23. Mr. Pate, in explaining the circumstances that allegedly

le d to the death of Mrs. Provvedi, testified that on February 13,

2017, Mrs. Provved i underwent an outpatient surgical procedure at

a plastic surgery center. Soon after the surgery, a Fentanyl

patch was applied to Mrs. Provvedi Ó s body for the treatment of

pain. Ms. Provvedi was then discharged home with a prescription

for Lorazepam and Robaxin, each of which is an oral pain

medication.

24. Mr. Pate testified that the federal Food and Drug

Administration (FDA) warns against the use of Fentanyl patches

post - surgery, and also warns against the combination of a Fentanyl

patch with other C NS depressant drugs , such as Lorazepam and

Robaxin. Mr. Pate explained, as to his theory of legal liability

against Mrs. Provvedi Ó s medical providers, that over time the

prescribed CNS depressants accumulated in Mrs. Provvedi Ó s body

which resulted in her being found unresponsive two days after

surgery. Mrs. Provvedi was transported by EMS to the hospital,

where, upon arrival, the Fentanyl patch was removed.

Mrs. Provvedi was diagnosed as having suffered from an acute

anoxic brain injury and respiratory failure due to a pain

medication overdose. Mrs. Provvedi never regained consc iousness ,

and one month later was discharged from the hospital to hospice

care where she died on March 24, 2017.

25. Mr. Pate Ó s undisputed testimony was that his

investigation revealed that Mr. and Mrs. Provvedi had a loving and

devoted marriage, and that it was emotionally devastating to

Mr. Provvedi to watch his wife die over the course of five weeks.

Mr. Pate also testified that his investigation revealed that the

Provvedi Ó s minor son, B.P. , who was five at the time of

Mrs. Provvedi Ó s death, was profoundly affected by the loss of his

mother and that Ms. Provvedi Ó s adult son, who lived with the

Provvedis prior to and at the time of his mother Ó s passing, was

similarly devasta ted by the death of his mo ther .

26. Mr. Pate credibly testified that based on his training

and experience, the wrongf ul death damages recoverable in

Mrs. Provvedi Ó s case had a conservative value of between

$3,054,071.79 to $5,054,071.79.

27. According to Mr. Pate Ó s undisputed testimony,

Mrs. Provvedi Ó s estate had a claim for damages in the amount of

$54,071.79, which is the amount of medical expenses that were

paid, and resulted from Mrs. Provvedi Ó s injury and death.

Mr. Pate excluded the funeral bil l from the estate Ó s damages

because the same bill was paid by Mr. Provvedi, as surviving

husband. Mr. Pate also testified that the estate likely did not

have a viable claim for net accumulations because Mrs. Provvedi

did not work outside of the marital ho me.

28. Mr. Pate testified that a wrongful death claim was

brought against the plastic surgeon that operated on Mrs. Provvedi

and the surgical facility where the procedure was performed. The

basis of the claim was that the doctor violated the standard of

care by prescribing the F entanyl patch to Mrs. Provvedi in clear

contravention of the FDA warnings, and it was error to prescribe

the other oral pain medicines in conjunction with the F entanyl

patch. Mr. Pate testified that he expected the at - fault par ties

to dispute causation, but ultimately the main issue was that the

alleged at - fault parties had only $250,000 in insurance coverage.

Mr. Pate credibly testified that expenses associated with

litigating the wrongful death case would be considerable and would

significantly erode any likely net recovery. Given these

concerns, the decision was made to settle the case pre - suit for

$225,000.

29. Utilizing the conservative value of $3,054,071.79, the

$225,000 settlement represe nts a recovery of only 7.36721 4 percent

of the value of all damages. Thu s, only 7.367214 percent of the

$54,071.79 claim for past medical expenses was recovered in the

settlement, or $3,983.58.

30. Based on the methodology of applying the same ratio the

settlement bore to the total m onetary value of all the damages to

the e state, $3,983.58 of the settlement represents the estate Ó s

compensation for past medical expenses. The allocation of

$3,983.58 of the settlement to the estate Ó s claim for past medical

expenses is reasonable and rat ional.

31. Petitioners have proven by a preponderance of the

evidence that $3,983.58 represents the portion of the $225,000

settlement recovered to compensate the estate for medical expenses

necessitated by the alleged negligence of the tortfeasors.

CONCL USIONS OF LAW

A. Jurisdiction

32. In Delgado v. Agency for Health Care Admin istration , 43

Fla. L. Weekly D245 (Fla. 1st DCA Jan. 26, 2018), the court found

that AHCA, by stipulation, and only as to the issue of DOAH Ó s

jurisdiction, waived its argument th at only a Ð living Ñ recipient

of Medicaid could contest the amount of AHCA Ó s lien under the

2016 version of section 409.910(17)(b). Nevertheless, the c ourt

opined that DOAH did in fact have subject matter jurisdiction to

resolve the dispute because the rep resentative of the estate and

the decedent Ó s survivors Ð independently had standing to file

their petition, irrespective of whether or not they were

ultimately found to be Ò recipient[s] Ó for purposes of section

409.910(17)(b). Ñ Id . at 11.

33. Almost a yea r to the day after Delgado was decided, in

Ammar Al Batha v. State of Florida, Agency for Health Care

Administration , 44 Fla. L. Weekly D236 (Fla. 1st DCA Jan. 14,

2019), the court, with respect to the 2016 version of the

statute, held that while the perso nal representative of the

decedent Ó s estate qualifies as a Ð recipient Ñ under section

409.910(17)(b), the decedent Ó s survivors do not, and although the

ALJ erred in dismissing the personal representative Ó s petition it

was not error for the ALJ to dismiss th e survivor Ó s petition

challenging the Medicaid lien. In reaching its decision, the

court in Al Batha made no mention of its decision in Delgado .

34. While there appears to be some tension, if not outright

conflict, between Delgado and Al Batha as to the question of

Ð standing Ñ of a decedent Ó s survivors to challenge a Medicaid lien

under the 2016 version of section 409.910(17)(b), it is

nevertheless clear that the current version of the statute

expressly allows for a challenge by Ð a recipient, or his or her

legal representative Ñ in Ð instances where federal law limits the

agency to reimbursement from the recovered medical expense

damages. Ñ

35. In Al Batha , the court opined that Ð [e]ven though a

person dies, his right to an existing cause of action does not

d ie with him . . . [and] [t]herefore, theoretically[,] a deceased

person could file a petition to challenge AHCA Ó s lien if he could

file a petition[,] [and,] [u]nder Florida law, the proper person

to file a cause of action on behalf of a deceased person is the

personal representative. Ñ Id. The court went on to opine that

Ð [s]ince a personal representative is the person authorized to

prosecute a deceased person Ó s claims, the personal representative

qualifies as a Ò recipient Ó providing the deceased person

qu alifies as a Ò recipient. ÓÑ Id. Succinctly stated, Al Batha

makes it clear that the personal representative stands in the

proverbial shoes of the decedent and is entitled to the same

rights as the decedent when challenging Medicaid Ó s lien.

36. Although t he dissenting opinion in Al Batha relies on

Goheagan v. Perkins , 197 So. 3d 112 (Fla. 4th DCA 2016) . and

Estate of He r nandez v. Agency for Health Care Administration , 190

So. 3d 139 (Fla. 3d DCA 2016), for the proposition that only a

living Medicaid recipi ent, and not, upon death, his or her

personal representative, can challenge a Medicaid lien under

section 409.910(17)(b), the court Ó s majority did not embrace the

rational of its sister courts. The undersigned finds Al Batha

more persuasive than Goheagan and Hernandez because the rationale

set forth therein gives appropriate consideration to the long -

held rights of a decedentÓs personal representative as codified

in the Florida Wrongful Death Act.

37. While it is true that Al Batha , Goheagan and Hernand ez

dealt with an earlier version of section 409.910(17)(b), there is

no indication that recent changes to Medicaid law now impose

restrictions on a recipient Ó s right[s] to challenge a Medicaid

lien in a manner different from what was allowed in 2016.

Beca use Al Batha recognizes that a decedentÓs personal

representative qualifies as a Ðrecipient,Ñ and is therefore able

to challenge a Medicaid lien to the same extent as the decedent,

had he/she lived, then, ipso facto, Arkansas Department of Health

& Human S ervices v. Ahlborn , 547 U.S. 268 (2006), Wos v. E.M.A.

ex rel Johnson , 133 S. Ct. 1391 (2013), and their progeny, apply

to, and indeed control, in the instant dispute.

38. In accordance with Al Batha and the express language of

section 40 9 .910(17)(b), Tim othy Provvedi, as Personal

Representative of the Estate of Grace Provvedi, is a Medicaid

Ð recipient Ñ and is therefore authorized to challenge AHCA Ó s

Medicaid lien to the same extent as Grace Provvedi, had she

lived.

39. In accordance with Delgado , Timothy Provvedi, as

surviving spouse of Grace Provvedi ; B.P. , as minor child of Grace

Provvedi ; and Kyle Lima , as surviving child of Grace Provvedi,

are proper parties to this action given that it is reasonable to

expect that their substantial interests could be affected, either

directly or indirectly, by the outcome of the instant proceeding.

See Delgado (citing Peace River/Manasota Reg Ó l Water Supply Auth.

v. IMC Phosphates Co. , 18 So. 3d 1079 (Fla. 2d DCA 2009)).

4 0. D OAH has jurisdiction over the subject ma tter and the

parties pursuant to sections 120.569, 120.57(1) and 409. 910(17),

Florida Statutes .

B. The Proper Lien Amount

41. AHCA is the agency authorized to administer Florida Ó s

Medicaid program. § 409.902, Fla. Stat.

42. The Medicaid program Ð provid e[s] federal financial

assistance to States that choose to reimburse certain costs of

medical treatment for needy persons. Ñ Harris v. McRae , 448 U.S.

297, 301 (1980).

43. Ð The Medicaid program is a cooperative one. The

Federal Government pays between 50 percent and 83 percent of the

costs a state incurs for patient care. In return, the State pays

its portion of the costs and complies with certain statutory

requirements for making eligibility determinations, collecting

and maintaining information, and ad ministering the program. Ñ

Estate of Hernandez v. Ag. for Health Care Admin . , 190 So. 3d

139, 141 - 42 (Fla. 3rd DCA 2016)(internal citations omitted).

44. Though participation is optional, once a s tate elects

to participate in the Medicaid program, it must comply with

federal requirements. Harris , 448 U.S. at 301.

45. One condition for receipt of federal Medicaid funds

requires states to seek reimbursement for medical expenses

incurred on behalf of Medicaid recipients who later recover from

legally liable third parties. See Ahlborn , at 276.

46. Consistent with this federal requirement, the Florida

Legislature enacted section 409.910, designated as the Ð Medicaid

Third - Party Liability Act, Ñ which authorizes and requires the

state to be reimbursed for Medic aid funds paid for a recipient Ó s

medical care when that recipient later receives a personal injury

judgment, award, or settlement from a third party. Smith v. Ag.

for Health Care Admin . , 24 So. 3d 590 (Fla. 5th DCA 2009). The

statute creates an automatic lien on any such judgment or

settlement for the medical assistance provided by Medicaid. See

§ 409.910(6)(c), Fla. Stat.

47. The amount to be recovered for Medicaid medical expenses

from a judgment, award, or settlement from a third party is

determined by the formula in section 409.910(11)(f). Ag. for

Health Care Admin. v. Riley , 119 So. 3d 514, 515 n.3 (Fla. 2d DCA

2013).

48. The parties stipulated that the amount due to the AHCA

in satisfaction of its lien pursuant to the formula set forth in

sectio n 409.910(11)(f) is $54,071.79. Petitioner, however,

asserts that a lesser amount is owed to Respondent.

49. Section 409.910(17)(b) provides as follows:

If federal law limits the agency to

reimbursement from the recovered medical

expense damages, a recip ient, or his or

her legal representative, may contest the

amount designated as recovered medical

expense 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 da te of payment of funds to the

agency or after the date of placing the

full amount of the third - party benefits

in the trust account for the benefit of

the agency pursuant to paragraph (a).

The petition shall be filed with the

Division of Administrative Hea rings. For

purposes of chapter 120, the payment of

funds to the agency or the placement of

the full amount of the third - party

benefits in the trust account for the

benefit of the agency constitutes final

agency action and notice thereof. Final

order auth ority for the proceedings

specified in this subsection rests with

the Division of Administrative Hearings.

This procedure is the exclusive method

for challenging the amount of third - party

benefits payable to the agency. In order

to successfully challenge the amount

designated as recovered medical expenses,

the recipient must prove, by clear and

convincing evidence, that the portion of

the total recovery which should be

allocated as past and future medical

expenses is less than the amount

calculated by the agency pursuant to the

formula set forth in paragraph (11)(f).

Alternatively, the recipient must prove

by clear and convincing evidence that

Medicaid provided a lesser amount of

medical assistance than that asserted by

the agency.

50. The language of s ection 409.910(17)(b), quoted above,

makes it clear that the formula set forth in subsection (11)

constitutes a default allocation of the amount of a settlement

that is attributable to medical costs, and sets forth an

administrative procedure for adversari al testing of that

allocation. See Harrell v. State , 143 So. 3d 478, 480 (Fla. 1st

DCA 2014)(adopting the holding in Riley that petitioner Ð should

be afforded an opportunity to seek the reduction of a Medicaid

lien amount established by the statutory defa ult allocation by

demonstrating, with evidence, that the lien amount exceeds the

amount recovered for medical expenses Ñ )(quoting Roberts v.

Albertson Ó s, Inc. , 119 So. 3d 457, 465 - 466 (Fla. 4th DCA 2012),

reh Ó g and reh Ó g en banc denied sub nom . Giorgione v .

Albertson Ó s, Inc. , 2013 Fla. App. LEXIS 10067 (Fla. 4th DCA

June 26, 2013)).

51. N otwithstanding the language of section 4 09.910(17)(b),

Petitioner Ó s burden in this case is a preponderance of the

evidence as directed by Gallarado v. Senior , Case No. 4 :16 - cv -

116 - MW - CAS (N.D. Fla. 2017), and stipulation of the parties .

52. Section 409.910(11)(f) provides as follows:

Notwithstanding any provision in this section

to the contrary, in the event of an action in

tort against a third party in which the

recipie nt 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 attorney Ó s fees and taxable costs as

defined by the Florida Rules of Civ il

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 a gency Ó s

recovery of medical assistance benefits paid,

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 provisi on of this

section to the contrary, the agency shall be

entitled to all medical coverage benefits up

to the total amount of medical assistance

provided by Medicaid. For purposes of this

paragraph, Ð medical coverage Ñ means any

benefits under health insuran ce, a health

maintenance organization, a preferred provider

arrangement, or a prepaid health clinic, and

the portion of benefits designated for medical

payments under coverage for workers Ó

compensation, personal injury protection, and

casualty.

53. In th e instant case, Petitioner proved by a

preponderance of the evidence that the settlement proceeds of

$ 225,000 represent s 7.367214 percent of Petitioner Ó s claim valued

at $3,054,071.79 ($225,000/$3,054,071.79) . It is concluded that

AHCA Ó s full Medicaid lie n amount should be reduced by the

percentage that Petitioner Ó s recovery represents of the total

value of Petitioner Ó s claim. Multiplying AHCA Ó s fu ll Medicaid

lien sum of $54,071.79 by 7.367214 percent results in $ 3,983.58,

which constitutes a fair, reason able, and accurate share of the

total recovery for past medical expenses actually paid by AHCA

through the Medicaid program. See generally Delgado (accepting

formula that AHCA Ó s full Medicaid lien amount should be reduced

by the percentage that Petitioner Ó s recovery represents of the

total value of Petitioner Ó s claim) .

DISPOSITION

Based on the foregoing Findings of Fact and Conclusions of

Law, it is hereby

ORDERED that :

The Agency for Health Care Administration is entitled to

$3,983.58 in satisfaction of i ts Medicaid lien.

DONE AND ORDERED this 9th day of April , 2019 , in

Tallahassee, Leon County, Florida.

S

LINZIE F. BOGAN

Administrative Law Judge

Division of Administrative Hearings

The DeSoto Building

1230 Apalachee Park way

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 9th day of April , 2019 .

ENDNOTE

1/ All subsequent references to Florida Statutes wi ll be to 2018,

unless otherwise indicated. The parties, by stipulation, agree

that the 2018 version of Florida Statutes controls the instant

proceeding.

COPIES FURNISHED:

Alexander R. Boler, Esquire

Suite 300

2073 Summit Lake Drive

Tallahassee, Florida 32317

(eServed)

John Cofield, Client Services Sr. Manager

Conduent Payment Integrity Solutions

Suite 300

2073 Summit Lake Drive

Tallahassee, Florida 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 32308

(eServed)

Richard J. Shoop, Agency Clerk

Agency for Health Care Administration

Mail Stop 3

2727 Mahan D rive

Tallahassee, Florida 32308

(eServed)

Shena Grantham, Esquire

Agency for Health Care Administration

Mail Stop 3

2727 Mahan Drive

Tallahassee, Florida 32308

(eServed)

Thomas M. Hoeler, Esquire

Agency for Health Care Administration

Mail Stop 3

2727 M ahan Drive

Tallahassee, Florida 32308

(eServed)

Stefan Grow, General Counsel

Agency for Health Care Administration

Mail Stop 3

2727 Mahan Drive

Tallahassee, Florida 32308

(eServed)

Mary C. Mayhew, Secretary

Agency for Health Care Administration

Mail St op 1

2727 Mahan Drive

Tallahassee, Florida 32308

(eServed)

NOTICE OF RIGHT TO JUDICIAL REVIEW

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 gover ned 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 District Court of Appeal in the appellate district where

the agency maintains its headquarters or where a party resides or

as otherwise provided by law.