19-003727MTR David Brown, An Individual, And Tonja Jenkins, His Wife vs. Agency For Health Care Administration
 Status: Closed
DOAH Final Order on Tuesday, December 3, 2019.


View Dockets  
Summary: Petitioners proved, by a preponderance of evidence, that $69,623.38 represents a fair and reasonable determination of past medical expenses actually recovered by Petitioners and payable to AHCA.

1STATE OF FLORIDA

4DIVISION OF ADMINISTRATIVE HEARINGS

8DAVID BROWN, AN INDIVIDUAL, AND

13TONJA JENKINS, HIS WIFE ,

17Petitioners , Case No. 19 - 3727MTR

23vs.

24AGENCY FOR HEALTH CARE

28ADMINISTRATION ,

29Respondent .

31/

32FINAL OR DER

35Pursuant to notice, on September 11, 2019, Administrative

43Law Judge Yolonda Y. Green of the Florida Division of

53Administrative Hearings (“Division”), held a hearing in

60Tallahassee, Florida.

62APPEARANCES

63For Petitioner s : Floyd B. Faglie, Esquire

71Staunton and Faglie, P.L.

75189 East Walnut Street

79Monticello, Florida 32344

82For Respondent: Alexander R. Boler, Esquire

882073 Summit Lake Drive, Suite 300

94Tallahasse e, Florida 32317

98STATEMENT OF THE ISSUE

102The issue to be determined is the amount payable to

112Respondent, Agency for Health Care Administration (“AHCA”), as

120reimbursement for medical expenses paid on behalf of David

129Brown (“Mr. Brown”) pursuant to section 409.910, Florida

137Statutes (2018), 1/ from settlement proceeds he received from a

147third party.

149PRELIMINARY STATEMENT

151On November 16, 2017, Petitioners, David Brown, an

159Individual, and Tonja Jenkins, His Wife (“Ms. Jenkins”) , filed

168a Petition to Determine Amo unt Payable to Agency for Health

179Care Administration in Satisfaction of Medicaid Lien (“the

187Petition”) to challenge AHCA’s placement of a Medicaid lien in

197the amount of $181,975.75 on Petitioners $2,500,000 settlement

208proceeds from a third party.

213The p arties filed a Joint Pre - H earing Stipulation that

225contained a statement of admitted and stipulated facts for which

235no further proof would be necessary. Those stipulated facts

244have been incorporated into the Findings of Fact below, to the

255extent necessary.

257The final hearing commenced as scheduled on September 11,

2662019. At hearing, Petitioners’ Exhibits 1 through 9 were

275admitted. Petitioner s presented the testimony of two expert

284witnesses: Brett Rosen, Esquire, and R. Vinson Barrett,

292Esquire. AHCA did not call any witnesses and did not offer any

304exhibits at the hearing.

308The Transcript of the hearing was filed with the Division

318on October 17, 2019. AHCA timely filed its Proposed Final Order

329(”PFO”) by the initial designated date. On October 29, 2019,

339P etitioners filed an Unopposed Motion for Extension of Time to

350File Proposed Final Order, which the undersigned granted.

358Petitioners timely filed their PFO on November 4, 2019. The

368PFOs filed by the parties have been considered in preparation of

379this Fina l Order.

383FINDING S OF FACT

387The following Findings of Fact are based on exhibits

396accepted into evidence, testimony offered at the hearing, and

405admitted facts set forth in the pre - hearing stipulation.

415Facts Pertaining to the Underlying Personal Injury Litigat ion

424and the Medicaid Lien

4281. Mr. Brown is the recipient of Medicaid for injuries he

439sustained in an automobile accident.

4442. AHCA is the state agency charged with administering the

454Florida Medicaid program, pursuant to chapter 409.

4613. On February 25, 2015, Mr. Brown, then 46 years old, was

473involved in a T - bone automobile accident. In the accident,

484Mr. Brown suffered a fractured wrist, torn shoulder, skin

493abrasions, a grade 4 bilateral pulmonary contusion, and a right

503middle cerebral artery infarct (c ommonly referred to as a

513stroke) with hemorrhagic contusion. Due to complications

520related to placement of a trachea, he underwent reconstructive

529surgery of his throat. Mr. Brown suffered permanent severe

538brain damage causing him to suffer left hemiparesi s and

548difficulty swallowing or speaking. As a result of the accident,

558Mr. Brown is now disabled and has difficulty ambulating, eating,

568and caring for himself without assistance.

5744. Mr. Brown’s medical care related to the injury was paid

585by Medicaid . A HCA provided $181,975.75 in benefits . A Medicaid

598Manage Care Plan, known as WellCare, provided an additional

607$110,559.15 in benefits. The sum of these benefits,

616$292,534.90 , constituted Mr. Brown’s entire claim for past

625medical expenses.

6275. Petitioner s pursued a personal injury action against

636the owner and operator of the car that caused the accident

647(“Defendant”) to recover all their damages.

6536. AHCA did not commence a civil action to enforce its

664rights under section 409.910 or intervene in Petitio ner s’ action

675against the Defendant .

6797. During the pendency of Mr. Brown’s personal injury

688action, AHCA was notified of the action and AHCA asserted a

699Medicaid lien of $181,975.75 against Petitioners’ cause of

708action and settlement of that action.

7148. There were liability issues with the case including the

724degree of comparative negligence that could be attributed to

733each driver. Specifically, there was a question of which driver

743had the green light. The personal injury claim ultimately

752settled for a l ump - sum unallocated amount of $2,500,000.

7659. By letter, AHCA was notified of settlement of

774Petitioners’ claim.

77610. AHCA has not filed a motion to set - aside, void , or

789otherwise dispute Petitioners’ settlement.

79311. The Medicaid program through AHCA s pent $181,975.75

803for Mr. Brown’s past medical expenses.

80912. Application of the formula set forth in

817section 409.910(11)(f) to Petitioners’ $2,500,000 settlement

825authorizes payment to AHCA of the full $181,975.75 Medicaid

835lien.

83613. Petitioners have dep osited AHCA’s full Medi caid lien

846amount in an interest - bearing account for the benefit of AHCA

858pending an administrative determination of AHCA’s rights.

86514. As a condition of eligibility for Medicaid, Mr. Brown

875assigned AHCA his right to recover medical expenses paid by

885Medicaid from liable third parties

890Expert Witness Testimony

893Testimony of Brett Rosen

89715. Petitioners presented the testimony of Brett Rosen,

905the lead trial attorney who litigated the underlying personal

914injury claim. Mr. Rosen is a shareholder with the law firm of

926Goldberg and Rosen in Miami, Florida. Mr. Rosen has been a

937trial attorney for approximately 12 years and he specializes in

947representing parties in catastrophic injury, personal injury,

954and wrongful death cases.

95816. Mr. Ro sen’s firm takes approximately eight to ten

968cases to trial each year. Since the firm routinely conducts

978civil jury trials, Mr. Rosen continuously educates himself on

987jury verdicts by reviewing the Florida Jury Verdict Reporter

996(a publication of jury v erdict reports) and conducting

1005roundtable discussions with other attorne ys. Using information

1013found in j ury v erdict reports , the Daily Business Review , and

1025his experience, Mr. Rosen makes assessments concerning the value

1034of damages sustained by individual s.

104017. Without objection, Mr. Rosen was accepted as an expert

1050in the valuation of damages suffered by Petitioners.

105818. In addition to presenting testimony as an expert,

1067Mr. Rosen also presented factual testimony regarding the

1075underlying personal injury claim. As the lead attorney,

1083Mr. Rosen met with Mr. Brown monthly on average during the two

1095years that he represented him. Mr. Rosen also consulted with a

1106neurologist and ENT physician who both treated Mr. Brown.

111519. Mr. Rosen testified that Mr. Brown ’ s vehicle was

1126struck on the right side (commonly referred to as T - bone

1138accident) by a vehicle , causing the vehicle he was driving to

1149flip over onto its side. While Mr. Brown was able to get out of

1163his vehicle , he suffered multiple injuries as further desc ribed

1173in paragraph three herein . In addition to the brain injury, he

1185had a tracheostomy that ultimately resulted in a bad outcome.

1195As a result, he could not eat, speak , or drink for approximately

1207two years.

120920. Mr. Rosen testified that Mr. Brown’s inj uries had

1219significant negative impact on Mr. Brown and his wife,

1228Ms. Jenkins. Mr. Rosen testified that Ms. Jenkins resigned from

1238her job to take care of her husband and assist with his

1250recovery. Ms. Jenkins also suffered loss of consortium damages

1259result ing from Mr. Brown’s injuries. The couple was forced to

1270live with relatives w hen they could not afford rent. Overall,

1281Mr. Rosen testified that the injuries negatively impacted

1289Mr. Brown’s ab ility to lead a normal life.

129821. Mr. Rosen testified that the l itigation of the case

1309involved factual, causation , and legal disputes. There were no

1318eyewitnesses , and the question remained regarding which driver

1326had the green light. In addition, the insurance policy was

1336limited to $50,000. Mr. Rosen later brought a bad faith claim

1348against the insurance company due to their failure to timely

1358tender the policy limits . After fully evaluating the risks, the

1369parties settled the case for $2,500,000.

137722. Mr. Rosen testified that the full value of the claim

1388is $10,500,000. However, Petitioners settled the claim for

1398$2,500,000 , which represents 23.8 percent of the value of their

1410damages. Mr. Rosen testified that since Mr. Brown only

1419recovered 23.8 percent of his total damages, he recovered in the

1430settlement only 23.8 perce nt of his $292,534.90 claim for past

1442medical expenses, which amounts to $69,623.38. Mr. Rosen

1451testified that it would be reasonable to allocate $69,623.38 of

1462the settlement to past medical expenses .

1469Testimony of Vinson Barrett

147323 . Vinson Barrett was also identified as Petitioners’

1482expert witness. Mr. Barrett, a trial attorney with 40 years of

1493experience, is a partner with the law firm of Barrett , Nonni and

1505Homola. His firm represents clients in medical mal practice,

1514automobile, premise liability, and pha rmaceutical products

1521liability cases. Mr. Barrett has conducted numerous jury trials

1530and has handled cases involving catastrophic injuries.

153724 . Mr. Barrett routinely reviews jury verdict reports,

1546disc usses cases with other lawyers, and makes assessment s

1556concerning the value of damages suffered by injured persons.

1565Mr. Barrett has also served as an expert in a number of cases

1578regarding evaluation of damages.

158225 . Mr. Barrett was recognized as an expert in the area of

1595evaluation of damages.

159826 . To eval uate the medical damages suffered by Mr. Brown,

1610Mr. Barrett reviewed the police report, medical records, and the

1620amended life care plan for Mr. Brown. Mr. Barrett also

1630considered the overall level of pain and suffering Mr. Brown

1640would suffer throughout th e remainder of his life. Mr. Barrett

1651testified that when compared to other traumatic brain cases,

1660Mr. Brown is a little better off than other traumatic cases he

1672has reviewed because he is able to ambulate using assistive

1682devices and his mental abilities h ave not been compromised

1692significantly.

169327 . Mr. Barrett opined that the overall value of the

1704damages would be more than $10,500,000 . Mr. Barrett testified

1716that his estimate was a conservative valuation of damages.

1725Mr. Barrett concluded that , accepting M r. Rosen’s even more

1735conservative valuation, the $2,500,000 settlement constituted

174323.8 percent of the full valu e of Petitioners’ damages.

1753Mr. Barrett testified that allocation of $69,623.38 of the

1763settlement would be a reasonable allocation of damages to the

1773past medical expenses.

1776Ultimate Findings of Fact

178028 . The undersigned finds that the testimony of Mr. R osen

1792and Mr. Barrett was credible and persuasive as to the total

1803damages incurred by Petitioners. While assigning a value to the

1813damages that pla intiffs could reasonably expect to receive from

1823a jury is not an exact science, Mr. Rosen’s extensive experience

1834with litigating personal injury lawsuits makes him a very

1843compelling witness regarding the valuation of damages suffered

1851by Petitioners. As a trial lawyer who has testified in nearly

186220 cases regarding valuation an d allocation of damages, and

187240 years of experience handling personal injury matters

1880i nvolving catastrophic injuries, Mr. Barrett is also a credible

1890witness regarding the valuation and allocation of damages in a

1900case such as Mr. Brown’s.

190529 . The undersigned also finds that Mr. Barrett was

1915qualified to present expert testimony as to how a damages award

1926should be allocated among its components, such as past medical

1936expenses, economic d amages, and noneconomic damages.

194330 . AHCA offered no evidence to counter the expert

1953opinions regarding Petitioners’ total damages or the past

1961medical expenses t he y recovered.

196731 . Accordingly, it is found that the preponderance of the

1978evidence demonstrat es that the total value of Petitioners’

1987personal injury claim is $10 ,500,000 and that the $2,500,000

2000settlement resulted in Petitioners reco vering 23.8 percent of

2009Mr. Brown’s past medical expenses. In addition, the

2017preponderance of th e evidence demonstrat es that $69 ,623.38

2027amounts to a fair and reasonable determination of the past

2037medical expenses actually recovered by Petitioners and payable

2045to AHCA.

2047CONCLUSIONS OF LAW

205032 . The Division has jurisdiction over the subject matter

2060and the parties in this c ase pursuant to sections 120.569,

2071120.57(1) and 409.910(17), Florida Statutes (2019).

20773 3 . AHCA is the agency authorized to administer Florida’s

2088Medicaid program. § 409.902, Fla. Stat.

209434 . The Medicaid program “provide[s] federal financial

2102assistance t o States that choose to reimburse certain costs of

2113medical treatment for needy persons.” Harris v. McRae , 448 U.S.

2123297, 301 (1980).

21263 5 . “The Medicaid program is a cooperative one. The

2137Federal Government pays between 50 percent and 83 percent of the

2148cos ts a state incurs for patient care. In return, the State

2160pays its portion of the costs and complies with certain

2170statutory requirements for making eligibility determinations,

2176collecting and maintaining information, and administering the

2183program.” Estate of Hernandez v. Ag. for Health Care Admin. ,

2193190 So. 3d 139, 14 1, 42 (Fla. 3rd DCA 2016)(internal citations

2205omitted).

220636 . Though participation is optional, once a state elects

2216to participate in the Medicaid program, it must comply with

2226federal requirement s. Harris , 448 U.S. at 301.

223437 . One condition for receipt of federal Medicaid funds is

2245that states must seek reimbursement for medical expenses

2253incurred on behalf of Medicaid recipients who later recover from

2263legally liable third parties. See Ark. Dep' t of Health & Human

2275Servs. v. Ahlborn , 547 U.S. 268, 276 (2006); see also Estate of

2287Hernandez , 190 So. 3d at 142 (noting that one such requirement

2298is that “each participating state implement a third party liability provision which requires the state to see k

2316reimbursement for Medicaid expenditures from third parties who

2324are liable for medical treatment provided to a Medicaid

2333recipient”).

233438 . Consistent with this federal requirement, the Florida

2343Legislature enacted section 409.910, designated as the “Medicai d

2352Third - Party Liability Act,” which authorizes and requires the

2363state to be reimbursed for Medicaid funds paid for a recipient's

2374medical care when that recipient later receives a personal

2383injury judgment, award, or settlement from a third party.

2392Smith v. Ag. for Health Care Admin. , 24 So. 3d 590 (Fla. 5th DCA

24062009); see also Davis v. Roberts , 130 So. 3d 264, 266 (Fla. 5th

2419DCA 2013)(stating that in order “[t]o comply with federal directives the Florida legislature enacted section 409.910,

2435Florida Statutes, which authorizes the State to recover from a

2445personal injury settlement money that the State paid for the

2455plaintiff’s medical care prior to recovery.”).

246139 . Section 409.910(1) sets forth the Florida

2469Legislature’s clear intent that Medicaid be repaid in full for

2479medical care furnished to Medicaid recipients by providing that:

2488It is the intent of the Legislature that

2496Medicaid be the payor of last resort for

2504medically necessary goods and services

2509furnished to Medicaid recipients. All other

2515sources of payme nt for medical care are

2523primary to medical assistance provided by

2529Medicaid. If benefits of a liable third

2536party are discovered or become available

2542after medical assistance has been provided

2548by Medicaid, it is the intent of the

2556Legislature that Medicaid be repaid in full

2563and prior to any other person, program, or

2571entity. Medicaid is to be repaid in full

2579from, and to the extent of, any third - party

2589benefits, regardless of whether a recipient

2595is made whole or other creditors paid.

2602Principles of common law an d equity as to

2611assignment, lien, and subrogation are

2616abrogated to the extent necessary to ensure

2623full recovery by Medicaid from third - party

2631resources. It is intended that if the

2638resources of a liable third party become

2645available at any time, the public tr easury

2653should not bear the burden of medical

2660assistance to the extent of such resources.

266740 . In addition, the Florida Legislature has authorized

2676AHCA to recover pay ments paid from any third party; the

2687recipient; the provider of the recipient’s medical se rvices ; or

2697any person who received the third - party benefits. § 409.910(7),

2708Fla. Stat.

271041 . Section 409.910(6)(a) outlines AHCA’s procedure to

2718recover the full amount paid for medical assistance as follows:

2728[I]s automatically subrogated to any rights

2734that an applicant, recipient, or legal

2740representative has to any third - party

2747benefit for the full amount of medical

2754assistance provided by Medicaid. Recovery

2759pursuant to the subrogation rights created

2765hereby shall not be reduced, prorated, or

2772applied to only a portion of a judgment,

2780award, or settlement, but is to provide full

2788recovery by the agency from any and all

2796third - party benefits. Equities of a

2803recipient, his or her legal representative,

2809a recipient’s creditors, or health care

2815providers shall not defeat , reduce, or

2821prorate recovery by the agency as to its

2829subrogation rights granted under this

2834paragraph.

283542 . The amount to be recovered by AHCA from a settlement,

2847which is of relevance here, from a third party is determined by

2859a formula in section 409.910 (11)(f). Ag. for Health Care

2869Admin. v. Riley , 119 So. 3d 514, 515 n.3 (Fla. 2d DCA 2013).

288243 . Section 409.910(11)(f) provides:

2887Notwithstanding any provision in this

2892section to the contrary, in the event of an

2901action in tort against a third party in

2909wh ich the recipient or his or her legal

2918representative is a party which results in a

2926judgment, award, or settlement from a third

2933party, the amount recovered shall be

2939distributed as follows:

29421. After attorney’s fees and taxable costs

2949as defined by the Flor ida Rules of Civil

2958Procedure, one - half of the remaining

2965recovery shall be paid to the agency up to

2974the total amount of medical assistance

2980provided by Medicaid.

29832. The remaining amount of the recovery

2990shall be paid to the recipient.

29963. For purposes of calculating the agency’s

3003recovery of medical assistance benefits

3008paid, the fee for services of an attorney

3016retained by the recipient or his or her

3024legal representative shall be calculated at

303025 percent of the judgment, award, or

3037settlement.

30384. Notwithst anding any provision of this

3045section to the contrary, the agency shall be

3053entitled to all medical coverage benefits up

3060to the total amount of medical assistance

3067provided by Medicaid. For purposes of this

3074paragraph, “medical coverage” means any

3079benefits un der health insurance, a health

3086maintenance organization, a preferred

3090provider arrangement, or a prepaid health

3096clinic, and the portion of benefits

3102designated for medical payments under

3107coverage for workers’ compensation, personal

3112injury protection, and cas ualty.

311744 . In the instant case, applying the formula in section

3128409.910(11)(f) to the $2,500,000 settlement results in AHCA

3138being owed $181,975.75 to satisfy the Medicaid lien.

3147Petitioner, however, asserts that a lesser amount is owed to

3157Respondent.

31584 5 . When AHCA has not participated in or approved a

3170settlement, the administrative procedure created by section

3177409.910(17)(b) serves as a means for determining whether a

3186lesser portion of a total recovery should be allocated as

3196reimbursement for medical e xpenses in lieu of the amount

3206calculated by application of the formula in section

3214409.910(11)(f).

321546 . Section 409.910(17)(b) provides, in pertinent part,

3223that: 2/

3225A recipient may contest the amount

3231designated as recovered medical expense

3236damages payable t o the agency pursuant to

3244the formula specified in paragraph (11)(f)

3250by filing a petition under chapter 120

3257within 21 days after the date of payment of

3266funds to the agency or after the date of

3275placing the full amount of the third - party

3284benefits in the trust account for the

3291benefit of the agency pursuant to paragraph

3298(a) . . . . In order to successfully

3307challenge the amount payable to the agency,

3314the recipient must prove, by clear and

3321convincing evidence, that a lesser portion

3327of the total recovery should be allocated as

3335reimbursement for past and future medical

3341expenses than the amount calculated by the

3348agency pursuant to the formula set forth in

3356paragraph (11)(f) or that Medicaid provided

3362a lesser amount of medical assistance than

3369that asserted by the agenc y.

337547 . Therefore, the formula in section 409.910(11)(f),

3383provides an initial determination of AHCA’s recovery for

3391medical expenses paid on a Medicaid recipient’s behalf, and

3400section 409.910(17)(b) sets forth an administrative procedure

3407for adversarial t esting of that recovery. See Harrell v.

3417State , 143 So. 3d 478, 480 (Fla. 1st DCA 2014)(stating that

3428petitioner “should be afforded an opportunity to seek the

3437reduction of a Medicaid lien amount established by the

3446statutory default allocation by demonstrat ing, with evidence,

3454that the lien amount exceeds the amount recovered for medical

3464expenses”).

346548 . Here, Petitioners proved by a preponderance of the

3475evidence that $2,500,000 repres ents 23.8 percent of

3485Petitioner s ’ personal injury claim valued at $10 ,500 ,000 . As a

3499result, the uncontroverted evidence demonstrates that AHCA’s

3506full Medicaid lien amount should be reduced by the percentage

3516that Petitioners’ recovery represents the total value of

3524Petitioner’s claim. When applying the percentage allocation of

353223.8 percent to the lien amount of $181,975.75 , this results in

3544the amount of $69,623.38, which constitutes the share of the

3555settlement proceeds fairly and proportionally attributable to

3562Mr. Brown’s recovery of past medical expenses.

356949 . While AHCA off ered no evidence to counter

3579Mr. Barrett’s and Mr. Rosen’s testimony, AHCA argued durin g the

3590final hearing and in its PFO that Mr. Barrett and Mr. Rosen

3602were not qualified to render an expert opinion as to what

3613portion of total damages amounts to a recovery of an individual

3624component of damages, such as past medical expenses. Both

3633Mr. Rosen and Mr. Barrett’s testimony demonstrated that each

3642witness had a considerable amount of experience making such

3651determinations. More importantly, Petitioners presented

3656s ufficient and uncontradicted evidence establishing $ 69,623.38

3665as the settlement portion properly allocated to past medical

3674expenses.

3675ORDER

3676Based on the foregoing Findings of Fact and Conclusions of

3686Law, it is ,

3689ORDERED that the Agen cy for Health Care Ad ministration is

3700entitled to $69,623.38 as satisfaction of its Medicaid lien.

3710DONE AND ORDERED this 3rd day of December , 2019 , in

3720Tallahassee, Leon County, Florida.

3724YOLONDA Y. GREEN

3727Administrative Law Judge

3730Division of Administrative Hearings

3734The DeSoto Building

37371230 Apalachee Parkway

3740Tallahassee, Florida 32399 - 3060

3745(850) 488 - 9675

3749Fax Filing (850) 921 - 6847

3755www.doah.state.fl.us

3756Filed with the Clerk of the

3762Division of Administrative Hearings

3766this 3rd day of December , 20 19 .

3774ENDNOTE S

37761/ Unless stated otherwise, all statutory references will be to

3786the 2018 version of the Florida Statutes. That version of the

3797Florida Statutes was in effect when Petitioners settled their

3806personal injury claim. See Cabrera v. Ag. for Hea lth Care

3817Admin. , Case No. 17 - 4557MTR (Fla. DOAH Jan. 23, 2018)(citing

3828Suarez v. Port Charlotte HMA , 171 So. 3d 740 (Fla. 2d DCA

38402015)).

38412/ The Northern District of Florida ruled that the Medicaid Act

3852prohibits AHCA from requiring a Medicaid recipient to

3860affirmatively disprove section 409.910(11)(f)’s formula - based

3867allocation with clear and convincing evidence. Gallardo v.

3875Dudek , 263 F. Supp. 3d 1247 (N.D. Fla. April 18, 2017).

3886How ever, section 120.57(1)(j) contains a default provision

3894regarding the bur den of proof and provides that “findings of

3905fact shall be based on a preponderance of the evidence, except

3916in penal or licensure disciplinary proceedings or except as

3925otherwise provided by statute.” A preponderance of the evidence

3934is defined as “the great er weight of the evidence,” or evidence

3947that “more likely than not tends to prove a certain

3957proposition.” S. Fla. Water Mgmt. v. RLI Live Oak, LLC , 139 So.

39693d 869, 871 (Fla. 2014).

3974In addition, the Florida Supreme Court recently ruled that

3983“federal law allows AHCA to lien only the past medical expenses

3994portion of a Medicaid beneficiary’s third - party tort recovery to

4005satisfy its Medicaid lien.” Giraldo v. Ag. for Health Care

4015Admin. , 248 So. 3d 53, 56 (Fla. 2018).

4023COPIES FURNISHED:

4025Floyd B. Faglie, Es quire

4030Staunton and Faglie, P.L.

4034189 East Walnut Street

4038Monticello, Florida 32344

4041(eServed)

4042Alexander R. Boler, Esquire

40462073 Summit Lake Drive , Suite 300

4052Tallahassee, Florida 32317

4055(eServed)

4056Kim Annette Kellum, Esquire

4060Agency for Health Care Administrat ion

40662727 Mahan Drive , Mail Stop 3

4072Tallahassee, Florida 32308

4075(eServed)

4076Richard J. Shoop, Agency Clerk

4081Agency for Health Care Administration

40862727 Mahan Drive, Mail Stop 3

4092Tallahassee, Florida 32308

4095(eServed)

4096Mary C. Mayhew, Secretary

4100Agency for Health C are Administration

41062727 Mahan Drive, Mail Stop 1

4112Tallahassee, Florida 32308

4115(eServed)

4116Stefan Grow, General Counsel

4120Agency for Health Care Administration

41252727 Mahan Drive, Mail Stop 3

4131Tallahassee, Florida 32308

4134(eServed)

4135Shena L. Grantham, Esquire

4139Agency for Health Care Administration

4144Building 3, Room 3407B

41482727 Mahan Drive

4151Tallahassee, Florida 32308

4154(eServed)

4155Thomas M. Hoeler, Esquire

4159Agency for Health Care Administration

41642727 Mahan Drive, Mail Stop 3

4170Tallahassee, Florida 32308

4173(eServed)

4174NOTICE OF R IGHT TO JUDICIAL REVIEW

4181A party who is adversely affected by this Final Order is entitled to judicial review pursuant to section 120.68, Florida

4201Statutes. Review proceedings are governed by the Florida Rules

4210of Appellate Procedure. Such proceedings are commenced by

4218filing the original notice of administrative appeal with the

4227agency clerk of the Division of Administrative Hearings within

423630 days of rendition of the order to be reviewed, and a copy of

4250the notice, accompanied by any filing fees prescribed b y law,

4261with the clerk of the District Court of Appeal in the appellate

4273district where the agency maintains its headquarters or where a

4283party resides or as otherwise provided by law.

Select the PDF icon to view the document.
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Date
Proceedings
PDF:
Date: 06/24/2020
Proceedings: Transmittal letter from Claudia Llado forwarding the one-volume Transcript, along with Petitioner's Exhibits to the agency.
PDF:
Date: 12/03/2019
Proceedings: DOAH Final Order
PDF:
Date: 12/03/2019
Proceedings: Final Order (hearing held September 11, 2019). CASE CLOSED.
PDF:
Date: 11/04/2019
Proceedings: Petitioners' Proposed Final Order filed.
PDF:
Date: 10/29/2019
Proceedings: Order Granting Extension of Time.
PDF:
Date: 10/29/2019
Proceedings: Unopposed Motion for Extension of Time to File Proposed Final Order filed.
PDF:
Date: 10/28/2019
Proceedings: Respondent's Proposed Final Order filed.
PDF:
Date: 10/17/2019
Proceedings: Notice of Filing Transcript.
Date: 10/17/2019
Proceedings: Transcript of Proceedings (not available for viewing) filed.
PDF:
Date: 10/17/2019
Proceedings: Petitioners' Notice of Filing Transcript filed.
Date: 09/11/2019
Proceedings: CASE STATUS: Hearing Held.
Date: 09/05/2019
Proceedings: Petitioner's Notice of Filing Proposed Exhibits filed (exhibits not available for viewing).
PDF:
Date: 09/04/2019
Proceedings: Petitioners' Notice of Filing Proposed Exhibits filed.
PDF:
Date: 09/04/2019
Proceedings: Joint Pre-Hearing Stipulation filed.
PDF:
Date: 09/03/2019
Proceedings: Petitioners' Notice of Calling Expert Witness filed.
PDF:
Date: 07/19/2019
Proceedings: Order of Pre-hearing Instructions.
PDF:
Date: 07/19/2019
Proceedings: Notice of Hearing by Video Teleconference (hearing set for September 11, 2019; 9:30 a.m.; Miami and Tallahassee, FL).
PDF:
Date: 07/18/2019
Proceedings: Response to Initial Order filed.
PDF:
Date: 07/16/2019
Proceedings: Initial Order.
PDF:
Date: 07/16/2019
Proceedings: Letter to General Counsel from C. Llado (forwarding copy of petition).
PDF:
Date: 07/15/2019
Proceedings: Petition to Determine Amount Payable to Agency for Health Care Administration in Satisfaction of Medicaid Lien filed.

Case Information

Judge:
YOLONDA Y. GREEN
Date Filed:
07/15/2019
Date Assignment:
07/16/2019
Last Docket Entry:
06/24/2020
Location:
Miami, Florida
District:
Southern
Agency:
Agency for Health Care Administration
Suffix:
MTR
 

Counsels

Related Florida Statute(s) (5):