19-004496MTR Russell Wellington vs. Agency For Health Care Administration Status: Closed DOAH Final Order on Monday, March 2, 2020.

Summary: Based on the uncontradicted and unrebutted testimony of his experts, the Petitioner proved by a preponderance of the evidence that ACHA's lien should be reduced to $5,260.72, by utilizing the proportionality methodolgy.

P RELIMINARY S TATEMENT

On Augu st 22, 2019, Petitioner filed a p etition with DOAH pursu ant to

s ection 409.910(17)(b), Florida Statutes (2019). 1 Th e matter was assigned to

the undersigned to conduct a formal administrative hearing and enter a final

order.

A final hearing was scheduled for December 16, 2019. Prior to the final

hearing , Petitioner filed an unopposed Motion for Leave to Amend the

Petit ion, which was granted. As a result, the Amended Petition to Determine

Medicaid Lien is the operative p etition in this matter.

Prior to the final hearing, the parties filed a Joint Pre - hearing Stipulation

(“JPHS”), which included numerous stipulated matte rs. The stipulated issues

of fact have been incorporated herein.

The December 16, 2019 , final h earing p roceeded as scheduled, with

Petitioner calling two expert witnesses, attorneys Steven C. Jugo , Esquire,

and R.

Vinson Barrett , Esquire . Petitioner’s Exh ibits 1 through 9 were

admitted into evidence. AHCA did not call any witnesses or submit any exhibits.

The one - volume T ranscript of the proceedings was filed with DOAH on

January 13, 2020. After being granted an extension of time, the parties filed

their respective proposed final o rders on January 31, 2020. Both proposed

final o rders were considered by the undersigned in the preparation of this

Final Order.

1 Unless othe rwise noted, all references to s ection 409.910 are to the 2019 version of the

statute, which is the version of the statute in effect when the personal injury action settled.

The parties stipulated that t he 2019 version was applicable.

F INDINGS OF F ACT

Based on the stipulations of the parties, the evidence presented at the

hearing, a nd the record as a whole, the following findings of fact are made:

1. On August 9, 2018, Petitioner, Russell Wellington ("Wellington") , who

was 59 years old, was driving a motorcycle in the inside northbound lane of

U.S. Highway 1 at or near mile marker 9 9 in Monroe County, Florida.

2. A vehicle driven by JI Young Chung ("Chung") , and owned by a car

rental company, was northbound in the outside lane on U.S. Highway 1.

Chung turned left into Wellington’s motorcycle causing him to be ejected from

the motorc ycle.

3. As a result of the accident, Wellington sustained catastrophic injuries

including a right leg amputation, a fractured pelvis, fractured humerus,

fractured ribs, kidney failure , and a head injury. Wellington is now disabled

and unable to work. JPH S p . 10 , ¶1.

4 . Wellington’s medical care related to the injury was paid by Medicaid,

and Medicaid , through AHCA, provided $191,298.99 in benefits. This

$191,298.99 constituted Wellington’s entire cl aim for past medical expenses.

JPHS p . 10 , ¶2.

5 . Welling ton pursued a personal injury claim against the driver and

owner of the car that struck his motorcycle (“tortfeasors ”) to recover all his

damages. JPHS p . 10 , ¶3.

6 . The other driver, Chung, maintained an insurance policy with only

$100,000 in insurance li mits , and had no other recoverable assets. The rental

company that o wned the vehicle maintained an insurance policy with only

$10,000 in insurance limits. Wellington’s personal injury claim against the tortfeasors was settled for an unallocated lump sum am ount of $110,000.00.

JPHS p . 10 , ¶4.

7 . As a condition of Wellingt on’s eligibility for Medicaid, Wellington

assigned to AHCA his right to recover from liable third - parties medical

expenses paid by Medicaid. See 42 U.S.C. § 1396a(a)(25)(H) ; § 409.910(6)(b) ,

Fla. Stat.

8 . During the pendency of Wellington’s personal injury claim, AHCA wa s

notified of the claim and asserted a $191,298.99 Medicaid lien against

Wellington’s cause of action and settlement of that action. JPHS p . 10 , ¶5.

9 . AHCA did not commence a civil action to enforce its rights under

section 409.910 or intervene or join in Wellington’s claim against the

tortfeasors. JPHS p . 10 , ¶6.

10 . By letter, AHCA was notifi ed of Wellington’s settlement. JPHS p . 10 ,

¶7 .

11 . AHCA has not filed a motion to s et - aside, void, or otherwise di spute

Wellington’s settlement. JPHS p . 10 , ¶8.

12 . The Medicaid program , through AHCA , spent $191,298.99 on behalf of

Wellington, all of which represents expenditures paid for Welli ngton’s past

medical expenses. JPHS p . 10 , ¶ 9.

13 . Wellington’s taxable costs incurred in securing the $110,0 00 .00

settlement totaled $766.78. JPHS p . 10 , ¶10.

14 . Application of the formula at section 409.910(11)(f) to Wellington’s

$110,000 .00 settlement requires payment to AHCA of $40,866.61. JPH S

p . 11 , ¶ 11.

15 . Petitioner has deposited the s ection 409.910(11)(f) formula amount in

an interest bearing account for the benefit of AHCA pending an

administrative determination of AHCA’s rights, and this constitutes “final agency action” for purposes of chapter 120, Florida Statutes, pursuant to

section 409.910(17). JPHS p .11 , ¶12 .

Testimony of Steven G. Jugo, Esq uire

16 . S teven G. Jugo , Esquire ("Jugo"), was called by Petitioner. He has

been an attorney for 41 years and practices with the law firm of Ju go &

Murp hy in Miami, Florida.

17. For the past 37 years, Jugo has practiced exclusively plaintiff’s

personal injury, medical malpractice , and wrongful death law. He routinely

handles jury trials and cases involving catastrophic injury. He is familiar

wit h reviewing medical records, reviewing accident reports, and deposing fact

and expert witnesses.

18. He stays abreast of jury ver dicts in his geographic area by reviewing

jury verdict r eporters and discussing cases with other trial attorneys. He is a

memb er of several trial attorney organizations including the Florida Justice

Association and the American Association for Justice.

19. A s a routine part of his practice , Jugo makes assessments concerning

the value of damages suffered by injured clients . He br iefly explained his

process for making th ese determinations. Jugo is familiar with, and routinely

participates in, processes involving the allocation of settlements in matters

including health insurance liens, worker s' compensation liens , and Medicare

set - asides, as well as, alloca tions of judgments made by judges post - verdict.

20 . Jugo represented Wellington in his underlying personal injury claim.

Jugo reviewed the accident report, reviewed Wellington’s medical records,

met with Wellington numerous times , and deposed the driver of the vehicle

that struck Wellington’s motorcycle.

21. As a result of the accident, Wellington underwent many surgeries and

extensive medical intervention. Jugo felt that Wellington’s injuries have

tremendously impacted his li f e in a negative way. He explained that

Wellin gton is no longer able to work and he is no longer able to adequately

care for or play with the three young children he adopted.

22. Without objection by AHC A, Jugo testified that based on his

professional trai ning and experience, it was his opinion that a very

conservative value for Wellington’s damages w ould be $4 million . Jugo

explained that his valuation of Wellington’s total projected damages was

based on his experience, his comparison of Wellington’s case to similar jury verdicts , and discussions about the case with other attorneys.

23. He explained that the jury verdicts outlined in Petitioner’s Exhibit 9

were comparable to Wellington’s case and supported his valuation of

Wellington’s total and projected damages in this case.

24. Jugo detailed that about 70 percent of the verdicts he reviewed which

were similar in nature, were in the $5 million range. He opined that this

demonstrated that Wellington’s total and projected damages would also have

a minimum value of $4 million.

25. Jugo discussed the value of Wellington’s damages with other

attorneys , and they agreed with the valuation of Wellington’s total projected

damages being in excess of $4 million.

26. Wellington’s personal injury claim was brought a gainst the driver and

the rental car company that owned the vehicle which struck Wellington’s

motorcycle. The vehicle driver, Chung, maintained an insurance policy wi th

only $100,000.00 in coverage , and had no other recoverable assets.

27. Jugo explained that because the vehicle was owned by a rental car

company, the law shielded the rental car company from suit. Nonetheless, he explained that the rental car company had a $10,000.00 insurance policy it

made available. As a result, the total settlement was $110,000.00.

28 . Jugo believed that the personal injury settlement did not fully

compensate Wellington for all of his project ed personal injury damages.

29. Without objection by AHC A’s counsel, Jugo testified that based on a

conserva tive value of all dam ages of $4 million, Wellington recove red in the

settlement only 2.75 percent of the value of his total and projected damages.

30. Again, without objection, he testified that because Wellington

recovered only 2.75 percent of his total and projected damages, he recovered

in the settlement only 2.75 percent of his $191,298.99 claim for past medical

expenses, or $5,260.72.

31. Jugo also testified that it would be reasonable to allocate $5,260.72 of

the settlement to past medical expenses, stating “[t]hat’s the maximum

amount I believe should be allocated to past medical expenses.”

Testimony of R. Vinson Barrett, Esq uire

32 . R. Vinson Barrett , Esquire ("Barrett"), has been a trial attorney for

over 40 years. He is a partner with the law firm of Barrett, Nonni an d

Homola, P.A. , in Tallahassee. His legal practice is dedicated to plaintiff’s

personal injury and wrongful death cases. He has handled cases involving

automobile accidents and catastrophic injuries. Barrett routinely handles

jury trials.

33. Barrett stay s abreast of jury verdicts by periodically reviewing jury

verdict reports and discussing cases with other trial attorneys. He is a

member of the Florida Justice Association and the Capital City Justice Association.

34. As a routine part of his practice , B arrett makes assessments

concerning the value of damages suffered by injured parties. He briefly

explained his process for making these assessments.

35. It has been part of his law practice to gain familiarity with settlement

allocation involving health i nsurance liens, Medicare set - asides , and workers’

compensation liens.

36. He is also familiar with the process of allocating settlements in the

context of Medicaid liens , and he described that process.

37. Barrett has been accepted as an expert in the va luation of personal

injury damages in federal court, as well as numerous Medicaid lien hearings

at DOAH.

38. Barrett addressed the instant case. He was familiar with Wellington’s

injuries and the circumstances resulting in the injuries. Barrett detailed th e

extensive nature of Wellington’s injuries and the general impact of such injuries.

39. Barrett testified, without objection, that based on his professional

training and experience, he believed Wellington’s damages had a

conservative value of $4 million . More specifically , he stated, “I felt that the

damages were conservatively, very conservatively, $4 Million. I believe this

case, if it had gone to a jury could well have gone up into the eight figures,

probably would have, I think. If I was asking for da mages in this case in front

of a jury, it would probably be somewhere, between $8 and 12 million or even a little higher, if I was in South Florida jurisdiction.”

40. Barrett has been accepted as an expert in the valuation of personal

injury damages in oth er cases at DOAH.

41. Barrett explained that the jury verdicts outlined in Petitioner’s

Exhibit 9 involved injuries comparable to Wellington’s injuries and supported

his valuation of Wellington’s to tal and projected damages at $4 million .

42. Barrett wen t on to explain that the average trial verdict and award he

reviewed from Exhibit 9 was $5.5 million and the average award for pain and

suffering was $3,788,333.00.

43. Barrett believed that the jury verdict in the Nummela case, from

Exhibit 9, most close ly tracked W ellington’s case. Barrett explained that the

injuries suffered by Nummela compared most closely with Wellington’s

injuries and he noted the similarities.

44. Barrett also pointed out that the jury in Nummela had determined

that the damages had a value of $9 .5 million, which Barrett testified was in

line with what he believed a jury would have awarded to Wellington, if this

matter had proceeded to trial.

45 . Barrett was aware that Wellington’s case had settled for the insurance

policy limits of $110,000.00. He testified that this settlement amount did not

fully compensate Wellington for all the personal injury damages he had

suffered.

46. Barrett tes tified, without objection by AHC A’s counsel, that u sing a

conservative value of $4 million for a ll projected damages, the $110,000.00

settlement represented a recovery of 2.75 percent of the total and projected

damages.

47. Barrett testified, again without ob jection, that because only 2.75

percent of his damages were recover ed in the settlement, onl y 2.75 percent of

the $191,298.99 claim for past medical expenses was recovered by Wellington

in the settlement, namely $5,260.72.

48. Barrett testified that it would be reasonable to allocate $5,260.72 of

Wellington’s settlement to his past medical expen ses.

49. Inexplicably, AHCA did not call any witnesses, present any

contradictory evidence as to a lower value of Wellington’s projected or total

damages, or call any witnesses to contest the methodology used to calculate

the $5,260.72 allocation to past medical expenses.

50. The unrebutted evidence supports that Wellington’s total and

projected damages had a value in excess of $4 million.

51. By applying the same ratio to AHCA's lien that the settlement

($110,000.00) bears to the total projected monetary value of all the damages

($4,000,000.00) , a finding is reached that $5,260.72 of the settlement is fairly

allocable to past medical expenses.

52. Under the proportionality methodology , the $110,000.0 0 settlement

represents a 2.75 percent recovery of the expert’s to tal and projected damages

of $4 million ($110,000.00 is 2.75 percent of $4 million). Applying this same

2.75 percent to the $191,298.99 claim for past medical expense, the experts

opined that Wellington recovered $5,260.72 in past medical expens e s in the

settlement. 2

53. Of particular consequence to this case, AHCA did not call any expert

witnesses, nor did it present any evidence , to rebut or contradict Petitioner's

experts or proposed allocation of $5,260.72 in the settlement to past medical

e xpenses.

54. Likewise, AHCA did not dispute or present any persuasive evidence or

arguments that Wellington’s injuries were overstated or incorrectly described

by Messrs. Jugo or Barrett.

2 This methodology is commonly referred to as the proportionality test or pro - rata formula.

55. On AHCA's cross - examination of the attorney experts, the

metho dology used by them to arrive at their opinion concerning a fair

allocation of past medical expenses in Wellington’s settlement was not

persuasively challenged or overcome by AHCA.

56. Simply put, the amount of $5,260.72 proposed by Petitioner as a f air

allocation of past medical expenses from the settlement agreement was not successfully refuted or challenged by AHCA.

57. Under the circumstances and proof presented in this case, Petitioner

proved by a preponderance of the evidence that $5,260.72 was a fair

allocation of the total settlement amount to past medical expenses.

58. AHC A failed to develop any adequate basis or evidence in the record to

reject Jugo’s or Barrett’s opinion, or to reach any other conclusion concerning

a fair allocation, other than the amount of $5,260.72 presented by the evidence and propose d by Petitioner.

C ONCLUSIONS OF L AW

59. The Agency for Health Care Administration is the state agency

responsible for administering Florida's Medicaid program. § 409.910(2), Fla.

Stat.

60. DOAH has jurisdiction of this matter, pursuant to section

409.910(17)(b), and the parties acknowledged that the proper standard of proof in this proceeding for Petitioner is a "preponderance of the evidence."

61. "Medicaid is a cooperative federal - state welfare program providing

medical assistance to needy people." Roberts v. Albertson's Inc. , 119 So. 3d

457 (Fla. 4th DCA 2012). Although state participation in this federal program

is voluntary, once a state elects to participate, it must comply with feder al

Medicaid law. Id.

62. Federal law requires that participating states seek reimbursement for

medical expenses incurred on behalf of Medicaid recipients who later recover

from legally - liable third parties.

63. Under the United States Supreme Court's rea soning in Arkansas

Department of Health and Human Services v. Ahlborn , 547 U.S. 268 (2006),

the federal Medicaid anti - lien provision at 42 U.S.C. § 1396p(a)(1) prohibit s a

Medicaid lien on any proceeds from a Medicaid recipient's tort settlement.

64. Howe ver , the provisions in federal law requiring states to seek

reimbursement of their Medicaid expenditures from liable third parties, also

create an express exception to the anti - lien law and authorizes states to seek

reimbursement from the medical expense p ortion of the recipient's tort

recovery.

65. As noted, t he Fed eral Medicaid Act limits a state 's recovery to certain

portions of the settlement funds received by the Medicaid recipient. In

Florida , t his has been recently interpreted by the Florida Supreme Court to

be the amount in a personal injury settlement which is fairly allocable to past

(not future) medical expenses. Giraldo v. Ag. for Health Care Admin. , 248 So.

3d 53 , 56 (Fla. 2018).

66. In this case, Wellington settled his personal injury claim ag ainst third

parties who were liable to him for injuries associated with AHCA' s Medicaid

claim. Therefore, AHC A has a lien which may be enforced against

Wellington’s tort settlement.

67. The underlying question in this case, however, is how much is AHCA

ent itled to recover from Petitioner as payment for past medical services

provided to him?

68. Section 409.910(11) establishes a formula to determine the amount

AHCA may recover for medical assistance benefits paid from a judgment,

award, or settlement from a third party. Section 409.910(11)(f) states, in

pertinent part:

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 whi ch results

in a judgment, award, or settlement from a third

party, the amount recovered shall be distributed as

follows:

1. After attorney's fees and taxable costs as defined

by the Florida Rules of Civil Procedure, one - half of

the remaining recovery shal l 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 agency's recovery

of medical assistance benefits paid, t he 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 shall be entitled to all

medical coverage benefits up to the total amount of

medical assistance provided by Medicaid. For

purposes of this paragraph, "medical coverage"

means any benefits under health insurance, a

health maintenance organization, a preferred

provid er arrangement, or a prepaid health clinic, and the portion of benefits designated for medical

payments under coverage for workers'

compensation, personal injury protection, and

casualty.

69. In essence , section 409.910(11)(f) provides that the agency's r ecovery

for a Medicaid lien is limited to the lesser of: (1) its full lien; or (2) one - half of

the total award, after deducting attorney's fees of 25 percent of the recovery

and taxable costs, not to exceed the total amount actually paid by Medicaid

on the recipient's behalf. See Ag. for Health Care Admin. v. Riley , 119 So. 3d

514 (Fla. 2d DCA 2013).

70. Here, the parties agreed that application of this section 409.910( 11 )(f)

formula to Petitioner's settlement would require payment to AHCA of

$40,86 6.61. JP HS p. 11, ¶11.

71. However, another section , section 409.910(17)(b), provides a method

by which a Medicaid recipi ent may challenge the amount AHC A seeks under

the statutory default formula found above at section 409.910(11)(f).

72. This is done during an administrative hearing at DOAH. It is to the

proof presented at the administr ative hearing that a determination

concerning the proper and fair allocation of the settlement agreement for past

medical expenses should be made.

73. More specifically, followin g the United States Supreme Court decision

in Wos v. E.M.A. , 568 U.S. 627, 633 (2013), the Florida Legislature created an

administrative process to challenge and ultimately determine what portion of

a judgment, award, or settlement in a tort action is prop erly allocable to

medical expens es and, thus, what portion of a Petitioner’s settlement may be

recovered to reimbur se the Medicaid lien held by AHC A .

Section 409.910(17)(b) states:

A recipient 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 date of payment of funds to the agency or after the date of placing the full amount of the third - party ben efits 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 amoun t 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 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 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 ass istance than that asserted by

the agency. 3

74. In more simple terms, if Petitioner can demonstrate, by a

preponderance of the evidence, that the portion of his settlement agreement

fairly allocable as payment for past medical expense is less than the amou nt

the agency seeks, then the amount Petitioner is obligated to pay to AHCA

would be reduced.

75. How to arrive at this amount and fairly allocate the past medical

expense portion of an undiff erentiated settlement agreement has been the

subject of consider able debate , and has not been squarely addressed by the

United States Supreme Court:

A question the Court had no occasion to resolve in

Ahlborn is how to determine what portion of a settlement represents payment for medical care.

The parties in that case s tipulated that about 6

percent of respondent Ahlborn's tort recovery

(approximately $35,600 of a $550,000 settlement)

represented compensation for medical care. Id., at

274, 126 S. Ct. 1752. The Court nonetheless

anticipated the concern that some settlemen ts

would not include an itemized allocation. It also

recognized the possibility that Medicaid beneficiaries and tortfeasors might collaborate to

allocate an artificially low portion of a settlement to

medical expenses.

Wos , 568 U.S. at 627, 634.

76. In i ts recent opinion in Giraldo , the Florida Supreme Court held that

future medical expense damages recovered by a Medicaid recipient are not

3 The parties agree, however, that the standard of proof is a preponderance of the evidence,

not clear and convincing .

available as a source of reimbursement for Medicaid payments made for the

recipient . Rather, only past medical expens es may be considered.

77. S everal recent d i strict c ourt of a ppeal opinions have consider ed

noteworthy, the following statement by the Florida Supreme Court :

Because we hold that the federal Medicaid Act

prohibits AHCA from placing a lien on the future

medi cal expenses portion of a Medicaid recipient's

tort recovery, we remand with instructions that the

First District direct the ALJ to reduce AHCA's lien

amount to $13,881.79. Although a factfinder may

reject "uncontradicted testimony," t here must be a "reaso nable basis in the evidence" for the rejection.

Wald v. Grainger , 64 So. 3d 1201, 1205 - 06 (Fla.

2011). Here, Villa presented uncontradicted

evidence establishing $13,881.79 as the settlement portion properly allocated to his past medical expenses, and ther e is no reasonable basis in this

record to reject Villa's evidence. For this reason, no

further fact finding is required.

Giraldo , 248 So. 3d at 56 .

78. In this case , there was no evidence presented by AHCA to contest or

contradict the amount of $5,260 .72 presented by Petition er's expert as the

fair allocation of past medical expenses in Wellington’s settlement.

79. Counsel for AHCA cross - examined Petitioner's experts, but elicited no

compelling information or evidence assailing their opinion s that a f air

allocation of past medical expenses was $5,260.72.

80. In short, Petitioner's expert testimony concerning a fair allocation of

the settlement agreement was unchallenged by AHCA, without any contrary

or contradictory facts or evidence in the record.

8 1. Many of the questions that existed in the law regarding the proper

methodology or proof to apply in a section 409.910( 17 ) (b) hearing ha ve been

resolved by the First District Court of Appeal in a series of recent opinions.

W hile the Florida Supreme Court has not , arguably, issued a definitive or

express opinion on the mat ter, the prevailing law in the F irst Di strict Court

of Appeal appears now to be settled .

82. In Eady v. Agency for Health Care Admin inistration , 279 So. 3d 1249

(Fla. 1st DCA 2019); Larr igui - Negron v. Agency for Health Care

Admin istration , 280 So. 3d 550 (Fla. 1st DCA 2019); and Moj ica v. Agency f or

Health Care Admin istration , 285 So. 3d 393 (Fla. 1st DCA 2019) , the First

District Court of Appeal panels discussed and accepted the proporti onality

test or method advanced by Petitioner. 4

83. More specifically, a Petitioner may carry his burden of proving how

much of his undifferentiated settlement agreement is fairly allocable to past

medical expenses, by applying the same ratio or percentag e Pet itioner’s

settlement amount bears to th e total projected damage claim , to AHCA's

claim for past medical expenses . This may be accomplished through the

testimony of expert witnesses.

4 These cases recognize, however, that AHCA may present evidence in an effort to refute or

contradict the expert testimony offered. Likewis e, every case is different. Eady , Larrigui -

Negron , and Mojica do not define the exact parameters of the pro - rata formula, nor do they

exclude the possibility that there may be facts elicited from the experts or other evidence

presented, to warrant an adjus tment to the proportionality test or the total damages

projected by the experts.

84. T he First D istrict Court of Appeal panels in these three recent cases

have determined that it would be error to reject the expert testimony , unless

there is a basis in the record to do so. There was no basis in this record to do

so.

85. As such, and based on this record, the undersigned is con strained to

conclude under the first d istrict’s opinions in Eady , Larrigui - Negron , and

Mojica , that $5,260.72 is the amount due to AHCA.

O RDER

Based on the foregoing Findings of Fact and Conclusions of Law, it is

O RDERED that the Agency for Health Care Administration is entitled t o

recover payment of $5,260.72 from the amount recovered in Petitioner's

personal injury matter.

D ONE A ND O RDERED this 2nd day of March , 2020 , in Tallahassee, Leon

County, Florida.

R OBERT L. K ILBRIDE

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 March , 2020 .

C OPIES F URNI SHED :

Alexander R. Boler, Esquire

2073 Summit Lake Drive , Suite 300

Tallahassee, Florida 32317

(eServed)

Floyd B. Faglie, Esquire

Staunton and Faglie, P.L.

189 East Walnut Street

Monticello, Florida 32344

(eServed)

Shena Grantham, Esquire

Agency for H ealth Care Administration

2727 Mahan Drive , Mail Stop 3

Tallahassee, Florida 32308

(eServed)

Steven G. Jugo, Esquire Jugo & Murphy

7695 Southwest 104th Street , Suite 200

Miami, Florida 33156

(eServed)

Mary C. Mayhew, Secretary

Agency for Health Care Ad ministration

2727 Mahan Drive, Mail Stop 1

Tallahassee, Florida 32308

(eServed)

Stefan Grow, General Counsel

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

(eServed)

Richard J. Shoop, Agency Clerk

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

(eServed)

Thomas M. Hoeler, Esquire

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

(eServed)

N OTICE OF R IGHT T O J U DICIAL 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 t he 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.