19-006863MTR Dee Ann Barnes vs. Agency For Health Care Administration Status: Closed DOAH Final Order on Tuesday, April 7, 2020.

Summary: The Petitioner failed to demonstrate by a preponderance of the evidence that AHCA's Medicaid lien should be reduced.

S TATE OF F LORIDA

D IVISION OF A DMINISTRATIVE H EARINGS

D EE A NN B ARNES ,

Petitioner ,

vs. Case No. 19 - 6863MTR

A GENCY F OR H EALTH C ARE

A DMINISTRATION ,

Respondent .

/

F INAL O R DER

Pursuant to notice, a formal administrative hearing was conducted before

Garnett W. Chisenhall, Administrative Law Judge (ÑALJÒ) of the Division of

Administrative Hearings (ÑDOAHÒ) , via video teleconference at sites in

Pensacola and Tallahassee, Florid a, on March 10, 2020.

A PPEARANCES

For Petitioner: Scott C. Barnes, Esquire

Ward and Barnes, P.A.

222 West Cervantes Street

Pensacola, Florida 32501

For Respondent: Alexander R. Boler, Esquire

Suite 300

2073 Summit Lake Dri ve

Tallahassee, Florida 32317

S TATEMENT OF T HE I SSUE

The issue to be determined is the amount Respondent, Agency for Health

Care Administration (ÑAHCAÒ), is to be reimbursed for medical expenses paid

on behalf of Dee Ann Barnes (ÑMs. BarnesÒ) , purs uant to section 409.910,

Florida Statutes (2019). 1

P RELIMINARY S TATEMENT

If a Medicaid recipient receives a personal injury settlement from a third

party, then section 409.910 mandates that those settlement proceeds shall be

used to reimburse the Medicaid program for medical expenses paid on the

Medicaid recipientÔs behalf. This mandate is facilitated by a statutory lien in

AHCAÔs favor on the settlement proceeds, and federal law mandates that

MedicaidÔs lien only applies to past medical expenses that the Medicaid

recipient actually recovered through the settlement . When a Medicaid

recipientÔs settlement proceeds are less than the recipientÔs total damages

(which may consist of multiple components, such as past medical

expenses, economic damages, and nonec onomic damages), a question can

arise as to how much of the past medical expenses were actually recovered

by the Medicaid recipient and thus subject to the Medicaid lien.

Section 409.910(11)(f), sets forth a formula to determine

the amount Medicaid shal l recover from the settlement proceeds, and

section 409.910(17)(b) , provides that a Medicaid recipient can request a

formal administrative hearing to demonstrate that the past medical expenses

actually recovered through the settlement were less than the a mount

calculated via section 409.910(11)(f).

On December 30, 2019, Ms. Barnes filed a ÑPetition to Determine the

Amount of MedicaidÔs LienÒ to challenge AHCAÔs imposition of a lien of

$14,640.89 on $75,000.00 of settlement proceeds recovered in a personal

injury lawsuit. Ms. Barnes valued her total damages as being at least

1 The parties stipulated that the 20 19 v ersion of the Florida Statutes applies to the instant

case. Accordingly, u nless stated otherwise, all statutory references will be to the 20 19 version

of the Florida Statutes.

$300,000.00. Because the $14,640.89 paid by AHCA equates to 4.9 percent of

her total damages, Ms. Barnes argued that AHCA was only entitled to

recover 4.9 percent of her settlement pro ceeds, i.e., $3,675.00.

The parties filed a Joint Pre - hearing Stipulation in which they identified

stipulated facts for which no further proof would be necessary. Those

stipulated facts have been accepted and considered in the preparation of this

Final O rder.

The final hearing was held as scheduled on March 10, 2020. Ms. Barnes

presented testimony from herself, Aaron Watson, Esquire, and Austin Ward,

Esquire. The undersigned accepted PetitionerÔs Exhibit 1 into evidence

without objection.

AHCA offered n o witnesses and did not move any exhibits into evidence.

Neither party ordered a transcript. Both parties filed timely proposed

final orders that were considered in the preparation of this Final Order.

F INDINGS OF F ACT

The following findings are base d on testimony, exhibits accepted into

evidence, admitted facts set forth in the Pre - hearing Stipulation, and matters

subject to official recognition.

Facts Pertaining to the Underlying Personal Injury Litigation and the

Medicaid Lien

1. Ms. Barnes was a guest at a friendÔs home during the evening of

March 29, 2014. While leaving the friendÔs home early the next morning,

Ms. Barnes slipped on a combination of ice and mold that was allegedly on

the walkway outside the front door. The temperature had been below freezing

that night, and Ms. Barnes had been aware of the freezing temperature and

had driven on icy roads on the way to her friendÔs home. However, she did not

recall seeing or experiencing ice while entering the residence via the walkway

several h ours prior to her fall. During previous trips to the friendÔs home,

Ms. Barnes had never noticed any problem with mold or slippery conditions.

2. Ms. BarnesÔ s friend asserted that he had no knowledge of any defective

condition prior to Ms. BarnesÔ s fall and that he was unaware of any ice or

mold on his walkway. Ms. Barnes gave him no notice of any dangerous

conditions prior to her fall.

3. The fall resulted in Ms. Barnes suffering a fractured humerus, cervical

kyphosis, a broad - based disc osteophyte, fora minal stenosis, and extensive

radiculopathy. Her initial medical treatment consisted of one or more

emergency room visits, orthopedic treatment, and chiropractic care.

Ms. Barnes ultimately received a referral to a neurosurgeon, who performed

an anterior discectomy and a two - level fusion at C5 through C7 on

February 17, 2016. However, Ms. Barnes continued to experience pain and

other problems due to her fall. Accordingly, Ms. BarnesÔ s neurosurgeon

recommended pain management treatment, and a pain manageme nt

physician has determined that Ms. Barnes will require treatment for the rest

of her life. That treatment will include facet injection and cervical rhizotomy

every 6 months.

4. Ms. Barnes is 56 years old, and her life expectancy is more than 27

years.

5 . While Ms. Barnes believed that the value of her injuries exceeds

$300,000.00, she was uncertain that a jury would have the same opinion and

settled a claim against her friend for $75,000.00.

6. FloridaÔs Medicaid program paid $14,640.89 for medical expen ses

associated with Ms. BarnesÔ s fall and has imposed a lien seeking to recover

that entire amount.

7. As required by section 409.910(17)(b), Ms. Barnes has deposited all of

the money claimed by AHCA in an interest - bearing trust account for AHCAÔs

benefit pending this administrative determination.

8. Applying the formula set forth in section 409.910(11)(f) would require

Ms. Barnes to satisfy the full amount of AHCAÔs $14,640.89 lien.

Valuation of the Personal Injury Claim

9. Aaron Watson, of the Watson law firm in Pensacola, Florida, has 10

years of experience in the personal injury field and has represented

thousands of personal injury plaintiffs.

10. Mr. Watson has represented clients with cervical injuries like those of

Ms. Barnes and opined that $350,0 00.00 was a conservative valuation of her

injuries. That valuation accounts for Ms. BarnesÔ s pain and suffering, past

medical expenses, and future medical expenses.

11. Mr. Watson also opined that Ms. Barnes probably settled her claim for

$75,000.00 becau se of uncertainty about liability. In other words, Mr. Watson

opined that a jury could have found that Ms. Barnes, rather than her friend,

was primarily at fault and reduced her damages accordingly.

12. Austin Ward is a partner in the Ward & Barnes law fir m in Pensacola.

He has 12 years of experience in the personal injury field and has

represented over 1,000 personal injury plaintiffs. Like Mr. Watson, Mr. Ward

has represented clients with cervical injuries, and he opined that the total

value of Ms. Barnes Ô injuries could be conservatively estimated as being

between $300,000.00 and $500,000.00.

13. While the cause of M s . BarnesÔ s injury was clear, Mr. Ward opined

that M s . Barnes probably settled her claim for $75,000.00 because of issues

regarding the assi gnment of liability and uncertainty about a juryÔs ultimate

findings. For example, ice on a walkway leading to a home is an Ñact of GodÒ

rather than a defect with a defendantÔs home, and there was no evidence

indicating Ms. BarnesÔ s friend was aware of the walkwayÔs condition prior to

her fall. Also, M s . Barnes had traversed the area where she was hurt a few

hours prior to the accident. As a result, she was probably in a better position

than her friend to know about the walkwayÔs condition.

Findings Re garding the Testimony Presented at the Final Hearing

14. Mr. Watson and Mr. Ward opined about the total value of Ms. BarnesÔ s

damages. 2 However, neither of them testified as to what portion of

Ms. BarnesÔ s $75,000.00 settlement amounts to a recovery of he r past medical

expenses. Also, neither Mr. Watson nor Mr. Ward presented any testimony

about how one could calculate what portion of Ms. BarnesÔ s settlement

represents a recovery of past medical expenses. Therefore, Ms. Barnes failed

to prove by a preponde rance of the evidence that AHCA should recover less

than the full amount of its $14,640.89 lien.

C ONCLUSIONS OF L AW

15 . DOAH has jurisdiction over the subject matter and the parties in this

case pursuant to sections 120.569, 120.57(1) , and 409.910(17), Fl orida

Statutes.

16 . AHCA is the agency authorized to administer FloridaÔs Medicaid

program. § 409.902, Fla. Stat.

17 . The Medicaid program Ñprovide[s] federal financial assistance to

States that choose to reimburse certain costs of medical treatment for needy

persons.Ò Harris v. McRae , 448 U.S. 297, 301 (1980).

18 . ÑThe 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 administering the program.Ò

2 Ms. BarnesÓ s attorney did not seek to have Mr. Watson and Mr. Ward accepted as experts in any

field. However, they generally had the Ñknowledge, skill, experience, training, or eductionÒ

required to allow them to offer expert testimony pursuant to section 90.702, Florida Statutes,

and AHCA did not object to them off ering opinions about the total value of Ms. Barnes Ôs

injuries.

Est . of Hernandez v. Ag. for Health Care Admin. , 190 So. 3d 139, 141 - 42 (Fla.

3rd DC A 2016)(internal citations omitted).

19 . Though participation is optional, once a State elects to participate in

the Medicaid program, it must comply with federal requirements. Harris , 448

U.S. at 301.

2 0 . One condition for receipt of federal Medicaid fu nds requires states to

seek reimbursement for medical expenses incurred on behalf of Medicaid

recipients who later recover from legally liable third parties. See Ark. Dep't of

Health & Human Servs. v. Ahlborn , 547 U.S. 268, 276 (2006); see also Est . of

Her nandez , 190 So. 3d at 142 (noting that one such requirement is that Ñeach

participating state implement a third - party liability provision , which requires

the state to seek reimbursement for Medicaid expenditures from third parties

who are liable for medica l treatment provided to a Medicaid recipient . Ò).

21 . Consistent with this federal requirement, the Florida Legislature

enacted section 409.910, designated as the ÑMedicaid Third - Party Liability

Act,Ò which authorizes and requires the state to be reimbur sed for Medicaid

funds paid for a recipient'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); see also

Davis v. Ro berts , 130 So. 3d 264, 266 (Fla. 5th DCA 2013)(stating that in

order Ñ[t]o comply with federal directives the Florida legislature enacted

section 409.910, Florida Statutes, which authorizes the State to recover from

a personal injury settlement money that the State paid for the plaintiffÔs

medical care prior to recovery.Ò).

22 . Section 409.910(1) sets forth the Florida LegislatureÔs clear intent that

Medicaid be repaid in full for medical care furnished to Medicaid recipients

by providing that:

It is the i ntent of the Legislature that Medicaid be

the payor of last resort for medically necessary

goods and services furnished to Medicaid

recipients. All other sources of payment for medical

care are primary to medical assistance provided by

Medicaid. If benefit s of a liable third party are

discovered or become available after medical

assistance has been provided by Medicaid, it is the

intent of the Legislature that Medicaid be repaid in

full and prior to any other person, program, or

entity. Medicaid is to be re paid in full from, and to

the extent of, any third - party benefits, regardless of

whether a recipient is made whole or other

creditors paid. Principles of common law and equity

as to assignment, lien, and subrogation are

abrogated to the extent necessary to ensure full

recovery by Medicaid from third - party resources.

It is intended that if the resources of a liable third

party become available at any time, the public

treasury should not bear the burden of medical

assistance to the extent of such resources.

23 . In addition, the Florida Legislature has authorized AHCA to recover

the monies paid from any third party, the recipient, the provider of the

recipientÔs medical services, and any person who received the third - party

benefits. § 409.910(7), Fla. Stat.

24 . AHCAÔs effort to recover the full amount paid for medical assistance is

facilitated by section 409.910(6)(a), which provides that AHCA:

[I]s automatically subrogated to any rights that an

applicant, recipient, or legal representative has to

any third - party benefit for the full amount of

medical assistance provided by Medicaid.

Recovery pursuant to the subrogation rights

created hereby shall not be reduced, prorated, or

applied to only a portion of a judgment, award, or

settlement, but is to provide f ull recovery by the

agency from any and all third - party benefits.

Equities of a recipient, his or her legal

representative, a recipientÔs creditors, or health

care providers shall not defeat, reduce, or prorate

recovery by the agency as to its subrogation rights

granted under this paragraph.

See also £ 409.910(6)(b)2., Fla. Stat. (providing that AHCA Ñis a bona fide

assignee for value in the assigned right, title, or interest, and takes vested

legal and equitable title free and clear of late nt equities in a third person.

Equities of a recipient, the recipientÔs legal representative, his or her

creditors, or health care providers shall not defeat or reduce recovery by the

agency as to the assignment granted under this paragraph . Ò).

25 . AHCAÔs efforts ar e also facilitated by the fact that AHCA has Ñan

automatic lien for the full amount of medical assistance provided by Medicaid

to or on behalf of the recipient for medical care furnished as a result of any

covered injury or illness by which a third party i s or may be liable, upon the

collateral, as defined in s. 409.901.Ò £ 409.910(6)(c), Fla. Stat.

26 . The amount to be recovered by AHCA 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).

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

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 which results

in a judgment, award, or settlement from a third

party, the amount recovered shall be distributed as

follows:

1. After attorneyÔs fees and taxable costs as defined

by the Florida Rules of Civil P rocedure, 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 agencyÔ 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.

28. Applying the formula in section 4 09.910(11)(f) to the $75,000.00

settlement in the instant case results in AHCA being owed $14,640.89, the

full amount of its Medicaid lien.

29. With regard to the instant case, Ms. Barnes made the following

argument in her Proposed Final Order:

21. Paym ent to AHCA of the full amount of past

medical charges of [$14,640.89] in this case of

limited recovery, runs afoul of Federal law and the

holdings of Gallardo and Giraldo . The evidence

demonstrates clearly that MedicaidÔs past medical

charges equate to ap proximately 4.9% (rounded up)

of the total conservative value of [Ms. BarnesÔ]

injuries of $300,000. However, AHCA is seeking

reimbursement of the full amount, which equates of

19.5% of the entire recovery made by [Ms. Barnes].

As such, in this case, the a pplication of the formula

contained in Florida Statute § 409.910(11)(f) would

result in a payment amount that is arbitrary and

that does not take into account the proportionality

required by applicable law. Payment of such

amount would amount to an overpay ment to AHCA

of the amount of settlement that was actually due

for past medical bills, and such overpayment would

be from funds due to [Ms. Barnes] as compensation

for other areas of her injury claim, including her

overwhelming future medical costs.

22. I n order to not run afoul of Federal law in this

case, it must be determined what portion of the

limited $75,000 recovery made by [Ms. Barnes] was

actually for the past medical expenses. The

evidence demonstrates clearly that MedicaidÔs past

medical charges equate to approximately 4.9%

(rounded up) of the total conservative value of [Ms.

BarnesÔ] injuries of $300,000. AHCA is thus

entitled to 4.9% of the amount of recovery actually

made of $75,000, which equate s to $3,675.00.

Notably, this amount of reimburs ement is

approximately 25% of AHCAÔs total reimbursement

claim, which is likewise consistent with

proportionality as the evidence has demonstrated

that [Ms. BarnesÔ s ] recovery of $75,000 was 25% of

the $300,000 conservative value of the claim.

23. Pursuan t to applicable law, AHCA is entitled to

reimbursement in the amount of $3,675.00 from

[Ms. BarnesÔ s ] personal injury settlement.

30. AHCA presented the following argument in its Proposed Final Order:

[Ms. Barnes] presented no testimonial evidence or

exhi bits to prove by any standard of evidence what

amount of the $75,000 settlement recovery should

be allocated as past medical expenses. While the

evidence may establish $350,000 or $300,000, or

even $500,000 as the value of Ms. BarnesÔ s

damages, this figure is useless without sufficient

evidence to provide a method for the allocation of

the settlement. [Ms. Barnes] merely argued in a

conclusory manner for a pro - rate methodology.

This diverges from the intent of the statute (Ñ[I]t is

the intent of the Legis lature that Medicaid be

repaid in full . . . from, and to the extent of, any

third - party benefits, regardless of whether a

recipient is made whole . . .Ò Section 409.910(1).)

and is wholly insufficient to prove that it is the

correct approach. ÑPrinciples of common law and

equity as to assignment, lien, and subrogation are

abrogated to the extent necessary to ensure full

recovery by Medicaid from third - party resources.Ò

Id.

31. As correctly noted by AHCA, neither Mr. Watson nor Mr. Ward

testified about wha t portion of Ms. BarnesÔ s $75,000.00 settlement amounts

to a recovery of her past medical expenses. Also, neither witness testified

about how one could calculate what portion of Ms. BarnesÔ s settlement

represents a recovery of past medical expenses. Instea d, Ms. BarnesÔ s

argument as to her recovery of past medical expenses is limited to a

computational argument set forth in her Proposed Final Order that is

unsupported by expert testimony opining that her computational argument is

a reasonable method by whic h to determine what portion of the $75,000.00

settlement amounts to a recovery of past medical expenses. 3 In that regard,

the outcome of the instant case is controlled by Gray v. Ag. for Health Care

Admin. , 288 So. 3d 95 (Fla. 1 st DCA 2019).

32. In Gray , a n ALJ ruled that AHCA was entitled to recover the full

amount of its Medicaid lien. The Gray appellant argued, in part, that the ALJ

erred by failing to use a pro rata formula to calculate AHCAÔs portion of the

recovery. In rejecting that argument, the Cou rt ruled as follows:

Gray argued that the $10,000 recovery represented

0.349% of the value of his $2.8 million verdict, so

AHCAÔs lien should be limited to 0.349% of the

3 Ms. BarnesÔ s argument differs from those of other petitioners who have predominantly

relied on expert testimony to justify a pr o rata reduction in AHCAÔs Medicaid lie n. The

detailed opinion in Eady v. State , 279 So. 3d 1249 (Fla. 1 st DCA 2019), describes how

petitioners typically argue for a pro rata reduction. The Eady petitioner called two attorneys

as witnesses, and both were accepted as experts in the valuation of damages. Id. at 1251. T he

first expert witness conservatively estimated the value of the petitionerÔs damages as being

at least $15,000,000. Id. at 1252. That witness then testified that the petitionerÔs $1,000,000

settlement represented approximately 6.66 percent of his total e stimated damages.

ÑApplying that same percentage differen ce to the $177,747.91

in past medical expenses claimed by AHCA, [the first witness]

testified that $11,838 would be a reasonable allocation of the

confidential settlement agreement for past medica l expenses .

In other words, the $11,838 represented a pro rata share of

the million dollar settlement.Ò Id. (emphasis added)

The second expert witness agreed that $15,000,000 was a conservative estimate of the

petitionerÔs total damages. Id. at 1253. The second expert witness also agreed that the

petitionerÔs $1,000,000 settlement represented a 6.66 percent recovery of his total damages.

Ñ[The second expert] also agreed that if [the petitioner]

recovered only 6.66% of the full value of his case, that s ame

percentage should be allocated to past medical expenses

recoverable by AHCA. Furthermore, he added that applying

that ratio was not only reasonable, but was common practice

in the legal proceedings with which he historically had been

associated. Again, [the second expert witness] approved of the

notion that applying a pro rata formula to the settlement

amount would result in $11,838 allocated to past medical

expenses.Ò Id.

Expert testimony of a similar nature was not provided in this case.

total amount Medicaid expended in medical

benefits ($65,615.054), which would equate t o

$229.49. AHCA argued that, under the statutory

formula, it was entitled to $3,750 from GrayÔs

recovery and that Gray failed to prove that AHCA

should be entitled to a lesser amount. Gray

conceded that no case law or other statute

authorized the ALJ to ap ply a pro rata formula

instead of the formula provided in the statute.

The ALJ found that Gray failed to show by clear

and convincing evidence that AHCA was entitled to

less than the presumptive amount under the

statute - $3,750. The ALJ found no evidence in the

record to show that Ñthe $10,000 recovery does not

include at least $3,750 that could be attributed to

[GrayÔs] medical costs. Neither does the evidence

indicate that the $3,750 amount includes payments

for expenses other than [GrayÔs] medical care and

services.Ò The ALJ ruled that AHCA was entitled to

$3,750 from the $10,000 recovery.

* * *

The evidence offered by Gray consisted of the

verdict form, the final judgment, and letters

providing the amount of the liens imposed by

FloridaÔs Medicaid P rogram, GeorgiaÔs Medicaid

Program, and FloridaÔs Brain and Spinal Cord

Injury Program. None of these records showed that

the $10,000 recovery was allocated in any way

between different categories of damages, costs, or

attorneyÔs fees. Gray could not show Ï even by a

preponderance of the evidence Ï that an amount

other than the total recovery of $10,000 should be

considered when applying the statutory formula to

determine the amount of the Medicaid lien. Thus,

the ALJ did not err in ruling that Gray failed to

meet his burden to show that the lien should be

reduced.

Even though he failed to produce evidence or

present testimony to meet his burden to show that

the lien amount should be reduced, Gray maintains

that the ALJ should have used a pro rata formula

to calculate AHCAÔs share of the tort recovery.

Gray acknowledges that nothing in the statute

authorizes the ALJ to use a pro rata formula to

calculate the lien amount. Rather, in situations

such as this case, when the plaintiff fails to produce

evidence o r present testimony showing that the lien

amount should be reduced, the plain language of

section 409.910(11)(f) requires the ALJ to apply the

statutory formula. The ALJ did exactly that here

and did not err in calculating the lien amount .

Gray , 288 So. 3 d 95. (emphasis added)

33. Like the appellant in Gray , Ms. Barnes failed to demonstrate by a

preponderance of the evidence that AHCAÔs Medicaid lien should be reduced.

There is no competent, substantial evidence on which the undersigned could

base a findin g that Ms. BarnesÔ s recovery of past medical expenses was, or

should be calculated to be, less than $14,640.00.

O RDER

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

hereby ,

ORDERED that the Agency for Health Care Administrat ion is entitled to

$14,640.00 from the third - party settlement at issue in this matter in

satisfaction of its Medicaid lien.

D ONE A ND ORDERED this 7 th day of April, 2020 , in Tallahassee, Leon

County, Florida.

S

G. W. C H ISENHALL

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 Adminis trative Hearings

this 7th day of April , 2020 .

C OPIES F URNISHED :

Scott C. Barnes, Esquire

Ward and Barnes, P.A.

222 West Cervantes Street

Pensacola, Florida 32501

(eServed)

Alexander R. Boler, Esquire

2073 Summit Lake Drive , Suite 300

Tallahassee, Flor ida 32317

(eServed)

Shena Grantham, Esquire

Agency for Health Care Administration

2727 Mahan Drive , Mail Stop 3

Tallahassee, Florida 32308

(eServed)

Austin Reeves Ward, Esquire

Ward and Barnes, P.A.

222 West Cervantes Street

Pensacola, Florida 32501

( eServed)

Mary C. Mayhew, Secretary

Agency for Health Care Administration

2727 Mahan Drive , Mail Stop 1

Tallahassee, Florida 32308

(eServed)

Stefan Grow, General Counsel

Agency for Health Care Administration

2727 Mahan Drive , Mail Stop 3

Tallahassee, Flor ida 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

Ta llahassee, Florida 32308

(eServed)

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

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

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

governed by the Florida Rule s 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 noti ce, accompanied

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

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

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