20-002124MTR Amy Lopez, Individually And As Parent And Natural Guardian Of A.F., A Minor vs. Agency For Health Care Administration Status: Closed DOAH Final Order on Thursday, September 3, 2020.

Summary: Petitioner proved by a preponderance of the evidence that Respondent should be reimbursed for its Medicaid lien in a lesser amount, per section 409.910(11)(f).

Medicaid lien against the proceeds pursuant to section 409.910, Florida

Statutes (2019). 1

P RELIMINARY S TATEMENT

On May 6, 2020, Amy Lopez, individually and as parent and natural

guardian of A.F., a minor ( Ms. Lopez or Petitioner) , filed a petition 2 at DOAH

pursuant to section 409.910(17)(b), for a determination of the amount payable

to AHCA in satisfaction of Respondent’s Medicaid lien against the proceeds of

a confidential settlement.

The case was assigned to the undersigned. Upon consul tation with the

parties, the hearing was scheduled for July 16, 2020, via Zoom technology

and was completed as planned.

On July 14, 2020, the parties filed a Joint Pre - hearing Stipulation in

which they stipulated to nine factual statements.

3 stipulations The parties’

are incorporated below, to the extent relevant.

At hearing, Ms. Lopez , as the mother of the minor child A.F. , testified, and

presented the testimony of three attorneys : Nathan Carter, Esquire ;

1 All citations will be to the 2019 edition of the Florida Statutes unless otherwise indicated.

2 On July 15, 2020, Ms. Lopez filed an “ Amended Petition to Determine Medicaid’s Lien

Am o unt to Satisfy Claim Against Per sonal Injury Recovery by the Agency For Health Care

Administratio n” (Amended Petition) to correct a mathematical error. At the start of the

hearing, the Amended Petition was presented and the Amended Petition was allowed.

3 At the beginning of the hearing , a correction to statement 8 on page 6 of the Joint Pre -

Hearing Stipulation was made , changing the initials of the individual named to “A.F., ” the

minor child of this action.

Troy Rafferty, Esquire ; and Kenneth McKenna, Esq uire. 4 Petitioner ’ s

Exhibits 1 through 8 were received into evidence without objection.

Respondent presented no witnesses. Respondent’s Exhibit 1 was received

in evidence over objection. 5

At the conclusion of the hearing, it was agreed that proposed f inal orders

(PFOs) would be due within ten days after the hearing transcript was filed. 6

The one - volume Transcript of the proceeding was filed on August 3, 2020. 7

The PFOs were timely filed. Each PFO has been considered in the preparation of this Final Ord er.

F INDINGS OF F ACT

Paragraphs 1 through 9 are the facts admitted 8 and agreed upon by the

parties, and required no proof at hearing.

1. On December 7, 2012, A.F., an eight - year - old female, underwent an

i nitial psychiatric evaluation. Following this asses sment, A.F. was sta rted on

treatment for Attention - Deficit/ Hyperactivity Disorder (ADHD) . A.F. was

4 Respondent’s Proposed F inal O rder provided that “Petitioner presented two wit nesses:

A ndrew Needle, Esq., and Kenneth Bush, Esq.” The undersigned did not hear any testimony

from Mr. Needle or Mr. Bush.

5 Respondent’s Exhibit 1, a “Provider Processing System Report , ” contained a different “Total

Claims” amount than the amount of A. F.’s medical expenses paid by AHCA to which the

parties stipulated . Without testimony this exhibit is hearsay, and cannot support a finding of

fact. As discussed at hearing, the parties agreed to use the stipulated amount: $261,334.61.

6 Although Petiti oner’s PFO recites that Petitioner “did not order a transcript of the

proceedings,” a review of the filed transcript shows otherwise. See Hearing Tran, pg . 10, line s

4 – 7 .

7 The Hearing Transcript was electronically filed with DOAH on August 3, 2020; the h ard –

copy original Transcript was filed with DOAH on August 14, 2020.

8 Statement 3 has been reworded for clarity purposes.

prescribed 18mg of the ADHD drug 9 that was the subject of the personal

injury litigation.

2. On March 30, 2013, at the age of nine, and shortly after her AD HD

medication was up titrated from 18mg to 27mg daily, A.F. attempted suicide

by way of hanging with a scarf fastened to her bunk bed. That action

detrimentally impeded oxygen flow to A.F.’s brain for a dangerously

prolonged period of time, resulting in ext ensive neurological damage and

substantial motor impairment; ultimately leaving A.F. in a permanent vegetative state.

3. Ms. Lopez , on behalf of A.F . , brought a product liability and medical

malpractice action to recover all of A.F.’s damages related to h er prescription

of the ADHD drug. This action was brought against various pharmaceutical

and medical malpractice defendants.

4. As a result of the alleged medical malpractice and pharmaceutical

product liability claims, A.F. suffered a massive hypoxic brai n injury. Since

this incident and the resulting hypoxic brain injury, A.F. has been in a

permanent vegetative state requiring 24/7 skilled nursing care.

5. In 2020, Ms. Lopez, on behalf of A.F. , settled her tort action for a

limited confidential amount, d ue to significant liability challenges with her

claims; even though she believed that A.F.’s injuries were tens of millions of

dollars in excess of the recovery.

6. AHCA was properly notified of A.F.’s lawsuit against the defendants

and indicated it had pa id benefits related to the injuries from the incident in

the amount of $261,334.61. AHCA has asserted a lien for the full amount it paid, $261,334.61, against A.F.’s settlement proceeds.

7. AHCA has maintained that it is entitled to application of section

409.910’s formula to determine the lien amount. Applying the statutory

9 The name of the drug is not being used based on the terms in the confidential settlement.

reduction formula to this particular settlement would result in no reduction

of the lien given the amount of the settlement.

8. AHCA paid $261,334.61 on behalf of A.F., related to her claim against

the liable third parties.

9. The parties stipulated that AHCA is limited by section 409.910(17)(b) to

the past medical expense portion of the recovery and that a preponderance of the evidence standard should be used in rendering this Final O rder.

10. There were two settlements regarding A.F.’s care and tr eatment: one

with the doctor(s) who alleg edly committed medical malpractice; and the

second involving the pharmaceutical maker of the ADHD drug prescribed to

A.F. Although AHCA was notified when the medical malpractice case was settled, AHCA did not file a lien on any of the recovery from the medical

malpractice settlement. Limited information about the medical malpractice

settlement was discussed, but the medical malpractice settlement is no t

considered in this Final Order.

11. Petitioner’s Exhibit 1 is a February 16, 2019, letter (lien letter) from

Conduent Payment Integrity Solutions, a

subcontractor to Health

Management Systems which is an authorized agent of AHCA “ to operate the

Florida Medicaid Casualty Recover Program.” In addition to directing A.F.’s

co unsel to review section 409.910 , to determine the “responsibilities to

Florida Medicaid,” Mark Lyles, Conduent’s case manager and author of this

letter also post ed the amount of the lie n asserted by AHCA: $261,334.61.

1 2 . A.F. lives with her mother, sister, grandmother, and Ms. Lopez’s

significant other. Everyone in the household can and does provide care and

assistance to A.F. when necessary. Ms. Lopez rarely leaves A.F. in someone

els e’s care.

1 3 . A.F. is unable to speak and requires total care. Ms. Lopez described

the injuries sustained by A.F. Ms. Lopez also detailed the care she has

provided and is continuing to provide to A.F. since the event. A.F . ’s activities

of daily living (AD Ls) must be met with assistance in every aspect of her

being. When A.F. wakes up each morning: she is given all her medications;

her diaper is changed; she is fed via a feeding tube; she is given lung

treatments each morning; her trachea tube is cleaned an d changed at times;

and she is turned or moved every two hours to prevent sores forming on her

skin. A.F. is on a ventilator at night and every four hours she is catheterize d

because she stopped urinating. In October 2019, A.F. started having seizures.

1 4 . Ms. Lopez testified that A.F.’s care is me ntally and emotionally

draining, and very tiring. She further added A.F.’s care is very repetitive and

the “best way to describe it [each day] is the movie G ROUNDHOG D AY ,”

(Columbia Pictures 1993); the same thing, every day.

1 5 . A.F. is confined to her hospital bed, a wheelchair , or a chai r to which

she can be secured. Although Ms. Lopez testified that A.F. is “ entitled ” to

skilled nursing care 24/7, Ms. Lopez has learned how to care for A.F. because

“they can’t s taff me” with a skilled nurse (presumably referring to a Medicaid

standard for care) .

1 6 . Mr. Rafferty is a Florida board - certified civil trial lawyer with

26 years’ experience in personal injury law. He concentrates and specializes

in pharmaceutical cases , including defective drug cases involving

catastrophic injury , throughout Florida and the United States . As part of his

ongoing practice, he routinely evaluates the damages suffered by injured

clients, and relies on his own experience and his review of ot her jury verdicts

to gauge any likely recovery for non - economic damages. Mr. Rafferty

continues to handle cases involving similar injuries suffered by A.F.

17 . Mr. Rafferty was tendered and without objection was accepted as an

expert regarding valuation o f personal injury damages.

18 . Mr. Rafferty, along with Nathan Carter as co - counsel, represented

A.F. and her mother in the civil litigation. He testified to the difficulties

associated with pharmaceutical litigation in general, and then focused on the

pro blematic causation and liability issues related to A.F. and her injuries.

19 . Mr. Rafferty met with the family; observed A.F. can no longer perform

her ADLs; reviewed all of A.F.’s medical information; evaluated how the

medication was up titrated causing A.F.’s injury; analyzed the causation,

liability issues , and fault; developed economic damages figures; and valued

non - economic damages. Mr. Rafferty credibly testified regarding the

evaluations he made regarding A.F.’s injuries and the pharmaceutical

prod uct prescribed. The non - economic damages included A.F . ’s pain and

suffering , both future and past, her loss of capacity to enjoy life, and her

mental anguish. Mr. Rafferty explained the importance of assessing all of the

elements of damages A.F. suffered a s a result of her catastrophic injuries.

20 . Mr. Rafferty’s unrefuted testimony placed the total full value of A.F.’s

damages conservatively in excess of $100,000,000.00. 10 Mr. Rafferty included

A.F.’s pain and suffering, mental anguish , and loss of quality of li fe, plus the

economic damages. Further, using the $100,000,000.00 valuation amount and

the confidential settlement proceeds, Mr. Rafferty opined that A.F. recovered

only 4.75% of the full measure of all her damages. Mr. Rafferty reviewed

Petitioner’s Exhibit 1, and as an experienced trial attorney understood the

letter to contain the “lien for past medical” expenses of $261,334.61.

Mr. Rafferty added that he routinely uses this type of approach with lien

holders in his practice. Mr. Rafferty’s testimo ny was uncontradicted and

persuasive on this point.

21 . Mr. Carter is an AV - rated Florida civil trial lawyer with 25 years’

experience in personal injury law , with an active civil trial practice. He has

always handled plaintiff’s medical malpractice, pro duct liability , and car

accident - type litigation. As a routine part of his practice, he makes

assessments concerning the value of damages suffered by injured clients,

including the liability, causation, and possible damages. Mr. Carter

10 For ease of discussion, the conservat ive total amount , $100,000, 0 00.00 will be used. All the

witnesses agreed that the economic value of the case was a bove $70 million and the non -

economic damages were at least $30 million.

confirmed that it is essential to have every element (liability, causation , and

damages) evaluated because these types of cases are exp ensive in both time

and money. Mr. Carter specifically looks at the injuries sustained , who the

plaintiff is , how the injuries have affected their life , and the permanency of

those injuries. He continues to handles cases with catastrophic injuries.

Mr. Carter testified that the injuries suffered by A.F. were “worse than

almost, almost any case … handled.” He added that A.F.’s damages were

“cata strophic” and “one of the worst damage cases [he had] ever seen.”

22 . Mr. Carter was tendered and without objection was accepted as an

expert regarding valuation of medical malpractice damages. 11 Mr. Carter

testified that “as a matter of course, [we] put ev ery lienholder on notice as

soon as we learn about them” and “then throughout the case.” Mr. Carter was

in regular contact with Mr . Lyles . The medical malpractice case was settled

before the pharmaceutical action. After the medical malpractice case was

set tled , Mr. Carter understood that AHCA would not negotiate on the

medical malpractice settlement . When the “entire case” was completed,

Mr. Carter notified Mr. Lyles, and then received the lien letter. A s an

experienced trial attorney he understood the lett er to contain the “ final lien

figure:” $261,334.61.

23 . Mr. Carter also met with the family, reviewed all of A.F.’s medical

information and records, and evaluated the medication that was up titrated.

Mr. Carter utilized a similar detailed analysis of A.F.’ s injuries and her

current condition. Mr. Carter also described the severity of A.F.’s injuries

that entered into his decision to pursue the civil case and to testify in this proceeding. Mr. Carter analyzed the causation, liability issues , and fault . He

ev aluated the economic damages figures and valued non - economic damages

11 Mr. Carter was offered as an expert in med ical malpractice damages . His insight in the

combined totality of the medical malpractice and pharmaceutical product litigation

warranted consideration , but AHCA’s failure to include the medical malpractice settlement

precluded any consideration of that settlement . Without a more decisive understanding of

what “pretty significant” means, ACHA’s attempt to question Mr. Carter’s knowledge of

A.F.’s past medical expenses is unpersuasive.

such as pain and suffering , both future and past, loss of capacity to enjoy life,

scarring and disfigurement , and mental anguish.

24 . Mr. Carter opined A.F.’s damages could have easily b een in excess of

$100,000,000.00. Mr. Carter further opined that A.F.’s non - economic

damages were “very significant” and “could have driven the total value of

damages in excess of the $100,000,000.00.” However, Mr. Carter testified he

used $100,000,000.00 in order to resolve the Medicaid lien. Mr. Carter used

the same mathematical approach he has used in other lien issues: he divided

the confidential settlement amount by the conservative full value of damages

($100,000,000.00) and arrived at a recovery of 4 .75% of th e full measure of

her damages. Mr. Carter’s testimony was uncontradicted and persuasive on

this point.

25 . Mr. McKenna is a board - certified, AV - rated Florida civil trial lawyer

with 25 years’ experience in personal injury law , who maintains an active

civil trial practice. He has always practiced plaintiff’s work, and has tried

between 40 and 50 cases to verdict. In the last 15 years, Mr. McKenna

testified that “at least half … focused on catastrophic cases either from the

medical malpractice a rena or from gene ral liability trucking arena.”

Mr. McKenna has reviewed thousands of personal injury cases relative to

damages, and provided a detailed explanation of how he evaluates damages

of catastrophic injury cases. He further provided that half of his cases were

wrongful death cases and the other half were physical or brain injury cases.

Mr. McKenna also provided the various resources he uses to keep abreast of

personal injury verdicts and settlements.

26 . Mr. McKenna was tendered as “an indepe ndent expert attorney as to

valuation of damages.” Mr. McKenna was not involved in the underlying civil

litigation, but became A.F.’s guardian ad litem, appointed by the trial judge,

to offer his “opinions regarding the reasonableness of the potential medi cal

malpractice settlement, and ... the pharmaceutical settlement” which is the

subject of this Final Order. Respondent did not object to Mr. McKenna’s

tender and he was accepted as an expert in the valuation of damages.

27 . Mr. McKenna testified that he r eviewed the facts and circumstances of

both the medical malpractice and the pharmaceutical sides and the

chronologies of A.F.’s medical records . He acquired an “intimate

understanding” of A.F’s on going care and treatment in light of the injuries

she susta ined. Mr. McKenna agreed with Messrs. Rafferty and Carter that

the non - economic damages in this case were very significant, and he agreed

with their conservative $100,000,000.00 valuation of her total damages.

28. Further, Mr. McKenna testified that the n ormal course for resolving

liens in Florida was to look at the total value of damages in relation to the

recovery to get a ratio by which to reduce the lien amount. Based on his past

experiences in resolving Medicaid liens, other courts have resolved such liens

using the formula from the Arkansas Departmen t of Health & Hum an

Serv ice s. v. Ahlborn , 547 U.S. 268 (2006), with the only other alternative

formula found in section 409.910.

2 9 . The testimony of Petitioner ’ s three experts regarding the total value o f

damages was credible, unimpeached, and unrebutted. Petitioner proved that

the confidential settlement does not fully compensate A.F. for the full value of

her damages.

30 . As testified to by the experts, A.F. ’ s recovery represents only 4.75% of

the total value of her claim.

3 1 . AHCA did not call any witnesses, present any evidence as to the value

of damages, or propose a different valuation of the damages. In short,

Petitioner ’ s evidence was unrebutted . AHCA did, however, contest the

methodology used to calculate the allocation of past medical expenses , but

was unpersuasive.

3 2 . The parties stipulated to the value of the services provided by Florida

Medicaid as $261,334.61. It is logical and rational to conclude that this figure

is the amount expended fo r A.F.’s past medical expenses.

3 3 . Applying the 4.75% pro rat a ratio to $261,334.61 equals $12,413.39,

which is the portion of the settlement representing reimbursement for past

medical expenses and the amount recoverable by AHCA for its lien.

Petitioner proved by a preponderance of the evidence as set forth in section

409.910(11)(f) that AHCA should be reimbursed at the lesser amount:

$12,413.39.

C ONCLUSIONS OF L AW

3 4 . DOAH has jurisdiction over the subject matter and the parties in this

case, and final order authority pursuant to sections 120.569, 120.57(1), and

409.910(17)(b), Fl orida Stat utes . The parties acknowledged that Petitioner’s

standard of proof in this proceeding is a preponderance of the evidence.

3 5 . AHCA is the state agency authorized to ad minist er Florida’s Medicaid

program. § 409.902, Fla. Stat.

3 6 . The Medicaid program “provide[s] federal financial assistance to

States that choose to reimburse certain costs of medical treatment for needy persons.” Harris v. McRae , 448 U.S. 297, 301 (1980) . Though participation is

optional, once a State elects to participate in the Medicaid program, it must

comply with federal requirements governing the same. Id.

3 7 . As a condition for receipt of federal Medicaid funds, states are

required to seek reimbur sement for medical expenses incurred on behalf of

beneficiaries who later recover from third - party tortfeasors. Ark ansas , 547 at

276.

3 8 . The Florida Legislature has enacted section 409.910, which authorizes

and requires the State to be reimbursed for Me dicaid funds paid for a

recipient’s medical care when that recipient later receives a personal injury judgment or settlement from a third party . Smith v. Ag. for Health Care

Admin. , 24 So. 3d 590 (Fla. 5th DCA 2009).

3 9 . The Florida Supreme Court has deter mined that the state’s recovery of

certain portions of settlement funds received by a Medicaid recipient to be the

amount in a personal injury settlement fairly allocable to pa s t medical

expenses. Giraldo v Ag. for Health Care Admin. , 248 So. 3d 53, 56 (Fl a.

2018). 12

40 . Section 409.910(6) provides in pertinent part:

When the agency provides, pays for, or becomes

liable for medical care under the Medicaid

program, it has the following rights, as to which the agency may assert independent principles of law, w hich shall nevertheless be construed together to

provide the greatest recovery from third - party

benefits:

* * *

(c) The agency is entitled to, and has, an

automatic lien for the full amount of medical assistance provided by Medicaid to or on beha lf of

the recipient for medical care furnished as a result of any covered injury or illness for which a third party is or may be liable, upon the collateral, as

defined in s. 409.901.

4 1 . AHCA ’ s recovery is limited to those proceeds allocable to past medi cal

expenses. Respondent’s argument that the past medical expenses have not

been established is disingenuous as the parties stipulated that AHCA’s lien

was for a specific amount: $261,334.61. That Respondent would not seek all

that it claims to be entitled to is novel, and unfounded. By its own choice,

AHCA choose not to file a lien on the medical malpractice settlement, and

cannot now claim the asserted lien amount is incorrect.

12 The Eleventh Circuit Court of Appeals determined that amounts in a settlement

agreement fairly allocable to both past and future medical expenses are subject to the

agency's lien. Gallardo v Dudek , 963 F 3d 1167 (11th C.A. 2020) . T his is contrary to the

Florida Supreme Court's holding in Giraldo . Generally, state courts are not required to

follow th e decisions of intermediate federal appellate courts on questions of federal law. As a

result, the undersigned has limited her inquiry to that portion of A.F.'s settlement allocable to past medical expenses.

4 2 . Section 409.910(11)(f) provides:

Notwithstanding any provision in this s ection 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 distrib uted 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 shall be paid to the agency

up to the total amount of medical assistance

provided by Medicaid.

2. The remai ning amount of the recovery shall be

paid to the recipient.

3. For purposes of calculating the agency’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 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 Medic aid. For purposes of this paragraph, “medical coverage”

means any benefits under health insurance, 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’

compensation, personal injury protection, and

casualty.

4 3 . Section 409.910(11)(f) provides a presumptive formula for AHCA’s

recovery for a Medicaid lien as one - half of the total award, after deducting

attorney’s fees of 25% o f the recovery and all taxable costs, up to, not to

exceed the total amount actually paid by Medicaid on the recipient’s behalf.

See Ag. f or Health Care Admin. v. Riley , 119 So. 3d 514, 515, n.3 (Fla. 2d

DCA 2013).

4 4 . Pursuant to the formula, the amount p ayable to AHCA is $261,334.61,

as the parties stipulated.

4 5 . The administrative procedure created by section 409.910(17)(b)

provides a means by which a Medicaid recipient may contest the amount

designated a s recovered Medicaid expenses. Section 409.910(17 )(b) , provides

in pertinent part:

If federal law limits the agency to reimbursement

from the recovered medical expense damages, a recipient, 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 date of

payment of funds to the agency or after the date of placing the full amount of the third - party benefits

in the tru st 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 amount of

the third - p arty 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 i s 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 po rtion 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 convinci ng

evidence that Medicaid provided a lesser amount of

medical assistance than that asserted by the

agency.

4 6 . Where uncontradicted testimony is presented, there must be a

“ reasonable basis in the record ” to reject it. Giraldo , 248 So. 3d at 56. Here,

the testimony was clear, concise, credible, and uncontradicted: there is no

reasonable basis to reject that testimony.

4 7 . In the instant case, the past medical expenses are $261,334.61.

48 . Ms. Lopez proved by a preponderance of the evidence that the

settlem ent proceeds represented only 4.75 % of the claim valued

conservatively at $100,000,000.00. Therefore, it is concluded that AHCA ’ s full

Medicaid lien amount should be reduced by the percentage that Ms. Lopez ’ s

recovery represents of the total value of Ms. L opez ’ s claim.

4 9 . The application of the 4.75 % ratio to the total past medical expenses of

$261,334.61 results in $12,413.39. This amount represents that share of the

settlement proceeds fairly and proportionately attributable to expenditures

that were act ually paid by AHCA for A.F. ’ s past medical expenses.

O RDER

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

hereby ORDERED that the Agency for Health Care Administration is entitled

to $12,413.39 in satisfaction of its Medicaid lien .

D ONE A ND O RDERED this 3rd day of September , 2020 , in Tallahassee, Leon

County, Florida.

L YNNE A. Q UIMBY - P ENNOCK

Administrative Law Judge

Division of Administrative Hearings

The DeSoto Building

1230 Apalachee Parkwa y

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 3rd day of September , 2020 .

C OPIES F URNISHED :

Alexander R. Boler, Esquire

2073 Summit L ake Drive , Suite 330

Tallahassee, Florida 32317

(eServed)

Shena L. Grantham, Esquire

Agency for Health Care Administration

2727 Mahan Drive , Building 3 , Room 3407B

Tallahassee, Florida 32308

(eServed)

Jason Dean Lazarus, Esquire

Special Needs Law Firm

2420 South Lakemont Avenue , Suite 160

Orlando, Florida 32814

(eServed)

Richard J. Shoop, Agency Clerk

Agency for Health Care Administration

2727 Mahan Drive, Mail Stop 3

Tallahassee, Florida 32308

(eServed)

Mary C. Mayhew, Secretary

Agency for Health C are Administration

2727 Mahan Drive, Mail Stop 1

Tallahassee, Florida 32308

( eServed)

Stefen Grow, General Counsel

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 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, Florid a 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 o f

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 d istrict c ourt of

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

or where a party resid es or as otherwise provided by law.