Resolution 2012-186 RESOLUTION NO. 2012 -1 8 6
A RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA, CONFIRMING ITS ACCEPTANCE OF
THE SETTLEMENT OPTION SET FORTH IN PARAGRAPH 3 OF THE
AMENDED STIPULATION PROVIDING FOR DISMISSAL OF SOME
PARTIES AND ABATEMENT OF CASE FOR REMAINING PARTIES
FILED IN ALACHUA COUNTY, FLORIDA, ET AL. V. ELIZABETH
DUDEK, ET AL.; CASE NO.: 2012-CA-1328, SECOND JUDICIAL
CIRCUIT, LEON COUNTY, FLORIDA.
WHEREAS, since 1972, the State of Florida has utilized billing and payment
mechanisms to charge its counties a percentage of the costs for certain services provided to
county residents through Florida's Medicaid Program; and
WHEREAS, inaccuracies attributed to an electronic billing system implemented by the
Agency for Health Care Administration have caused a backlog in billings resulting in a shortfall
in the State's General Revenue Fund; and
WHEREAS, in 2012, the Florida Legislature passed and the Governor signed HB 5301
(now Chapter 2012-33, Laws of Florida) to collect past disputed bills through an automatic
garnishment of the county revenue sharing and half-cent sales tax distributions; and
WHEREAS, Collier County, through its Board of County Commissioners (Board),
joined numerous fellow counties and the Florida Association of Counties as a plaintiff in
litigation challenging the constitutionality of Chapter 2012-33, Laws of Florida; and
WHEREAS, on July 24, 2012, during a public hearing, the Board accepted Staff s
recommendation to elect not to dispute the State's certified amount of Collier County's unpaid
Medicaid backlog; accept a 15% reduction of this certified amount; make an early payment
toward the backlog amount in FY 2012; and spread the remaining balance over the next five (5)
fiscal years; and
WHEREAS, this election is formalized as "The Settlement Option" in an Amended
Stipulation signed by Counsel for the Plaintiffs and the State dated September 20, 2012; and
WHEREAS, the Amended Stipulation requires formal acceptance by the Board of
County Commissioners; and
WHEREAS, the Board has formally considered the Amended Stipulation Providing for
Dismissal of Some Parties and Abatement of Case for Remaining Parties and desires to withdraw
from this litigation pursuant to the Settlement Option set forth in Paragraph 3 therein.
1
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that it has elected to take the
Settlement Option provided in Paragraph 3 of the Amended Stipulation Providing for Dismissal
of Some Parties and Abatement of Case for Remaining Parties, filed in Alachua County, Florida
et al v. Elizabeth Dudek, et al; Case No.: 2012-CA-1328, Second Judicial Circuit, Leon County,
Florida, a copy of which is attached hereto and made a part hereof.
THIS RESOLUTION ADOPTED after motion, second and majority vote favoring
same, this 9th day of October, 2012.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT t:LB4 OCK, CLERK COLLIER COUNTY, FLORIDA
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IN THE CIRCUIT COURT OF THE SECOND JUDICIAL CIRCUIT
IN AND FOR LEON COUNTY, FLORIDA
ALACHUA COUNTY, FLORIDA;
ET AL,
Plaintiffs, Case No.: 2012-CA-1328
vs.
ELIZABETH DUDEK, in her official capacity as
SECRETARY of the STATE OF FLORIDA, AGENCY
FOR HEALTH CARE ADMINISTRATION; and
LISA VICKERS, in her official capacity as
EXECUTIVE DIRECTOR of the STATE OF
FLORIDA, DEPARTMENT OF REVENUE,
Defendants.
AMENDED STIPULATION PROVIDING FOR DISMISSAL OF SOME
PARTIES AND ABATEMENT OF CASE FOR REMAINING PARTIES
This Amended Stipulation Providing for Dismissal of some Parties and Abatement of
Case for Remaining Parties is entered into between Plaintiffs ALACHUA COUNTY, FLORIDA;
BAY COUNTY, FLORIDA; BREVARD COUNTY, FLORIDA; BRADFORD COUNTY,
FLORIDA; CHARLOTTE COUNTY, FLORIDA; CITRUS COUNTY, FLORIDA; CLAY
COUNTY, FLORIDA; COLLIER COUNTY, FLORIDA; DIXIE COUNTY, FLORIDA; DUVAL
COUNTY, FLORIDA; ESCAMBIA COUNTY, FLORIDA; FLAGLER COUNTY, FLORIDA;
FRANKLIN COUNTY, FLORIDA; GADSDEN COUNTY, FLORIDA; GILCHRIST COUNTY,
FLORIDA; GULF COUNTY, FLORIDA; HAMILTON COUNTY, FLORIDA; HARDEE
COUNTY, FLORIDA; HENDRY COUNTY, FLORIDA; HERNANDO COUNTY, FLORIDA;
HIGHLANDS COUNTY, FLORIDA; HILLSBOROUGH COUNTY, FLORIDA; INDIAN RIVER
Page 1 of 15
COUNTY, FLORIDA; LEE COUNTY, FLORIDA; LEON COUNTY, FLORIDA; LEVY COUNTY,
FLORIDA; LIBERTY COUNTY, FLORIDA; MADISON COUNTY, FLORIDA; MANATEE
COUNTY, FLORIDA; MARION COUNTY, FLORIDA; MARTIN COUNTY, FLORIDA;MIAMI-
DADE COUNTY, FLORIDA; MONROE COUNTY, FLORIDA; NASSAU COUNTY, FLORIDA;
OKALOOSA COUNTY, FLORIDA; OKEECHOBEE COUNTY, FLORIDA; OSCEOLA
COUNTY, FLORIDA; PASCO COUNTY, FLORIDA; PINELLAS COUNTY, FLORIDA; POLK
COUNTY, FLORIDA; PUTNAM COUNTY, FLORIDA; SARASOTA COUNTY, FLORIDA;
SEMINOLE COUNTY, FLORIDA; SUWANNEE COUNTY, FLORIDA; TAYLOR COUNTY,
FLORIDA; VOLUSIA COUNTY, FLORIDA; and WAKULLA COUNTY, FLORIDA (hereafter
the "Counties") and the FLORIDA ASSOCIATION OF COUNTIES(hereafter the "Association")
and the Defendants, ELIZABETH DUDEK in her official capacity as Secretary of the State of
Florida Agency for Health Care Administration (hereafter the "Agency") and MARSHALL
STRANBURG in his official capacity as Interim Executive Director(in place of former Executive
Director, LISA VICKERS) of the State of Florida Department of Revenue (hereafter the
"Department"), collectively Plaintiffs and Defendants are hereafter the "Parties."
WITNESSETH:
WHEREAS, Plaintiffs have filed a Complaint against Defendants challenging the
constitutionality of certain legislation (i.e., HB 5301), which was adopted by the House and
Senate in the 2012 Legislative Session and signed into law by the Governor on March 29, 2012.
HB 5301 is now known as Chapter 2012-33, Laws of Florida. Section 12 of Chapter 2012-33
amends section 409.915, Florida Statutes, which relates to county contributions to Medicaid.
Page 2 of 15
WHEREAS, Section 12 of Chapter 2012-33 (hereafter, "Section 12") amends section
409.915, Florida Statutes, as it previously existed to include':
a. Section 12 requires the Agency to certify to each county the amount of
such county's unpaid billings from November 1, 2001, through April 30, 2012 (the "Prior
Unpaid Amounts").
b. Section 12 provides that Counties may challenge the Prior Unpaid
Amounts in an administrative process under chapter 120, Florida Statutes. Counties that
do not challenge the Prior Unpaid Amounts shall pay only 85% of that county's Prior
Unpaid Amounts. Counties that prove by a preponderance of the evidence that the
Prior Unpaid Amounts were incorrect will be entitled to a credit on future payments.
c. Section 12 implements a "collection enforcement mechanism" in order to
require Counties to pay for the Prior Unpaid Amounts. Over a five year period
beginning October, 2012, the Department will deduct from each county's monthly
distribution pursuant to section 218.26, Florida Statutes (the "County Revenue Sharing
Funds"), that county's portion of the Prior Unpaid Amounts as certified by the Agency.
The Department must leave sufficient County Revenue Sharing Funds to service
outstanding debt secured by such funds.
d. Section 12 provides that, beginning May 7, 2012 and continuing on the
7th day of each month thereafter, the Agency will certify the Counties' monthly share of
Medicaid reimbursement ("Future Billings") and thereafter the Department will deduct
The Parties stipulate and agree that the provisions of the Section 409.915, Florida Statutes, as amended by Section
12, speak for themselves, and that the following descriptions thereof are merely a summary of the pertinent
provisions rather than a binding agreement as to the Parties' interpretation of the meaning of that statutory section.
Page 3 of 15
Half Cent Sales Tax Funds from each County's distribution pursuant to section 218.61,
Florida Statutes. Section 12 further provides, however, that the Department must leave
sufficient Half Cent Sales Tax Funds to service outstanding debt secured by such funds.
e. Section 12 provides that Counties may contest Future Billings by
requesting a refund under a process to be determined by the Agency, the Department,
and FAC - which process is currently under rule development by the Agency. If the
Agency determines the refund request is appropriate, the Department may refund the
amount to the county from the General Revenue Fund or issue the refund in the form of
a credit against the Future Billings which process is currently under development by the
Agency.
WHEREAS, Plaintiffs have concern with the following circumstances, provisions or
practices among others:
a. Section 12 requires monthly payment of prior unpaid amounts from each
County's monthly distribution pursuant to § 218.26, Florida Statutes, of the Counties'
revenue sharing monies rather than from a revenue source of each County's choosing.
b. Section 12 requires monthly future billings to be paid from the Counties'
distribution pursuant to § 218.61, Florida Statutes of the shared Half Cent Sales Tax
Funds rather than from a revenue source of each County's choosing.
WHEREAS, the Complaint filed by Plaintiffs includes three (3) counts. The first and
second counts assert challenges pursuant to Article VII, section 18(a) and (c), Florida
Constitution, for violation of the unfunded mandate provisions. The third count asserts that
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unpaid claims extending from 2001 - 2008 are time barred pursuant to §§95.11(3)(f) and (p) and
95.11(6), Florida Statutes(2011).
WHEREAS, the Parties have worked together to identify and correct billing system
errors.
WHEREAS, the Counties have had unprecedented access to Agency staff for
collaboration in seeking solutions.
WHEREAS, the Parties, are creating a Joint Work Group comprised of representatives
from the Agency and the Association (on behalf of the Counties) to raise, address and solve
ongoing concerns and problems, that will meet on a regularly scheduled basis.
WHEREAS, to facilitate the orderly payment of these claims, the Agency has authorized
the Counties to make a one time prepayment in whole or in part, to reduce or avoid the burden
of revenue share withholding.
WHEREAS, in order to administer these claims, the Agency has permitted counties to
dispute Prior Unpaid Amounts (sometimes referred to as 'Backlog" claims) based upon Agency
policies in effect at the time each claim was originally disputed.
WHEREAS, working in conjunction with the Counties, the Agency has created and
implemented an Advanced Refund Request (ARR) process, allowing a prepayment dispute
process on claims, and extending that process through April 2013.
WHEREAS, working in conjunction with the Counties, the Agency has created and
implemented a Back End Refund Request (BERR) process, including the allowance of filing
BERRs on the denied ARRs, and thus allowing a prepayment dispute process on these claims as
well, with finality and appeal rights.
Page 5 of 15
WHEREAS, the Agency, working in conjunction with the Counties, has provided for
direct monthly payments on prospective bills in order to allow Counties to choose to avoid
revenue share withholdings.
WHEREAS, the Florida Department of Children and Families ("DCF"), working in
conjunction with the Agency and the Counties has permitted the Counties unprecedented
access to the DCF Medicaid eligible recipient address database.
WHEREAS, the Agency working in conjunction with the Counties, has provided for a 60
day County review cycle, and a date certain for receipt of monthly statements on the second
business day of the month, as well as a process of tracking payments, refunds, and credits on a
monthly basis.
WHEREAS, the Agency working in conjunction with the Counties, has created detailed
time frames for responses and dispute resolution methods to avoid such backlogs from ever
happening again.
WHEREAS, the Agency working in conjunction with the Counties, has worked to
enhance the fairness of the collection system by: 1) providing a $0 certification for the first
month that HB 5301 was to be implemented, on May 7, 2012; 2) allowing for direct monthly
payments on prospective bills to allow Counties to choose to avoid Half Cent Sales Tax
withholding; 3) authorizing a one-time prepayment in whole or in part, by 11:59 p.m., Eastern
Standard Time, on September 13, 2012 to allow Counties to choose to reduce or avoid the
burden of revenue share withholding; and 4) has provided preliminary backlog statements in
advance of the August 1, 2012 statutory certification date in order to facilitate the review and
resolution of these disputed claims.
Page 6 of 15
WHEREAS, the Counties, working in conjunction with the Agency and in order to show
their willingness to pay their fair share of the State's Medicaid payment, have paid those
amounts which are accurate, and due and owing during the pendency of this litigation.
WHEREAS, the Agency has begun the rule making process as required by Section 12
and has been working cooperatively with the Counties and the Association in an effort to
address many of the Counties' concerns regarding how the collection process will be
administered in the future and how the monthly payments for prior and future billings might
be made directly to the Agency from revenue sources of the county's choice rather than
providing for certification and automatic deduction by the Department from county revenue
sources shared with the State.
WHEREAS, the Parties recognize that the Chapter 120 process has been legislatively
sanctioned as the forum for disputes relating to the backlog amounts under HB 5301, and no
abridgement of any rights to make such challenges is contemplated by this Stipulated
Settlement and Dismissal.
WHEREAS, the Parties recognize that the Department's role is primarily ministerial and
the Department does not have a role in disputing Medicaid billings unless there is an issue of
the protection of existing bond commitments required under HB 5301.
WHEREAS, the Parties by entering into this stipulation recognize that the circumstances
of the Counties on an individual basis may differ substantially; i.e., some Counties may be
willing to accept the 15% discount available to Counties that do not challenge the Agency's
certification, some Counties may want to bring an action under Chapter 120 challenging the
prior unpaid amount that the Agency has certified including the right to assert a claim for what
Page 7 of 15
the Counties perceive to be stale or time barred. Some Counties will be willing to dismiss their
claims and some, though not prepared to dismiss their claims at this time are willing to agree to
an abatement to facilitate further resolution of this matter, for an undefined period, but no later
than December 31, 2012.
NOW THEREFORE, in consideration of the mutual promises set forth herein and other
valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties
agree as follows:
1. The above recitals are true and correct and by this reference are incorporated
herein.
2. Those Counties and Association under this stipulation may choose between one
of the two options (i.e., a SETTLEMENT OPTION or an ABATEMENT OPTION) set forth in
paragraphs 3 and 4 below.
3. The SETTLEMENT OPTION is for Counties (or the Association) that intend to
withdraw from this litigation. This includes both Counties that do not intend to challenge the
Prior Unpaid Amounts and Counties that do intend to challenge the Prior Unpaid Amounts
under Chapter 120 Florida Statutes. As to these Counties the Complaint will be deemed to be
dismissed with prejudice as to Counts I and II and without prejudice as to Count III. As to
these Counties, the Agency, as provided in paragraph 7 below, will accept periodic direct
payment of such County's Prior Unpaid Amount. The Agency acknowledges that a county
which enters into this Agreement does not thereby waive the right to assert any valid
affirmative defense it would otherwise have been able to assert in an administrative proceeding
pursuant to Section 409.915(7)(a), Florida Statutes. Counties choosing the SETTLEMENT
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OPTION must provide notification of this choice to the Agency by sending a scanned copy of a
signed and verified stipulation form (the "Stipulation Form") attached hereto as Exhibit 6 by
email and U.S. Mail to the Agency's General Counsel (with a copy to the Association) which is
emailed and post marked no later than September 12, 2012. An initial list of those Counties (or
Association) choosing the SETTLEMENT OPTION is set forth in Exhibit 2.
4. The ABATEMENT OPTION is for Counties (or the Association) that intend to
remain in this litigation. These Counties (including the Association) together with the Agency
and the Department agree that this litigation will be held in abeyance by mutual agreement to
facilitate further resolution of this matter for an undefined period but no later than December
31, 2012. This abatement is to the litigation only, and all provisions and deadlines of HB 5301
continue to take effect as set forth therein. The Parties acknowledge that the abatement applies
only to the litigation and does not abate or otherwise affect the requirements imposed on the
Parties by statute. Provided that nothing in this Stipulation shall prevent an abating county
from individually dismissing the Complaint without prejudice and re-filing an action on its
own behalf. An initial list of those parties choosing the ABATEMENT OPTION is set forth in
Exhibit 3.
5. The Agency further agrees that any County (whether agreeing to settle or not)
filing a Chapter 120 challenge of the Prior Unpaid Amount will be offered the opportunity to
abate those proceedings to facilitate further resolution of the matter for a period not less than 90
days, which period may be extended upon the mutual agreement of the parties to such
proceeding.
Page 9 of 15
6. The Parties agree that Exhibits 2 and 3 of the Stipulation can be amended by the
Association to add to Exhibit 2 the names of additional Counties choosing to settle and delete
from Exhibit 3 the names of those Counties choosing to settle by filing such information in an
addendum no later than September 16, 2012 at 5:00 p.m. (Eastern/Standard Time).
7. The Parties recognize that section 409.915(8), Florida Statutes, as amended by
Section 12, provides for the payment of each county's Prior Unpaid Amount by the automatic
deduction by the Department(over a sixty (60) month, or longer, time period) of each County's
revenue sharing distribution. The Parties further recognize that the calculation and amount of
each County's monthly deduction can be obtained from the Agency. As an accommodation to
those Counties choosing THE SETTLEMENT OPTION that would like to avoid the automatic
deduction of their revenue sharing distribution and that would like to make payments from a
revenue source of their choosing, the Agency and Department agree that such Counties shall
make periodic advance payments(in monthly, quarterly or greater increments or to be specified
at the time the county enters into a payment plan with the Agency) to the Agency on or before
October 5th by 11:59 p.m., (Eastern/Standard Time) and on or before the fifth day of each month
thereafter by 11:59 p.m. (Eastern/Standard Time) from a revenue source of the County's
choosing (unless an advance payment has already been submitted for that month). Once the
Agency enters into a payment plan with a county, the Agency shall notify the Department of
the details of the payment plan. If the incremental payment is not received by 11:59 p.m. of the
date payment is required, the Agency shall notify the Department and the Department shall
deduct that month's payment from that County's revenue sharing distribution. As set forth in
paragraph 8 below, it is further agreed that a county's ability to continue to make the advance
Page 10 of 15
payments provided in this paragraph shall be lost if the county fails to make a timely advance
payment to the agency.
8. The Parties agree that if a County's incremental payment is not timely received
by the Agency pursuant to paragraph 7, supra, that such County shall be in material and
irreparable breach of this Agreement. As a consequence of that breach the Agency shall, within
two (2) business days, amend its prior certification to the Department pursuant to section
409.915 (7), Florida Statutes, to include all amounts remaining unpaid by that County at the
time of the breach. The Department shall act upon the Agency's amended certification in
accordance with section 409.915 (8), Florida Statutes, by thereafter reducing the breaching
County's distributions pursuant to that subsection, prospectively, from the time of the Agency's
amended certification. The Counties hereby waive their right to administratively challenge the
Agency's determination as to whether a payment has been timely received pursuant to this
paragraph and paragraph 7,supra.
9. The Agency agrees to include the provisions of Composite Exhibit 4 in its
proposed rules and further to move forward and work with the Counties and the Association in
good faith with the proposed rules that are presently being considered for adoption. The
Parties acknowledge that the Agency's draft rule attached hereto as Composite Exhibit 4 is
presently in the administrative rulemaking process pursuant to Section 120.54, Florida Statutes,
and that the draft rule will not become final until that process, including any administrative
challenges that may be brought under Chapter 120, Florida Statutes, is successfully completed.
The Parties agree that, should the rule or any other aspect of this settlement be successfully
['age 11 of 15
challenged under Chapter 120, Florida Statutes, and be ruled invalid, it shall not constitute a
breach by the Agency of this agreement or of any order entered that adopts this agreement.
10. The Parties agree that if any provision of this agreement is ruled by a judicial or
administrative tribunal to be illegal, unenforceable, or void, then the Parties shall be relieved of
their respective obligations arising under such provision, and the validity of the remainder of
the agreement shall not be affected.
11. The Parties agree that in the interest of fairness the SETTLEMENT OPTION set
forth in paragraph 3 above shall also be available to Counties that have not joined as Plaintiffs
in this action, (the "Non-Plaintiff Counties") where any such County provides to the Agency by
email and U.S. Mail to the Agency's General Counsel (with a copy to the Association), which is
emailed and postmarked no later than September 12, 2012, a notice and waiver of such
Counties' ability to pursue an action in Circuit Court challenging HB 5301 on the basis of an
alleged violation of the unfunded mandate provisions of Art. VII, Sec. 18, Florida Constitution
in substantially the form of the notice and waiver attached hereto as Exhibit 5. The Association
shall provide a copy by email of this Stipulation to the County Attorney of all Non-Plaintiff
Counties.
12. The Agency is willing to accept a tentative notice of acceptance of the settlement
option (the "Tentative Notice of Acceptance") from those counties (both Plaintiff Counties and
Non-Plaintiff Counties) that have not had an opportunity to make a formal determination of
which option to accept. The Tentative Notice of Acceptance must be provided by the Chairman
of the Board of County Commissioners or a member of such County's Senior Staff by September
12, 2012. The Tentative Notice of Acceptance must be accompanied by evidence that the Board
Page 12 of 15
of County Commissioners will be formally considering the County's options no later than
October 12, 2012, at 11:59 p.m. (Eastern/Standard Time) and shall be substantially the form
attached hereto as Exhibit 1. Notice of the subsequent formal action of the Board of County
Commissioners approving the settlement option ("Notice of Approval") must be provided by
sending a scanned copy of a signed and verified Stipulation as provided in Exhibit 6 by email
and U.S. Mail to the Agency's General Counsel (with a copy to the Association) and to the
Department's Office of General Counsel no later than October 13, 2012 at 5:00 p.m.
(Eastern/Standard Time). If a properly executed Notice of Approval which evidences that
County's formal approval of the settlement option is not timely received by the Agency
pursuant to this paragraph, that event shall constitute a material and irreparable breach of this
Agreement. As a consequence of that breach the Agency shall, within two (2) business days,
amend its prior certification to the Department pursuant to section 409.915 (7), Florida Statutes,
to include all amounts remaining unpaid by that County at the time of the breach. The
Department shall act upon the Agency's amended certification in accordance with section
409.915 (8), Florida Statutes, by thereafter reducing the breaching County's distributions
pursuant to that subsection, prospectively, from the time of the Agency's amended certification.
The Counties hereby waive their right to administratively challenge the Agency's determination
as to whether a payment has been timely received pursuant to this paragraph
13. The Parties hereby agree that the signing of this Stipulation by any of them does
not constitute an admission of any liability or wrongdoing whatsoever. Rather, the Parties have
entered into this Stipulation in a desire to amicably compromise their differences and avoid
protracted litigation, by dismissal and abatement.
Page 13 of 15
14. This Stipulation shall not be construed against any one party, but shall be
construed as if it were prepared jointly by all of them, and any uncertainty or ambiguity, or
both, shall not be interpreted against any party.
15. The Parties agree that each shall pay their own attorney's fees and costs incurred
in connection with this litigation.
16. The Parties recognize that St. Lucie County and St. Johns County are separately
represented in this matter, and are not bound by the terms and conditions of this document or
any prior stipulation.
17. The Parties acknowledge that Broward County is not a party to this Stipulation
and is not bound by the terms and conditions of this document or any prior stipulation.
DATED this 2, •hclay of September, 2012.
�
s H. Churuti 9-17 D 2
' ph C.Mellichamp, I
Fla. ar No. 284076 Timothy E.Dennis
jr, Thomas B. Drage,Jr. Assistant Attorney General
Fla.Bar No. 173070 Office of the Attorney General
Bryant Miller Olive,P.A. Revenue Litigation Bureau
One Tampa City Center,Suite 2700 PL-01,The Capitol
Tampa, FL 33602 Tallahassee, Florida 32399-1050
(813) 273-6677 Facsimile: 850-488-5865
(813) 223-2705 (fax)
schuruti@bmolaw.com
and
Page 14 of 15
Virginia Saunders Delegal
Fla. Bar No. 989932
General Counsel
Florida Association of Counties
100 S. Monroe Street
Tallahassee, FL 32301
(850)922-4300
(850)488-7192(fax)
gdelegal@fl-Counties.com
i
Stuart Williams, General Counsel
Bill Roberts, Deputy General Counsel
State of Florida, Agency for Healthcare
Administration
2727 Mahan Drive, Mail Stop #3
Tallahassee, Florida 32308
Facsimile: 850-921-0158
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that on September 20, 2012,a copy of the foregoing was furnished
via PDF email upon the following counsel of record:
Stuart Williams, General Counsel Joseph C.Mellichamp, III
Bill Roberts, Deputy General Counsel Timothy E. Dennis
State of Florida, Agency for Healthcare Assistant Attorney General
Administration Office of the Attorney General
2727 Mahan Drive, Mail Stop #3 Revenue Litigation Bureau
Tallahassee, Florida 32308 PL-01 The Capitol
Facsimile: 850-921-0158 Tallahassee, FL 32399-1050
Stuart.williams @acha.myflorida.com toe.mellichamp@myfloridalegal.com
Page 15 of 15
Gregory Stewart, Esq.
Nabors Giblin & Nickerson
PO Box 11008
Tallahassee, FL 32302
gstewartcs'ngn-tally.com
•/ I/ ., u,/ ,k
Tho tr B. Drage,Jr. ,
FAN Z
Page 16 of 15
EXHIBIT 1
, 2012
Stuart Williams, Esquire Joseph C. Mellichamp, III, Esquire
General Counsel Chief Assistant Attorney General
State of Florida Agency for Florida Office of the Attorney General
Healthcare Administration Revenue Litigation Bureau
2727 Mahan Drive, Mail Stop #3 400 S. Monroe Street, # PL-01
Tallahassee, Florida 32308 Tallahassee, Florida 32399
Email: stuart.williams @ahca.myflorida.com Email: joe.mellichamp @myfloridalegal.com
Re: Tentative Notice of Acceptance
Dear Mr. Williams&Mr.Mellichamp:
The purpose of this letter is to advise the Agency for Healthcare Administration (the
"Agency") and the Florida Department of Revenue (the "Department") that I ] County
(the "County") intends to provide Tentative Notice of Acceptance that the County has elected to
accept the Settlement Option as provided in paragraph 3 of Stipulation Providing for
Dismissal of Some Parties and Abatement of Case for Remaining Parties (the "Stipulation")
entered into in the case of Alachua County;et al. vs. Elizabeth Dudek, et al., Case No. 2012-CA-1328
in the Circuit Court for the Second Judicial Circuit in and for Leon County, Florida (the
"Lawsuit").
Although, the County intends to settle the Lawsuit, the Board of County Commissioners
has not had the opportunity to formally consider the matter. Please accept this as the County's
Tentative Notice of Acceptance of the Settlement Option. Attached I have provided evidence
indicating that the County will formally consider the Settlement Option no latter than October
12, 2012 at 11:59 p.m. (Eastern/Standard Time).
[Senior Staff/County Administrator/
Manager/Deputy County Administrator/
County Attorney]
cc: Ginger Delegal, General Counsel
Florida Association of Counties
EXHIBIT 1
EXHIBIT 2
List of Counties Choosing the Settlement Option:
Brevard County, Florida
Charlotte County, Florida
Collier County, Florida
Duval County, Florida
Gilchrist County, Florida
Gulf County, Florida
Hamilton County,Florida
Hardee County, Florida
Hendry County, Florida
Highlands County, Florida
Indian River County, Florida
Manatee County,Florida
Monroe County, Florida
Osceola County, Florida
Polk County, Florida
Sarasota County,Florida
Suwannee County, Florida
Taylor County, Florida
EXHIBIT 2
EXHIBIT 3
List of Counties Choosing to Abate:
Alachua County, Florida
Bay County, Florida
Bradford County, Florida
Citrus County, Florida
Clay County, Florida
Dixie County, Florida
Escambia County, Florida
Nagler County, Florida
Franklin County, Florida
Gadsden County, Florida
Hernando County, Florida
Hillsborough County, Florida
Lee County, Florida
Leon County, Florida
Levy County, Florida
Liberty County, Florida
Madison County, Florida
Marion County, Florida
Martin County, Florida
Miami-Dade County, Florida
Nassau County, Florida
Okaloosa County, Florida
Okeechobee County, Florida
Pasco County, Florida
Pinellas County, Florida
Putnam County, Florida
Seminole County, Florida
Volusia County, Florida
Wakulla County, Florida
EXHIBIT 3
COMPOSITE EXHIBIT 4
Notice of Change/Withdrawal
AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid
RULE NO.: RULE TITLE:
59G-1.025: Medicaid County Billing
NOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in
accordance with subparagraph 120.54(3)(d)1., F.S.,published in Vol. 38 No.26, June 29, 2012
• issue of the Florida Administrative Weekly.
The following changes have been made to the proposed rule.
THE FULL TEXT OF THE PROPOSED RULE IS:
59G-1.025 Medicaid County Billing.
(1) Retrospective Bills. This paragraph applies to the certification of county billings from
November 1, 2001, through April 30, 2012, that remain unpaid, as provided in section
409.915(7), F.S.
(a) By August 1, 2012, the Agency will certify to each county the amount that is unpaid for
retrospective bills.
(b) By September 1, 2012, a county may contest the amount certified by filing a petition
under the applicable provisions of chapter 120.This procedure is the exclusive method to
challenge the amount certified.
(c) September 13, 2012, 5:00 p.m. Eastern Standard Time, each county may make total or
partial payment in the form of a check or wire transfer to the Agency of the amount certified by
the Agency pursuant to subsection (1)(a).
(d) By September 15, 2012, the Agency will certify to the Department of Revenue:
COMPOSITE EXHIBIT 4
Page 1 of 7
1. 100 percent of the amount provided in subsection (1)(a)minus amounts credited to the
counties and/or amounts paid and received by the Agency pursuant to subsection (1)(c) for each
county that challenges the certified amount by filing a petition pursuant to subsection (1)Cb)by
September 1, 2012.
2. 85 percent of the amount provided in subsection (1)(a) minus amounts credited to the
counties and/or paid and received by the Agency pursuant to section (1)(c)for each county that
does not challenge the certified amount by filing a petition pursuant to subsection (1)(b)by
September 1, 2012.
(2) Prospective Bills. This paragraph applies to the monthly amount of each county's
contribution to Medicaid as required in section 409.915, F.S. The monthly bills will be rendered
to the counties no later than the second business day of the month.
(a) Certification
1. For all certifications prior to June 1,2013, the Agency will certify to the Department of
Revenue by the 7th day of each month the amount of the monthly bill rendered one month prior
less any amounts as provided in subsections(2)(b) and (2)(c).
2. For the June, 2013 certification, the Agency will certify to the Department of Revenue the
amount of the monthly bills rendered in May, 2013 and June, 2013 less any amounts credited to
a county pursuant to subsection (2)(b).
3. Beginning July 1, 2013, the Agency will certify to the Department of Revenue by the 70' day
of each month the amount of the monthly bill rendered that month less any amounts as
provided in subsection (2)(b).
COMPOSITE EXHIBIT 4
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4. If the 7th day of the month falls on a weekend or holiday, certification will be completed on
the first business day following the 7th day of the month.
5.If the Department of Revenue determines there are insufficient funds to pay a county's
monthly certified amount, the Department will notify the Agency of the amount still owed, and
the Agency will send an invoice to the affected county within two months of receiving the
Department's notice. The county shall pay the invoice within 60 days of receipt. The balance
on any invoice that remains unpaid after 60 days will be re-certified to the Department of
Revenue in subsequent months until paid in full.
(b) Payments
Each county may choose to submit payment in the form of a check or wire transfer to the
Agency. Such payment must be received by 5:00 p.m. Eastern Standard Time two business days
prior to the date of certification.
(c) Refund Requests
1. Advanced-Refund Request
a. No later than the last business day of each billing month, each county may request an
advanced refund request through the county billing portal for those claims on the same
monthly billing that the county disputes. If the request is less than or equal to the amount of the
county's highest monthly dispute rate reasonable, the Agency will stay certification of the
amount requested in the for-the advanced refund request.
b. Refund requests resulting in certification amounts stayed will be researched within 60
days by the Agency.
COMPOSITE EXHIBIT 4
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I. Denied refund requests will be certified to the county on a subsequent bill no later than 45
days from the completion of Agency research.
II. Bills for which a refund request is granted on the basis that the bill should have been
submitted to a different county will be transferred and certified to the appropriate county on a
subsequent bill no later than 45 days from the completion of Agency research.
c. A county does not waive any right to paragraph (c)2., Back End Refund Request, by
making an advanced refund request.
d. Except for cub paragraph 1.b,, subsection paragraph 1.sShall expire on April 30, 2013.
2. Back End Refund Request
a. Each county may request a back end refund request noNe later than 60 days from the date
of certification of the monthly bill for which the back end refund request is being requested the
refuftd-Fequest.
b. Back end refund requests must be in writing and must include the reason and
documentation for the request, . _ _ - - - - - - - _, • _. _ ..
•
c. Within 960 days of receipt of the certification west, the Agency will notify the county
whether the request is granted, either in part or in whole. If any portion of the request is
denied, the agency will provide information as to the reasons for the denial. If any portion of
the refund request is granted, the refund will be in the form of a credit notification to the
Department of Revenue, or a credit applied to a subsequent bill, within 60 days of the Agency's
decision. Approved refunds that should have been billed to a different county, will be
COMPOSITE EXHIBIT 4
Page 4 of 7
transferred to the appropriate county on a subsequent bill, within 60 days of the Agency's
decision.
(d) Receipts
1. The Agency will provide each county a monthly receipt of amounts billed, amounts paid
and amounts certified to the Department of Revenue.
2.The Agency will provide each county a monthly receipt of action taken on Advance
Refund Requests.
Actions taken include:
a. ARR Denied-Advance Refund Request Denied and the claim will appear on a subsequent
bill with a status of ARR Denied;
b. ARR Transferred Out-Advance Refund Request Transferred Out and the claim will be
transferred to a different county than the county requesting Advanced Refund;
eft
3.The-Aged-williar-ovidc eaeh-eetutnty-a--w ten-reeeipt-approv-i-n -e -
&A-Reba-Rd-Request:.
dRe€und Requests--will--be-Fred•ited--tea-fttturc hu h
b-[3enied Rad( Enti--Refund-4Req • . -- • )r denial
Rulemaking Authority 409.919 FS. Law Implemented 409.915 FS. History-New
COMPOSITE EXHIBIT 4
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Notice of Change/Withdrawal
AGENCY FOR HEALTH CARE ADMINISTRATION
Medicaid
RULE NO.: RULE TITLE:
59G-1.020: Definition of County of Residence
NOTICE OF CHANGE
Notice is hereby given that the following changes have been made to the proposed rule in
accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 38 No. 26,June 29, 2012
issue of the Florida Administrative Weekly.
The following changes have been made to the proposed rule.
THE FULL TEXT OF THE PROPOSED RULE IS:
59G-1.020 Definition of County of Residence.
For the purpose of county financial participation in the Medicaid Program, the county of
residence for inpatient hospital care and nursing home care is determined by the recipient's
address information contained in the federally approved Medicaid eligibility system.
(1) For hospital claims, whether through fee-for-service or managed care, the address is
based on the
current living or residential address, with the exception of when the resident lives in a nursing
home. When an recipient individual al lives in a nursing home, the address is based on the prior
address.
(2) For nursing home claims, whether through fee-for-service or managed care, the address
is based on the prior address, except when an-recipient in-d-Md-ul is admitted to a nursing
home directly from a place of residence outside of the State of Florida. If the recipient
individual is admitted to a nursing home from another state, the nursing home address will be
used for county billing purposes.
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(3) Since address information for children in custody of the Department of Children and
Families is unavailable, counties are not responsible for these payments.
. - - _ - .. . - - • . - edieel•(2) Wes,hen--aft-applicant -- .. - - . - --
-•- - •- • - - • Re F ind-a-resider efhas-been-estabfished--Ehe
•
lee-Med,
deeisien-is-net-possible-en- ' . , - . .i the-Of fi.€ f—Sok a-a4
•
Rulemaking Authority 409.919 FS. Law Implemented 409.915 FS. History-New 1-1-77, Formerly
IOC-7.31, IOC-7.031,Amended
COMPOSITE EXHIBIT 4
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EXHIBIT 5
, 2012
Stuart Williams, Esquire Joseph C. Mellichamp, III, Esquire
General Counsel Chief Assistant Attorney General
State of Florida Agency for Florida Office of the Attorney General
Healthcare Administration Revenue Litigation Bureau
2727 Mahan Drive, Mail Stop #3 400 S. Monroe Street, #PL-01
Tallahassee, Florida 32308 Tallahassee, Florida 32399
Email: stuart.williams @ahca.myflorida.com Email: joe.mellichamp @myfloridalegal.com
Re: Notification and Waiver by Non-Plaintiff County
Dear Mr. Williams& Mr. Mellichamp:
The purpose of this letter is to provide notification to the Agency for Healthcare
Administration (the "Agency") and the Florida Department of Revenue(the "Department") that
1 County (the "County") intends to take advantage of those provisions available to a
"non-plaintiff county" as set forth in paragraphs 3, 7 and 10 of that Stipulation Providing for
Dismissal of Some Parties and Abatement of Case for Remaining Parties (the "Stipulation")
entered into in the case of Alachua County;et al. vs. Elizabeth Dudek, et al., Case No. 2012-CA-1328
in the Circuit Court for the Second Judicial Circuit in and for Leon County, Florida (the
"Lawsuit").
As you may know the County did not join in the Lawsuit and has not otherwise filed a
challenge to that certain legislation (i.e., HB 5301) which was passed in the 2012 Legislative
Session and signed into law by the Governor on March 29, 2012.
The County's Board of County Commissioners has authorized me [as Chairman of the
Board of County Commissioners or County Administrator/Manager or County Attorney] to
provide this notification and to provide a limited waiver of the right of the County individually
or in concert with others to make a Circuit Court challenge of HB 5301 on the basis of an alleged
violation of the Unfunded Mandate Provision of Art. VII, Sec. 18, Florida Constitution. This
notification and waiver is not in any way deemed to affect the ability of the County to challenge
the amount of prior unpaid Medicaid billings in a Chapter 120 proceeding (as provided by
existing law). Further, the County is not waiving the ability to assert in such 120 challenge or a
subsequent Circuit Court Challenge any defenses which it might have, including defenses
related to the statute of limitations, laches and equitable estoppel.
cc: Ginger Delegal, General Counsel
Florida Association of Counties
EXHIBIT 5
EXHIBIT 6
, 2012
Stuart Williams, Esquire Joseph C.Mellichamp, III, Esquire
General Counsel Chief Assistant Attorney General
State of Florida Agency for Florida Office of the Attorney General
Healthcare Administration Revenue Litigation Bureau
2727 Mahan Drive, Mail Stop #3 400 S. Monroe Street, #PL-01
Tallahassee, Florida 32308 Tallahassee, Florida 32399
Email: stuart.williams@ahca.myflorida.com Email: joe.mellichamp @myfloridalegal.com
Re: Verified Stipulation
Dear Mr. Williams&Mr.Mellichamp:
The purpose of this letter is to verify that [_ ] County (the "County")has elected to
take the Settlement Option provided in paragraph 3 of the Stipulation Providing for Dismissal
of Same Parties and Abatement of Case for Remaining Parties filed in Alachua County, Florida
et al v. Elizabeth Dudek et al; Case No.: 2012-CA-1328 in the Circuit Court of the Second Judicial.
Circuit in and for Leon County, Florida. The County's election to take this option was made by
[Resolution, Motion or Delegation to the County Attorney].
[If by Resolution or Motion, attach verified copies to letter, if possible.]
[If by Delegation to County Attorney, indicate that the Board of County Commissioners
has provided parameters for settlement of this case and has authorized the undersigned to settle
on behalf of the County.]
cc: Ginger Delegal, General Counsel
Florida Association of Counties
EXHIBIT 6