05-1578 LOWER FL. KEYS V. BEACON HEALTH

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State: Florida

Court: Florida Third District Court

Docket No: 05-1578 LOWER FL. KEYS V. BEACON HEALTH

Case Date: 12/27/2006

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IN THE DISTRICT COURT OF APPEAL OF FLORIDA THIRD DISTRICT JULY TERM, A.D. 2006

LOWER FLORIDA KEYS HEALTH SYSTEMS, INC. and KEY WEST HMA, INC., Appellant, vs. BEACON HEALTH PLANS, INC., Appellee.

** ** ** ** ** ** LOWER TRIBUNAL NO. 00-376 CASE NO. 3D05-1578

Opinion filed December 27, 2006. An Appeal from the Circuit Court for Monroe County, Mark H. Jones, Judge. Morgan & Hendrick Goldsmith, for appellant. and James T. Hendrick; Steven M.

Steven M. Ziegler and Bradley M. Seldin and Kenneth E. White and Dorothy Wallace, for appellee.

Before COPE, C.J., and GREEN, J., and SCHWARTZ, Senior Judge. COPE, C.J. This is an appeal from a declaratory judgment regarding the terms of a settlement agreement. We affirm.

Appellants

are

Lower

Florida

Keys

Health

Systems,

Inc.

("LFKHS") and Key West HMA, Inc. ("HMA").

LFKHS operated the

Lower Florida Keys Hospital until April 30, 1999 when HMA took over operation pursuant to a contract between LFKHS and HMA. 1 Appellee Beacon Health Plans, ("HMO") Inc. the ("Beacon") members of is a Health were

Maintenance

Organization

which

provided services by the hospital from 1997 until July 1999. During LFKHS' operation of the hospital, LFKHS and Beacon had ongoing disputes about payment for services rendered and LFKHS eventually claimed that Beacon owed it several hundred thousand dollars. In early 1999 LFKHS was preparing to hand over operation of the hospital to HMA and sought to settle its outstanding claims with Beacon prior to transfer. Both parties agree that a

settlement was reached and that Beacon paid $583,993.18. dispute other terms of the settlement agreement.

They

LFKHS claims

that the terms of the settlement agreement were reflected in an April 1, 1999 letter from LFKHS to Beacon. the terms were set forth in an April Beacon claims that 19, 1999 Settlement

Agreement and Release signed by LFKHS. After a non-jury trial, the court found that there had been an oral settlement agreement. The trial court agreed with

Beacon's version of the settlement.
1

LFKHS and HMA appeal.

The hospital building and land are owned by other entities. 2

Appellants argue that the trial court erred in not finding that the April 1 letter and payment resulted in an enforceable agreement and in finding the April 19 release enforceable. cannot agree. We

While the evidence regarding the settlement was

sharply disputed, the trial court's findings are supported by competent substantial evidence. As we are not at liberty to

reweigh that evidence, we must affirm on this point. See Stevens v. Cricket Club Condominium, Inc., 784 So.2d 517, 518-19 (Fla. 3d DCA 2001)(finding that an appellate court's function is not to reweigh the evidence, but to determine if the record contains competent substantial evidence to support the conclusions of the trier of fact, and that the trial court's findings are presumed correct); Raulerson v. Metzger, 375 So.2d 576 (Fla. 5th DCA

1979)(if there exists any substantial competent evidence on the record, the findings of fact must stand and the judgment entered thereon must be affirmed). Appellants also argue that the trial court erred on the issue of set-off. The trial court found that in exchange for

Beacon's payment of $583,993.18, LFKHS released Beacon from any claims for services LFKHS rendered on or before April 1, 1999. However, the evidence showed that after the settlement, LFKHS and its successor HMA submitted a significant number of claims with service dates on or before April 1, 1999, and Beacon

3

erroneously paid them.

The sum of $139,000 was paid in error to

LFKHS and $300,000 to HMA for a total of $439,000. Upon realizing the error, Beacon set off the total sum of $439,000 against invoices which had been submitted by HMA for services rendered after April 1. June and July, 1999. Appellants argue that the setoffs violated subsection These setoffs occurred in May,

641.3155(4), Florida Statutes (1999).

We do not agree.

The statute states in relevant part: (4) Any retroactive reductions of payments or demands for refund of previous overpayments which are due to retroactive review of coverage decisions or payment levels must be reconciled to specific claims unless the parties agree to other reconciliation methods and terms. . . .

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