HEALTH OPTIONS v. AGENCY FOR HEALTH CARE

Nos. 1D03-3751, 1D03-3763, 1D03-3766, 1D03-3769, 1D03-3770, 1D03-3771, 1D03-3773, & 1D03-3774.

889 So.2d 849 (2005)

HEALTH OPTIONS, INC., Appellant, v. AGENCY FOR HEALTH CARE ADMINISTRATION and Baycare Health System, Inc., Appellees.

District Court of Appeal of Florida, First District.

Rehearing Denied January 4, 2005.


Attorney(s) appearing for the Case

John Radey and Donna E. Blanton of Radey, Thomas, Yon & Clark, P.A., Tallahassee; Richard L. Shackelford and James W. Boswell of King & Spalding LLP, Atlanta, GA, for Appellant.

Gregory J. Philo, Chief Appellate Counsel, Tallahassee, for Appellee Agency for Health Care Administration.

H. Jack Klingensmith of Walters, Levine, Brown, Klingensmith & Thomison, P.A., Sarasota, for Appellee BayCare Health System, Inc.

George N. Meros, Jr. and Carlos G. Muniz of Gray Robinson, P.A., Tallahassee, for Amici Curiae Florida Association of Health Plans and American Association of Health Plans — Health Insurance Association of America.

Diane D. Tremor and Steven T. Mindlin of Rose, Sundstrom & Bentley, LLP, Tallahassee, for Amici Curiae Florida Hospital Association and Florida Academy of Health Care Attorneys.


ERVIN, J.

In these consolidated appeals, Health Care Options, Inc.,1 a health maintenance organization, challenges eight final orders of the Agency for Health Care Administration (agency or AHCA), which adopted the recommendations of the fact-finder, Maximus, Inc., an independent third-party claim-dispute-resolution entity, selected by AHCA to review claim disputes between health providers and managed care organizations pursuant to the...

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