Agency for Health Care Administration v. South Broward Hospital District
Agency for Health Care Administration v. South Broward Hospital District
Opinion of the Court
The Agency for Health Care Administration (“AHCA”) petitions this Court to review a non-final order of the administrative law judge (“ALJ”) granting Respondents’ motions to unseal files relevant to two Medicaid provider overpayment complaints filed against them by AHCA and rejecting AHCA’s argument that the files should remain sealed under section 409.913(12), Florida Statutes (2015).
“ ‘The scope of review
From a practical standpoint, this standard requires the petition to dearly reflect how the potential “harm is incurable” by a final appeal. Bared & Co., Inc, v. McGuire, 670 So.2d 153,157 (Fla. 4th DCA 1996). Without this critical component, we lack “the power to exercise discretion” either to grant or withhold review of the non-final order. Id.
Here, AHCA has failed to allege how the order caused it material injury that cannot be remedied on a final appeal. Because there is no prima facie showing of irreparable harm, AHCA is not entitled to our evaluation of the non-final agency order. See Robles v. Baptist Health S. Fla., Inc., 197 So.3d 1196, 1199 (Fla. 3d DCA 2016); Nucci v. Target Corp., 162 So.3d 146, 151 (Fla. 4th DCA 2015) (“If a petition fails to make a threshold showing of irreparable harm, this Court will dismiss the petition.”) (citation omitted); Royal Marble, Inc. v. Innovative Flooring & Stonecrafters of SWF, Inc., 932 So.2d 221, 222 (Fla. 2d DCA 2005) (“Because Royal Marble has failed to allege irreparable harm, we dismiss the petition”).
Therefore, the petition for review of non-final agency action is DISMISSED.
. Section 409.913(12) provides in pertinent part as follows: "The complaint and all information obtained pursuant to an investigation of a Medicaid provider ... relating to an allegation of fraud, abuse, or neglect are confidential and exempt from the provisions of s. 119.07(1) ....’’ Section 119.07(1), Florida Statutes, appears in Florida’s Public Records Act. See §§ 119.01-.15, Fla. Stat.
. See § 120.68(1), Fla. Stat.; Fla. R. App. P. 9.030(b)(1)(C), 9.100(c)(3) & 9.190(b)(2); State, Dep’t of Fin, Servs. v. Fugett, 946 So.2d 80, 81 (Fla. 1st DCA 2006).
. Final hearing transcripts, for example, typically cannot be viewed from the online docket on DOAH’s website even though it is well-settled that the transcripts are public records that must be made available for public inspection—and copying, after payment of duplicating costs—upon request to the DOAH clerk (while the case is pending at DOAH) or the agency clerk (after the record has been transmitted to the agency). See Dep't of Health & Rehab. Servs. v. Southpointe Pharmacy, 636 So.2d 1377, 1382-83 (Fla. 1st DCA 1994).
Concurring Opinion
concurring.
I agree that AHCA has not alleged or established “irreparable harm.” But, even if it had done so, I would deny the petition for review because the challenged order does not depart from the essential requirements of law.
The underlying cases at the Division of Administrative Hearings (DOAH) are run-of-the-mill Medicaid program integrity (MPI) overpayment cases—not abuse cases as AHCA contends
DOAH’s case files are, without question, public records because DOAH is a state agency and the case files are comprised of documents prepared by DOAH (e.g., notices and orders issued by the ALJ) and received by DOAH (e.g., agency referrals, motions and other papers filed by the parties, exhibits and other evidence presented at the final hearing) in the course of official proceedings undér Chapter 120, Florida Statutes, or another law. See § 119.011(12), Fla. Stat. (defining “public records” to include documents and other material “made or received pursuant to law ... in connection with the transaction of official business by any agency”). Accordingly, DOAH’s case files must be open to the public for inspection and copying, unless there is a specific statute exempting the file from public disclosure. See §§ 119.01(1), 119.07(1), Fla. Stat.; Wait v. Fla. Power & Light Co., 372 So.2d 420, 425 (Fla. 1979) (explaining that the Public Records Law exempts from public disclosure “only those public records that are provided by statutory law to be confidential or which are expressly exempted by general or special law”).'
It is the prerogative of the Legislature, not DOAH or the referring agency, to determine which, if any, DOAH case files are entirely exempt from public disclosure. The Legislature has exempted the entire case file from public disclosure in certain types of DOAH cases, see, ~ e.g., § 1003.57(l)(c), Fla. Stat. (requiring hearings in special education cases to be conducted by DOAH ALJs and providing that “[a]ny records created as a result of such hearings are confidential and exempt from s. 119.07(1)”), but there is no such blanket public records exemption for' MPI case files at DOAH.
Section 409.913(12), by its clear and unambiguous language, exempts from public disclosure only (1) the complaint against a Medicaid provider relating to an allegation of fraud, abuse or neglect, and (2) all information' obtained pursuant to AHCA’s investigation of such a complaint.
Although it may be more expedient to seal the entire DOAH case file in an MPI case, the Public Records Law does not allow the entire file to be shielded from the public simply because it might be cumbersome to seal or redact only the exempt portions of the file. Instead, the Public Records Law contemplates precisely what is mandáted by the Initial Order entered
With these additional observations, I concur in the majority opinion.
. On this point, the ALJ cogently explained:
AHCA contends that it alleged in the final audit reports [FARs] that Respondents had engaged in "Medicaid billing 'abuse' as defined in” section 409.913(l)(a), which states in relevant part, that:
"Abuse” means:
1. Provider practices that are inconsistent with generally accepted business or medical practices and that result in an unnecessary cost to the Medicaid program or in reimbursement for goods or services that are not medically necessary or that fail to meet professionally recognized standards for health care.
(Emphasis added). AHCA does not argue that it has accused either Respondent of committing fraud or acts involving neglect. The undersigned has studied the respective [FARs] and can find no factual allegations against either Respondent which, if proved, would support a determination that one Respondent or the other engaged in "[p]ro-
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Absent allegation of fact which would establish that provider practices inconsistent with generally accepted business or medical practices had been engaged in, there can be no disputed issues of fact involving "abuse” as that term is defined in section 409.913(l)(a). Without legally sufficient allegations of such abuse, there is no basis to seal the file of DOAH pursuant to section 409.913(12)—at least not where, as here, there are admittedly no allegations of fraud or neglect.
. Counsel for AHCA asserted at oral argument that AHCA only asked DOAH to seal the FARs, but that argument was not made below (or in AHCA’s filings in this court) and it is refuted by the letters through which AHCA referred these cases to DOAH. Each of the letters asserted that the FAR "related to [Medicaid] program abuse” (even though it did not) and cited section 409.913(12) for the proposition that "the FAR, and all information obtained pursuant to the complaint or the investigation resulting in the FAR” are confidential and exempt from the Public Records Law. However, each letter also went on to state: "Thus, [AHCA] requests that DOAH seal this case.” (Emphasis added).
. The exemption expires when certain events occur, including when AHCA "takes final agency action with respect to the provider.” § 409.913(12)(a), Fla. Stat. Although that has not yet occurred in these cases, it is noteworthy that the online docket on DOAH’s website reflects that there are numerous closed MPI cases—including Case No. 14-5306MPI, which was purportedly unsealed by the ALJ in that case—that still contain a notation that the case "is not available online based on statute, rule, or court order” (emphasis’added) even though it appears that a final order has been entered in the case. It is unknown whether these cases were sealed based on section 409.913(12) or some other statute, and it is also unknown whether these DOAH case files can be viewed "offline” upon request.
Case-law data current through December 31, 2025. Source: CourtListener bulk data.