L v. v. Sunshine State Health Plan, Inc.

• Court: District Court of Appeal of Florida
• Decided: April 30, 2025
• Docket: 3D2024-1389
• Status: Published

Opinion

Third District Court of Appeal State of Florida

Opinion filed April 30, 2025. Not final until disposition of timely filed motion for rehearing.

________________

No. 3D24-1389 Lower Tribunal No. 24-FH1970 ________________

L.V., Appellant,

vs.

Sunshine State Health Plan, Inc., Appellee.

An Administrative Appeal from the State of Florida, Agency for Health Care Administration, Office of Fair Hearings.

L.V., in proper person.

Hogan Lovells US LLP, and Craig H. Smith, for appellee.

Before SCALES, GORDO and BOKOR, JJ.

PER CURIAM. L.V., as designated representative on the behalf of A.V., a Medicaid

recipient under a plan administered by Sunshine State Health Plan, Inc.

(“Sunshine Health”), appeals a final administrative order of the Agency for

Health Care Administration (the “Agency”) dismissing L.V.’s request for a

Medicaid Fair Hearing. Because the Agency received L.V.’s request 183

days after Sunshine Health denied L.V.’s appeal and issued a Notice of Plan

Appeal Resolution (“NPAR”), along with information regarding L.V.’s right to

request a fair hearing, and L.V.’s initial brief fails to identify any specific error

below, we affirm the challenged order. See Fla. Admin. Code R. 59G-

1.100(8)(g) (“A fair hearing request by an enrollee must be received by the

Agency within 120 days of the date the required NPAR is sent to the

enrollee.”); Fla. Admin. Code R. 59G-1.100(9)(b)3. (“A Hearing Officer is

authorized to deny or dismiss a request for a fair hearing for reasons

consistent with this rule, including the following: . . . [a] fair hearing request

is untimely[.]”); V.T. v. Liberty Dental Plan of Fla., Inc., 338 So. 3d 989, 989-

90 (Fla. 3d DCA 2022).

Affirmed.