CERTAIN ADDITIONAL REGULATORY MATTERS. Neither the Company nor any Subsidiary, nor the officers, directors or managing employees, as that term is defined in 42 C.F.R. Section 1001.1001(a)(1), nor to the Knowledge of the Company or any Subsidiary, the other employees or agents of any of the Company or any Subsidiary have engaged in any activities which are prohibited under criminal law, or are cause for civil penalties or mandatory or permissive exclusion from Medicare or Medicaid, or any other State Health Care Program or Federal Health Care Program (as defined in Section 4.35 below) under Sections 1320a-7, 1320a-7a, 1320a-7b or 1395nn of Title 42 of the United States Code, the federal Civilian Health and Medical Plan of the Uniformed Services statute ("CHAMPUS"), or the regulations promulgated pursuant to such statutes or regulations or related state or local statutes or which are prohibited by any private accrediting organization from which the Company or any of its Subsidiaries seeks accreditation or by generally recognized professional standards of care or conduct, including, but not limited to, the following activities:
(a) Knowingly and willfully making or causing to be made a false statement or representation of a material fact in any application for any benefit or payment;
(b) Knowingly and willfully making or causing to be made any false statement or representation of a material fact for use in determining rights to any benefit or payment;
(c) Presenting or causing to be presented a claim for reimbursement under CHAMPUS, Medicare, Medicaid or any other State Health Care Program or Federal Health Care Program that is (i) for an item or service that the Person presenting or causing to be presented knows or should know was not provided as claimed, or (ii) for an item or service that the Person presenting knows or should know that the claim is false or fraudulent;
(d) Knowingly and willfully offering, paying, soliciting or receiving any remuneration (including any kickback, bribe or rebate), directly or indirectly, overtly or covertly, in cash or in kind (i) in return for referring, or to induce the referral of, an individual to a Person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part by CHAMPUS, Medicare or Medicaid or any other State Health Care Program or any Federal Health Care Program, or (ii) in return for, or to induce the purchase, lease or order or the arranging for or recommending of the purchase, lease o...
CERTAIN ADDITIONAL REGULATORY MATTERS. 38 4.35 Medicare/Medicaid Participation.....................................39 4.36 Compliance with Medicare/Medicaid and Insurance Programs............39
CERTAIN ADDITIONAL REGULATORY MATTERS. 25 3.26 Medicare/Medicaid Participation; Accreditation......... 26
CERTAIN ADDITIONAL REGULATORY MATTERS. 38 4.35 Medicare/Medicaid Participation.. . . . . . . . . . . . . . . . . 39 4.36 Compliance with Medicare/Medicaid and Insurance Programs. . . . . 40 ARTICLE V
CERTAIN ADDITIONAL REGULATORY MATTERS. 20 3.23 MEDICARE/MEDICAID PARTICIPATION ACCREDITATION..........................................................21 3.24
CERTAIN ADDITIONAL REGULATORY MATTERS. (a) None of the Sellers, the Entities or any officer, director or managing employee of the Sellers or the Entities (within the meaning of 42 U.S.C. (ss. 1320a-5(b)) have engaged in any activities which constitute violations of, or are cause for imposition of civil penalties upon any Entity or mandatory or permissive exclusion of any Entity from Medicare or Medicaid, under (S) 1320a-7, 1320a-7a, 1320a-7b, or 1395nn of Title 42 of the United States Code, the federal Civilian Health and Medical Plan of the Uniformed Services statute ("CHAMPUS"), or the regulations promulgated pursuant to such statutes or regulations or related state or local statutes or which constitute violations of or deficiencies under the standards of any private accrediting organization from which any Entity is accredited or seeks accreditation, including the following activities:
(i) knowingly and willfully making or causing to be made a false statement or representation of a material fact in any application for any benefit or payment;
(ii) knowingly and willfully making or causing to be made any false statement or representation of a material fact for use in determining rights to any benefit or payment;
(iii) knowingly and willfully presenting or causing to be presented a claim for reimbursement under CHAMPUS, Medicare, Medicaid or any other State Health Care Program or Federal Health Care Program that is (i) for an item or service that the Person presenting or causing to be presented knows or should know was not provided as claimed, or (ii) for an item or service where the Person presenting knows or should know that the claim is false or fraudulent;
CERTAIN ADDITIONAL REGULATORY MATTERS. (a) None of MDI, any Subsidiary of MDI, any Affiliate of MDI or any Subsidiary of MDI or the officers, directors, or employees or agents of MDI, any Subsidiary of MDI, any Affiliate of MDI or any Subsidiary of MDI (or Person having a direct or indirect ownership interest in MDI or any MDI Subsidiary within the meaning of 42 U.S. ss. (S)1320a-7(b)(8)), and none of the Persons who provide professional services under Agreements with MDI or any Subsidiary of MDI or any Affiliate of MDI or any Subsidiary of MDI as agents of MDI or any Subsidiary of MDI, to the knowledge of each such Person, have engaged in any activities which constitute violations of, or are cause for imposition of civil penalties upon MDI or any Subsidiary of MDI for mandatory or permissive exclusion of MDI or any Subsidiary of MDI from Medicare or Medicaid, under (S) 1320a-7, 1320a-7b, or 1395m of Title 42 of the United States Code, the Federal Civilian Health and Medical Plan of the Uniformed Services state ("CHAMPUS"), or the regulations promulgated pursuant to such statutes or regulations or related state or local statutes or which constitute violations of or deficiencies under the standards of any private accrediting organization from which MDI or any Subsidiary of MDI is accredited or seeks accreditation:
(i) knowingly and willfully making or causing to be made a false statement or representation of a material fact in any application for any benefit or payment;
(ii) knowingly and willfully making or causing to be made any false statement or representation of a material fact for use in determining rights to any benefit or payment;
(iii) presenting or causing to be presented a claim for reimbursement under CHAMPUS, Medicare, Medicaid or any other State Health Care Program or Federal Health Care Program that is (A) for an item or service that the Person presenting or causing to be presented knows or should know was not provided as claimed, or (B) for an item or service where the Person presenting knows or should know that the claim is false or fraudulent;
(iv) knowingly and willfully offering, paying, soliciting or receiving any remuneration (including any kickback, bribe or rebate), directly or indirectly, overtly or covertly, in cash or in kind (i) in return for referring, or to induce the referral of, an individual to a person for the furnishing or arranging for the furnishing of any item or service for which payment may be made in whole or in part by CHAMPUS, Medicare or Medicaid, or a...
CERTAIN ADDITIONAL REGULATORY MATTERS. None of the Company, any Affiliate of the Company, or the officers, directors, or employees or agents of any of the Company or any Affiliate, and, to the Best Knowledge of the Seller, none of the Persons who provide professional services under agreements with any of the Company or any Affiliate as agents of such entities have engaged in any activities on behalf of the Company or its Affiliates which constitute violations of, or are cause for imposition of civil penalties upon the Company or the NY Subsidiary or mandatory or permissive exclusion of the Company from Medicare or Medicaid, under ss.sx. 0020a-7, 1320a-7a, 1320a-7b, or 1395nn of Title 42 of the United States Code, the federal Civilian Health and Medical Plan of the Uniformed Services statute ("CHAMPUS"), or the regulations promulgated pursuant to such statutes or regulations or related state or local statutes or which constitute material violations of or material deficiencies under the standards of any private accrediting organization from which the Company or the NY Subsidiary seeks accreditation, including the following activities:
CERTAIN ADDITIONAL REGULATORY MATTERS. 20 4.27 Medicare/Medicaid Participation . . . . . . . . . . . . . . . . 21 4.28 Physician Relationships . . . . . . . . . . . . . . . . . . . . 22 4.29 Other Hospital Relationships. . . . . . . . . . . . . . . . . . 22
CERTAIN ADDITIONAL REGULATORY MATTERS. 20 4.27 Medicare/Medicaid Participation............................................................21 4.28 Physician Relationships....................................................................22 4.29 Other Hospital Relationships...............................................................22
