Common use of EFFECTIVE AND BINDING AGREEMENT Clause in Contracts

EFFECTIVE AND BINDING AGREEMENT. Each Provider and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a Provider’s obligations under this CIA based on a certification by the Provider that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider is relieved of its CIA obligations, the Provider will be required to notify OIG in writing at least 30 days in advance if the Provider plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. The undersigned Provider signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider Consistent with the provisions in the Settlement Agreement pursuant to which this CIA is entered, and into which this CIA is incorporated, HealthSouth and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of HealthSouth; B. This CIA shall become final and binding on the date the final signature is obtained on the CIA.; B. This C. Any modifications to this CIA constitutes shall be made with the complete agreement between the parties and may not be amended except by prior written consent of the parties to this CIA.; C. D. OIG may agree to a suspension of a ProviderHealthSouth’s obligations under this the CIA based on a certification by in the Provider that it is no longer providing health care items or services that will be billed to any event of HealthSouth’s cessation of participation in Federal health care program programs. If HealthSouth withdraws from participation in Federal health care programs and that it does not have any ownership is relieved of its CIA obligations by OIG, HealthSouth shall notify OIG at least 30 days in advance of HealthSouth’s intent to reapply as a participating provider or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills supplier with any Federal health care program. If the Provider is relieved Upon receipt of its CIA obligations, the Provider will be required to notify OIG in writing at least 30 days in advance if the Provider plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such timenotification, OIG shall evaluate whether the CIA will should be reactivated or modified.. Corporate Integrity Agreement HealthSouth Corporation D. E. The undersigned Provider signatories represent HealthSouth signatory represents and warrant warrants that they are he is authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement HealthSouth Corporation /s/ Jxxx Xxxxxx 12-30-04 DATE JXXX XXXXXX Executive Vice President and Chief Compliance Officer Corporate Integrity Agreement HealthSouth Corporation /s/ Lxxxx Xxxxxx 12/30/04 DATE LXXXX XXXXXX Chief Counsel to the Inspector General Office of Inspector General U. S. Department of Health and Human Services Corporate Integrity Agreement HealthSouth Corporation This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider Xxx and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderArc’s obligations under this CIA based on a certification by the Provider Arc that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider Arc is relieved of its CIA obligations, the Provider will Arc shall be required to notify OIG in writing at least 30 days in advance if the Provider Arc plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) Arc’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider Arc signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement 4/17/18 /Xxxxxxx X. Xxxxxx/ XXXXXXX X. XXXXXX 4-18-18 This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA. A. IRO Engagement‌ 1. Xxx shall engage an IRO that possesses the qualifications set forth in Paragraph B, below, to perform the responsibilities in Paragraph C, below. The IRO shall conduct the review in a professionally independent and objective fashion, as set forth in Paragraph D. Within 30 days after OIG receives the information identified in Section V.A.7 of the CIA or any additional information submitted by Arc in response to a request by OIG, whichever is later, OIG will notify Arc if the IRO is unacceptable. Absent notification from OIG that the IRO is unacceptable, Arc may continue to engage the IRO.‌ 2. If Xxx engages a new IRO during the term of the CIA, that IRO must also meet the requirements of this Appendix. If a new IRO is engaged, Arc shall submit the information identified in Section V.A.7 of the CIA to OIG within 30 days of engagement of the IRO. Within 30 days after OIG receives this information or any additional information submitted by Xxx at the request of OIG, whichever is later, OIG will notify Arc if the IRO is unacceptable. Absent notification from OIG that the IRO is unacceptable, Arc may continue to engage the IRO.‌ B. IRO Qualifications The IRO shall:‌‌ 1. assign individuals to conduct the Claims Review who have expertise in the Alaska Medicaid program requirements applicable to the claims being reviewed;‌ 2. assign individuals to design and select the Claims Review sample who are knowledgeable about the appropriate statistical sampling techniques;‌ 3. assign individuals to conduct the coding review portions of the Claims Review who have expertise in the Alaska Medicaid coding requirements applicable to the claims being reviewed;‌ 4. assign licensed nurses or physicians with relevant education, training and specialized expertise (or other licensed health care professionals acting within their scope of practice and specialized expertise) to make the medical necessity determinations‌ required by the Claims Review; and 5. have sufficient staff and resources to conduct the reviews required by the CIA on a timely basis.‌ C. IRO Responsibilities The IRO shall:‌‌ 1. perform each Claims Review in accordance with the specific requirements of the CIA;‌ 2. follow all applicable Alaska Medicaid program rules and reimbursement guidelines in making assessments in the Claims Review;‌ 3. request clarification from the appropriate authority if in doubt of the application of a particular Alaska Medicaid program policy or regulation;‌ 4. respond to all OIG inquires in a prompt, objective, and factual manner; and‌ 5. prepare timely, clear, well-written reports that include all the information required by Appendix B to the CIA.‌

EFFECTIVE AND BINDING AGREEMENT. Each Provider Liberty and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderLiberty’s obligations under this CIA based on a certification by the Provider Liberty that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider Liberty is relieved of its CIA obligations, the Provider will Liberty shall be required to notify OIG in writing at least 30 days in advance if the Provider Liberty plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) Liberty’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider Liberty signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider The U.S. Healthcare Parties and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a Provider’s the U.S. Healthcare Parties’ obligations under this CIA based on a certification by the Provider U.S. Healthcare Parties that it is they are no longer providing health care items or services that will be billed to any Federal health care program and that it does they do not have any ownership or control interest, as defined in 42 U.S.C. §§ 1320a-3, in any entity that bills any Federal health care program. If the Provider is U.S. Healthcare Parties are relieved of its their CIA obligations, the Provider will U.S. Healthcare Parties shall be required to notify OIG in writing at least 30 days in advance if the Provider plans U.S. Healthcare Parties plan to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) the U.S. Healthcare Parties’ responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider signatories for the U.S. Healthcare Parties and the Xxxxx Entities represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active//Xxx X. Xxxxx/ 8/25/2016 XXX X. XXXXX DATE On behalf of U.S. Healthcare Supply, LLC, Spectrum Diabetic Services, LLC, Heritage Diabetic Supply, Inc, and Dependable Diabetic Supply, LLC /Xxx X. Xxxxx/ 8/25/2016 XXX X. XXXXX DATE On behalf of U.S. Diagnostics, NJ /Xxx X. Xxxxx/ 8/25/2016 XXX X. XXXXX DATE Individually /Xxxxxx X. Xxxxx/ 8/25/2016 XXXXXX X. XXXXX DATE On behalf of U.S. Diagnostics, Inc. /Xxxxxx X. Xxxxx/ 8/25/2016 XXXXXX X. XXXXX DATE Individually /Xxxxxx X. Xxxxxx Xx./ 8/29/2016 XXXXXX X. XXXXXX XX. DATE Xxxxxxx Procter LLP Counsel for U.S. Healthcare Supply, LLC, Spectrum Diabetic Services, LLC, Heritage Diabetic Supply, Inc; Dependable Diabetic Supply, LLC; U.S. Diagnostics, Inc., U.S. Diagnostics NJ; Xxxxxx X. Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement ; and Xxx X. Xxxxx ON BEHALF OF THE OFFICE OF INSPECTOR GENERAL OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES‌ /Xxxxxx X. XxXxxxx/ 8/30/2016 XXXXXX X. XXXXXXX DATE Assistant Inspector General for Legal Affairs Office of Inspector General U.S. Department of Health and Human Services /Xxxxx X. Xxxxx/ 8/30/2016 XXXXX XXXXX DATE Associate Counsel Office of Counsel to the Inspector General U.S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider Memorial Health and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderMemorial Health’s obligations under this CIA based on a certification by the Provider Memorial Health that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider Memorial Health is relieved of its CIA obligations, the Provider will Memorial Health shall be required to notify OIG in writing at least 30 days in advance if the Provider Memorial Health plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) Memorial Health’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider Memorial Health signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D III.E of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider XXXXX and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a Provider’s VITAS' obligations under this CIA based on a certification by the Provider VITAS that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider VITAS is relieved of its CIA obligations, the Provider will VITAS shall be required to notify OIG in writing at least 30 days in advance if the Provider VITAS plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) VITAS' responsibility to follow all applicable Federal health care program requirements or (2) the government's right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider VITAS signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Vitas Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.Agreement

EFFECTIVE AND BINDING AGREEMENT. Each Provider The Providers and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by prior written consent of the parties to this CIA. C. OIG may agree to a suspension of a Provider’s the Providers’ obligations under this CIA based on a certification by the Provider Providers that it is they are no longer providing health care items or services that will be billed to any Federal health care program programs and that it does they do not have any ownership or control interest, as defined in 42 U.S.C. §§ 1320a-3, in any entity that bills any Federal health care program. If the Provider is Providers are relieved of its their CIA obligations, the Provider will Providers shall be required to notify OIG in writing at least 30 days in advance if the Provider Providers plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, the OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to, and do not affect (1) the Providers’ responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable program requirements. E. The undersigned Provider signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities capacity and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.President, Chief Executive Officer, and Owner, Institute for Therapy and Psychological Solutions, L.L.C. DATE

EFFECTIVE AND BINDING AGREEMENT. Each Provider ‌ CRC and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderCRC’s obligations under this CIA based on a certification by the Provider CRC that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider CRC is relieved of its CIA obligations, the Provider will ,CRC shall be required to notify OIG in writing at least 30 days in advance if the Provider CRC plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) CRC’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider CRC signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider Lincare and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderLincare’s obligations under this CIA based on a certification by the Provider Lincare that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §§ 1320a-3, in any entity that bills any Federal health care program. If the Provider Lincare is relieved of its CIA obligations, the Provider will Lincare shall be required to notify OIG in writing at least 30 days in advance if the Provider Lincare plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) Lincare’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider Lincare signatories represent and warrant that they are authorized to execute this CIACIA . The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider UCI and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderUCI’s obligations under this CIA based on a certification by the Provider UCI that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider UCI is relieved of its CIA obligations, the Provider will UCI shall be required to notify OIG in writing at least 30 days in advance if the Provider UCI plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) UCI’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider UCI signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider Pentec and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderPentec’s obligations under this CIA based on a certification by the Provider Pentec that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider Pentec is relieved of its CIA obligations, the Provider will Pentec shall be required to notify OIG in writing at least 30 days in advance if the Provider Pentec plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) Pentec’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider Pentec signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider The U.S. Healthcare Parties and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a Provider’s the U.S. Healthcare Parties’ obligations under this CIA based on a certification by the Provider U.S. Healthcare Parties that it is they are no longer providing health care items or services that will be billed to any Federal health care program and that it does they do not have any ownership or control interest, as defined in 42 U.S.C. §§ 1320a-3, in any entity that bills any Federal health care program. If the Provider is U.S. Healthcare Parties are relieved of its their CIA obligations, the Provider will U.S. Healthcare Parties shall be required to notify OIG in writing at least 30 days in advance if the Provider plans U.S. Healthcare Parties plan to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) the U.S. Healthcare Parties’ responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider signatories for the U.S. Healthcare Parties and the Xxxxx Entities represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider VITAS and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a Provider’s VITAS’ obligations under this CIA based on a certification by the Provider VITAS that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider VITAS is relieved of its CIA obligations, the Provider will VITAS shall be required to notify OIG in writing at least 30 days in advance if the Provider VITAS plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) VITAS’ responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider VITAS signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider SERA and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderSERA’s obligations under this CIA based on a certification by the Provider SERA that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider SERA is relieved of its CIA obligations, the Provider will SERA shall be required to notify OIG in writing at least 30 days in advance if the Provider SERA plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) SERA’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider SERA signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider ‌ VirtuOx and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderVirtuOx’s obligations requirements under this CIA based on a certification by the Provider VirtuOx that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider VirtuOx is relieved of its CIA obligationsrequirements, the Provider will VirtuOx shall be required to notify OIG in writing at least 30 days in advance if the Provider VirtuOx plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) VirtuOx’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider VirtuOx signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement May 6, 2022 DATE /Xxxx X. Xxxxxxxx/_ May 6, 2022 DATE APPENDIX A INDEPENDENT REVIEW ORGANIZATION‌ This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA. A. IRO Engagement‌ 1. VirtuOx, Inc. (VirtuOx) shall engage an IRO that possesses the qualifications set forth in Paragraph B, below, to perform the responsibilities in Paragraph C, below. The IRO shall conduct the review in a professionally independent and objective fashion, as set forth in Paragraph E. Within 30 days after OIG receives the information identified in Section V.A.7 of the CIA or any additional information submitted by VirtuOx in response to a request by OIG, whichever is later, OIG will notify VirtuOx if the IRO is unacceptable. Absent notification from OIG that the IRO is unacceptable, VirtuOx may continue to engage the IRO.‌

EFFECTIVE AND BINDING AGREEMENT. Each Provider PHC and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of B. This CIA shall become final and binding on the date the final signature is obtained on the CIA.; B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA.; C. D. OIG may agree to a suspension of a ProviderPHC’s obligations under this CIA based on a certification by the Provider PHC that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider PHC is relieved of its CIA obligations, the Provider PHC will be required to notify OIG in writing at least 30 days in advance if the Provider PHC plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned Provider PHC signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement APPENDIX A INDEPENDENT REVIEW ORGANIZATION This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D III.E of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider ‌ Spring Gate and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a ProviderSpring Gate’s obligations under this CIA based on a certification by the Provider Spring Gate that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §§ 1320a-3, in any entity that bills any Federal health care program. If the Provider Spring Gate is relieved of its CIA obligations, the Provider will Spring Gate shall be required to notify OIG in writing at least 30 days in advance if the Provider Spring Gate plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) Spring Gate’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider Spring Gate signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.Electronically-‌

EFFECTIVE AND BINDING AGREEMENT. Each Provider ‌ Sutter and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a Provider’s Xxxxxx’x obligations under this CIA based on a certification by the Provider Sutter that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider Sutter is relieved of its CIA obligations, the Provider will Sutter shall be required to notify OIG in writing at least 30 days in advance if the Provider Sutter plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) Xxxxxx’x responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned Provider Sutter signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider eTEL-Rx and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of eTEL- Rx. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. D. OIG may agree to a suspension of a ProvidereTEL-Rx’s obligations under this CIA based on a certification by the Provider eTEL-Rx that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If the Provider eTEL-Rx is relieved of its CIA obligations, the Provider eTEL-Rx will be required to notify OIG in writing at least 30 days in advance if the Provider eTEL-Rx plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned Provider eTEL-Rx signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA.. eTEL-Rx Corporate Integrity Agreement E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. Each Provider Xxxxxxx and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of a Provider’s obligations under B. All requirements and remedies set forth in this CIA based on a certification by the Provider that it is no longer providing health care items or services that will be billed are in addition to any and do not affect (1) Xxxxxxx’s responsibility to follow all applicable Federal health care program and that it does not have any ownership requirements or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If (2) the Provider is relieved of its CIA obligations, the Provider will be required government’s right to notify OIG in writing at least 30 days in advance if the Provider plans impose appropriate remedies for failure to resume providing health care items or services that are billed to any follow applicable Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modifiedrequirements. D. C. The undersigned Provider Xxxxxxx signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. D. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. Alliance/Active/Xxxxx/Xxxx/Xxxxxx Corporate Integrity Agreement U.S. Department of Health and Human Services‌ U.S. Department of Health and Human Services‌ APPENDIX A INDEPENDENT REVIEW ORGANIZATION‌‌ This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.D of the CIA. A. IRO Engagement‌ 1. Lincare shall engage an IRO that possesses the qualifications set forth in Paragraph B, below, to perform the responsibilities in Paragraph C, below. The IRO shall conduct the reviews in a professionally independent and objective fashion, as set forth in Paragraph E. Within 30 days after OIG receives the information identified in Section V.A.8 of the CIA or any additional information submitted by Xxxxxxx in response to a request by OIG, whichever is later, OIG will notify Lincare if the IRO is unacceptable. Absent notification from OIG that the IRO is unacceptable, Lincare may continue to engage the IRO.‌ 2. If Lincare engages a new IRO during the term of the CIA, that IRO must also meet the requirements of this Appendix. If a new IRO is engaged, Xxxxxxx shall submit the information identified in Section V.A.8 of the CIA to OIG within 30 days of engagement of the IRO. Within 30 days after OIG receives this information or any additional information submitted by Lincare at the request of OIG, whichever is later, OIG will notify Lincare if the IRO is unacceptable. Absent notification from OIG that the IRO is unacceptable, Lincare may continue to engage the IRO.‌ B. IRO Qualifications The IRO shall:‌‌ 1. assign individuals to conduct the Claims Reviews who have expertise in the Federal health care program requirements applicable to the claims being reviewed;‌ 2. assign individuals to design and select the Claims Review samples who are knowledgeable about the appropriate statistical sampling techniques;‌ 3. assign individuals to conduct the coding review portions of the Claims Reviews who have a nationally recognized coding certification and who have maintained this certification (e.g., completed applicable continuing education requirements);‌‌ 4. assign licensed nurses or physicians with relevant education, training and specialized expertise (or other licensed health care professionals acting within their scope of practice and specialized expertise) to make the medical necessity determinations required by the Claims Reviews; and‌ 5. have sufficient staff and resources to conduct the reviews required by the CIA on a timely basis.‌ C. IRO Responsibilities The IRO shall:‌‌‌ 1. perform each Claims Review in accordance with the specific requirements of the‌