Medicare and Medicaid Participation. (a) Except as set forth on Schedule 2.21(a),
(i) Each of the Facilities is eligible to participate without restriction under Title XVIII ("MEDICARE") and Title XIX ("MEDICAID") of the Social Security Act and is a "PROVIDER" with valid and current provider agreements and with one (1) or more provider numbers with the federal Medicare and all applicable state Medicaid programs through intermediaries;
(ii) Each of the Facilities that receives payments under CHAMPUS or TRICARE, if any, is a "PROVIDER" with valid and current provider agreements and with one or more provider numbers with CHAMPUS and/or TRICARE and successor programs through intermediaries; Medicare, Medicaid, CHAMPUS, TRICARE and other federal, state or local governmental reimbursement programs, or successor programs to any of the above, are referred to herein as "GOVERNMENT PROGRAMS";
(iii) To the extent that one (1) or more of the Facilities currently participates in Government Programs, each of the Facilities that currently participates is in compliance with the conditions of participation for the Government Programs in all material respects;
(iv) Each Seller currently holds such licenses, agreements, and certificates pertaining to Medicare and Medicaid provider agreements entered into with the State of Florida, the United States, and any municipality or other governmental agency or administrative body that authorizes the Sellers to conduct their business at the respective Facilities as are necessary to conduct the business of each Facility as presently operated ("MEDICARE AND MEDICAID LICENSES"); and
(v) Each agreement currently in effect between Sellers and a Government Program is listed on Schedule 2.21(a)(v), and each such agreement is in full force and effect and is applicable to the Facility specified on Schedule 2.21(a)(v).
(b) All cost reports of each of the Sellers and the Facilities for the Government Programs which were required to be filed have been properly filed and are complete in all material respects.
Medicare and Medicaid Participation. This Section 4.16 sets forth all representations and warranties of the Company concerning Medicare, Medicaid and other Government Program participation matters and the other healthcare regulatory matters addressed in this Section. No other representations or warranties made by the Company in this Agreement shall be construed to concern Medicare, Medicaid or other Government Program participation matters or the other healthcare regulatory matters addressed in this Section.
(a) Except as set forth in Schedule 4.16, the Company is eligible for participation in the Medicare, Medicaid and CHAMPUS/TRICARE programs (collectively, the “Government Programs”) and has current and valid provider contracts with such Government Programs. The Company is in compliance with the conditions of participation for the Government Programs in all material respects. There is neither pending, nor, to the Company’s or a Stockholder’s Knowledge, threatened, any Action under the Government Programs involving the Company. The Stockholders have made available to Buyer true and complete copies of the most recent Government Program survey reports and all plans of correction, if any, which Company was required to submit in response to such surveys, and all such plans of correction have been accepted by the applicable Government Program and all have been or are in the process of being implemented. Company’s billing practices for all third-party payors, including the Government Programs and private insurance companies, are in compliance in all material respects with applicable Law and billing requirements of such third party payors and Government Programs and the Company has not knowingly billed or received any material payment or reimbursement in excess of amounts allowed by Law. Schedule 4.16 contains a list of all of the Company’s Government Program provider numbers and other third-party payor provider numbers.
(b) Company has: (i) timely filed all reports and xxxxxxxx required to be filed with respect to any Government Program or any third-party payor (all of which are complete and accurate in all material respects and prepared and filed in compliance with applicable Law), and (ii) paid or caused to be paid any undisputed refunds, overpayments, discounts, or adjustments that have become due pursuant to such reports and xxxxxxxx.
Medicare and Medicaid Participation. Xxxxx shall cause Xxxxx Facilities to become qualified for participation in the Medicare and Medicaid programs or any Universal Governmental Plan and shall maintain such qualifications throughout the term.
Medicare and Medicaid Participation. (a) No portion of the income from any Property is attributable to Medicare, Medicaid or any other third party payor program, except as shown on the Rent Roll attached as Schedule 2.7(b).
(b) Except as set forth on Schedule 2.17, 15 <PAGE> (i) if any Facility has historically received Medicare or Medicaid reimbursement, it is eligible to receive payment without restriction under Title XVIII ("Medicare") and Title XIX ("Medicaid") of the Social Security Act, or both, and is a "provider" with valid and current provider agreements and with one or more provider numbers with the federal Medicare and all applicable state Medicaid and successor programs. For purposes of this provision, Medicare, Medicaid, CHAMPUS, TRICARE and other federal, state or local governmental reimbursement programs, or successor programs to any of the above, are referred to as "Government Programs".
Medicare and Medicaid Participation. (a) The Company and each Subsidiary that bills the Medicare program with respect to a billing location is a "home health agency" within the meaning of SSA sec. 1861(o) for such location and is in compliance with the conditions of participation imposed by the SSA and the Secretary of Health and Human Services. Each of the Company (or Subsidiary, as the case may be) has a Medicare provider agreement and a Medicare provider number in force covering each agency at which the Company (or Subsidiary, as the case may be) accepts Medicare patients.
(b) Each of the Company and the NY Subsidiary or a Subsidiary thereof has a Medicaid provider agreement and Medicaid provider number in force in each state in which the Company (or Subsidiary, as the case may be) bills the Medicaid program.
Medicare and Medicaid Participation. Specialty Provider hereby represents and warrants that Specialty Provider is a Medicare certified Specialty Provider in good standing under the Federal Medicare Program (Title XVIII of the Social Security Act, as amended) and that Specialty Provider will use his/her/its best efforts to maintain this good standing. Specialty Provider hereby represents and warrants that Provider is eligible for participation in the Medicaid program; however, the provider is not required to participate in the Medicaid program as an RHS Medicaid Specialty Provider. If, for any reason, Specialty Provider receives notice of any sanction from the Medicare or Medicaid Programs, Specialty Provider agrees to notify RHS promptly of the sanction. Specialty Provider shall not employ or contract with any individual who is excluded from participation in the Medicare or Medicaid programs under sections 1128 or 1128A of the Social Security Act (or with an entity that employs or contracts with such an individual) for the provision of any health or administrative services, including, without limitation, healthcare services, utilization review or medical social work. Specialty Provider agrees and acknowledges that RHS and/or Healthcare Plan receives payment for Covered Services in whole or in part from federal funds and to the extent Specialty Provider treats Members for whom RHS and/or Healthcare Plan(s) receives federal funds and delegates Covered Services to RHS and/or Healthcare Plan(s) (e.g. Medicare and Medicaid Members), Specialty Provider is subject to certain laws that are applicable to individuals and entities receiving federal funds.
Medicare and Medicaid Participation. Service Provider represents and warrants that neither it nor any affiliate (i.e., any entity that Service Provider holds at least twenty-five percent ownership or control of), nor to the best of its knowledge after due inquiry and investigation, has Service Provider, its employees, or Subcontractors, or their respective majority-owned or controlled affiliates, been (i) excluded, debarred, or suspended from participation in any program under Title XVIII or Title XIX under any of the provisions of Section 1128(a) or (b) of the Social Security Act (42 U.S.C. Section 1320 a-7) (ii) have not within a three-year (3) period preceding this Agreement been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (iii) are not presently indicted or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in (ii) above; and (iv) have not within a three-year (3) period preceding this Agreement had one or more public transactions (federal, state or local) terminated for cause or default. Service Provider agrees that it shall notify the Authority within three (3) days of the date it receives notice that any action is being taken against the Service Provider or any persons defined under the provisions of Section 1128(a) or (b), or against any Subcontractor, which could result in exclusion, debarment, or suspension from the Medicare or Medicaid programs, or any other governmental health care program. Service Provider shall develop, maintain and follow procedures for identifying excluded providers and terminating their ability to deliver Covered Services in a timely manner. Service Provider shall execute a Debarment and Suspension Agreement and Certification (attached hereto as Appendix C), and shall ensure that its Subcontractors providing Covered Services hereunder complete the same form(s), and shall execute and deliver such forms as Authority requires confirming the Service Provider representations and warranties.
Medicare and Medicaid Participation. (a) Except as set forth on Schedule 7.1.25,
(i) Each of the Facilities that is eligible to receive payment under Title XVIII ("Medicare") and Title XIX ("Medicaid") of the Social Security Act has valid and current provider agreements and one or more provider numbers with the federal Medicare, all applicable state Medicaid and successor programs through intermediaries;
(ii) Each of the Facilities that is receiving payments under CHAMPUS or TRICARE has valid and current provider agreements with one or more 21 provider numbers with CHAMPUS and/or TRICARE programs through intermediaries;
(iii) Medicare, Medicaid, CHAMPUS, TRICARE and other federal, state or local governmental reimbursement programs, or successor programs to any of the above, are referred to herein as "Government Programs"; and
(iv) Each of the Facilities is in compliance with the conditions of participation for applicable Government Programs except where the failure to so comply taken as a whole would have a material adverse effect on the Facilities taken as a whole.
(b) The Xxxxxxx Entities are in compliance in all material respects with the obligations under the CIA.
Medicare and Medicaid Participation. (a) Attached hereto as Schedule 2.16(a) is a true and complete census report which sets forth the occupancy status of each Facility, the average daily rate and other charges payable with respect thereto, the class of payment or reimbursement (i.e., the payor mix or allocation among private, third‑party payor, Medicare, Medicaid and Veterans Administration), the average monthly census of the applicable Facility, occupancy rates and any arrearages in payments for each Facility for calendar year 2014 and year-to-date for 2015. An updated Schedule 2.16(a) containing the information required for the period expiring on the last date of the calendar month before the Closing Date will be delivered by Seller to Purchaser at least five (5) Business Days before the Closing.
(b) Except as set forth on Schedule 2.16(b),
(i) each Facility is currently eligible, and between the Date of Execution and the Effective Time will remain eligible to receive payment without restriction under Title XVIII (“Medicare”) and Title XIX (“Medicaid”) of the Social Security Act, and is a “provider” with valid and current Provider Agreements and with one or more provider numbers, licenses, agreements and certificates with the federal Medicare and all applicable state Medicaid and successor programs.
(ii) all material Provider Agreements and Licenses have been obtained by Seller and are in full force and effect, including approved provider status in any Third Party Payor Programs. For purposes of this Agreement, “Third Party Payors” collectively means Medicare, Medicaid, TRICARE, private or public insurers, health maintenance organizations, preferred provider organizations or programs and self-insured employee assistance programs and any other federal, state or local governmental reimbursement programs, or successor programs to any of the above, and “Third Party Payor Programs” collectively means all programs with Third Party Payors in which the Facilities participate;
Medicare and Medicaid Participation. Primary Care Provider hereby represents and warrants that Primary Care Provider is a Medicare certified Primary Care Provider in good standing under the Federal Medicare Program (Title XVIII of the Social Security Act, as amended) and that Primary Care Provider will use his/hers/its best efforts to maintain this good standing. Primary Care Provider hereby represents and warrants that Provider is eligible for participation in the Medicaid program; however, the provider is not required to participate in the Medicaid program as an RHS Medicaid Primary Care Provider. If, for any reason, Primary Care Provider receives notice of any sanction from the Medicare or Medicaid Programs, Primary Care Provider agrees to notify RHS promptly of the sanction. Primary Care Provider shall not employ or contract with any individual who is excluded from participation in the Medicare or Medicaid programs under sections 1128 or 1128A of the Social Security Act (or with an entity that employs or contracts with such an individual) for the provision of any health or administrative services, including, without limitation, healthcare services, utilization review or medical social work. Primary Care Provider agrees and acknowledges that RHS and/or Healthcare Plan(s) receives payment for Covered Services in whole or in part, directly or indirectly, from federal funds and to the extent Primary Care Provider treats Members for whom RHS and/or Healthcare Plan(s) receives federal funds and delegates Covered Services to RHS and/or Healthcare Plan(s) (e.g. Medicare and Medicaid Members), Primary Care Provider is subject to certain laws that are applicable to individuals and entities receiving federal funds.
