Common use of OIG Removal of IRO Clause in Contracts

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable), or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN in writing that CHN shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN to engage a new IRO shall be made at the sole discretion of OIG.

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable)E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN Dakwa and HEAG in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN Dakwa and HEAG shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN Dakwa and HEAG regarding the its IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN Dakwa and HEAG in writing that CHN Dakwa and HEAG shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN Dakwa and HEAG must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN Dakwa and HEAG to engage a new IRO shall be made at the sole discretion of OIG.OIG.‌ APPENDIX B QUARTERLY CLAIMS REVIEW‌‌‌

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable)D, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualificationsmay, independenceat its sole discretion, relationship to CHN or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN in writing that CHN shall be required require Choudhary-Rolla Neurology to engage a new IRO in accordance with Paragraph A of this Appendix. CHN Choudhary-Rolla Neurology must engage a new IRO within 60 days of termination of the IRO. Prior to requiring Choudhary-Rolla Neurology to engage a new IRO, OIG shall notify Choudhary-Rolla Neurology of its receipt intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Choudhary-Rolla Neurology may present additional information regarding the IRO’s written noticequalifications, independence or performance of its responsibilities. The OIG will attempt in good faith to resolve any differences regarding the IRO with Choudhary-Rolla Neurology prior to requiring Choudhary-Rolla Neurology to terminate the IRO. However, the final determination as to whether or not to require CHN Choudhary- Rolla Neurology to engage a new IRO shall be made at the sole discretion of OIG.

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable)E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN PC, Xxxxx, and Bandar in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN PC, Xxxxx, and Bandar shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN PC, Xxxxx, and Bandar regarding the its IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN PC, Xxxxx, and Bandar in writing that CHN PC, Xxxxx, and Bandar shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN PC, Xxxxx, and Bandar must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN PC, Xxxxx, and Bandar to engage a new IRO shall be made at the sole discretion of OIG.

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable)D, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualificationsmay, independenceat its sole discretion, relationship to CHN or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN in writing that CHN shall be required require Xxxxxxxxx-Rolla Neurology to engage a new IRO in accordance with Paragraph A of this Appendix. CHN Choudhary-Rolla Neurology must engage a new IRO within 60 days of termination of the IRO. Prior to requiring Choudhary-Rolla Neurology to engage a new IRO, OIG shall notify Xxxxxxxxx-Rolla Neurology of its receipt intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Choudhary-Rolla Neurology may present additional information regarding the IRO’s written noticequalifications, independence or performance of its responsibilities. The OIG will attempt in good faith to resolve any differences regarding the IRO with Xxxxxxxxx-Xxxxx Neurology prior to requiring Xxxxxxxxx-Rolla Neurology to terminate the IRO. However, the final determination as to whether or not to require CHN Choudhary- Rolla Neurology to engage a new IRO shall be made at the sole discretion of OIG.

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable), or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN FHS in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN FHS shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN FHS or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN FHS regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN FHS in writing that CHN FHS shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN FHS must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN FHS to engage a new IRO shall be made at the sole discretion of OIG.. APPENDIX B SKILLED NURSING FACILITY CLAIMS REVIEW

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph Section B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable)E, or has failed to carry out its responsibilities as described in Paragraph Section C, OIG shall notify CHN Novartis in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualificationsOIG may, independenceat its sole discretion, relationship to CHN or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN in writing that CHN shall be required require Novartis to engage a new IRO in accordance with Paragraph Section A of this Appendix. CHN Novartis must engage a new IRO within 60 days of its receipt of OIG’s written notice. The Prior to requiring Novartis to engage a new IRO, OIG shall notify Novartis of its intent to do so and provide a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Novartis may present additional information regarding the IRO’s qualifications, independence, or performance of its responsibilities. OIG will attempt in good faith to resolve any differences regarding the IRO with Novartis prior to requiring Novartis to terminate the IRO. However, the final determination as to whether or not to require CHN Novartis to engage a new IRO shall be made at the sole discretion of OIG.. APPENDIX C

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable)E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN Neurosurgical Associates in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN Neurosurgical Associates shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN Neurosurgical Associates regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN Neurosurgical Associates in writing that CHN Neurosurgical Associates shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN Neurosurgical Associates must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN Neurosurgical Associates to engage a new IRO shall be made at the sole discretion of OIG.OIG.‌ 3‌ Appendix A

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable)E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN PC, Xxxxx, and Bandar in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN PC, Xxxxx, and Bandar shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN PC, Xxxxx, and Bandar regarding the its IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN PC, Xxxxx, and Bandar in writing that CHN PC, Xxxxx, and Bandar shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN PC, Xxxxx, and Xxxxxx must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN PC, Xxxxx, and Xxxxxx to engage a new IRO shall be made at the sole discretion of OIG.

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable), or has failed to carry out its responsibilities as described in Community Health Systems, Inc. Corporate Integrity Agreement, Amended – Appendix A Paragraph C, OIG shall notify CHN CHSI in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN CHSI shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN CHSI or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN CHSI regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN CHSI in writing that CHN CHSI shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN CHSI must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN CHSI to engage a new IRO shall be made at the sole discretion of OIG.. Community Health Systems, Inc. Corporate Integrity Agreement, Amended – Appendix A

OIG Removal of IRO. In the event OIG has reason to believe that the IRO (including the Legal Reviewer(s)) does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable)E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN PANF in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN PANF shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN PANF regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN PANF in writing that CHN PANF shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN PANF must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN PANF to engage a new IRO shall be made at the sole discretion of OIG.OIG.‌ Integrity Agreement with Patient Access Network Foundation Appendix B‌‌

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable)E, or has failed to carry out its responsibilities as described in Paragraph C, OIG shall notify CHN Eastern Iowa Dermatology in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN Eastern Iowa Dermatology shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN independence or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN Eastern Iowa Dermatology regarding the its IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN Eastern Iowa Dermatology in writing that CHN Eastern Iowa Dermatology shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN Eastern Iowa Dermatology must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN Eastern Iowa Dermatology to engage a new IRO shall be made at the sole discretion of OIG.

OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in Paragraph B, is not independent and objective as set forth in Paragraph E or has a prohibited relationship as set forth in paragraph F (as applicable), or has failed to carry out its responsibilities as described in in‌ Paragraph C, OIG shall notify CHN CHSI in writing regarding OIG’s basis for determining that the IRO has not met the requirements of this Appendix. CHN CHSI shall have 30 days from the date of OIG’s written notice to provide information regarding the IRO’s qualifications, independence, relationship to CHN CHSI or performance of its responsibilities in order to resolve the concerns identified by OIG. If, following OIG’s review of any information provided by CHN CHSI regarding the IRO, OIG determines that the IRO has not met the requirements of this Appendix, OIG shall notify CHN CHSI in writing that CHN CHSI shall be required to engage a new IRO in accordance with Paragraph A of this Appendix. CHN CHSI must engage a new IRO within 60 days of its receipt of OIG’s written notice. The final determination as to whether or not to require CHN CHSI to engage a new IRO shall be made at the sole discretion of OIG.. APPENDIX B CLAIMS REVIEW‌