Common use of Participation Criteria Clause in Contracts

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. §0000 et seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (a) PROVIDER understands and agrees meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, abuse including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. §0000 et U.S.C. 3729 et. seq.) and the anti-anti- kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l)), and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, 162 and 164. PROVIDER hereby warrants and represents PROVIDER and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (a) PROVIDER understands and agrees meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, , (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, Participating Provider, or any practitionerpractitioner of PROVIDER, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. U.S.C. §0000 3729 et seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), ) and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier numberIdentification Number, as applicable. (a) PROVIDER understands and agrees meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs Plan(s)/Product programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, or any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s his/her/its employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. §0000 et seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal Federal health care program as described in Sections 1128B(b) and Section 1128B(f) of the Social Security Act, and that all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current Universal Provider Identification Number and/or National Provider Identifier number, as applicableIdentifier. (a) PROVIDER understands and agrees that meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs Plan(s)/Product programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal Federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands that this Agreement shall automatically be terminated if PROVIDER, any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal Federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s his/her/its employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. U.S.C. §0000 3729 et seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (a) PROVIDER understands and agrees meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, or any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. §0000 et seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (a) PROVIDER understands and agrees meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s his/her/its employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including but not limited to, general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal Federal funds, including applicable HIPAA administrative simplification rules at 45 C.F.R. parts 160, 162, and 164; and federal laws and regulations designed to prevent or ameliorate fraud, waste waste, and abuse, including applicable provisions of federal criminal lawincluding, but not limited to, the False Claims Act (31 X.X.X. §0000 et U.S.C. 3729 et. seq.) and the anti-kickback statute (section 1128B(b) of the Act, 42 U.S.C. §1320a-7b(b)), 42 CFR C.F.R. §§422.504(h)(l§ 422.504(h)(1), 423.505(h)(l423.505(h)(1), and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal Federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and that all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (a) PROVIDER understands and agrees that meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs Plan(s)/Product programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal Federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal Federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage programProgram, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. §0000 et U.S.C. 3729 et. seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), ) and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, 162 and 164. PROVIDER hereby warrants and represents PROVIDER that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal Federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and that all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (a) PROVIDER understands and agrees that meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs Plan(s)/Product programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal Federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands that this Agreement shall automatically be terminated if PROVIDER, any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal Federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services services, currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. U.S.C. §0000 3729 et seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier numberIdentifier, as applicable. (a) PROVIDER understands and agrees meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs Plan(s)/Product programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.the

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services services, currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. §0000 et seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier numberIdentifier, as applicable. (a) PROVIDER understands and agrees meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs Plan(s)/Product programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.the

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal Federal funds; federal laws law designed to prevent or ameliorate fraud, waste waste, and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. U.S.C. §0000 et 3729 et. seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR CFR. §§422.504(h)(l), 423.505(h)(l), ) and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (a) PROVIDER understands and agrees that meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, PROVIDER or any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws law designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. U.S.C. §0000 et 3729 et. seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l423.505 (h)(l), ) and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (a) PROVIDER understands and agrees that meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s his/her/its employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. §0000 U.S.C. 3729 et seq.) and the antianti kick-kickback back statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l422.504(h)(1), 423.505(h)(l423.505(h)(1), and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal Federal health care program as described in Sections Section 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (a) PROVIDER understands and agrees that meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal Federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, or any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal Federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER understands and agrees payments may be derived from federal and State funds, and PROVIDER shall be civilly and/or criminally liable to both Plan(s) and government agencies for non-performance, non-compliance, misrepresentation, and fraud or abuse of Covered Services rendered hereunder. (a) PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s his/her/its employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services services, currently meet, and throughout the Term of this Agreement shall continue to meet meet, any and all applicable conditions necessary to participate in the Medicaid, Medical Assistance, Medicare/Medicare Advantage programprograms, including general provisions relating to non- non-discrimination, sexual harassment harassment, or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. U.S.C. §0000 3729 et seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), ) and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, . and 164. PROVIDER hereby warrants and represents PROVIDER PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections Section 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, as applicable. (ab) PROVIDER understands and agrees meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder andhereunder, and is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs Plan(s)/Product covered under this Agreement. (bc) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands agrees this Agreement shall automatically be terminated if PROVIDER, or any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.

Participation Criteria. PROVIDER hereby warrants and represents that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors and/or independent contractors who provide Covered Services under this Agreement, including without limitation health care, utilization review, and/or administrative services currently meet, and throughout the Term of this Agreement shall continue to meet any and all applicable conditions necessary to participate in the Medicare/Medicare Advantage program, including general provisions relating to non- non-discrimination, sexual harassment or fraud and abuse, as well as all applicable laws pertaining to the receipt of federal funds; federal laws designed to prevent or ameliorate fraud, waste and abuse, including applicable provisions of federal criminal law, the False Claims Act (31 X.X.X. U.S.C. §0000 3729 et seq.) and the anti-kickback statute (42 U.S.C. §1320a-7b(b)), 42 CFR §§422.504(h)(l), 423.505(h)(l), ) and the HIPAA administrative simplification rules at 45 CFR Parts 160, 162, and 164. PROVIDER hereby warrants and represents PROVIDER that PROVIDER, and all of PROVIDER’s employees, affiliates, subcontractors, and/or independent contractors are not excluded, sanctioned or barred from participation under a federal health care program as described in Sections 1128B(b) and 1128B(f) of the Social Security Act, and all employees, affiliates, subcontractors, and/or independent contractors of PROVIDER are able to provide a current National Provider Identifier number, Number as applicable. (a) PROVIDER understands and agrees meeting the Participation Criteria is a condition precedent to PROVIDER’s participation, and a condition precedent to the participation by PROVIDER’s employees, affiliates, subcontractors, and/or independent contractor(s) hereunder and, is an ongoing condition to the provision of Covered Services hereunder by both the PROVIDER as well as a condition precedent to the reimbursement by XXXXX for such Covered Services rendered by PROVIDER. Upon PROVIDER’s meeting all of the Participation Criteria set forth in this Agreement PROVIDER shall participate as a Participating Provider for Plan(s)/programs Plan(s)/Product programs covered under this Agreement. (b) PROVIDER may not employ, contract with, or subcontract with an individual, or with an entity that employs, contracts with, or subcontracts with an individual, who is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in a federal Federal health care program for the provision of any of the following: (a) health care, (b) utilization review, (c) medical social work or (d) administrative services. PROVIDER acknowledges and understands this Agreement shall automatically be terminated if PROVIDER, or any practitioner, or any person with an ownership or control interest in PROVIDER, is excluded from participation in Medicare under Section 1128 or 1128A of the Social Security Act or from participation in any other federal health care program. Any payments received by PROVIDER hereunder on or after the date of such exclusion shall constitute overpayments.