Reimbursement Matters. Except as disclosed on Schedule 3.1(x), (a) Seller has not and, to the Seller's Knowledge, no nursing home, hospital or other facility with respect to which Seller provides services has received any written notice of denial or recoupment from the Medicare or Medicaid programs, or any other third party reimbursement source (inclusive of managed care organizations) with respect to products or services provided by Seller, (b) to the Seller's Knowledge, there is no basis for the assertion after the Closing Date of any such denial or recoupment claim, and (c) neither Seller nor, to the Seller's Knowledge, any nursing home, hospital or other facility with respect to which Seller provides services has received written notice from any Medicare or Medicaid program or any other third party reimbursement source (inclusive of managed care organizations) of any pending or threatened investigations or surveys specifically with respect to, or arising out of, products or services provided by Seller, and to the Seller's Knowledge, no such investigation or survey is pending, threatened or imminent. Seller has fully and accurately disclosed to the appropriate intermediaries and carriers all material billing and business practices with respect to Medicare and Medicaid reimbursement with respect to the Business to the extent necessary for Seller to comply with applicable law. Seller has complied with all material requirements imposed by any such intermediary or carrier with respect to such billing. Seller has billed the applicable intermediaries and/or carriers for the services rendered by Seller in material compliance with all applicable Medicare and Medicaid laws, and Seller is not aware of any non-compliance by it with any state licensing or corporate practice of medicine law that would cause such billing or business practices to not be in material compliance with any of such Medicare or Medicaid laws. Seller has not received any notice from any regulatory authority or intermediary that indicates that Buyer could not continue to xxxx intermediaries in substantially the same manner and structure as Seller is billing on the date hereof.
Reimbursement Matters. Seller, to the extent necessary to conduct its business in a manner consistent with past practice, is qualified for participation in the Medicare and Medicaid programs. Except as disclosed on Schedule 13(u), (i) Seller and Shareholder have not received any notice of denial or recoupment from the Medicare or Medicaid programs, or any other third party reimbursement source (inclusive of managed care organizations) with respect to products or services provided by it, (ii) to Seller's and Shareholder's knowledge, there is no basis for the assertion after the Closing Date of any such denial or recoupment claim, and (iii) Seller and the Shareholders have not received notice from any Medicare or Medicaid program or any other third party reimbursement source (inclusive of managed care organizations) of any pending or threatened investigations or surveys with respect to, or arising out of, products or services provided by Seller or otherwise, and to the knowledge of Seller and the Shareholders, no such investigation or survey is pending, threatened or imminent.
Reimbursement Matters. Except as disclosed on Schedule 3.1(w) of the Company Disclosure Schedule, since January 1, 2001, (a) neither the Company nor any of the Subsidiaries has received any written notice of denial of payment or overpayment of a material nature from a federal health care program or any other third party reimbursement source (inclusive of managed care organizations) with respect to items or services provided by the Company and/or any of the Subsidiaries, other than those that have been finally resolved in any settlement for an amount less than $25,000, (b) to the knowledge of the Company, there is no basis for the assertion of any such denial or overpayment claim and (c) neither the Company nor any of the Subsidiaries has received written notice from a federal health care program or any other third party reimbursement source (inclusive of managed care organizations) of any pending or threatened legal proceedings or surveys specifically with respect to, or arising out of, items or services provided by the Company or any of the Subsidiaries, and to the knowledge of the Company, no such investigation or survey is pending, threatened or imminent. Neither the Company nor any of the Subsidiaries is subject to (i) a “focused review” of claims by Medicare or (ii) a “Corporate Integrity Agreement” or similar government-mandated compliance program.
Reimbursement Matters. (a) Company has filed when due all cost reports and other documentation and reports required to be filed with third-party payors and Governmental Authorities in compliance with applicable contractual provisions and Laws.
(b) Except as set forth on Schedule 3.29(b), since the Company was formed, neither Company nor Sellers has been informed of any Recoupment Claim or received any notice of denial of payment or overpayment from a federal health care program or any other third party reimbursement source (inclusive of managed care organizations) with respect to any items or services provided by any of them. There is no basis for any such Recoupment Claim or other claim.
(c) Neither Company nor any Seller is subject to: (i) a "focused review" of claims by Medicare; or (ii) a "Corporate Integrity Agreement" or similar government-mandated compliance program, nor does Company or any Seller have any reason to believe that Company or such Seller will become subject to: (i) a "focused review" of claims by Medicare; or (ii) a "Corporate Integrity Agreement" or similar government-mandated compliance program.
Reimbursement Matters. The Seller is not subject to (i) a "focused review" of claims by Medicare or (ii) a "Corporate Integrity Agreement" or similar government-mandated compliance program, nor does Seller have any reason to believe that Seller will become subject to (i) a "focused review" of claims by Medicare or (ii) a "Corporate Integrity Agreement" or similar government-mandated compliance program.
Reimbursement Matters. Seller has delivered or made available to Buyer complete copies of all Medicare cost reports and related forms that have been filed during the past three years with respect to the Business. Seller has not received any written notices that either Medicare or Medi-Cal has any claims against it which may reasonably be expected to result in consolidated net offsets against future reimbursement in excess of that provided for in such Financial Statements. Seller has not been indicted, convicted or, to the best of Seller's knowledge, subject to an investigation of the Office of Inspector General of the Department of Health and Human Services (the "OIG") or other applicable government agency, or received a notice from the OIG or other applicable government agency, with respect to a violation or an alleged violation of the Medicare and Medi-Cal fraud and abuse provisions of the federal Social Security Act or the physician ownership and referral provisions of the Ethics in Patient Referral Act, and to the best of Seller's knowledge, has Seller not committed a violation of any of such provisions.
Reimbursement Matters. 23 5.26 Medicare/Medicaid Participation......................................23 5.27
Reimbursement Matters. Except as set forth on Schedule 5.25, each of the Company, each Subsidiary and, to the Company's knowledge, each operator of any Managed Facility (each, a "MANAGED FACILITY OPERATOR"), to the extent necessary to conduct its business in a manner consistent with past practice, is qualified for participation in the Medicare and Medicaid programs, and each other third party reimbursement source in which it participates. Except as set forth on Schedule 5.25, none of the Company, any Subsidiary and any Managed Facility Operator has any liability with respect to recoupment from the Medicare or Medicaid programs or any other third party reimbursement source (inclusive of managed care organizations) that would exceed the reserves or allowances made therefor as set forth on the Balance Sheet, and there is no basis for the assertion of any such recoupment claim, and none of the Company, any Subsidiary and any Managed Facility Operator has received any notice of any such assertion, including without limitation, any notice of denial or recoupment from the Medicare or Medicaid programs, or any other third party reimbursement source that arose out of any transactions completed prior to the date hereof, and no Medicare or Medicaid investigation, survey, or audit is pending or, to the knowledge of the Company, threatened with respect to the operation of the business of any Facility. None of the Company, any Subsidiary and any Managed Facility Operator nor, to the knowledge of the Company, any of their respective licensed employees has been convicted of, or pled guilty or nolo contendere to any criminal offense related to any Medicare or Medicaid program while such person was an employee of any of them or after the termination of such person's employment by any of them for acts committed while employed by any of them, and, to the knowledge of the Company, none of such employees has committed any offense which may serve as the basis for suspension, restriction, or exclusion of the Company, any Subsidiary or any Managed Facility Operator from the Medicare and Medicaid programs, or any other third party reimbursement source. Except as set forth on Schedule 5.25, since January 1, 1998, none of the Company, the Subsidiaries and the Managed Facility Operators has received any notice from the Medicare or Medicaid programs or any other third party reimbursement source to the effect that the basis on which it receives reimbursement for its services is to be changed in any manner tha...
Reimbursement Matters. 27 Section 3.26
Reimbursement Matters. Except as disclosed on Schedule 2.31, --------------------- ------------- for the previous three years, the Seller, the Companies and the Subsidiaries have not received any written notice of denial of payment or overpayment of a material nature from a federal health care program or any other third party reimbursement source (inclusive of managed care organizations) with respect to items or services provided by any Company and/or any Subsidiary, other than those which have been finally resolved in any settlement for an amount less than $100,000.
