Third Party Payor Agreements. 38
(a) The Lessee or the Facility is fully qualified as a provider of services under and participates in all Third Party Payor Programs and referral programs as is necessary for the prudent operation of the Facility in the good faith exercise of commercially reasonable business judgment.
(b) Attached hereto as EXHIBIT C is a list of national accounts and local discount agreements, which constitute all of the agreements between the Lessee or the Facility, on the one hand, and Third Party Payors on the other hand, pursuant to which the Lessee or the Facility agrees to provide services based on a discount factor from the rates regularly charged for services rendered by the Lessee or the Facility.
(c) No member of the Leasing Group, nor the Facility has any rate appeal currently pending before any Governmental Authority or any administrator of any Third Party Payor Program or any other referral source other than such appeals which, if determined adversely to any member of the Leasing Group or the Facility would not have a materially adverse effect, either singly or in the aggregate, on the financial condition of any member of the Leasing Group or the Facility.
(d) All cost reports and financial reports submitted to any Third Party Payor with respect to the Facility by any member of the Leasing Group have been materially accurate and complete and have not been misleading in any material respect. As a result of any audits by any Third Party Payor, there are no related recoupment claims made or contests pending or threatened other than such recoupment claims or contests which, if determined adversely to any member of the Leasing Group or the Facility, would not have a materially adverse effect, either singly or in the aggregate, on the financial condition of any member of the Leasing Group or the Facility. As of the date hereof, no cost reports for the Facility remain open or unsettled other than those listed on EXHIBIT D.
Third Party Payor Agreements. Neither Lessee nor the Facility is qualified as a provider of services under or participates in any Third Party Payor Programs and neither Lessor nor the Facility is accredited by any Accreditation Body.
Third Party Payor Agreements. Neither Lessee with respect to the Facility nor the Facility is, or upon completion of construction, will be qualified as a provider of services under, or does, or upon completion of construction will, participate in, any Third Party Payor Programs and neither Lessee with respect to the Facility nor the Facility is, or upon completion of construction will be, accredited by an Accreditation Body.
Third Party Payor Agreements. The Lessee or the Facility is fully qualified as a provider of services under and participates in all Third Party Payor Programs and referral programs as is necessary for the prudent operation of the Facility in the good faith exercise of commercially reasonable business judgment.
Third Party Payor Agreements. From and after the Closing, the ---------------------------- Shareholders shall cause the New PC to cooperate in all ways necessary or reasonably requested by ADP with respect to the assignment from each Company to the New PC of, and the assumption by the New PC of such Company's obligations under, such agreements as may be designated by ADP pursuant to which either Company receives payments for the provision of dental services, whether in the form of capitation payments, on a fee-for- service basis, or otherwise, and obtaining the consents of the payors under those agreements, including without limitation causing the New PC to execute an assignment and assumption agreement in form and substance satisfactory to ADP.
Third Party Payor Agreements. Consents to the assignment of the Third Party Payor Agreements listed on Schedule 1.1(j) shall have been received by Care for Kids, to its satisfaction, and Care for Kids has, to its satisfaction, concluded any and all due diligence with respect to the relationship between Sellers and the Top 10 Third Party Payors, it being understood by the Parties that Care for Kids has entered into this Agreement based upon representations that the relationships with the Top 10 Third-Party Payors will continue following consummation of the transactions contemplated by this Agreement.
Third Party Payor Agreements. LHH and MIBSPC will use commercially reasonable efforts to offer Bariatric Services to beneficiaries under existing and new agreements with third party payors.
Third Party Payor Agreements. DIA acknowledges that Hospital has entered into, and will in the future enter into, Agreements with governmental agencies, preferred provider organizations, health maintenance organizations, and other public and private entities (‘Programs”) to provide health care services to the patient covered by the Programs at rates which may vary from Hospital’s and/or DIA’s customary charges for similar services to other patients. DIA agrees that, as requested by Hospital, DIA shall negotiate in good faith for participation by DIA in such programs and/or networks in which Hospital may participate with health maintenance organizations, preferred provider organizations, other payors and physician-hospital organizations. Hospital agrees to assist XXX in negotiating terms of participation. However, in the event DIA fails to agree to terms of participation and, as a result thereof, Hospital is threatened with exclusion or expulsion from the network or program or reduced compensation for its services, then Hospital may immediately terminate the exclusive provisions of this Agreement and further terminate the Agreement in its entirety pursuant to this Agreement. The other provisions of this Agreement to the contrary notwithstanding, if DIA fails to agree to terms of participation because proposed reimbursement rates fall below DIA’s lowest contracted rate of reimbursement for similar product lines (Medicare or Medicaid), Hospital shall not be able to terminate DIA.
Third Party Payor Agreements. Furthermore, many private third-party payor contracts contain provisions that allow the third-party payor to deny payment for any service rendered at a time when the provider was not in compliance with all applicable laws. Thus, violation of the federal anti-kickback law can result in significant loss of reimbursement, or claims for recovery of reimbursements previously paid, not only with respect to Medicare and Medicaid but also with respect to private third-party payors.
Third Party Payor Agreements. A. Neither the Borrower nor the Facility is qualified as a provider of services under or participates in any Third Party Payor Programs and neither Borrower nor the Facility is accredited by any Accreditation Body; B. No provision of this Loan Agreement shall be deemed to require the Borrower to commence participation in any Third Party Payor Program or any Managed Care Plan; .
