EXHIBIT 10.5
SETTLEMENT AGREEMENT AND RELEASE
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I. PARTIES
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This Settlement Agreement ("Agreement") is entered by and among:
A. The United States of America, acting through its Department of Justice
and the United States Attorneys' Offices for the Districts of Massachusetts and
the Southern District of Florida, and on behalf of (1) the United States
Department of Health and Human Services through its Office of Inspector
General("HHS-OIG"); (2) the United States Department of Defense through its
TRICARE Support Office ("TSO") (formerly the Office of the Civilian Health and
Medical Program of the Uniformed Services), a field activity of the Office of
the Secretary of Defense, through counsel; (3) the United States Office of
Personnel Management ("OPM"), through the Director of Programs; and (4) the
United States Department of Veteran Affairs ("VA"), through counsel;
(collectively the preceding will be referred to as the "United States");
B. National Medical Care, Inc. ("NMC"), a Delaware corporation, and its
affiliate entities listed on Exhibit E hereto that provide or have provided
dialysis services (jointly and severally "DSD"); and Fresenius Medical Care
Holdings, Inc. ("FMCH") (d/b/a Fresenius Medical Care North America); and
C. Xxxxxxx X. Xxxxx ("Price"), individually, and Xxxxxxx Xxxxxxxx
("Bradford"), individually, (collectively the "Relators"), each acting through
his authorized representative.
Collectively, all of the above will be referred to as "the Parties."
II. PREAMBLE
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A. WHEREAS, at all relevant times, NMC primarily was in the business of
providing dialysis and related services to patients with End-Stage Renal Disease
("ESRD") throughout the United States.
B. WHEREAS, DSD submitted or caused to be submitted ESRD claims for
payment for dialysis, patient care, and related goods and services to the
Medicare program, Title XVIII of the Social Security Act, 42 U.S.C. (S)(S) 1395-
1395ddd (1997), which is administered by HHS;
C. WHEREAS, DSD submitted or caused to be submitted ESRD claims for
payment for dialysis, patient care, and related goods and services to the
TRICARE Program (also known as the Civilian Health and Medical Program of the
Uniformed Services ("CHAMPUS")), 10 U.S.C. (S)(S) 1071-1106, which is
administered by the Department of Defense through the TSO;
D. WHEREAS, DSD submitted or caused to be submitted ESRD claims for
payment for dialysis, patient care, and related goods and services to the
Federal Employees Health Benefit Program ("FEHBP"), 5 U.S.C. (S)(S) 8901-8914,
which is administered by OPM;
E. WHEREAS, DSD submitted or caused to be submitted ESRD claims for
payment for dialysis, patient care, and related goods
and services to the Railroad Retirement Medicare program ("Railroad Medicare"),
established under the Railroad Retirement Act of 1974, 45 U.S.C. (S)(S) 231-
231v, which is paid from the Medicare Trust Fund, and administered by the United
States Railroad Retirement Board ("RRB");
F. WHEREAS, DSD submitted or caused to be submitted ESRD claims for
payment for dialysis, patient care, and related goods and services to the
Veteran Affairs Program, 38 U.S.C. (S)(S) 1701-1743, which is administered by
the VA;
G. WHEREAS, DSD submitted or caused to be submitted ESRD claims for
payment for dialysis, patient care, and related goods and services to the
Medicaid programs, 42 U.S.C. (S)(S) 1396-1396v (1997), of the thirty-three
states of Alabama, Arizona, Arkansas, California, Connecticut, Colorado,
Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Maine, Maryland,
Massachusetts, Michigan, Mississippi, Missouri, New Hampshire, New Jersey, New
Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island,
South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin, and the
District of Columbia, (the "Participating States"), and to the Territory of
Puerto Rico (the "Participating Territory");
H. WHEREAS, the United States contends that it has certain civil claims
against DSD and NMC, and against FMCH, as parent, for violations of the federal
statutes and/or common law doctrines, specified in Paragraph 10 below in
connection with the following conduct ("the Covered Conduct"):
(1) Failing to refund to HCFA or its fiscal intermediaries, overpayments
(hereinafter "Unreconciled Payments") received by DSD from Medicare that DSD
reported as Unreconciled Payments on HCFA Forms 838;
(2) Failing to report on HCFA Forms 838 filed or caused to be filed by DSD
from 1991 to the present, Unreconciled Payments it had received from the
Medicare program, and recognized as income during the period 1975-1993;
(3) In connection with amendments to the Medicare Secondary Payor
provisions made by the Omnibus Budget Reconciliation Act ("OBRA") of 1993 ("OBRA
`93"), failing to report to HCFA or its fiscal intermediaries on HCFA Forms 838
Unreconciled Payments at the time of billing to employer group health plans and
otherwise failing to report in a timely fashion to HCFA or its fiscal
intermediaries.
(4) Failing to report and/or refund to HCFA or its fiscal intermediaries
overpayments that Home Dialysis Services, Inc. ("HDS"), a company established by
NMC, had received from the Medicare program resulting from its billing of home
dialysis services and equipment in excess of the Method II home dialysis cost
cap contained in OBRA `89;
(5) Failing to report and/or refund to HCFA and its fiscal intermediaries
overpayments received by HDS from the Medicare program resulting from its
billing in excess of the reasonable charge for home dialysis prior to OBRA `89;
(6) Failing to report and/or refund to the Participating States and
Territory Medicaid programs overpayments received during the years 1975-1993;
(7) Failing to report and/or refund to TRICARE overpayments received
during the years 1975-1993;
(8) Failing to report and/or refund to FEHPB overpayments received
during the years 1975-1993; and
(9) Failing to report and/or refund to the VA overpayments received
during the years 1975-1993.
I. WHEREAS, the United States also contends that it has certain
administrative claims against DSD and FMCH, as parent, under the provisions for
permissive exclusion from the Medicare, Medicaid and other federal health care
programs, 42 U.S.C. (S) 1320a-7(b), and the provisions for civil monetary
penalties, 42 U.S.C. (S) 1320a-7a, for the Covered Conduct.
J. WHEREAS, Relator Xxxxxxx X. Xxxxx has filed under seal a qui tam
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complaint on behalf of the United States: United States ex rel. Price v. W.R.
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Grace & Co., National Medical Care, Inc., et al., Civil Action No. 97-11022-NG
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(D. Mass.)(the "Price Civil Action").
K. WHEREAS, Relator Xxxxxxx Xxxxxxxx has filed under seal a qui tam
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complaint on behalf of the United States: United States ex rel. Xxxxxxxx x.
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National Medical Care, Inc., et al., Civil Action No. 96-3350-Hoeveler (S.D.
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Fla.)(the "Bradford Civil Action").
L. WHEREAS, DSD, and FMCH specifically deny and affirmatively contest
the contentions of the United States as set
forth in Paragraph H, above, and the allegations of the Relators in the Price
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and Bradford Civil Actions, and specifically deny any wrongdoing in connection
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with those claims; and further contend that DSD's practices described in the
Covered Conduct were appropriate and lawful and did not result in any violations
of federal law, state law, or common law doctrines, and do not give rise to any
civil or administrative cause of action; and
M. WHEREAS, over the years, DSD reported Medicare Unreconciled Payments
on HCFA Forms 838 through the quarter ended December 31, 1998, of which NMC and
FMCH warrant and represent on Exhibit E attached hereto and incorporated herein
by reference, that $10,982,885.16 million has not yet been recouped by the
fiscal intermediaries as of January 3, 2000 and remains outstanding ("Unrecouped
Credit Balances"); and
N. WHEREAS, in order to avoid the delay, uncertainty, inconvenience and
expense of protracted litigation of these claims and contentions of the Parties,
the Parties reach a full and final compromise for the Covered Conduct, pursuant
to the Terms and Conditions set forth below.
III. TERMS AND CONDITIONS
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NOW, THEREFORE, in reliance on the representations contained herein and in
consideration of the mutual promises, covenants, and obligations in this
Agreement, and for good and valuable consideration, receipt of which is hereby
acknowledged, the Parties agree as follows:
1. NMC and FMCH, collectively, shall pay to the United States and the
Participating States and Participating Territory, collectively, the sum of
sixteen million eight hundred seventeen thousand seven hundred eight dollars
($16,817,708) (the "Settlement Amount"), and this sum shall constitute a debt
immediately due and owing to the United States on the "First Payment Date",
which is the later of the dates on which (a) the four civil Settlement
Agreements are fully executed by the Parties, (b) all notices of dismissal
described in the civil Settlement Agreements are docketed by the Court, or (c)
the Court accepts LIFECHEM, INC.'s, NMC Medical Products, Inc.'s, and NMC
Homecare, Inc.'s guilty pleas and imposes the sentences set forth in their
respective Plea Agreements. NMC and FMCH, collectively, shall pay the
Settlement Amount to the United States according to the schedule, terms and
instructions contained in the Promissory Note executed contemporaneously with
this Agreement, attached as Exhibit A, and incorporated herein by reference.
Within a reasonable amount of time after receipt of the first payment from NMC
and FMCH pursuant to the terms of the Promissory Note, the United States shall
pay to (a) the Participating States, collectively, according to written payment
instructions from the Participating States, an amount of seven hundred fifty
four thousand one hundred twenty-five dollars ($754,125) as their share of the
Settlement Amount and (b) the Participating Territory, according to written
payment instructions from the Participating Territory, an amount of sixty
thousand one hundred
fifty-five dollars ($60,155) as its share of the Settlement Amount.
2. As an express condition of the Settlement Agreement, to secure NMC's
and FMCH's payment obligations under Paragraph 1 of this Agreement (and the
other civil Settlement Agreements and criminal Plea Agreements being executed at
the same time), NMC and FMCH shall:
(a) procure from the Bank of Nova Scotia and deliver or cause to be
delivered to the United States Attorney's Office for the District of
Massachusetts, on or before January 19, 2000, an amendment to the unconditional,
irrevocable Letter of Credit No. S020/43695/96 issued to the United States of
America on September 27, 1996 (the "Letter of Credit") to increase the amount of
the Letter of Credit to $189,634,446.00. Such amendment shall be in the form
attached as Exhibit B. Within 10 days of receipt by the U.S. Attorney's Office
of written confirmation from the transferring bank that a quarterly payment, as
described in Paragraphs 1.B. through 1.E. of the Promissory Note, or prepayment
of such quarterly payments, has been made to the United States, the United
States shall provide written permission to the Bank of Nova Scotia to reduce the
amount available for drawing under Letter of Credit No. S020/43695/96 by the
amount of the principal payment received. In the event that the entire
outstanding payment obligation secured by the Letter of Credit is prepaid, then
the United States shall provide written permission to reduce the amount
available for drawing to zero. The United States shall return this Letter of
Credit for cancellation when
all obligations are paid in full or it is determined, by the United States, or
pursuant to a final and non-appealable order of a court of competent
jurisdiction, that NMC and FMCH have fulfilled all payment obligations pursuant
to this Agreement.
(b) On January 19, 2000, NMC and FMCH shall establish an escrow account in
an initial amount of $236,401,919.00 to be held by an independent third party
agreeable to the United States, and NMC and FMCH shall increase the escrow
amount each day in an amount of $48,546.00 (through accrued interest and/or
deposits), beginning on January 20, 2000 and continuing through April 15, 2000,
when NMC and FMCH shall increase the escrow amount by an additional amount each
day of $7,271.00 (through accrued interest and/or deposits), for each quarterly
payment due before the first payment is due on the First Payment Date. On the
First Payment Date, all funds in the escrow account shall be paid to the United
States to satisfy the payment obligation in Paragraph 1. The terms and
conditions of this escrow account shall in no way limit NMC's and FMCH's payment
obligations to the United States secured by the Letter of Credit.
3. NMC and FMCH, collectively, agree to pay to the Health Care Financing
Administration ("HCFA") the Unrecouped Credit Balances, and this sum shall
constitute a debt immediately due and owing to the United States upon the later
of the date on which (a) this Agreement is fully executed by the Parties, or (b)
the notices of dismissal described in Paragraph 18 of this Agreement are filed
and docketed by the Court. NMC and FMCH shall pay the Unrecouped Credit
Balances in accordance with
written payment instructions to be provided by the United States Attorneys's
Office for the District of Massachusetts. HCFA shall direct its fiscal
intermediaries identified in Exhibit E, in writing, that they should cease any
efforts to recoup the Unrecouped Credit Balances received by DSD prior to
January 1, 1999 and reported by DSD on Forms 838. NMC and FMCH shall provide
HCFA with any additional documentation necessary to this process. In the event
that HCFA or any fiscal intermediary initiates a recoupment contrary to such
directions, NMC and FMCH shall notify Xxxx Xxxxxxxx, Associate General Counsel
of HCFA, and HCFA shall instruct the fiscal intermediary to suspend the
recoupment.
4. NMC and FMCH are in default of this Agreement on
the date of occurrence of any of the following events ("Events of Default"):
a. NMC's and FMCH's failure to procure, deliver or maintain the
Letter of Credit;
b. NMC's and FMCH's failure to pay any amount provided for in the
Promissory Note attached as Exhibit A within two days of when such payment is
due and payable;
1. NMC's and FMCH's failure to pay the Unreconciled
Credit Balances as provided for in Paragraph 3 above;
d. If prior to making the full payment of the amount
due under the Promissory Note or Paragraph 3 above,(i) NMC and/or
FMCH commences any case, proceeding, or other action (A) under
relief of debtors, seeking to have any order for relief of
debtors, or seeking to adjudicate NMC and/or FMCH as bankrupt or
insolvent, or (B) seeking appointment of a receiver, trustee,
custodian or other similar official for NMC and/or FMCH or for
all or any substantial part of NMC's and/or FMCH's assets; or
(ii) there shall be commenced against NMC and/or FMCH any such
case, proceeding or other action referred to in clause (i) which
results in the entry of an order for relief and any such order
remains undismissed, or undischarged or unbonded for a period of
thirty (30) days; or (iii) NMC and/or FMCH takes any action
authorizing, or in furtherance of, or indicating its consent to,
approval of, or acquiescence in, any of the acts set forth above
in this sub-Paragraph 4.d.;
2. Failure by NMC and FMCH to establish, maintain or
make the required payments to the escrow account described in
Paragraph 2b.
If payments due under Paragraph 1 are received late, but within
the two-day grace period provided in Paragraph 5 of the
Promissory Note, interest incurred during such grace period will
be assessed at two times the daily amount in effect on the date
the payment was due.
6. NMC and FMCH shall provide the United States written notice of an
Event of Default within two (2) business days of such event by overnight mail,
or facsimile followed by overnight delivery, to the United States Attorney's
Office, District of Massachusetts, Xxx Xxxxxxxxxx Xxx, Xxxxx 0000, Xxxxxx, XX
00000, Attention: Xxxxxxx X. Xxxxxxx, Assistant U.S. Attorney (or to the
attention of such other person as may be designated in writing by the United
States Attorney's Office).
7. Immediately upon the occurrence of an Event of Default,
without further notice or presentment and demand by the United States:
a. The Settlement Amount plus accrued interest through the end of the
applicable quarter as set forth in Paragraph 1 of the Promissory Note and the
Unreconciled Credit Balances referenced in Paragraph 3 above (minus any payments
to date of principle and accrued interest) shall become immediately due and
payable ("Settlement Default Amount"). Interest shall be calculated on the
Settlement Default Amount at the Prime Rate as published in the Wall Street
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Journal on the Effective Date of this Agreement, plus 5% from the date of the
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Event of Default.
b. In addition, NMC and FMCH will pay the United States all
reasonable costs of collection and enforcement of this Agreement, including
attorney's fees and expenses, plus interest described in Paragraph 7.a. above.
The Settlement Default Amount, plus interest, described in Paragraph 7.a. above,
together with the costs of collection and enforcement described
in this sub-paragraph, will be referred to as the "Default Obligation".
8. Upon the occurrence of an Event of Default, the United States may
exercise, at its sole option, one or more of the following rights:
a. The United States may draw the full amount available for drawing
under the Letter of Credit and retain all proceeds thereof.
b. The United States may enforce the terms of the Guarantee
Agreement between the United States of America, Fresenius Medical Care GMBH, a
German corporation and the predecessor of Fresenius Medical Care AG, X.X. Xxxxx
& Co., a New York corporation, and National Medical Care, Inc., dated July 31,
1996, attached as Exhibit C.
c. The United States retains any and all other rights and remedies
it has or may have under law and equity.
3. No failure or delay on the part of the United States to exercise
any right or remedy shall operate as a waiver of the United
States' rights. No single or partial exercise by the United
States of any right or remedy shall operate as a waiver of the
United States' rights.
9. In an Event of Default under Paragraph 4.d. above (Commencement of
Bankruptcy or Reorganization Proceeding): a. NMC and FMCH agree not to
contest or oppose any motion filed by the United States seeking relief
from or
modification of the automatic stay of 11 U.S.C. (S) 362(a); not
to seek relief under 11 U.S.C. (S) 105 to enjoin or restrain the
United States from recovering monies owed by NMC and FMCH arising
out of this Agreement or the attached Promissory Note, or from
recovering monies through presentment against the Letter of
Credit. NMC and FMCH recognize that this express waiver is in
consideration for the settlement of claims by the United States
described in Preamble Paragraph H above, under the terms and
conditions contained in this Settlement Agreement.
b. By expressly waiving the automatic stay provision,
NMC and FMCH agree not to oppose or interfere with any motion
made in federal court (including bankruptcy courts) by the United
States to suspend payments to NMC and DSD from the Title XVIII
(Medicare), Title XIX (Medicaid) programs, and other federal
health care programs;
c. This Agreement shall be voidable at the sole
option of the United States;
d. If any term(s) of this Agreement are set aside for
any reason, including as a result of a preference action brought
pursuant to 11 U.S.C. (S) 547, the United States, at its sole
option and in its discretion, may rescind all
terms of this Agreement and seek recovery of the full amount of
claims and allegations identified herein and in the Civil
Actions, or, in the alternative, enforce the remaining terms of
this Agreement. In the event of rescission of this Agreement, all
Parties reserve all rights, claims, and defenses that are
available under law and equity as of the Effective Date of this
Agreement; and
e. In addition to the rights enumerated in Paragraph
8.a. through 8.d. above, the United States and all other Parties
shall retain all rights and claims they have or may have under
law and equity.
10. Subject to the exceptions and limitations in Paragraph
11 below, in consideration of the obligations of DSD and FMCH set
forth in this Agreement, conditioned upon payment in full of the
Settlement Amount and the Unrecouped Credit Balances, subject to
Paragraph 30, (concerning bankruptcy proceedings commenced within
91 days of any payment under this Agreement), the United States,
on behalf of itself, and its officers, agents, agencies, and
departments, will release and will be deemed to have released DSD
including NMC, FMCH, and the subsidiaries of NMC and FMCH listed
on the
attached Exhibit D (collectively, the subsidiaries of NMC and
FMCH listed on Exhibit D will be referred to as the "NMC
Companies," and the corporate entities listed on Exhibit D
comprise the only entities which constitute the "NMC Companies"
within the meaning of this Agreement), and the current directors,
officers, employees, and agents of the DSD, FMCH and the NMC
Companies who were not employed by or in any way affiliated with
DSD, FMCH and the NMC companies prior to September 30, 1996, from
any civil or administrative monetary claim (including recoupment
claims) that the United States has or may have under the False
Claims Act, 31 U.S.C. (S)(S) 3729-3733; the Program Fraud Civil
Remedies Act, 31 U.S.C. (S)(S) 3801-3812; the Civil Monetary
Penalties Law, 42 U.S.C. (S) 1320a-7a; or common law claims for
fraud, payment by mistake of fact, breach of contract or unjust
enrichment for the conduct described in Preamble Paragraphs H and
M above with respect to Medicare, Railroad Retirement Medicare,
TRICARE, FEHBP, the VA, and/or the Medicaid programs of the
Participating States and the Participating Territory.
11. Notwithstanding any term of this Agreement, the United
States specifically does not
release DSD, FMCH or the NMC Companies, or any individual from
any and all of the following: (a) any potential criminal, civil
or administrative claims arising under Title 26, U.S. Code
(Internal Revenue Code); (b) any criminal liability; (c) any
potential liability to the United States (or any agencies
thereof) for any conduct other than that identified in Preamble
Paragraphs H and M above, including but not limited to any
allegations in the Civil Actions not encompassed by Preamble
Paragraphs H and M; (d) any entities not specifically included on
the list of NMC Companies set forth in Exhibit D; (e) any claims
based upon such obligations as are created by this Agreement; (f)
except as explicitly stated in this Agreement, any administrative
liability, including mandatory exclusion from Federal health care
programs; (g) any express or implied warranty claims or other
claims for defective or deficient products and services provided
by DSD, including quality of testing or product claims; (h) any
claims for personal injury or property damage or for other
consequential damages arising from the conduct described in
Preamble Paragraphs H and M above; (i) any claims based upon
failure to deliver items or services; (j) any civil or
administrative claims against any individual who was an officer,
director, trustee, agent, employee, or was in any way affiliated
with DSD or NMC's parents, subsidiaries, divisions, or affiliates
at any time prior to September 30, 1996; or (k) any civil or
administrative claims against any individual, including current
directors, officers, employees and agents, who is criminally
indicted or convicted of an offense, or who enters a criminal
plea related to the conduct alleged in Preamble Paragraphs H and
M above.
12. FMCH, on behalf of itself and its parents, affiliates,
subsidiaries, and divisions, including but not limited to NMC,
has entered into a Corporate Integrity Agreement with HHS-OIG,
which is incorporated by reference into this Agreement. FMCH
will immediately upon execution of this Agreement implement its
obligations under the Corporate Integrity Agreement.
13. In consideration of the obligations of DSD and FMCH
set forth in this Agreement, conditioned upon payment in full of
the Settlement Amount and the Unrecouped Credit Balances, subject
to Paragraph 30 below (concerning bankruptcy proceedings
commenced within 91 days of any payment under this Agreement),
and conditioned upon FMCH's entering into the Corporate Integrity
Agreement incorporated by reference, the OIG-HHS agrees to
release and refrain from instituting, directing, or maintaining
any administrative claim or any action seeking exclusion from the
Medicare, Medicaid or other Federal health care programs (as
defined in 42 U.S.C. (S) 1320a-7b(f)) against DSD, FMCH or the
NMC Companies and their current directors, officers, employees,
and agents who were not employed by or in any way affiliated with
DSD or any of NMC's parents, subsidiaries, divisions, or
affiliates at any time prior to September 30, 1996, under 42
U.S.C. (S) 1320a-7a (Civil Monetary Penalties Law) or 42 U.S.C.
(S) 1320a-7(b) (permissive exclusion) for the conduct described
in Preamble Paragraphs H and M, except as reserved in Paragraph
11 above and as reserved in this Paragraph. The OIG-HHS
expressly reserves all rights to comply with any statutory
obligations to exclude the DSD, FMCH and the NMC Companies from
the Medicare, Medicaid, or other Federal health care programs
under 42 U.S.C. (S) 1320a-7(a) (mandatory exclusion). Nothing in
this Paragraph precludes the OIG-HHS from taking action against
entities or individuals for conduct and practices for which civil
claims have been reserved in Paragraph 11 above.
14. In consideration of the obligations of DSD and
FMCH set forth in this Agreement, conditioned upon payment in
full of the Settlement Amount and Unrecouped Credit Balances, and
subject to Paragraph 30 below (concerning bankruptcy proceedings
commenced within 91 days of any payment under this Agreement),
TSO agrees to release and refrain from instituting, directing, or
maintaining any administrative claim or any action seeking
exclusion from the TRICARE program against DSD, FMCH or the NMC
Companies and their directors, officers, employees, and agents
who were not employed by or in any way affiliated with DSD or
NMC's subsidiaries, divisions, and affiliates at any time prior
to September 30, 1996, under 32 C.F.R. (S) 199.9 for the conduct
described in Preamble Paragraphs H and M, except as reserved in
Paragraph 11 above and as reserved in this Paragraph. The TSO
expressly reserves all rights to comply with any statutory
obligations to exclude DSD, FMCH and the NMC Companies from the
TRICARE program under 32 C.F.R. (S)(S) 199.9(f)(1)(i)(A),
(f)(1)(i)(B), (f)(1)(i)(D), and (f)(1)(iii). Nothing in this
Paragraph precludes the TSO from taking action against entities
or persons, or for conduct or practices, for which
civil claims have been reserved in Paragraph 11 above.
15. In consideration of the obligations of DSD and FMCH as
set forth in this Agreement, conditioned upon payment in full of
the Settlement Amount and Unrecouped Credit Balances, and subject
to Paragraph 30 below (concerning bankruptcy proceedings
commenced within 91 days of any payment under this Agreement),
OPM agrees to release and refrain from instituting, directing, or
maintaining any administrative claim or any action seeking
exclusion from FEHBP against DSD, FMCH and the NMC Companies and
their directors, officers, employees, and agents who were not
employed by or in any way affiliated with DSD or NMC's
subsidiaries, divisions, or affiliates at any time prior to
September 30, 1996, under 5 U.S.C. (S) 8902a or 5 C.F.R. Part 970
for the conduct described in Preamble Paragraphs H and M
including that in the Civil Action, except as reserved
in Paragraph 11 above, and except if the DSD, FMCH or the NMC
Companies or any individuals are excluded by the Office of
Inspector General of HHS pursuant to 42 U.S.C. (S) 1320a-7(a).
Nothing in this paragraph precludes OPM from taking action
against entities or persons, or for conduct and practice for
which civil claims have been reserved in Paragraph 11 above. 16.
Bradford agrees that the settlement of his Civil Action is fair,
adequate and reasonable under all the circumstances, pursuant to
31 U.S.C. (S) 3730(c)(2)(B). Price agrees that the settlement of
his Civil Action is fair, adequate and reasonable under all the
circumstances, pursuant to 31 U.S.C. (S) 3730(c)(2)(B). On the
United States' receipt of the First Payment pursuant to Paragraph
1 above, each of Relator Price and Bradford, for himself, his
heirs, successors and assigns, will release and will be deemed to
have released DSD, FMCH and the NMC Companies and their parents,
affiliates, divisions, subsidiaries, predecessors, successors,
assigns, and transferees, and any of their current or former
directors, officers, employees, counsel, agents, and
representatives from any and all claims that he has or may have
that arise from or relate to any and all of the allegations in
his Civil Action, the conduct described in Preamble Paragraphs H
and M, and his employment with any of the corporate entities
referenced in this Paragraph, except claims by Relators Price
and/or Bradford for attorney's fees and costs pursuant to 31
U.S.C. (S) 3730(d)(1). If NMC and FMCH default on their payment
obligations under Paragraph 1
above, the respective releases given by Relator Price and
Bradford shall, at the sole option and discretion of each
Relator, upon written notice to NMC and FMCH, be rescinded.
17. The United States agrees to pay Relators Bradford and
Price according to the terms set forth below:
a. The United States agrees to pay Relator Bradford
18% from the Federal Share of the Settlement Amount attributable
to the allegations in the Bradford qui tam ($799,194), a total
principal amount of one hundred forty three thousand eight
hundred fifty five dollars ($143,855) plus 18% of the interest
paid by NMC and FMCH on that principal amount, if any. To satisfy
this obligation, the United States will pay Relator Bradford as
payments by NMC are received under the terms of the
Promissory Note, as more particularly set forth in Exhibit A to
the Promissory Note as those payments relate to this Agreement.
The first payment to Relator Bradford will be made within 21 days
after the First Payment Date, and subsequent payments to Relator
Bradford will be made within 21 days after each additional
payment is received by the United States, by wire transfer to
Relator Bradford in accordance with instructions to be provided
by Relator's counsel. Relator Bradford, for himself
individually, and for his respective heirs, successors, and
assigns, will release and will be deemed to have released and
forever discharged the United States from any claims pursuant to
31 U.S.C. (S) 3730, including 31 U.S.C. (S)(S) 3730(b), (c), (d)
and (d)(1), for a share of the proceeds of the Civil Action, from
any claims for a share of the Settlement Amount, and from any
claims arising from the filing of his Civil Action, and in full
settlement of claims under this Agreement. This Agreement does
not resolve or in any manner affect any claims the United States
has or may have against Relator Bradford, arising under Title 26,
U.S. Code (Internal Revenue Code), or any claims arising under
this Agreement.
b. The United States agrees to pay Relator Price 18% of the
Federal Share of the Settlement Amount attributable to the
allegations of the Price qui tam ($15,204,234), a total principal
amount of two million seven hundred thirty six thousand seven
hundred sixty two dollars ($2,736,762), plus 18% of the interest
paid by NMC and FMCH on that principle amount of $15,204,234, if
any. To satisfy this obligation, the United States will pay
Relator Price as payments by NMC are received under the terms of
the Promissory Note, as more particularly set forth in Exhibit A
to the Promissory Note as those payments relate to this
Agreement. The first payment to Relator Price will be made
within 21 days after the First Payment Date, and subsequent
payments to Relator Bradford will be made within 21 days after
each additional payment is received by the United States, by wire
transfer to Relator Price in accordance with instructions to be
provided by Relator's counsel. Relator Price, for himself
individually, and for his respective heirs, successors, and
assigns, will release and will be deemed to have released and
forever discharged the United States from any claims pursuant to
31 U.S.C. (S) 3730, including 31 U.S.C. (S)(S) 3730(b), (c), (d)
and (d)(1), for a
share of the proceeds of the Civil Action, from any claims for a
share of the Settlement Amount, and from any claims arising from
the filing of his Civil Action, and in full settlement of claims
under this Agreement. This Agreement does not resolve or in any
manner affect any claims the United States has or may have
against Relator Price, arising under Title 26, U.S. Code
(Internal Revenue Code), or any claims arising under this
Agreement.
18. After this Agreement is fully executed, the United
States and the Relators will notify the Court that all pertinent
Parties have stipulated that, to the extent alleged in Paragraph
H only, the Civil Action shall be dismissed with prejudice
effective upon receipt by the United States, the Participating
States and Participating Territory of the payments described in
Paragraph 1 above, pursuant to and consistent with the terms of
this Agreement. The United States and the Relators will also
notify the court that all pertinent Parties have stipulated that
the remaining claims by the Relators in the Civil Actions, to the
extent not alleged in Preamble Paragraph H, shall be dismissed
with prejudice as to the respective Relator and without prejudice
as to the United States with the exception of Relators' claims
for
attorney's fees and costs pursuant to 31 U.S.C. (S) 3730(d)(1),
which shall not be dismissed. The Parties agree that, except for
Relator Bradford's claims for statutory attorney's fees and
costs, which will remain in the jurisdiction of the United States
District Court for the Southern District of Florida, the United
States District Court for the District of Massachusetts shall
maintain jurisdiction of any remaining claims in each Civil
Action, in any Events of Default as defined in Paragraph 4, or in
the event of disputes under this Agreement.
19. Effective upon the filing and docketing of the notices
of dismissal described in Xxxxxxxxx 00, XXX, FMCH and the NMC
Companies, and their parent, successor, subsidiary and affiliate
corporations release and will be deemed to have released each of
Bradford and Price, individually, any and all claims that these
corporations have or may have related to or arising from any of
the allegations in the Civil Actions, the conduct described in
Preamble Paragraph H and any matters arising from either
Relator's employment with the corporate entities referenced in
this Paragraph.
20. DSD, FMCH and the NMC Companies waive and will not
assert any defenses these entities may have to any criminal
prosecution or
administrative action relating to the conduct described in
Preamble Paragraphs H and M, which defenses may be based in whole
or in part on a contention that, under the Double Jeopardy Clause
of the Fifth Amendment of the Constitution or Excessive Fines
Clause of the Eighth Amendment of the Constitution, this
Settlement Agreement bars a remedy sought in such criminal
prosecution or administrative action. DSD and the NMC Companies
further agree that nothing in this Agreement is punitive in
purpose or effect.
FMCH and the NMC Companies covenant to cooperate fully
and truthfully with the United States' civil investigation of individuals and
entities not specifically released in this Agreement. Upon reasonable notice,
the NMC Companies will make reasonable efforts to facilitate access to, and
encourage the cooperation of, its directors, officers, and employees for
interviews and testimony, consistent with the rights and privileges of such
individuals, and will furnish to the United States, upon reasonable request, all
non-privileged documents and records in its possession, custody or control.
22. On the effective date of this Agreement, DSD, FMCH and the NMC
Companies release and will be deemed to have released the United States, its
agencies, employees, servants, and agents from any claims (including attorneys
fees, costs, and expenses of every kind and however denominated) which DSD and
the NMC
Companies have or may have against the United States, its agencies, employees,
servants, and agents, related to or arising from the United States' civil,
criminal and administrative investigation and prosecution of DSD, NMC and FMCH.
23. The Settlement Amount and the Unrecouped Credit Balances that NMC and
FMCH must pay pursuant to Paragraphs 1 and 3 of this Agreement will not be
decreased as a result of the denial of claims for payment now being withheld
from payment by any Medicare carrier or intermediary, Railroad Retirement
Medicare carrier, TRICARE, FEHBP, VA, or any Medicaid payor, related to the
conduct described in Preamble Paragraph H; and DSD and the NMC Companies agree
not to resubmit to any Medicare carrier or intermediary, Railroad Retirement
Medicare carrier, TRICARE, FEHBP, VA, or any Medicaid payor any previously
denied claims related to the conduct described in Preamble Paragraph H, and
agree not to appeal any such denials of claims.
24. The FMCH and the NMC Companies agree that all costs (as defined in the
Federal Acquisition Regulations ("FAR") (S) 31.205-47 and in Titles XVIII and
XIX of the Social Security Act, 42 U.S.C. (S)(S) 1395-1395ddd (1997) and 1396-
1396v(1997), and the regulations promulgated thereunder) incurred by or on
behalf of DSD and the NMC Companies, and their divisions, subsidiaries and
affiliates, and their present and former officers, directors, employees,
shareholders and agents in connection with: (a) the matters covered by this
Agreement; (b) the Government's audits, administrative, civil and criminal
investigation and prosecution of DSD and FMCH; (c) these corporate entities'
investigation,
defense, and corrective actions undertaken in response to the Government's
administrative, civil and criminal investigations, and in connection with the
matters covered by this Agreement, and including the obligations undertaken
pursuant to the Corporate Integrity Agreement (including attorneys fees); (d)
the negotiation and performance of this Agreement, and the Corporate Integrity
Agreement; and (e) the payments made to the United States provided for in this
Agreement, and to Relators for attorney's fees and costs, are unallowable costs
on Government contracts and under Medicare, Railroad Retirement Medicare,
Medicaid, TRICARE, FEHBP, and the VA programs (hereafter, "unallowable costs").
These unallowable costs will be separately estimated and accounted for by DSD
and the NMC Companies and these entities will not charge such unallowable costs
directly or indirectly to any contracts with the United States or any Medicaid
program, or seek payment for such unallowable costs through any cost report,
cost statement, information statement or payment request submitted by the NMC
Companies or any of their divisions, subsidiaries or affiliates to the Medicare,
Railroad Retirement Medicare, Medicaid, TRICARE, VA or FEHBP programs.
FMCH and the NMC Companies further agree that within 270 days of the
effective date of this Agreement these entities will identify to applicable
Medicare, Railroad Retirement Medicare, and TRICARE fiscal intermediaries,
carriers and/or contractors, and Medicaid, VA and FEHBP fiscal agents, any
unallowable costs (as defined above) included in payments previously sought from
the United States, or any Medicaid Program, including, but not
limited to, payments sought in any cost reports, cost statements, information
reports, or payment requests already submitted by the NMC Companies or any of
their subsidiaries, affiliates, or divisions and will request, and agree, that
such cost reports, cost statements, information reports or payment requests,
even if already settled, be adjusted to account for the effect of the inclusion
of the unallowable costs. FMCH and the NMC Companies agree that the United
States will be entitled to recoup from the NMC Companies any overpayment as a
result of the inclusion of such unallowable costs on previously-submitted cost
reports, information reports, cost statements or requests for payment. Any
payments due after the adjustments have been made shall be paid to the United
States pursuant to the direction of the Department of Justice, and/or the
affected agencies. The United States reserves its rights to disagree with any
calculations submitted by DSD, FMCH and the NMC Companies, or any of their
subsidiaries, affiliates or divisions, on the effect of inclusion of unallowable
costs (as defined above) on the NMC Companies or any of their subsidiaries,
affiliates or divisions' cost reports, cost statements or information reports.
Nothing in this Agreement shall constitute a waiver of the rights of the United
States to examine or reexamine the unallowable costs described above.
25. This Agreement is intended to be for the benefit of the Parties only,
and by this instrument the Parties do not release any claims against any other
person or entity except as
specifically identified in Paragraphs 10, 13, 14, 15, 16, 17 and 19 above.
26. FMCH and the NMC Companies agree that they will not seek payment for
any of the health care xxxxxxxx covered by this Agreement from any health care
beneficiaries or their parents, sponsors, estates, heirs, successors or assigns.
DSD and the NMC Companies waive any causes of action against these beneficiaries
or their parents, sponsors, estates, heirs, successors, or assigns based upon
the claims for payment covered by this Agreement.
27. Nothing in this Agreement constitutes an agreement by the United
States concerning the characterization of the amounts paid hereunder for
purposes of any proceeding under Title 26 of the Internal Revenue Code.
28. Except as provided in Paragraph 7.b., and except for Relators' claim
for statutory attorney's fees and costs, each party to this Agreement will bear
its own legal and other costs incurred in connection with this matter, including
by way of example only, all costs incurred in the investigation and defense of
this matter, the preparation and performance of this Agreement, and all
corrective actions taken in response to the investigation and resolution of this
matter.
29. NMC and FMCH expressly warrant that they have reviewed their financial
condition and that they currently are solvent on a consolidated basis within the
meaning of 11 U.S.C. Section 547(b)(3), and expect to remain solvent on a
consolidated basis following payment to the United States hereunder. Further,
the
Parties expressly warrant that, in evaluating whether to execute this Agreement,
the Parties (a) have intended that the mutual promises, covenants and
obligations set forth herein constitute a contemporaneous exchange for new value
given to DSD, NMC and FMCH within the meaning of 11 U.S.C. Section 547(c)(1),
and (b) have concluded that these mutual promises, covenants, and obligations
do, in fact, constitute such a contemporaneous exchange.
30. In the event NMC or FMCH commences, or a third party commences, within
91 days of any payment under of this Agreement, any case, proceeding, or other
action (i) under any law relating to bankruptcy, insolvency, reorganization or
relief of debtors, seeking to have any order for relief of NMC and/or FMCH's
debts, or seeking to adjudicate NMC and/or FMCH as bankrupt or insolvent, or
(ii) seeking appointment of a receiver, trustee, custodian or other similar
official for NMC and/or FMCH or for all or any substantial part of NMC and/or
FMCH's assets, NMC and FMCH agree as follows:
a. NMC and FMCH's obligations under this Agreement may not be
avoided pursuant to 11 U.S.C. Section 547, and NMC and FMCH will not argue or
otherwise take the position in any such case, proceeding or action that: (i)
NMC and/or FMCH's obligations under this Agreement may be avoided under 11
U.S.C. Section 547; (ii) NMC and FMCH were insolvent on a consolidated basis at
the time this Agreement was entered into, or became insolvent on a consolidated
basis as a result of the payment made to the United States hereunder; or (iii)
the mutual promises, covenants and obligations set forth in this Agreement do
not
constitute a contemporaneous exchange for new value given to NMC and/or FMCH.
b. In the event that NMC and/or FMCH's obligations hereunder are
avoided pursuant to 11 U.S.C. Section 547, the United States, at its sole
option, may rescind the releases in this Agreement, and bring any civil and/or
administrative claim, action or proceeding against DSD, and/or FMCH for the
claims that would otherwise be covered by the releases provided in Paragraphs
10,13, 14 and 15 above. If the United States chooses to do so, DSD and FMCH
agree that (i) any such claims, actions or proceedings brought by the United
States (including any proceedings to suspend payments to NMC and DSD from
Medicare, Medicaid, or other federal health care programs) are not subject to an
"automatic stay" pursuant to 11 U.S.C. Section 362(a) as a result of the action,
case or proceeding described in the first clause of this Paragraph, and that DSD
and FMCH will not argue or otherwise contend that the United States' claims,
actions or proceedings are subject to an automatic stay; (ii) that DSD and FMCH
will not plead, argue or otherwise raise any defenses under the theories of
statute of limitations, laches, estoppel or similar theories, to any such civil
or administrative claims, actions or proceeding which are brought by the United
States within 90 calendar days of written notification to NMC and FMCH that the
releases herein have been rescinded pursuant to this Paragraph, except to the
extent such defenses were available on the date of this Agreement; and (iii) the
United States has a valid claim against NMC and FMCH in the
amount of the Default Obligation, and the United States may pursue its claim,
inter alia, in the Price and Bradford Civil Actions, as well as in any other
case, action, or proceeding.
c. DSD and FMCH acknowledge that its agreements in this Paragraph
are provided in exchange for valuable consideration provided in this Agreement.
31. DSD and FMCH and the Relators represent that this Agreement is freely
and voluntarily entered into without any degree of duress or compulsion
whatsoever.
32. This Agreement is governed by the laws of the United States. The
Parties agree that the exclusive jurisdiction and venue for any disputes arising
between and among the Parties under this Agreement will be the United States
District Court for the District of Massachusetts, except that disputes arising
under the Corporate Integrity Agreement shall be resolved exclusively upon the
dispute resolution provisions set forth in the Corporate Integrity Agreemen t.
33. The undersigned DSD and FMCH signatories represent and warrant that
they are authorized by their respective Board of Directors to execute this
Agreement. The undersigned United States signatories represent that they are
signing this Agreement in their respective official capacities and that they are
authorized to execute this Agreement.
34. Except for the representations in Paragraph 29 (regarding solvency),
Paragraph 30 (concerning bankruptcy proceedings commenced within 91 days of any
payments under this Agreement), and Preamble Paragraph M (express
representations by
NMC and FMCH upon which the United States relies), the Parties agree that
nothing in this Agreement constitutes an admission by any person or entity with
respect to any issue of law or fact.
35. This Agreement is effective on the date of signature of the last
signatory to the Agreement (the "Effective Date").
36. This Agreement shall be binding on all successors, transferees, heirs
and assigns.
37. This Agreement, together with Exhibits A through E, and the Corporate
Integrity Agreement, constitute the complete agreement among the Parties with
regard to the conduct described in Preamble Paragraphs H and M and the Civil
Actions. This Agreement may not be amended except by written consent of the
Parties, except that only FMCH and OIG-HHS must agree in writing to modification
of the Corporate Integrity Agreement.
38. This Agreement may be executed in counterparts, each of which shall
constitute an original and all of which shall constitute one and the same
Agreement.
THE UNITED STATES OF AMERICA
----------------------------
/s/ Xxxxxxx X. Xxxxxxx January 18, 2000
By: -------------------------- Dated: ------------------
XXXXXXX X. XXXXXXX
Assistant U.S. Attorney
District of Massachusetts
/s/ Xxxx X. Xxxxxx January 18, 2000
By: -------------------------- Dated: ------------------
XXXX XXXXXX
Assistant U.S. Attorney
Southern District of Florida
/s/ Xxxxxxxx X. Xxxxxxxx January 18, 2000
By: -------------------------- Dated: ------------------
XXXXXXXX X. XXXXXXXX
Special Assistant U.S. Attorney
District of Massachusetts
By: /s/ Xxxx Xxxxxx January 18, 2000
-------------------------- Dated: ------------------
XXXX XXXXXX
Trial Attorney
Civil Division
U.S. Department of Justice
/s/ Xxxxx Xxxxxx 1/18/00
By: -------------------------- Dated: ------------------
XXXXX XXXXXX
Assistant Inspector General
Office of Inspector General
U.S. Department of Health and
Human Services
/s/ Xxxxx X. Xxxxx January 18, 2000
By: -------------------------- Dated: -------------------
XXXXX X. XXXXX
Assistant Director for
Insurance Programs
U.S. Office of Personnel
Management
/s/ Xxxxxx X. Xxxxxx 1-18-00
By: -------------------------- Dated: -------------------
XXXXXX X. XXXXXX
General Counsel
TRICARE Support Office
U.S. Department of Defense
NATIONAL MEDICAL CARE, INC.
FRESENIUS MEDICAL CARE HOLDINGS, INC.
By: /s/ Xxx X. Xxxxx Dated: 1/18/00
------------------------ --------------------
Xxx X. Xxxxx
President
National Medical Care, Inc.
By: /s/ Xxx X. Xxxxx Dated: 1/18/00
------------------------ --------------------
Xxx X. Xxxxx
President
Fresenius Medical Care Holdings, Inc.
Acknowledged:
-------------
By: /s/ Xxxxxx X. Xxxxxx Dated: 1/18/00
------------------------ -------------------
XXXXXX X. XXXXXX
Counsel to NMC Dialysis
Services Division, Inc.
National Medical Care, Inc.
Fresenius Medical Care Holdings, Inc.
By: /s/ Xxxx X. Xxxxxx Dated: 1/18/00
----------------------- -------------------
XXXX X. XXXXXX
Counsel to NMC Dialysis
Services Division, Inc.
National Medical Care, Inc.
Fresenius Medical Care Holdings, Inc.
RELATOR XXXXXXX X. XXXXX
By: /s/ Xxxxxxx X. Xxxxx Dated: 1/18/00
----------------------- ----------------
Xxxxxxx X. Xxxxx
Acknowledged:
-------------
By: /s/ W. Xxxxxxxxx Xxxxx Dated: 1/18/00
----------------------- ----------------
W. Xxxxxxxxx Xxxxx
Counsel to Messr. Price
RELATOR XXXXXXX XXXXXXXX
By: /s/ Xxxxxxx Xxxxxxxx Dated: 1/18/00
----------------------- ----------------
Xxxxxxx Xxxxxxxx
Acknowledged:
-------------
By: /s/ Xxxxxx Xxxxxxx Dated: 1/18/00
----------------------- ----------------
Xxxxxx Xxxxxxx
Counsel to Messr. Bradford
EXHIBIT A
(Promissory Note)
The Promissory Note dated January 19, 2000 from National Medical Care, Inc. and
Fresenius Medical Care Holdings, Inc. payable to the order of the United States
is incorporated by reference to Exhibit A of Exhibit 10.2 to this Current Report
on Form 8-K.
EXHIBIT B
(Amendment to Irrevocable Nontransferable Letter of Credit)
The Amendment to Irrevocable Nontransferable Letter of Credit dated January 19,
2000 issued by the Bank of Nova Scotia, Atlanta Agency to the United States is
incorporated by reference to Exhibit B of Exhibit 10.2 to this Current Report on
Form 8-K.
EXHIBIT C
(Guarantee)
The Guarantee Agreement dated as of July 31, 1996 among Fresenius Medical Care
GmbH, the predecessor to Fresenius Medical Care AG, National Medical Care, Inc.,
X.X. Xxxxx & Co. and the United States of America, is incorporated by reference
to the Company's Registration Statement on Form S-4 (Registration No. 333-09497)
dated August 2, 1996 and the exhibits thereto.
EXHIBIT D
(List of Fresenius Affiliated Entities)
The List of Fresenius Affiliated Entities is incorporated by reference to
Exhibit D of Exhibit 10.2 to this Current Report on Form 8-K.
EXHIBIT E
[LETTERHEAD OF FRESENIUS MEDICAL CARE]
January 4, 2000
Xx. Xxxx Xxxxxx
Arent Fox Xxxxxxx Xxxxxxx & Xxxx
0000 Xxxxxxxxxxx Xxxxxx, XX
Xxxxxxxxxx, XX 00000-0000
Dear Xxxx:
I enclose a summary of Medicare credit balances for FMC dialysis facilities
which were entered into the 4245 account through December 31, 1998, (Exhibit A).
These balances have not been recouped by the Medicare fiscal intermediaries as
of January 3, 2000.
An explanation of procedures used to develop the summary is also enclosed.
(Exhibit B).
A listing of all NMC dialysis billing centers and associated provider
numbers is being prepared and will be forwarded by separate cover.
Please not that the total outstanding credit balance of $10,982,885. 16
excludes funds taken into income prior to 1994 which are addressed in the
pending civil settlement.
Please do not hesitate to call me if you have any questions.
Sincerely,
/s/ Xxxx Xxxxxx
Xxxx Xxxxxx
Senior Vice President
Corporate Compliance
JM/mep
Attachments
cc: X. Xxxxx, Esq.
X. Xxxx
X. XxXxxxx
X. Xxxxxxx
MEDICARE UNRECONCILED PAYMENTS BY TRANSACTION CODE
THROUGH 12/31/98
FOR ALL FACILITIES
(QUERY RUN DATE 1/3/00)
Transaction Transaction Total
Code Name Amount
--------------------------------------------------------------------------------
OPR Unreconciled Payment $74,681,842.81
OPMR Medicare Refund ($1,250,561.72)
OPF Refund ($8,604,488.78)
OPA Recoupment ($50,302,511.80)
OPD Transfer to Corporate ($5,111,380.29)
OPCC Debit Correction ($5,490,761.40)
OPCD Credit Correction $6,185,324.36
OPMD Medicare Credit $163,526.07
OPG Audited Transaction $618,387.11
-----------
Medicare UP Balance from System: $10,889,366.36
Neomedica UP Balance: $93,518.80
----------
Total Medicare UP Balance: $10,982,885.16
FRESENIUS MEDICAL CARE'S UNRECONCILED PAYMENT SYSTEM
AN OVERVIEW OF ACCOUNT 4245 AND
THE OPEN BALANCE CALCULATION
FMC, through input to the Medical Manager Cash Management System, posts all
payments which represent credit balances to the 4245 account which is the
Unreconciled Payment (U/P) account. These credits are posted to the G/L as a
liability. All subsequent debit and credit activity is made utilizing
transaction codes.
All U/P transactions are maintained in a separate database which currently
resides on the HP UX10.20 server. There had been no purges to the database and
this database is accessed using a SQLPLUS query tool.
In preparation for our settlement of U/P issues with the OIG, query Q010200.txt
was run in January. The selection criteria was to produce a summary of all
transactions for Medicare credit balances by year for all dates through December
31, 1998. The U/P system does not produce an open balance report. We have
calculated the U/P balance using the summaries of all the credit and debit
transactions.
This query report is the basis for determining the U/P balance for all Medicare
credit balances recorded in the system through December 31, 1998. The report
indicates that $74,681,842.81 (transaction code OPR) in Medicare credits was
posted as unreconciled payments. Of this amount $9,855,060.50 (transaction
codes OPF and OPMR) was refunded to Medicare and $50,302,511.80 was recouped by
Medicare (transaction code OPA). The total of all Medicare refunds and
recoupments is $60,157,572.30 through December 31, 1998.
The $5,111,380.29 represents monies transferred to Corporate (transaction code
OPD) and taken into income.
Transaction codes OPCC and OPCD are debit and credit entries used to correct
errors and adjustments to U/Ps already keyed into the system.
Transaction code OPMD, a Medicare credit of $163,526.07, was occasionally
utilized in the past and is an addition to the U/P total. We have not done a
detailed research of these entries.
Transaction code OPG entitled Audited Transaction $618,387.11 occurred from 1979
through 1981. We have been advised that these were additions made to the U/P
account based on account audits.
The U/P Medicare Balance on the 4245 account for this time period is
$10,889,366.36. In addition we have $93,518.80 in unrefunded and unrecouped
Medicare credit balances form Neomedica which maintains separate accounting
records and does not appear in our 4245 account.
FRESENIUS MEDICAL
CARE, N.A.
DIVISION SUMMARY BY FISCAL INTERMEDIARY
Facility Name Facility Medicare provider Fiscal Intermediary
Number #
-------------------------------------------------------------------------------------------------
Mansfield 1262 36-2508 Administar Federal
Central Ohio 1272 36-2501 Administar Federal
Akron 1273 36-2503 Administar Federal
Indianapolis 1300 15-2500 Administar Federal
Xxxxxx County 1362 15-2512 Administar Federal
Grant Park 1433 36-2514 Administar Federal
Southern Indiana 1434 15-2504 Administar Federal
Xxxxxxxx 1481 15-2510 Administar Federal
South Summit 1633 36-2521 Administar Federal
Central Ohio East 1639 36-2520 Administar Federal
Northwest Indianapolis 1697 15-2524 Administar Federal
Wooster 1724 36-2531 Administar Federal
Ashland 1795 18-2524 Administar Federal
Portsmouth 1796 36-2534 Administar Federal
Heart Of Ohio 1827 36-2549 Administar Federal
Scottsburg 1906 15-2529 Administar Federal
Louisville 1250 18-2503 Administar/Kent
Somerset 1480 18-2516 Administar/Xxxx
Xxxx Louisville 1490 18-2514 Administar/Kent
South Louisville 1635 18-2523 Administar/Kent
East Louisville 1676 18-2527 Administar/Kent
Xxxxxxxxxxx 0000 18-2507 Administar/Xxxx
Xxxxxx 1792 18-2517 Administar/Xxxx
Xxxxxxxx 1793 18-2509 Administar/Xxxx
Xxxxxx Xxxx 1794 18-2521 Administar/Kent
BMA LEWISTON 1102 20-2501 Assoc. Hosp. Svcs. of ME
BMA FRAMINGHAM 1109 22-2504 Assoc. Hosp. Svcs. of ME
BMA BOSTON-TKC 1110 22-2500 Assoc. Hosp. Svcs. of ME
BMA SPRINGFIELD 1111 22-2502 Assoc. Hosp. Svcs. of ME
BMA CAPE COD 1112 22-2501 Assoc. Hosp. Svcs. of ME
BMA PROVIDENCE 1170 41-2500 Assoc. Hosp. Svcs. of ME
BMA PORTLAND 1190 20-2500 Assoc. Hosp. Svcs. of ME
BMA BOSTON (XXXXXX) 1211 22-2506 Assoc. Hosp. Svcs. of ME
BMA MEDFORD 1246 22-2507 Assoc. Hosp. Svcs. of ME
BMA WOONSOCKET 1307 41-2503 Assoc. Hosp. Svcs. of ME
BMA CHICOPEE 1389 22-2513 Assoc. Hosp. Svcs. of ME
BMA BROCKTON 1392 22-2505 Assoc. Hosp. Svcs. of ME
BMA WESTWOOD 1422 22-2511 Assoc. Hosp. Svcs. of ME
BMA DOVER 1449 30-2501 Assoc. Hosp. Svcs. of ME
BMA NEW HAMPSHIRE 1450 30-2500 Assoc. Hosp. Svcs. of ME
BMA MANCHESTER 1487 30-2502 Assoc. Hosp. Svcs. of ME
BMA ROXBURY 1630 22-2525 Assoc. Hosp. Svcs. of ME
BMA FALL RIVER 1631 22-2516 Assoc. Hosp. Svcs. of ME
BMA SHREWSBURY 1684 22-2521 Assoc. Hosp. Svcs. of ME
BMA NORTH PROVIDENCE 1691 41-2506 Assoc. Hosp. Svcs. of ME
BMA WARWICK 1692 41-2504 Assoc. Hosp. Svcs. of ME
BMA BATH 1761 20-2502 Assoc. Hosp. Svcs. of ME
BMA BOSTON 1942 22-2522 Assoc. Hosp. Svcs. of ME
BMA STONEHAM 1943 22-2524 Assoc. Hosp. Svcs. of ME
BMA WEYMOUTH 1944 22-2519 Assoc. Hosp. Svcs. of ME
Ohio Valley 1077 39-2579 BCBS of W. Pennsylvania
Jefferson 1081 39-2576 BCBS of W. Pennsylvania
Harrisburg 1087 39-2594 BCBS of W. Pennsylvania
Latrobe 1108 39-2561 BCBS of W. Pennsylvania
Philadelphia 1120 39-2501 BCBS of W. Pennsylvania
Southwestern Penna 1122 39-2519 BCBS of W. Pennsylvania
Pottsville 1123 39-2518 BCBS of W. Pennsylvania
Pittsburgh 1175 39-2503 BCBS of W. Pennsylvania
Greensburg 1176 39-2520 BCBS of W. Pennsylvania
Butler 1178 39-2525 BCBS of W. Pennsylvania
Hazleton 1209 39-2524 BCBS of W. Pennsylvania
Northern Philadelphia 1220 39-2509 BCBS of W. Pennsylvania
Easton 1222 39-2517 BCBS of W. Pennsylvania
Bethlehem 1223 39-2511 BCBS of W. Pennsylvania
Xxxxxx Barre 1271 39-2512 BCBS of W. Pennsylvania
East Stroudsburg 1274 39-2547 BCBS of W. Pennsylvania
Allentown 1276 39-2505 BCBS of W. Pennsylvania
Central Philadelphia 1281 39-2507 BCBS of W. Pennsylvania
West Penn 1302 39-2542 BCBS of W. Pennsylvania
Northeastern Philadelphia 1314 39-2533 BCBS of W. Pennsylvania
South Hills 1324 39-2544 BCBS of W. Pennsylvania
Abington 1333 39-2506 BCBS of W. Pennsylvania
Temple/Germantown 1342 39-2530 BCBS of W. Pennsylvania
Northwest Philadelphia 1380 39-2560 BCBS of W. Pennsylvania
Three Rivers 1386 39-2559 BCBS of W. Pennsylvania
Fairmount 1395 39-2540 BCBS of W. Pennsylvania
New Castle 1417 39-2552 BCBS of W. Pennsylvania
Kittanning 1418 39-2554 BCBS of W. Pennsylvania
Pittston 1514 39-2621 BCBS of W. Pennsylvania
Mon Valley 1606 39-2565 BCBS of W. Pennsylvania
Episcopal 1638 39-2568 BCBS of W. Pennsylvania
Parkview 1652 39-2569 BCBS of W. Pennsylvania
Uniontown 1683 39-2553 BCBS of W. Pennsylvania
Ellwood City 1698 39-2578 BCBS of W. Pennsylvania
Fullerton 1766 39-2603 BCBS of W. Pennsylvania
Delco 1831 39-2551 BCBS of W. Pennsylvania
Manayunk 1852 39-2611 BCBS of W. Pennsylvania
South Philadelphia 1936 39-2607 BCBS of W. Pennsylvania
Eastern Shore 1066 01-2547 BCBS of Alabama
Mobile 1204 01-2507 BCBS of Alabama
Huntsville 1437 01-2522 BCBS of Alabama
Scottsboro 1438 01-2519 BCBS of Alabama
Montgomery 1462 01-2500 BCBS of Alabama
East Mobile 1626 01-2524 BCBS of Alabama
West Mobile 1627 01-2525 BCBS of Alabama
Prichard 1634 01-2537 BCBS of Alabama
Univ S. Alabama 1737 01-2559 BCBS of Alabama
Xxxxxxx 1050 11-2623 BCBS of Xxxxxxx
Xxxxxx 1113 11-2563 BCBS of Xxxxxxx
Xxxxxx 1164 11-2524 BCBS of Georgia
Marietta 1212 11-2510 BCBS of Xxxxxxx
XXX Xxxxxxxx Xxxxxxx 0000 11-2551 BCBS of Georgia
Augusta 1260 11-2501 BCBS of Xxxxxxx
Xxxxxxxx Xxxxxxx 1268 11-2521 BCBS of Xxxxxxx
Xxxxxxx 1270 11-2540 BCBS of Georgia
Carrollton 1304 11-2520 BCBS of Georgia
Atlanta 1308 11-2504 BCBS of Xxxxxxx
Xxxxxxx 1309 11-2519 BCBS of Xxxxxxx
Xxxxxx Xxxxxxx 1406 11-2531 BCBS of Georgia
Sandersville 1407 11-2534 BCBS of Xxxxxxx
Xxxxx 1440 11-2533 BCBS of Xxxxxxx
Xxxxxxxxx 1442 11-2533 BCBS of Georgia
Dekalb-Gwinnett 1443 11-2511 BCBS of Georgia
Coastal 1561 11-2507 BCBS of Xxxxxxx
Xxxxxxxxxx 1115 21-2503 BCBS of Maryland
Capitol Hill 1116 09-2502 BCBS of Maryland
SE Washington 1117 09-2505 BCBS of Maryland
Columbia Heights 1118 09-2503 BCBS of Xxxxxxxx
Xxxxxxxx xx Xxxxxxxx 0000 09-2501 BCBS of Maryland
Takoma Park 1129 21-2533 BCBS of Maryland
Annapolis 1181 21-2509 BCBS of Maryland
Baltimore 1245 21-2504 BCBS of Maryland
Xxxxxx Xxxxxx Xxxx, Xx. 1306 09-2509 BCBS of Maryland
Laurel 1354 21-2506 BCBS of Maryland
Leonardtown 1355 21-2510 BCBS of Maryland
Camp Springs 1356 21-2501 BCBS of Maryland
Anacostia 1375 09-2508 BCBS of Xxxxxxxx
Xxxxxxx Xxxxxxxxx 0000 21-2531 BCBS of Maryland
Northeast D.C. 1466 09-2515 BCBS of Maryland
La Plata 1625 21-2541 BCBS of Maryland
South Annapolis 1730 21-2557 BCBS of Maryland
Woodlawn 1768 21-2558 BCBS of Maryland
Metropolitan 1837 21-2524 BCBS of Maryland
Upper Marlboro 1910 21-2559 BCBS of Maryland
QCDC Baltimore 1948 21-2540 BCBS of Maryland
HIC Capitol 1964 21-2562 BCBS of Maryland
HIC Baltimore 1977 21-2554 BCBS of Maryland
BMA TRENTON 1261 31-2504 BCBS of New Jersey
BMA JERSEY CITY 1298 31-2502 BCBS of New Jersey
BMA PINEBROOK 1330 31-2503 BCBS of New Jersey
BMA NEWARK 1332 31-2505 BCBS of New Jersey
BMA IRVINGTON 1334 31-2501 BCBS of New Jersey
BMA HILLSIDE 1338 31-2506 BCBS of New Jersey
BMA HOBOKEN 1716 31-2529 BCBS of New Jersey
BMA PRINCETON 1717 31-2516 BCBS of New Jersey
BMA PLAINFIELD 1720 31-2515 BCBS of New Jersey
BMA COLONIA 1721 31-2518 BCBS of New Jersey
Rich Square 1034 34-2586 BCBS of North Carolina
Pamlico 1061 34-2561 BCBS of North Carolina
Lincolnton 1092 34-2568 BCBS of North Carolina
Concord 1126 34-2519 BCBS of North Carolina
Xxxx Xxxxxxxxx 1146 34-2554 BCBS of North Carolina
Chester 1249 42-2518 BCBS of North Carolina
South Greensboro 1269 34-2537 BCBS of North Carolina
North Charlotte 1325 34-2549 BCBS of North Carolina
Charlotte 1328 34-2503 BCBS of North Carolina
Gastonia 1329 34-2513 BCBS of North Carolina
Kinston 1358 34-2518 BCBS of North Carolina
Greesboro 1366 34-2504 BCBS of North Carolina
New Bern 1374 34-2534 BCBS of North Carolina
Asheboro 1411 34-2524 BCBS of North Carolina
Monroe 1415 34-2525 BCBS of North Carolina
Fayetteville 1447 34-2510 BCBS of North Carolina
Lumberton 1448 34-2528 BCBS of North Carolina
Burlington 1482 34-2533 BCBS of North Carolina
Rocky Mount 1498 34-2517 BCBS of North Carolina
Zebulon 1520 34-2589 BCBS of North Carolina
Laurinburg 1557 34-2540 BCBS of North Carolina
Windsor 1607 34-2547 BCBS of Xxxxx Xxxxxxxx
Xxxxxx 0000 34-2509 BCBS of North Carolina
Hickory 1609 34-2516 BCBS of North Carolina
Albermarle 1612 34-2555 BCBS of North Carolina
Raleigh 1653 34-2512 BCBS of North Carolina
Smithfield 1654 34-2545 BCBS of North Carolina
Cary 1655 34-2544 BCBS of North Carolina
Roanoke Rapids 1656 34-2542 BCBS of North Carolina
Clinton 1688 34-2559 BCBS of North Carolina
Burke Cnty 1699 34-2563 BCBS of North Carolina
Beatties Ford 1772 34-2581 BCBS of North Carolina
West Xxxxxxxxx 2016 34-2590 BCBS of North Carolina
Dunn 2123 34-2557 BCBS of North Carolina
Wake 2125 34-2522 BCBS of North Carolina
Pitt County 1174 34-2502 BCBS of North Carolina
Queens QAKC Bal Sheet Acct 1106 33-2517 Empire BCBS
NY S.Queens 1377 33-2531 Empire BCBS
Medical Center KC 1594 33-3506 Empire BCBS
Nephro-Care 2168 33-2534 Empire BCBS
RCC Brandywine 1186 08-2501 Empire BCBS
RCC Millsboro 1242 08-2503 Empire BCBS
RCC Central Delaware 1303 08-2502 Empire BCBS
Christiana 1493 08-2506 Empire BCBS
Milford 1719 08-2507 Empire BCBS
Southern Maryland/QCDC 1950 21-2539 Mutual of Omaha
Camden 1254 42-2509 Palmetto Govt. Benefits
Admin.
Beaufort 1255 42-2514 Palmetto Govt. Benefits
Admin.
Twin Oaks/Greenville 1279 42-2503 Palmetto Govt. Benefits
Admin.
Columbia 1294 42-2504 Palmetto Govt. Benefits
Admin.
Lexington 1379 42-2517 Palmetto Govt. Benefits
Admin.
Georgetown 1390 42-2519 Palmetto Govt. Benefits
Admin.
Xxxxxxxx 1414 42-2531 Palmetto Govt. Benefits
Admin.
S. Columbia 1468 42-2543 Palmetto Govt. Benefits
Admin.
Bennettsville 1550 42-2520 Palmetto Govt. Benefits
Admin.
Chesterfield 1551 42-2551 Palmetto Govt. Benefits
Admin.
Darlington 1552 42-2530 Palmetto Govt. Benefits
Admin.
Xxxxxx 1554 42-2541 Palmetto Govt. Benefits
Admin.
Kingstree 1555 42-2521 Palmetto Govt. Benefits
Admin.
LaurensCnty 1556 42-2544 Palmetto Govt. Benefits
Admin.
Xxxxxx 1558 42-2545 Palmetto Govt. Benefits
Admin.
Mid-Town/Nothside 1559 42-2546 Palmetto Govt. Benefits
Admin.
Rock Hill 1560 42-2538 Palmetto Govt. Benefits
Admin.
West Columbia 1675 42-2550 Palmetto Govt. Benefits
Admin.
Lower Richland 1771 42-2564 Palmetto Govt. Benefits
Admin.
Sumter 1840 42-2510 Palmetto Govt. Benefits
Admin.
Xxxxxxx 1841 42-2537 Palmetto Govt. Benefits
Admin.
Loris 1843 42-2535 Palmetto Govt. Benefits
Admin.
Myrtle Beach 1844 42-2507 Palmetto Govt. Benefits
Admin.
Xxxxxxxx 2087 42-2505 Palmetto Govt. Benefits
Admin.
Bristol 1201 44-2519 Riverbend Govt. Benefits
Admin.
Eastern Tennessee 1312 44-2522 Riverbend Govt. Benefits
Admin.
Xxxxxxx City 1391 44-2501 Riverbend Govt. Benefits
Admin.
Kingsport 1693 44-2577 Riverbend Govt. Benefits
Admin.
Dialysis Assoc West 1974 44-2533 Riverbend Govt. Benefits
Admin.
N. Knoxville 1978 44-2527 Riverbend Govt. Benefits
Admin.
BMA Rio Grande City 1021 45-2666 TrailBlazer
QCDC-Univ. Kid. Ctr. North 1022 45-2662 TrailBlazer
St. John's 1062 10-2684 TrailBlazer
Yazoo City 1065 25-2536 TrailBlazer
Mesa 1069 03-2539 TrailBlazer
Arcadia 1070 03-2542 TrailBlazer
North County 1074 26-2509 TrailBlazer
Normandy 1075 26-2531 TrailBlazer
Central Phoenix 1078 03-2517 TrailBlazer
Xxx Xxxx Xxxx 0000 00-0000 XxxxxXxxxxx
Xxxxx Xxxxxxxx 1085 03-2545 TrailBlazer
Florida Kidney Center 1095 10-2559 TrailBlazer
Northwest Broward 1096 10-2544 TrailBlazer
Northeast Broward 1097 10-2570 TrailBlazer
Tamarac 1098 10-2629 TrailBlazer
Jacksonville 1104 10-2612 TrailBlazer
New Iberia 1107 19-2522 TrailBlazer
Belle Glade 1114 10-2571 TrailBlazer
Miami 1125 10-2503 TrailBlazer
Hialeah 1127 10-2530 TrailBlazer
Tampa 1130 10-2506 TrailBlazer
Eureka 1137 05-2543 TrailBlazer
Los Angeles 1140 05-2508 TrailBlazer
Long Beach 1141 05-2523 TrailBlazer
Torrance 1142 05-2556 TrailBlazer
Irving Dialysis Center 1143 45-2561 TrailBlazer
Oakland 1147 05-2534 TrailBlazer
Fremont 1149 05-2722 TrailBlazer
BMA Xxxxx Xxxxx 0000 45-2502 TrailBlazer
BMA West Houston 1154 45-2519 TrailBlazer
BMA Houston 1155 45-2500 TrailBlazer
BMA Abilene 1157 45-2511 TrailBlazer
BMA Amarillo 1158 45-2513 TrailBlazer
BMA Corpus Christi 1159 45-2514 TrailBlazer
BMA Xxxxxxxxx 0000 45-2520 TrailBlazer
Xxxxxx 0000 05-2568 TrailBlazer
BMA Santa Fe 1169 32-2501 TrailBlazer
Union City 1171 05-2571 TrailBlazer
Los Gatos 1172 05-2694 TrailBlazer
BMA Xxxxx 1177 45-2537 TrailBlazer
Okeechobee 1182 10-2589 TrailBlazer
BMA Pasadena 1185 45-2533 TrailBlazer
Xxxxxxx 1191 19-2521 TrailBlazer
Xxxxx 1193 25-2529 TrailBlazer
BMA Seguin 1194 45-2545 TrailBlazer
Xxxxxxx 1196 10-2546 TrailBlazer
BMA Xxxxxxxxx 1197 45-2542 TrailBlazer
BMA Jasper 1199 45-2573 TrailBlazer
BMA Laredo 1210 45-2518 TrailBlazer
Humacao 1214 40-2514 TrailBlazer
Mayaguez 1215 40-2503 TrailBlazer
Permian Basin - Midland 1216 45-2512 TrailBlazer
Fort Xxxxxxx 1217 06-2505 TrailBlazer
BMA McAllen 1218 45-2508 TrailBlazer
BMA Brownsville 1219 45-2517 TrailBlazer
Deltona 1224 10-2616 TrailBlazer
BMA Wichita Falls 1226 45-2510 TrailBlazer
BMA Beaumont 1227 45-2524 TrailBlazer
BMA Xxxxxxx Xxxxx 0000 00-0000 XxxxxXxxxxx
Xxxxxx 0000 40-2505 TrailBlazer
Bayamon 1232 40-2504 TrailBlazer
Lincoln 1236 03-2510 TrailBlazer
Ukiah 1237 05-2548 TrailBlazer
BMA Uvalde 1239 45-2540 TrailBlazer
Lafayette 1240 19-2504 TrailBlazer
BMA S. San Antonio 1241 45-2544 TrailBlazer
South Phoenix 1244 03-2508 TrailBlazer
Sarasota 1252 10-2515 TrailBlazer
BMA Baytown 1256 45-2575 TrailBlazer
Carbondale 1258 14-2514 TrailBlazer
Gainsville 1264 10-2512 TrailBlazer
Xxxxx 1267 40-2502 TrailBlazer
BMA Albuquerque 1278 32-2500 TrailBlazer
Santa Xxxxxxx 1282 05-2513 TrailBlazer
BMA Bexar County 1283 45-2527 TrailBlazer
San Xxxx 1284 40-2501 TrailBlazer
BMA San Antonio 1285 45-2507 TrailBlazer
Baton Rouge 1286 19-2501 TrailBlazer
BMA West Ft. Worth 1287 45-2594 TrailBlazer
Bakersfield 1288 05-2518 TrailBlazer
Whittier 1289 05-2519 TrailBlazer
Treasure Coast North 1290 10-2525 TrailBlazer
Orlando 1291 00-0000 XxxxxXxxxxx
Xx Xxxxxxxxxx 0000 10-2519 TrailBlazer
Clearwater 1297 10-2542 TrailBlazer
Sebring 1301 10-2564 TrailBlazer
BMA N.E. San Antonio 1305 45-2565 TrailBlazer
BMA X. Xxxxxxx 1310 45-2574 TrailBlazer
Glendora 1311 05-2681 TrailBlazer
BMA W. San Antonio 1316 45-2616 TrailBlazer
Vero Beach 1317 10-2597 TrailBlazer
Phoenix 1318 03-2503 TrailBlazer
BMA S. Plains 1319 45-2506 TrailBlazer
BMA Bedford 1321 45-2583 TrailBlazer
BMA Eagle Pass 1322 45-2541 TrailBlazer
Xxxxxxxxxx 0000 10-2594 TrailBlazer
Inverness 1339 10-2579 TrailBlazer
South St.Petersburg 1343 10-2547 TrailBlazer
Carolina 1344 40-2507 TrailBlazer
Guayama 1345 40-2509 TrailBlazer
Crystal River 1346 10-2661 TrailBlazer
Lake City 1347 10-2548 TrailBlazer
BMA N.E. Albuquerque 1349 32-2504 TrailBlazer
Alameda County 1353 05-2586 TrailBlazer
Fresno 1359 05-2677 TrailBlazer
Lantana 1364 10-2539 TrailBlazer
Hollywood 1367 10-2508 TrailBlazer
BMA X.X. Xxxxxxx 1373 45-2576 TrailBlazer
Thousand Oaks 1383 05-2579 TrailBlazer
Ocala 1385 10-2537 TrailBlazer
Natchitoches 1387 19-2525 TrailBlazer
San German 1393 40-2506 TrailBlazer
Arecibo 1394 40-2508 TrailBlazer
Minden 1400 19-2541 TrailBlazer
BMA Weslaco 1401 45-2585 TrailBlazer
Chula Visata 1402 05-2563 TrailBlazer
BMA Xxxxx 1404 45-2582 TrailBlazer
Aguadilla 1410 40-2513 TrailBlazer
Xxxxxxx 1413 10-2584 TrailBlazer
Bradenton 1419 10-2538 TrailBlazer
Palmetto 1420 10-2562 TrailBlazer
Camarillo 1423 05-2668 TrailBlazer
Greeley 1424 06-2510 TrailBlazer
BMA S. Arlington 1426 45-2592 TrailBlazer
BMA Central San Antonio 1427 45-2595 TrailBlazer
Xxxxxxx 1435 25-2505 TrailBlazer
BMA Lubbock 1444 45-2568 TrailBlazer
BMA Victoria 1445 45-2567 TrailBlazer
Kendall 1451 10-2522 TrailBlazer
Metropolitan Miami 1452 10-2566 TrailBlazer
Canton 1454 25-2522 TrailBlazer
Glendale 1455 03-2521 TrailBlazer
St. Augustine 1461 10-2557 TrailBlazer
Gainsville East 1467 10-2613 TrailBlazer
Rio Piedras 1471 40-2515 TrailBlazer
Las Americas 1472 40-2512 TrailBlazer
Xxxx.Xx Lucie 1473 10-2609 TrailBlazer
Apopka 1474 10-2592 TrailBlazer
BMA Corsicana 1477 45-2553 TrailBlazer
Southwest Jackson 1483 25-2524 TrailBlazer
Xxxxxx 1485 05-2687 TrailBlazer
BMA Clear Lake 1489 45-2609 TrailBlazer
East Orlando 1492 10-2619 TrailBlazer
Kansas City 1494 26-2501 TrailBlazer
Blue Springs 1495 26-2511 TrailBlazer
Desert Valley 1496 03-2530 TrailBlazer
Belmont 1565 14-2531 TrailBlazer
Bridgeport 1566 14-2524 TrailBlazer
Loop/E. Delaware 1567 14-2502 TrailBlazer
Evergreen 1568 14-2545 TrailBlazer
Gurnee 1569 14-2549 TrailBlazer
Xxxxxxx Estates 1570 14-2547 TrailBlazer
Lutheran General 1571 14-2559 TrailBlazer
Melrose Pk 1572 14-2554 TrailBlazer
Marquette 1573 14-2566 TrailBlazer
Cumberland/Norridge 1574 14-2521 TrailBlazer
Rolling Xxxxxxx 1576 14-2525 TrailBlazer
South 1577 14-2519 TrailBlazer
South Holland 1578 14-2542 TrailBlazer
South Shore 1579 14-2572 TrailBlazer
Mission Hills 1614 05-2633 TrailBlazer
Midwest City 1615 37-2510 TrailBlazer
BMA New Braunfels 1618 45-2626 TrailBlazer
Madison Cty 1619 44-2550 TrailBlazer
Souwest Tennessee 1620 44-2544 TrailBlazer
Memphis 1624 44-2569 TrailBlazer
East Mobile 1626 01-2524 TrailBlazer
East Arkansas 1644 04-2528 TrailBlazer
St. Louis 1645 26-2507 TrailBlazer
St Xxxxxxx 1646 26-2521 TrailBlazer
Southwest Illinois 1647 14-2535 TrailBlazer
BMA N.W. Bexar Cnty 1648 45-2631 TrailBlazer
Jupiter 1649 10-2657 TrailBlazer
BMA Texas City 1651 45-2635 TrailBlazer
BMA Mission 1657 45-2636 TrailBlazer
Xxxxxxxx 1659 03-2537 TrailBlazer
West Xxxxx 1662 40-2517 TrailBlazer
BMA S.E. San Antonio 1664 45-2638 TrailBlazer
Live Oak 1669 10-2652 TrailBlazer
Xxxxx 1670 10-2662 TrailBlazer
Petaluma 1677 05-2624 TrailBlazer
Santa Xxxx 1678 05-2524 TrailBlazer
BMA Cleburne 1679 45-2644 TrailBlazer
Xxxxxx City 1690 05-2544 TrailBlazer
Penn Valley 1695 26-2538 TrailBlazer
Homestead 1705 10-2565 TrailBlazer
Xxxx Xxxxxxx 1706 10-2595 TrailBlazer
Ventura County 1711 05-2656 TrailBlazer
Las Xxxxx 1712 05-2692 TrailBlazer
South Miami 1713 10-2502 TrailBlazer
Coconut Grove 1714 10-2653 TrailBlazer
Bastrop 1735 19-2594 TrailBlazer
Univ of S. Alabama 1737 01-2559 TrailBlazer
BMA W. Bexar Cnty 1738 45-2668 TrailBlazer
BMA Jourdanton 1739 45-2673 TrailBlazer
BMA N.W. Houston 1740 45-2671 TrailBlazer
BMA Liberty 1742 45-2669 TrailBlazer
BMA Dallas South 1746 45-2679 TrailBlazer
BMA S. Central Xxxxxx XX 1748 45-2680 TrailBlazer
BMA Dallas Central 1749 45-2684 TrailBlazer
BMA N.W. Xxxxxx XX 1750 45-2683 TrailBlazer
Avon Park 1753 10-2694 TrailBlazer
East Memphis 1775 44-2524 TrailBlazer
BMA Central Ft. Worth 1784 45-2689 TrailBlazer
Xxxxxxxx 1790 37-3506 TrailBlazer
BMA Westminster 1801 45-2709 TrailBlazer
Concord 1802 05-2759 TrailBlazer
Walnut Creek 1803 05-2758 TrailBlazer
Xxxxxxxxx 0000 05-2757 TrailBlazer
Carrollwood 1805 10-2681 TrailBlazer
Naples 1806 10-2534 TrailBlazer
Xxxxxx Springs 1807 10-2650 TrailBlazer
BMA Xxxxxx XX 1812 45-2698 TrailBlazer
BMA Dallas East 1813 45-2700 TrailBlazer
BMA Xxxxxxx XX 1817 45-2701 TrailBlazer
BMA S. Dallas County 1818 45-2697 TrailBlazer
Gulfport 1822 25-2540 TrailBlazer
Graceland 1838 44-2591 TrailBlazer
N.E. Tx Dialysis Center 1872 45-2694 TrailBlazer
Swiss Ave. Dialysis Ctr. 1874 45-2693 TrailBlazer
Village II Dialysis Ctr. 1875 45-2688 TrailBlazer
Oak Cliff Dialysis Ctr. 1876 45-2691 TrailBlazer
Xxxxxxx Xxxxxxxx Xxx. 0000 45-2699 TrailBlazer
S. Oak Cliff Dialysis Ctr. 1878 45-2687 XxxxxXxxxxx
Xxxx Xxxx Xxxxxxxx Xxx. 0000 45-2690 TrailBlazer
Mockingbird Dialysis Ctr. 1881 45-2501 TrailBlazer
North Memphis 1891 44-2593 TrailBlazer
Preferred Dialysis Mgmt. 1893 29-2507 TrailBlazer
West Boca 1908 10-2582 TrailBlazer
BMA Cliffview 1909 45-2674 TrailBlazer
Palatka 1912 10-2676 TrailBlazer
El Centro 1917 05-2690 TrailBlazer
Berkeley 1920 05-2651 TrailBlazer
BMA West Texas 1921 45-2604 TrailBlazer
North Phx 1923 03-2550 TrailBlazer
Xxxxxx 1924 10-2668 TrailBlazer
Xxxxxx 1926 03-2522 TrailBlazer
Flagstaff 1927 03-2524 TrailBlazer
Salt River 1928 03-2529 TrailBlazer
Xxxxxxx 1929 03-2536 TrailBlazer
QCDC St Louis 1947 26-2528 TrailBlazer
Dallas/QCDC 1952 45-2621 TrailBlazer
University Kidney Ctr. 1953 45-2603 TrailBlazer
North Coast 1954 05-2708 TrailBlazer
Florida Ins.for Peritoneal 1973 10-2643 TrailBlazer
Hillcrest 1981 05-2500 TrailBlazer
National City 1982 05-2536 TrailBlazer
Chula Vista South 1984 05-2653 TrailBlazer
N. Chicago/W. Belmont 2022 14-2523 TrailBlazer
Evanston 2044 14-2511 TrailBlazer
Niles 2052 14-2500 TrailBlazer
Morningstar 2295 37-2537 TrailBlazer
Milwaukee South 1082 52-2516 United Government Svcs.
Kempsville 1083 49-2567 United Government Svcs.
Alexandria 1132 49-2505 United Government Svcs.
Roanoke 1133 49-2513 United Government Svcs.
Norfolk 1135 49-2502 United Government Svcs.
Suffolk 1195 49-2530 United Government Svcs.
Xxx Arbor 1253 23-2502 United Government Svcs.
Northeast Wisconsin 1257 52-2500 United Government Svcs.
Livonia 1263 23-2501 United Government Svcs.
Detroit 1265 23-2500 United Government Svcs.
North Arlington 1275 49-2515 United Government Svcs.
Fairfax 1277 49-2504 United Government Svcs.
Fredericksburg 1311 49-2508 United Government Svcs.
Martinsburg 1331 51-2502 United Government Svcs.
Xxxxx County 1340 49-2510 United Government Svcs.
Xxx Xxxxx Xxxxxx 0000 00-0000 Xxxxxx Xxxxxxxxxx Svcs.
North Roanoke 1397 49-2548 United Government Svcs.
Charleston 1398 51-2503 United Government Svcs.
Eastern Virginia 1441 49-2538 United Government Svcs.
Bluefield 1458 51-2501 United Government Svcs.
Dulles 1488 49-2540 United Government Svcs.
Richmond 1601 49-2519 United Government Svcs.
Xxxx Xxx 0000 00-0000 Xxxxxx Xxxxxxxxxx Svcs.
Warrenton 1603 49-2525 United Government Svcs.
Tappahanock 1604 49-2536 United Government Svcs.
Xxxxxx 1605 23-2514 United Government Svcs.
Madison Heights 1637 23-2525 United Government Svcs.
Owosso 1663 23-2522 United Government Svcs.
Flint 1667 23-2521 United Government Svcs.
Morgantown 1680 51-2506 United Government Svcs.
Milwaukee South 1685 52-2510 United Government Svcs.
Northwest Indianapolis 1686 23-2526 United Government Svcs.
Appleton 1689 52-2514 United Government Svcs.
Oshkosh 1696 52-2518 United Government Svcs.
Great Lakes 1727 23-2533 United Government Svcs.
Farmville 1797 49-2526 United Government Svcs.
Xx. Xxxxx Xxxxxx 0000 00-0000 Xxxxxx Xxxxxxxxxx Svcs.
Mt. Xxxxxx/QCDC 1949 49-2557 United Government Svcs.
Norfolk Community Hosp. 1995 49-2585 United Government Svcs.
Crystal Springs 2091 49-2570 United Government Svcs.
