FOUNDATION ACCOUNTABLE CARE NETWORK ACO PARTICIPANT AGREEMENTBusiness Associate Agreement • September 5th, 2017 • California
Contract Type FiledSeptember 5th, 2017 JurisdictionThis ACO Participant Agreement (“Agreement”), is by and between FOUNDATION ACCOUNTABLE CARE NETWORK (“ACO”), 3993 Jurupa Avenue, Riverside, CA 92506, and
▪ ACO Participation Agreement (PA): Pages 1, 2, 16, 21Business Associate Agreement • May 30th, 2017 • California
Contract Type FiledMay 30th, 2017 Jurisdiction🞎 ACO PARTICIPATION AGREEMENT (PA): Page 2 can be signed by a group signatory. Each provider under the TIN must receive a copy (which you can email to them) however, please complete the following: