Medicare and Medicaid Participation. (a) Except as set forth on Schedule 7.1.25,
Medicare and Medicaid Participation. Primary Care Provider hereby represents and warrants that Primary Care Provider is a Medicare certified Primary Care Provider in good standing under the Federal Medicare Program (Title XVIII of the Social Security Act, as amended) and that Primary Care Provider will use his/hers/its best efforts to maintain this good standing. Primary Care Provider hereby represents and warrants that Provider is eligible for participation in the Medicaid program; however, the provider is not required to participate in the Medicaid program as an RHS Medicaid Primary Care Provider. If, for any reason, Primary Care Provider receives notice of any sanction from the Medicare or Medicaid Programs, Primary Care Provider agrees to notify RHS promptly of the sanction. Primary Care Provider shall not employ or contract with any individual who is excluded from participation in the Medicare or Medicaid programs under sections 1128 or 1128A of the Social Security Act (or with an entity that employs or contracts with such an individual) for the provision of any health or administrative services, including, without limitation, healthcare services, utilization review or medical social work. Primary Care Provider agrees and acknowledges that RHS and/or Healthcare Plan(s) receives payment for Covered Services in whole or in part, directly or indirectly, from federal funds and to the extent Primary Care Provider treats Members for whom RHS and/or Healthcare Plan(s) receives federal funds and delegates Covered Services to RHS and/or Healthcare Plan(s) (e.g. Medicare and Medicaid Members), Primary Care Provider is subject to certain laws that are applicable to individuals and entities receiving federal funds.
Medicare and Medicaid Participation. (a) The cost reports for reimbursement by Medicare, Medicaid (if required), Blue Cross (if required), or any other cost-based third party payor (the "Programs") have been audited (i.e., settled, with a Notice of Program Reimbursement issued) through the period set forth in Part 2.20 of the Company Disclosure Schedule attached hereto, and all cost reports were filed when due. Except as set forth in Part 2.20(a) of the Company Disclosure Schedule, all cost reports are complete and correct in all material respects. Except as set forth in Part 2.20(a) of the Company Disclosure Schedule, (i) no Acquired Company has received written notice of any dispute between a Healthcare Facility and Blue Cross, a Governmental Entity or any Medicare or Medicaid fiscal intermediary regarding cost reports (with respect to the audited cost reports, only for any period subsequent to the period specified in Part 2.20(a) of the Company Disclosure Schedule) other than with respect to net reimbursable adjustments thereto made in the ordinary course of business which do not involve individual amounts in excess of $50,000 per cost report or $750,000 in the aggregate; (ii) there are no pending or, to the knowledge of the Company, threatened claims or investigations by any of the Programs against any Healthcare Facility; and (iii) each Healthcare Facility currently meets the conditions for participation in the Programs.
Medicare and Medicaid Participation. (a) (i) There are no pending or, to the knowledge of Parent, threatened claims or investigations by Medicare, Medicaid, Blue Cross or any other cost-based third party payor (the "Programs") against any Parent Company or Parent Program; and (ii) each Parent Company and Parent Program currently meets the conditions for participation in the Programs.
Medicare and Medicaid Participation. The Party and any Affiliates, as applicable, are qualified for participation in the Medicare and Medicaid programs and have current and valid provider agreements with the Medicare and Medicaid programs. To the Knowledge of the Party, the Party and its Affiliates are in substantial compliance with the conditions of participation in the Medicare and Medicaid programs, including conditions related to status as a Critical Access Hospital, and there are no failures of compliance (whether or not substantial) which might reasonably be expected to affect the Party’s continuing participation in such programs after Closing.
Medicare and Medicaid Participation. (a) No portion of the income from any Property is attributable to Medicare, Medicaid or any other third party payor program, except as shown on the Rent Roll attached as Schedule 2.7(b).
Medicare and Medicaid Participation. (a) For purposes of this provision, Medicare, Medicaid, CHAMPUS, TRICARE and other federal, state or local governmental reimbursement programs, or successor programs to any of the above, are referred to as "Government Programs".
Medicare and Medicaid Participation. Service Provider represents and warrants that neither it nor any affiliate (i.e., any entity that Service Provider holds at least twenty-five percent ownership or control of), nor to the best of its knowledge after due inquiry and investigation, has Service Provider, its employees, or Subcontractors, or their respective majority-owned or controlled affiliates, been (i) excluded, debarred, or suspended from participation in any program under Title XVIII or Title XIX under any of the provisions of Section 1128(a) or (b) of the Social Security Act (42 U.S.C. Section 1320 a-7) (ii) have not within a three-year (3) period preceding this Agreement been convicted of or had a civil judgment rendered against them for commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing a public (federal, state, or local) transaction or contract under a public transaction; violation of federal or state antitrust statutes or commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making false statements, or receiving stolen property; (iii) are not presently indicted or otherwise criminally or civilly charged by a government entity (federal, state or local) with commission of any of the offenses enumerated in (ii) above; and (iv) have not within a three-year (3) period preceding this Agreement had one or more public transactions (federal, state or local) terminated for cause or default. Service Provider agrees that it shall notify the Authority within three (3) days of the date it receives notice that any action is being taken against the Service Provider or any persons defined under the provisions of Section 1128(a) or (b), or against any Subcontractor, which could result in exclusion, debarment, or suspension from the Medicare or Medicaid programs, or any other governmental health care program. Service Provider shall develop, maintain and follow procedures for identifying excluded providers and terminating their ability to deliver Covered Services in a timely manner. Service Provider shall execute a Debarment and Suspension Agreement and Certification (attached hereto as Appendix C), and shall ensure that its Subcontractors providing Covered Services hereunder complete the same form(s), and shall execute and deliver such forms as Authority requires confirming the Service Provider representations and warranties.
Medicare and Medicaid Participation. (a) The Company is eligible for participation in the Medicare, Medicaid and CHAMPUS/TRICARE programs (collectively, the “Government Programs”) and has current and valid provider contracts with such Government Programs. The Company is in compliance with the conditions of participation for the Government Programs in all respects. There is neither pending, nor, to the Company’s or a Majority Stockholder’s Knowledge, threatened, any Action under the Government Programs involving the Company. The Majority Stockholders have made available to Buyer true and complete copies of the most recent Government Program survey reports and all plans of correction, if any, which Company was required to submit in response to such surveys, and all such plans of correction have been accepted by the applicable Government Program and all have been or are in the process of being implemented. Company’s billing practices for all third party payors, including the Government Programs and private insurance companies, are in compliance in all material respects with applicable Law and billing requirements of such third party payors and Government Programs and the Company has not knowingly billed or received any material payment or reimbursement in excess of amounts allowed by Law. Schedule 4.16 contains a list of all of the Company’s Government Program provider numbers and other third party payor provider numbers.
Medicare and Medicaid Participation. (a) The Company and each Subsidiary that bills the Medicare program with respect to a billing location is a "home health agency" within the meaning of SSA sec. 1861(o) for such location and is in compliance with the conditions of participation imposed by the SSA and the Secretary of Health and Human Services. Each of the Company (or Subsidiary, as the case may be) has a Medicare provider agreement and a Medicare provider number in force covering each agency at which the Company (or Subsidiary, as the case may be) accepts Medicare patients.
