PAYMENTS TO THIRD-PARTY PAYORS AND UNINSURED CLASS MEMBERS Sample Clauses

PAYMENTS TO THIRD-PARTY PAYORS AND UNINSURED CLASS MEMBERS. (a) The Sulzer Settlement Trust shall pay to the United States on behalf of the Centers for Medicare and Medicaid Services (formerly known as the Health Care Finance Administration) and other Third-Party Payors in respect of subrogation or other claims for medical expenses paid on behalf of Class Members and shall pay reasonable and necessary expenses incurred by Uninsured Affected Product Recipients in respect of each Affected Product Revision Surgery; provided, however, that any such amount paid by the Sulzer Settlement Trust shall not exceed (i) $15,000 in the aggregate for any and all claims made in respect of a single Affected Product Revision Surgery (unless approved by Sulzer as set forth below) and (ii) $60.0 million, in the aggregate. In the event that all such payments reach $60.0 million in the aggregate, Sulzer agrees to fund to the Sulzer Settlement Trust amounts necessary to pay Third-Party Payors in respect of subrogation or other claims for medical expenses paid by such Third-Party Payors on behalf of Class Members in excess of $15,000 in the aggregate per Affected Product Revision Surgery if such settlement with the Third-Party Payor was approved by Sulzer. In addition, Sulzer agrees to fund to the Sulzer Settlement Trust amounts necessary to pay the reasonable and necessary expenses incurred by Uninsured Affected Product Recipients in respect of an Affected Product Revision Surgery that exceed $15,000 as set forth in clause (i) above, up to a maximum of $2.0 million in the aggregate. The Parties agree that they will negotiate and settle all claims with respect to unpaid medical expenses paid by Third-Party Payors on behalf of Class Members from and after the Insurance Proceeds Delivery Date, and Sulzer shall not be obligated to fund any additional amounts to the Sulzer Settlement Trust as provided in this Section 3.9(a) in the event the amount owed is in connection with a settlement not authorized and directed by Sulzer. The Trustee on behalf of the Sulzer Settlement Trust agrees to honor all agreements that have been entered into or will be entered into after the date of this Agreement by Sulzer with the United States on behalf of the Centers for Medicare and Medicaid Services and/or other Third-Party Payors and to make payments in accordance with any such agreements from and following the Insurance Proceeds Delivery Date. Sulzer and the Sulzer Settlement Trust shall obtain a full and complete release of Settled Claims of the Released Pa...
AutoNDA by SimpleDocs

Related to PAYMENTS TO THIRD-PARTY PAYORS AND UNINSURED CLASS MEMBERS

  • Reimbursement from Third Party Payors The accounts receivable of Holdings, the Borrower and the Restricted Subsidiaries have been and will continue to be adjusted to reflect the reimbursement policies required by all applicable Requirements of Law and other Third Party Payor Arrangements to which Holdings, the Borrower or such Restricted Subsidiary is subject, and do not exceed in any material respect amounts the Borrower or such Restricted Subsidiary is entitled to receive under any capitation arrangement, fee schedule, discount formula, cost-based reimbursement or other adjustment or limitation to usual charges. All xxxxxxxx by Holdings, the Borrower and each Restricted Subsidiary pursuant to any Third Party Payor Arrangements have been made in compliance with all applicable Requirements of Law, except where failure to comply would not, individually or in the aggregate, be reasonably likely to have a Material Adverse Effect. There has been no intentional or material over-billing or over-collection by the Borrower or any Restricted Subsidiary pursuant to any Third Party Payor Arrangements, other than as created by routine adjustments and disallowances made in the ordinary course of business by the Third Party Payors with respect to such xxxxxxxx.

  • Payments to Third Parties Except as expressly set forth herein, each Party shall be solely responsible for any payments due to Third Parties under any agreement entered into by such Party with respect to the Licensed Product, as a result of activities hereunder.

  • RECOVERY FROM THIRD PARTIES 6.1 Where the Sellers have paid an amount in full discharge of a liability under paragraph 2 in respect of any Liability for Taxation and the Buyer, the Company is or becomes entitled to recover from some other person (not being the Buyer, the Company or any other company within the Buyer’s Tax Group), any amount in respect of such Liability for Taxation, the Buyer shall or shall procure that the Company shall:

  • Third Party Payments Neither the Advisor nor any of its officers, directors, employees or stockholders shall receive any commissions, compensation, remuneration or payments whatsoever from any broker with which the Company carries an account for transactions executed in the Company’s account. The parties acknowledge that a familial relationship of any of the foregoing persons may receive floor brokerage commissions in respect of trades effected pursuant to the Advisor’s Trading Approach on behalf of the Company, which payment shall not violate the preceding sentence.

  • Distribution of payments to Creditor Parties Subject to Clauses 16.5, 16.6 and 16.7:

  • THIRD PARTY PAYORS Company, Shareholders and each licensed professional employee or independent contractor of Company has timely filed all claims or other reports required to be filed with respect to the purchase of services by third-party payors, and all such claims or reports are complete and accurate, and has no liability to any payor with respect thereto. There are no pending appeals, overpayment determinations, adjustments, challenges, audit, litigation or notices of intent to open Medicare or Medicaid claim determinations or other reports required to be filed by Company, any Shareholder and each licensed professional employee of Company. Neither Company, nor any Shareholder, nor any licensed professional employee of Company has been convicted of, or pled guilty or nolo contendere to, patient abuse or negligence, or any other Medicare or Medicaid program related offense and none has committed any offense which may serve as the basis for suspension or exclusion from the Medicare and Medicaid programs or any other third party payor program. With respect to payors, Company, Shareholders and Company's licensed professional employees has not (a) knowingly and willfully making or causing to be made a false statement or representation of a material fact in any application for any benefit or payment; (b) knowingly and willfully making or causing to be made any false statement or representation of a material fact for use in determining rights to any benefit or payment; (c) failed to disclose knowledge of the occurrence of any event affecting the initial or continued right to any benefit or payment on its own behalf or on behalf of another, with the intent to fraudulently secure such benefit or payment; and (d) violated any applicable state anti-remuneration or self-referral statutes, rules or regulations.

  • Non-Third Party Claims Upon discovery of any claim for which Buyer has an indemnification obligation under the terms of Section 12.1 which does not involve a claim by a third party against the Indemnitee, the Indemnitee shall give prompt notice to Buyer of such claim and, in any case, shall give Buyer such notice within 30 days of such discovery. A failure by Indemnitee to timely give the foregoing notice to Buyer shall not excuse Buyer from any indemnification liability except to the extent that Buyer is materially and adversely prejudiced by such failure.

  • Settlement of Third Party Claims Notwithstanding any other provision of this Agreement, the Indemnifying Party shall not enter into settlement of any Third Party Claim without the prior written consent of the Indemnified Party, except as provided in this Section 8.05(b). If a firm offer is made to settle a Third Party Claim without leading to liability or the creation of a financial or other obligation on the part of the Indemnified Party and provides, in customary form, for the unconditional release of each Indemnified Party from all liabilities and obligations in connection with such Third Party Claim and the Indemnifying Party desires to accept and agree to such offer, the Indemnifying Party shall give written notice to that effect to the Indemnified Party. If the Indemnified Party fails to consent to such firm offer within ten days after its receipt of such notice, the Indemnified Party may continue to contest or defend such Third Party Claim and in such event, the maximum liability of the Indemnifying Party as to such Third Party Claim shall not exceed the amount of such settlement offer. If the Indemnified Party fails to consent to such firm offer and also fails to assume defense of such Third Party Claim, the Indemnifying Party may settle the Third Party Claim upon the terms set forth in such firm offer to settle such Third Party Claim. If the Indemnified Party has assumed the defense pursuant to Section 8.05(a), it shall not agree to any settlement without the written consent of the Indemnifying Party (which consent shall not be unreasonably withheld or delayed).

  • Received From Third Party Such information was or is hereafter rightfully received by the party from a third party (expressly excluding the Fund’s custodian, prime broker and administrator) without restriction on its disclosure and without breach of this Agreement or of a similar confidential disclosure agreement regarding them; or

  • No Third Parties Benefited This Agreement is made and entered into for the sole protection and legal benefit of the Company, the Banks, the Agent and the Agent-Related Persons, and their permitted successors and assigns, and no other Person shall be a direct or indirect legal beneficiary of, or have any direct or indirect cause of action or claim in connection with, this Agreement or any of the other Loan Documents.

Time is Money Join Law Insider Premium to draft better contracts faster.