Common use of EFFECTIVE AND BINDING AGREEMENT Clause in Contracts

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. The undersigned ▇▇▇▇▇▇▇▇ signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ EGS and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ EGS’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ EGS that it is no longer providing health care items or services Government Reimbursed Products that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ EGS is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ EGS will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ EGS plans to resume providing health care items or services Government Reimbursed Products that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. The undersigned ▇▇▇▇▇▇▇▇ EGS signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 2-6-2014 ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Chairman EndoGastric Solutions Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇/ 2-7-14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇DATE ▇▇▇▇▇ Laboratories, Lovells US LLP Counsel for EndoGastric Solutions Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 2/11/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇/ 2-7-14 ▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. U.S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.G of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ PRMC and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of PRMC; B. This CIA shall become final and binding on the date the final signature is obtained on the CIA.; B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA.; C. OIG ▇. ▇▇▇ may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ PRMC’s obligations under this the CIA based on a certification by ▇▇▇▇▇▇▇▇ that it is no longer providing health care items or services that will be billed to any in the event of PRMC’s cessation of participation in Federal health care program programs. If PRMC withdraws from participating in Federal health care programs and that it does not have any ownership is relieved of its CIA obligations by OIG, PRMC shall notify OIG at least 30 days in advance of PRMC’s intent to reapply as a participating provider or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills supplier with any Federal health care program. If ▇▇▇▇▇▇▇▇ is relieved Upon receipt of its CIA obligations, ▇▇▇▇▇▇▇▇ will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such timenotification, OIG shall evaluate whether the CIA will should be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ PRMC signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ ▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ (▇▇▇▇▇) ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇DR.M President/CEO Date August 2, 2011 /▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services 8/9/11 Date /▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ ▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services 8/8/11 Date This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.E of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Ensign Group and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of Ensign Group. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ Ensign Group’s obligations in whole or in part under this CIA based on a certification by ▇▇▇▇▇▇▇▇ Ensign Group that it is no longer providing health care items or services that will be billed directly or indirectly to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Ensign Group is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ Ensign Group will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Ensign Group plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Ensign Group signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. ON BEHALF OF THE ENSIGN GROUP, INC. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇/ 10/1/13 ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire ▇ DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ LaboratoriesThe Ensign Group, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇/ 10/1/2013 ▇▇▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇ DATE President and Chief Executive Officer The Ensign Group, Esquire Skadden, Arps, Slate, Inc. /▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 10/1/13 ▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE ▇▇▇▇▇▇ & ▇▇▇▇, ▇▇▇ LLP Counsel for ▇▇▇▇▇▇▇▇ LaboratoriesThe Ensign Group, Inc. ON BEHALF OF THE OFFICE OF INSPECTOR GENERAL OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 9/27/13 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇ ▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇/ 9/27/2013 ▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Counsel to the Inspector General U. S. Office of Inspector General U.S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ GGNSC and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of GGNSC. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ GGNSC’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ GGNSC that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §§ 1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ GGNSC is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ GGNSC will be required to notify OIG in writing at least 30 thirty (30) days in advance if ▇▇▇▇▇▇▇▇ GGNSC plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ GGNSC signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. G. This CIA is by and between the parties hereto. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel The CIA is not intended to establish any legal rights for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating or confer any legal rights upon any non-governmental entities or persons not a party to the Independent Review Organization (IRO) required by Section III.E.2 of the CIA. The parties agree, however, that this CIA is a public document and it may be admissible in a judicial or administrative proceeding.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ will shall be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) ▇▇▇▇▇▇’▇ responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned ▇▇▇▇▇▇▇▇ signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇-▇▇▇▇▇▇ and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of ▇▇▇▇▇▇▇-▇▇▇▇▇▇. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG ▇. ▇▇▇ may agree to a suspension of ▇▇▇▇▇▇▇-▇▇▇▇▇▇’▇ obligations under this CIA based on a certification by ▇▇▇▇▇▇▇-▇▇▇▇▇▇ that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇Harmony-▇▇▇▇▇▇ is are relieved of its CIA obligations, ▇▇Harmony-▇▇▇▇▇▇ will be required to notify OIG in writing at least 30 days in advance if ▇▇Harmony-▇▇▇▇▇▇ plans plan to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇Harmony-▇▇▇▇▇▇ signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. DATED: 11/8/12 BY: /▇▇▇▇▇▇ ▇▇▇▇▇▇/ ▇▇▇▇▇▇ ▇▇▇▇▇▇ DATED: 11/8/12 BY: /▇▇▇▇▇▇ ▇▇▇▇▇/ ▇▇▇▇▇▇ ▇▇▇▇▇ Counsel for ▇▇▇▇▇▇ ▇▇▇▇▇▇ Harmony Care Hospice, Inc. and ▇▇▇▇▇▇ ▇▇▇▇▇▇ Corporate Integrity Agreement DATED: 11/8/12 BY: /▇▇▇▇▇▇ ▇▇▇▇▇▇/ ▇▇▇▇▇▇ ▇▇▇▇▇▇, Chief Executive Officer DATED: 11/8/12 BY: /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ LaboratoriesCounsel for Harmony Care Hospice Harmony Care Hospice, Inc. /and ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. Corporate Integrity Agreement /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Chief Counsel to the Inspector General Office of Inspector General U. S. Department of Health and Human Services 11/15/12 DATE /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇/ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇ Associate Counsel 11/8/12 DATE Harmony Care Hospice, Inc. and ▇▇▇▇▇▇ ▇▇▇▇▇▇ Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Baptist and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ Baptist’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ Baptist that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Baptist is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ Baptist will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Baptist plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. The undersigned ▇▇▇▇▇▇▇▇ Baptist signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles or e-mails of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE / 2/11/15 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Corporate Compliance and Privacy Officer Baptist Health /▇▇, Esquire ▇▇ ▇▇▇▇▇/ 2/11/2015 ▇▇▇▇ ▇▇▇▇▇ DATE Baptist Health Chief Executive Officer /▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇/ 2/9/15 ▇▇▇▇ ▇. ▇▇▇▇▇▇ & ▇▇▇▇, LLP DATE Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. Baptist Health /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 2/20/15 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. U.S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇/ 5/9/14 ▇02-12-15 ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇ DATE Senior Counsel Administrative and Civil Remedies Branch Office of Counsel to the Inspector General U. S. U.S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Tenet and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of Tenet. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This C. Any modifications to this CIA constitutes shall be made with the complete agreement between the parties and may not be amended except by prior written consent of the parties to this CIA. C. D. OIG may agree to a suspension of ▇▇▇▇T▇▇▇▇’▇ obligations under this the CIA based on a certification by in the event of T▇▇▇▇’▇ cessation of participation in Federal health care programs. If Tenet withdraws from participation in Federal health care programs and is relieved of its CIA obligations by OIG, Tenet shall notify OIG at least 30 days in advance of T▇▇▇▇’▇ that it is no longer providing health care items intent to reapply as a participating provider or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills supplier with any Federal health care program. If ▇▇▇▇▇▇▇▇ is relieved Upon receipt of its CIA obligations, ▇▇▇▇▇▇▇▇ will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such timenotification, OIG shall evaluate whether the CIA will should be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Tenet signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. //s/ T▇▇▇▇▇ ▇▇▇▇▇▇ 9/27/06 T▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇T▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇Healthcare Corporation /s/ S▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇9/27/06 S▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇ DATE Senior Vice President, Ethics and Compliance and Chief Compliance Officer T▇▇▇▇ Healthcare Corporation /s/ R▇▇▇▇ ▇. ▇▇▇▇▇▇▇ 9/27/06 R▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE L▇▇▇▇▇ & W▇▇▇▇▇▇ LLP Counsel for T▇▇▇▇ Healthcare Corporation /s/ G▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ 9/27/06 G▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. U.S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 of the CIA.Services

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Allegiance and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of Allegiance. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ Allegiance’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ Allegiance that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Allegiance is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ Allegiance will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Allegiance plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Allegiance signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇▇▇/ 4/23/13 ▇▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. President and Chief Executive Officer Allegiance Health DATE /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇/ 4/25/2013 ▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate▇ DATE ▇▇▇▇, ▇▇▇▇▇▇, ▇▇▇▇▇▇▇, ▇▇▇▇▇ & ▇▇▇▇▇, LLP Counsel for ▇.▇. ▇▇▇▇▇▇▇ Laboratories, Inc. for Allegiance Health /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 6/5/13 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇/ 6/14/2013 ▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization Organization(s) (IRO) required by Section III.E.2 III.E of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Consistent with the provisions in the Settlement Agreement pursuant to which this CIA is entered, and into which this CIA is incorporated, King and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of King; B. This CIA shall become final and binding on the date the final signature is obtained on the CIA.; B. This C. Any modifications to this CIA constitutes shall be made with the complete agreement between the parties and may not be amended except by prior written consent of the parties to this CIA. C. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified.; D. The undersigned ▇▇▇▇▇▇▇▇ signatories King signatories’ represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA.; and E. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIAagreement. Facsimiles of signatures shall constitute acceptableCorporate Integrity Agreement King Pharmaceuticals, binding signatures for purposes of this CIA. /Inc. /s/ F▇▇▇▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇▇, ▇▇. 10/31/05 F▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇. Corporate Compliance Officer DATE /s/ M▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇10/31/05 M▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 Esq. Counsel for King Pharmaceuticals, Inc. DATE Corporate Integrity Agreement King Pharmaceuticals, Inc. /s/ L▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. 10/28/05 L▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Chief Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant to the Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services Corporate Integrity Agreement King Pharmaceuticals, Inc. This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA. Capitalized terms used in this Appendix A and not defined herein have the meanings assigned to them in the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of ▇▇▇▇▇▇; B. This CIA shall become final and binding on the later of (1) the date the final signature is obtained on the CIA; or (2) the date the Civil Settlement Agreement becomes effective. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA.; C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership ▇▇▇▇▇▇ Medical Technology, Inc. — Corporate Integrity Agreement or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ LaboratoriesMedical Technology, Inc. /▇▇— Corporate Integrity Agreement /s/: ▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇ 9/22/10 ▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice ▇ President & and Chief Compliance Executive Officer ▇▇▇▇▇▇▇▇ LaboratoriesMedical Technology, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇/s/: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ESQ. 9/22/10 ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇, ESQ. Ober, Kaler, ▇▇▇▇▇▇ & ▇▇▇▇▇▇▇, P.C. Counsel for ▇▇▇▇▇▇ Medical Technology, Inc. DATE /s/: ▇▇▇▇▇ ▇. ▇▇▇▇▇, ESQ. 9/23/10 ▇▇▇▇▇ ▇. ▇▇▇▇▇, ESQ. ▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇ ▇▇▇▇ and ▇▇▇▇ LLP Counsel for ▇▇▇▇▇▇ Medical Technology, Inc. DATE ▇▇▇▇▇▇ Medical Technology, Inc. — Corporate Integrity Agreement /s/: ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ 9/29/10 ▇▇▇▇▇▇▇ DATE ▇. ▇▇▇▇▇▇ Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /DATE ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services Medical Technology, Inc. — Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.E of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Lutheran and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of ▇▇▇▇▇▇▇ Lutheran. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ Lutheran’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ Lutheran that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Lutheran is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ Lutheran will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Lutheran plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Lutheran signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA.. ▇▇▇▇▇▇▇ Lutheran Corporate Integrity Agreement E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 of the CIA.Lutheran Corporate Integrity Agreement

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Ensign Group and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of Ensign Group. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ Ensign Group’s obligations in whole or in part under this CIA based on a certification by ▇▇▇▇▇▇▇▇ Ensign Group that it is no longer providing health care items or services that will be billed directly or indirectly to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Ensign Group is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ Ensign Group will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Ensign Group plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Ensign Group signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ The CareAll Entities and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of the CareAll Entities. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ the CareAll Entities’ obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ the CareAll Entities that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ is the CareAll Entities are relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ the CareAll Entities will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ plans the CareAll Entities plan to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ CareAll Entities signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. DATED: 8/10/12 BY: /▇▇▇▇▇ ▇. Carell/ ▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇. Carell DATED: 8/10/12 BY: /▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Counsel for ▇▇▇▇▇ ▇. Carell DATED: 8/10/12 BY: /▇▇▇▇▇▇▇ Carell/ ▇▇▇▇▇▇▇ Carell, Esquire DATE Vice President & Chief Compliance Officer Manager DATED: 8-10-12 BY: /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇/ ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇ LaboratoriesCounsel for Diversified DATED: 8/10/12 BY: /▇▇▇▇▇ ▇. Carell/ ▇▇▇▇▇ ▇. Carell, Special Appointee DATED: 8/10/12 BY: /▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Counsel for CareAll, Inc. DATED: 8/10/12 BY: /▇▇▇▇▇ ▇. Carell/ ▇▇▇▇▇ ▇. Carell, Special Appointee DATED: 8/9/12 BY: /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇/ ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇ Counsel for VIP Home Nursing and Rehabilitation Services, Esquire/ 5/7/2014 LLC DATED: 8/10/12 BY: /▇▇▇▇▇ ▇. Carell/ ▇▇▇▇▇ ▇. Carell, Special Appointee DATED: 8/9/12 BY: /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇/ ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇ Counsel for Professional Home Health Care, Esquire LLC DATED: 8/10/12 BY: /▇▇▇▇▇ ▇. Carell/ ▇▇▇▇▇ ▇. Carell, Special Appointee DATED: 8/9/12 BY: /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇/ ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇ Counsel for University Home Health, LLC /▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Chief Counsel to the Inspector General Office of Inspector General U. S. Department of Health and Human Services 8/9/12 DATE /▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire / ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ August 3, 2012 DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇ ▇▇▇▇▇ and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of ▇▇▇ Heart. B. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG ▇. ▇▇▇ may agree to a suspension of ▇▇▇ ▇▇▇▇▇▇’▇ ’s obligations under this CIA based on a certification by ▇▇▇▇ ▇▇▇▇▇ that it is no longer providing health care items or services that will be billed to any Federal health care program and that neither it does not have nor any owner of ▇▇▇ ▇▇▇▇▇ has any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Kai Heart is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ Kai Heart will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Kai Heart or any owner of Kai Heart plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Kai Heart signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇/ 5/6/2014 11/02/2012 ▇▇▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇Owner, Esquire Director, President DATE Vice President & Chief Compliance Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇ ▇▇▇▇▇▇▇▇, Esquire ▇/ 11-2-12 ▇▇▇▇▇▇▇▇ ▇. ▇▇ ▇▇▇▇▇, Esquire SkaddenOwner, ArpsDirector, Slate, ▇▇▇Secretary DATE /Hsi-▇▇▇▇ & ▇▇/ 11-2-2012 ▇▇▇▇, LLP Counsel for ▇▇▇▇-▇▇▇▇ Laboratories▇▇, Inc. Owner, Director, Vice President DATE Chief Operating Officer /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services 11/5/12 DATE /▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ ▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ 11/2/12 DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of Orthofix; B. This CIA shall become final and binding on the date the final signature is obtained on the CIA.; B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA.; C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ Orthofix’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ Orthofix that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Orthofix is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ Orthofix will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Orthofix plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Orthofix signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent represents that they are signing this CIA in their official capacities capacity and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ President and Chief Executive Officer Orthofix International, Esquire/ 05/06/2014 N.V. 5/31/2012 DATE /▇▇▇▇▇ ▇. O’Connor/ BRIEN ▇. ▇’▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ Ropes & Gray LLP Prudential Tower, ▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇, Esquire ▇▇ ▇▇▇▇▇-▇▇▇▇ 5/31/2012 DATE /▇. ▇▇▇▇▇ ▇▇▇▇▇▇▇▇/ ▇. ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ Senior Vice President and Chief Financial Officer Orthofix, Inc 5/31/2012 DATE /▇▇▇▇▇ ▇. O’Connor/ BRIEN ▇. ▇’▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ Ropes & Gray LLP Prudential Tower, ▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇ 5/31/2012 DATE Assistant /▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ General Counsel and Secretary Blackstone Medical Inc. 5/31/2012 DATE /▇▇▇▇▇ ▇. O’Connor/ BRIEN ▇. ▇’▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ Ropes & Gray LLP Prudential Tower, ▇▇▇ ▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇ ▇▇▇▇▇-▇▇▇▇ 5/31/2012 DATE /▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Chief Counsel to the Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services 6/6/2012 DATE /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services 6/5/2012 DATE /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇June 5, 2012 ▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. U.S. Department of Health and Human Services DATE This Appendix contains the requirements relating to the Independent Review Organization Organization(s) (IRO) required by Section III.E.2 III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Zimmer and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of Zimmer; B. This CIA shall become final and binding on the date the final signature is obtained on the CIA.; B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA.; C. D. OIG may agree to a suspension of ▇▇▇Z▇▇▇▇▇’▇ obligations under this the CIA based on a certification by in the event of Z▇▇▇▇▇▇▇’▇ that it is no longer providing health care cessation of the delivery, sale, marketing, or furnishing of items or services that will be billed to reimbursed by any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care programprograms. If ▇▇▇▇▇▇▇▇ such cessation occurs and Zimmer is relieved of its CIA obligationsobligations by OIG, ▇▇▇▇▇▇▇▇ will be required to Zimmer shall notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ plans of the date on which Zimmer intends to resume providing health care begin delivering, selling, marketing, or furnishing items or services that are billed to reimbursed by any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care programprograms. At Upon receipt of such timenotification, OIG shall evaluate whether the CIA will should Corporate Integrity Agreement between OIG-HHS and Z▇▇▇▇▇, Inc. be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Zimmer signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /Corporate Integrity Agreement between OIG-HHS and Z▇▇▇▇▇, Inc. /s/ D▇▇▇▇ ▇. ▇▇▇▇▇▇ 09/27/07 D▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Chief Executive Officer and President Z▇▇▇▇▇, Inc. /s/ L▇▇▇▇ ▇. ▇’ ▇▇▇▇▇▇▇ L▇▇▇▇ ▇. ▇’ ▇▇▇▇▇▇▇ 09/27/07 DATE Chief Compliance Officer Z▇▇▇▇▇, Inc. /s/ F▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇ 09/27/07 F▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇ ▇▇▇, Esq. DATE President and Chief Executive Officer ▇Fulbright & J▇▇▇▇▇▇▇ LaboratoriesLLP Counsel for Z▇▇▇▇▇, Inc. /Corporate Integrity Agreement between OIG-HHS and Z▇▇▇▇▇, Inc. /s/ G▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇ 09/27/07 G▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Counsel to the Inspector General U. S. Department of Health and Human Services /Corporate Integrity Agreement between OIG-HHS and Z▇▇▇▇▇▇▇▇ ▇, Inc. Zimmer shall create and maintain an Arrangements Database to track all new and existing Arrangements, including Contractual Arrangements and Non-Contractual Arrangements, in order to ensure that each Arrangement does not violate the Anti-Kickback Statute. A. The Arrangements Database shall contain certain information to assist Zimmer in evaluating whether each Contractual Arrangement violates the Anti-Kickback Statute, including but not limited to the following: 1. Each party involved in the Arrangement; 2. The type of Arrangement (e.g., physician employment contract, medical directorship, lease agreement); 3. The term of the Arrangement, including the effective and expiration dates and any automatic renewal provisions; 4. The amount of compensation to be paid pursuant to the Arrangement and the means by which compensation is paid; 5. The methodology for determining the compensation under the Arrangements, including the methodology used to determine the fair market value of such compensation; 6. Whether the amount of compensation to be paid pursuant to the Arrangement is determined based on the volume or value of referrals between the parties; 7. Whether each party has fulfilled the requirements of Section III.D.2; and 8. Whether the Arrangement satisfies the requirements of an Anti-Kickback Statute safe harbor. Corporate Integrity Agreement between OIG-HHS and Z▇▇▇▇▇▇/ 5/9/14 , Inc. B. The Arrangements Database shall contain certain information to assist Zimmer in evaluating whether each Non-Contractual Arrangement violates the Anti-Kickback Statute, including but not limited to the following: 1. The name of the entity or individual receiving the Non-Contractual remuneration; 2. The type of Non-Contractual remuneration (listing in the aggregate multiple distributions of the same type of Non-Contractual remuneration to each entity or individual); 3. The aggregate value of each type of Non-Contractual remuneration given to each entity or individual during the Reporting Period; 4. Whether the Non-Contractual remuneration given pursuant to the Non-Contractual Arrangement is determined based on the volume or value of referrals between the parties; and 5. Whether the Non-Contractual Arrangement satisfies the requirements of an Anti-Kickback Statute safe harbor. Corporate Integrity Agreement between OIG-HHS and Z▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services , Inc. This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.E of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Exactech and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of Exactech; B. This CIA shall become final and binding on the later of (1) the date the final signature is obtained on the CIA.; or (2) the date the Civil Settlement Agreement becomes effective. Exactech, Inc. - Corporate Integrity Agreement B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA.; C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ Exactech’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ Exactech that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Exactech is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ Exactech will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Exactech plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Exactech signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent signatory represents that they are he is signing this CIA in their his official capacities capacity and that they are he is authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /Exactech, Inc. - Corporate Integrity Agreement ON BEHALF OF EXACTECH /S/ ▇▇▇▇▇▇▇ ▇▇▇▇▇ December 2, 2010 ▇▇▇▇▇▇▇ ▇▇▇▇▇ DATE Chief Executive Officer Exactech, Inc. /S/ ▇▇▇▇▇▇▇ ▇. ▇▇▇ December 3, 2010 ▇▇▇▇▇▇▇ ▇. ▇▇▇ DATE ▇▇▇▇▇▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, LLP Counsel for Exactech, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ LaboratoriesExactech, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇- Corporate Integrity Agreement ON BEHALF OF THE OFFICE OF INSPECTOR GENERAL OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES /s/ ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇ 12/7/2010 ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇/s/ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇ 12/7/2010 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Senior Counsel Office of Counsel to the Inspector General Office of Inspector General U. S. Department of Health and Human Services Exactech, Inc. - Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.E of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Orthofix and OIG agree as follows: A. This CIA shall be binding on the successors, assigns, and transferees of Orthofix; B. This CIA shall become final and binding on the date the final signature is obtained on the CIA.; B. C. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA.; C. D. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ Orthofix’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ Orthofix that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Orthofix is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ Orthofix will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Orthofix plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. E. The undersigned ▇▇▇▇▇▇▇▇ Orthofix signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent represents that they are signing this CIA in their official capacities capacity and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. //s/ ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇ 5/31/2012 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE President and Chief Executive Officer Orthofix International, Esquire DATE Vice President & Chief Compliance Officer N.V. /s/ Brien ▇. ▇’▇▇▇▇▇▇ Laboratories, Inc. /5/31/2012 BRIEN ▇. ▇’▇▇▇▇▇▇ DATE ▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ Ropes & ▇▇▇▇ LLP Prudential Tower, Esquire 800 Boylston Street Boston, MA 02199-3600 /s/ R. ▇▇▇▇▇ ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 of the CIA.5/31/12

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ Genova and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ Genova’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ Genova that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ Genova is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ will Genova shall be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ Genova plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) Genova’s responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned ▇▇▇▇▇▇▇▇ Genova signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇/_ _ 13APR20 ▇▇▇▇ ▇▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. Genova Diagnostics /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 / 4/17/20 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire ▇ DATE Vice President & Chief Compliance Officer ▇▇Counsel for ▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇ Green ▇▇▇ ▇▇▇▇, Esquire ▇▇▇▇ ▇▇▇▇▇▇ ▇. ▇▇ ▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇ ▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇Re/ _ 4/17/20 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇ RE DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. U.S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 4/15/2020 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Administrative and Civil Remedies Branch Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. U.S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇ USPh, Old Towne, and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇’▇ USPh’s or Old Towne’s obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇ USPh or Old Towne that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §§ 1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇ USPh or Old Towne is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇ USPh or Old Towne will be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇ USPh or Old Towne plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. The undersigned ▇▇▇▇▇▇▇▇ USPh and Old Towne signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇ DATE Assistant Inspector General for Legal Affairs Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA.

EFFECTIVE AND BINDING AGREEMENT. ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇ and OIG agree as follows: A. This CIA shall become final and binding on the date the final signature is obtained on the CIA. B. This CIA constitutes the complete agreement between the parties and may not be amended except by written consent of the parties to this CIA. C. OIG may agree to a suspension of ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇’▇ obligations under this CIA based on a certification by ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇ that it is no longer providing health care items or services that will be billed to any Federal health care program and that it does not have any ownership or control interest, as defined in 42 U.S.C. §1320a-3, in any entity that bills any Federal health care program. If ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇ is relieved of its CIA obligations, ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ will ▇▇▇▇▇▇ shall be required to notify OIG in writing at least 30 days in advance if ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇ plans to resume providing health care items or services that are billed to any Federal health care program or to obtain an ownership or control interest ▇▇▇▇▇▇▇▇▇▇–Zwanger ▇▇▇▇▇▇ – Corporate Integrity Agreement in any entity that bills any Federal health care program. At such time, OIG shall evaluate whether the CIA will be reactivated or modified. D. All requirements and remedies set forth in this CIA are in addition to and do not affect (1) ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇’▇ responsibility to follow all applicable Federal health care program requirements or (2) the government’s right to impose appropriate remedies for failure to follow applicable Federal health care program requirements. E. The undersigned ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇ signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatories represent that they are signing this CIA in their official capacities and that they are authorized to execute this CIA. E. F. This CIA may be executed in counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles Electronically-transmitted copies of signatures shall constitute acceptable, binding signatures for purposes of this CIA. /▇▇▇▇▇▇▇▇▇▇–Zwanger ▇▇▇▇▇▇ – Corporate Integrity Agreement DATE ▇▇▇ ▇▇▇▇ ▇▇▇▇▇▇/ 5/6/2014 ▇▇▇▇ ▇▇▇▇▇▇ DATE President and Chief Executive Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire/ 05/06/2014 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire DATE Vice President & Chief Compliance Officer ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇▇▇▇, Esquire/ 5/7/2014 ▇▇ ▇▇▇▇▇ DATE ▇▇▇ ▇▇▇▇ ▇. ▇▇▇▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇▇▇▇▇▇, Esquire DATE ▇▇ ▇▇▇▇▇ DATE ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇▇▇, Esquire ▇▇▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇, Esquire Skadden, Arps, Slate, ▇▇▇▇▇▇▇ & ▇▇▇▇, LLP Counsel for ▇▇▇▇▇▇▇▇ Laboratories, Inc. /▇▇▇-▇▇▇▇▇▇▇ ▇. ▇▇▇▇▇ DATE ▇▇▇▇▇▇ Moscou ▇▇▇▇▇▇▇/ 5/15/14 ▇▇▇, ▇▇▇ .▇. ▇▇▇▇▇▇▇ for ▇▇▇▇▇▇▇▇▇▇-▇▇▇▇▇▇▇ ▇▇▇▇▇▇ DATE ▇▇▇▇▇▇▇▇▇▇–Zwanger ▇▇▇▇▇▇ – Corporate Integrity Agreement /▇▇▇▇ ▇. Re/ 10/26/16 ▇▇▇▇ ▇. RE DATE Assistant Inspector General for Legal Affairs Office of Counsel to the Inspector General U. S. Office of Inspector General U.S. Department of Health and Human Services /▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ Berlin/ 5/1/14 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇ BERLIN DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services /▇▇/ 11/1/16 ▇▇▇▇▇▇ ▇. ▇▇▇▇▇▇/ 5/9/14 ▇▇ DATE Senior Counsel Office of Counsel to the Inspector General Office of Inspector General U.S. Department of Health and Human Services ▇▇▇▇▇▇▇▇ ▇. ▇▇–Zwanger ▇▇▇▇▇▇ DATE Senior Counsel Office of Inspector General U. S. Department of Health and Human Services – Corporate Integrity Agreement This Appendix contains the requirements relating to the Independent Review Organization (IRO) required by Section III.E.2 III.D of the CIA.