Document:

exv10w2

 

    Exhibit 10.2

 

    CONFIDENTIAL
    TREATMENT REQUESTED.

 

    [*]
    indicates confidential portions omitted pursuant to a request
    for confidential treatment and filed separately with the
    Securities and Exchange Commission

 

    EXECUTION
    VERSION

 

 

 

    FOURTH
    AMENDED AND RESTATED

 

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

 

    among

 

    PARADIGM
    FUNDING LLC,

 

    GIRO
    BALANCED FUNDING CORPORATION,

 

    LIBERTY
    STREET FUNDING LLC,

    as
    Conduit Investors

 

    NMC
    FUNDING CORPORATION,

    as
    Transferor

 

    NATIONAL
    MEDICAL CARE, INC.,

    as
    Collection Agent

 

    THE
    FINANCIAL INSTITUTIONS PARTIES HERETO,

    as Bank
    Investors

 

    BAYERISCHE
    LANDESBANK, NEW YORK BRANCH,

    as an
    Administrative Agent

 

 

    THE BANK
    OF NOVA SCOTIA

    as an
    Administrative Agent

 

    and

 

 

    WESTLB
    AG, NEW YORK BRANCH,

    as an
    Administrative Agent and as Agent

    Dated as
    of October 16, 2008

 

    TABLE OF
    CONTENTS

 

	 	 	 	 	 	 	 	 	 
	

    ARTICLE I

    

    DEFINITIONS

	 
	

    Section 1.1.
    

	 
	
 
	
    Certain Defined Terms
	
 
	 
	
    1
	 

	 
	

    Section 1.2.
    

	 
	
 
	
    Other Terms
	
 
	 
	
    19
	 

	 
	

    Section 1.3.
    

	 
	
 
	
    Computation of Time Periods
	
 
	 
	
    19
	 

	 
	

    Section 1.4.
    

	 
	
 
	
    Amendment and Restatement
	
 
	 
	
    19
	 

	 
	

    Section 1.5.
    

	 
	
 
	
    Funding on Effective Date
	
 
	 
	
    19
	 

	
 

	

    ARTICLE II

    

    PURCHASE AND SETTLEMENTS

	 
	

    Section 2.1.
    

	 
	
 
	
    Facility
	
 
	 
	
    19
	 

	 
	

    Section 2.2.
    

	 
	
 
	
    Transfers; Certificates; Eligible
    Receivables(a) Incremental Transfers
	
 
	 
	
    19
	 

	 
	

    Section 2.3.
    

	 
	
 
	
    Selection of Tranche Periods and Tranche Rates
	
 
	 
	
    21
	 

	 
	

    Section 2.4.
    

	 
	
 
	
    Discount, Fees and Other Costs and Expenses
	
 
	 
	
    23
	 

	 
	

    Section 2.5.
    

	 
	
 
	
    Non-Liquidation Settlement and Reinvestment Procedures
	
 
	 
	
    23
	 

	 
	

    Section 2.6.
    

	 
	
 
	
    Liquidation Settlement Procedures
	
 
	 
	
    23
	 

	 
	

    Section 2.7.
    

	 
	
 
	
    Fees
	
 
	 
	
    24
	 

	 
	

    Section 2.8.
    

	 
	
 
	
    Protection of Ownership Interest of the Investors; Special
    Accounts and Concentration Account
	
 
	 
	
    24
	 

	 
	

    Section 2.9.
    

	 
	
 
	
    Deemed Collections; Application of Payments
	
 
	 
	
    25
	 

	 
	

    Section 2.10.
    

	 
	
 
	
    Payments and Computations, Etc
	
 
	 
	
    26
	 

	 
	

    Section 2.11.
    

	 
	
 
	
    Reports
	
 
	 
	
    26
	 

	 
	

    Section 2.12.
    

	 
	
 
	
    Collection Account
	
 
	 
	
    26
	 

	 
	

    Section 2.13.
    

	 
	
 
	
    Sharing of Payments, Etc
	
 
	 
	
    27
	 

	 
	

    Section 2.14.
    

	 
	
 
	
    Right of Setoff
	
 
	 
	
    27
	 

	 
	

    Section 2.15.
    

	 
	
 
	
    Additional Transferring Affiliates
	
 
	 
	
    27
	 

	
 

	

    ARTICLE III

    

    REPRESENTATIONS AND WARRANTIES

	 
	

    Section 3.1.
    

	 
	
 
	
    Representations and Warranties of the Transferor
	
 
	 
	
    28
	 

	 
	

    Section 3.2.
    

	 
	
 
	
    Reaffirmation of Representations and Warranties by the Transferor
	
 
	 
	
    31
	 

	 
	

    Section 3.3.
    

	 
	
 
	
    Representations and Warranties of the Collection Agent
	
 
	 
	
    31
	 

	
 

	

    ARTICLE IV

    

    CONDITIONS PRECEDENT

	 
	

    Section 4.1.
    

	 
	
 
	
    Conditions to Closing
	
 
	 
	
    32
	 

	
 

	
    ARTICLE V

    

    COVENANTS

	 
	

    Section 5.1.
    

	 
	
 
	
    Affirmative Covenants of Transferor
	
 
	 
	
    34
	 

	 
	

    Section 5.2.
    

	 
	
 
	
    Negative Covenants of the Transferor
	
 
	 
	
    37
	 

	 
	

    Section 5.3.
    

	 
	
 
	
    Affirmative Covenants of the Collection Agent
	
 
	 
	
    40
	 

	 
	

    Section 5.4.
    

	 
	
 
	
    Negative Covenants of the Collection Agent
	
 
	 
	
    41
	 

	
 

	
    ARTICLE VI

    

    ADMINISTRATION AND COLLECTION

	 
	

    Section 6.1.
    

	 
	
 
	
    Appointment of Collection Agent
	
 
	 
	
    41
	 

	 
	

    Section 6.2.
    

	 
	
 
	
    Duties of Collection Agent
	
 
	 
	
    42
	 

	 
	

    Section 6.3.
    

	 
	
 
	
    Right After Designation of New Collection Agent
	
 
	 
	
    43
	 

	 
	

    Section 6.4.
    

	 
	
 
	
    Collection Agent Default
	
 
	 
	
    43
	 

	 
	

    Section 6.5.
    

	 
	
 
	
    Responsibilities of the Transferor
	
 
	 
	
    44
	 

    

    i

 

	 	 	 	 	 	 	 	 	 
	
    ARTICLE VII

    

    TERMINATION EVENTS

	 
	

    Section 7.1.
    

	 
	
 
	
    Termination Events
	
 
	 
	
    44
	 

	 
	

    Section 7.2.
    

	 
	
 
	
    Termination
	
 
	 
	
    46
	 

	
 

	
    ARTICLE VIII

    

    INDEMNIFICATION; EXPENSES; RELATED MATTERS

	 
	

    Section 8.1.
    

	 
	
 
	
    Indemnities by the Transferor
	
 
	 
	
    46
	 

	 
	

    Section 8.2.
    

	 
	
 
	
    Indemnity for Taxes, Reserves and Expenses
	
 
	 
	
    48
	 

	 
	

    Section 8.3.
    

	 
	
 
	
    Taxes
	
 
	 
	
    50
	 

	 
	

    Section 8.4.
    

	 
	
 
	
    Other Costs, Expenses and Related Matters
	
 
	 
	
    51
	 

	 
	

    Section 8.5.
    

	 
	
 
	
    Reconveyance Under Certain Circumstances
	
 
	 
	
    51
	 

	
 

	

    ARTICLE IX

    

    THE AGENT; BANK COMMITMENT; THE ADMINISTRATIVE AGENTS

	 
	

    Section 9.1.
    

	 
	
 
	
    Authorization and Action
	
 
	 
	
    52
	 

	 
	

    Section 9.2.
    

	 
	
 
	
    Agent’s Reliance, Etc
	
 
	 
	
    52
	 

	 
	

    Section 9.3.
    

	 
	
 
	
    Credit Decision
	
 
	 
	
    53
	 

	 
	

    Section 9.4.
    

	 
	
 
	
    Indemnification of the Agent
	
 
	 
	
    53
	 

	 
	

    Section 9.5.
    

	 
	
 
	
    Successor Agent
	
 
	 
	
    53
	 

	 
	

    Section 9.6.
    

	 
	
 
	
    Payments by the Agent
	
 
	 
	
    53
	 

	 
	

    Section 9.7.
    

	 
	
 
	
    Bank Commitment; Assignment to Bank Investors
	
 
	 
	
    53
	 

	 
	

    Section 9.8.
    

	 
	
 
	
    Appointment of Administrative Agents
	
 
	 
	
    56
	 

	 
	

    Section 9.9.
    

	 
	
 
	
    Administrative Agent’s Reliance, Etc
	
 
	 
	
    56
	 

	 
	

    Section 9.10.
    

	 
	
 
	
    Indemnification of the Administrative Agents
	
 
	 
	
    57
	 

	 
	

    Section 9.11.
    

	 
	
 
	
    Successor Administrative Agents
	
 
	 
	
    57
	 

	 
	

    Section 9.12.
    

	 
	
 
	
    Payments by the Administrative Agents
	
 
	 
	
    57
	 

	
 

	

    ARTICLE X

    

    MISCELLANEOUS

	 
	

    Section 10.1.
    

	 
	
 
	
    Term of Agreement
	
 
	 
	
    58
	 

	 
	

    Section 10.2.
    

	 
	
 
	
    Waivers; Amendments
	
 
	 
	
    58
	 

	 
	

    Section 10.3.
    

	 
	
 
	
    Notices
	
 
	 
	
    58
	 

	 
	

    Section 10.4.
    

	 
	
 
	
    Governing Law; Submission to Jurisdiction; Integration
	
 
	 
	
    60
	 

	 
	

    Section 10.5.
    

	 
	
 
	
    Severability; Counterparts
	
 
	 
	
    60
	 

	 
	

    Section 10.6.
    

	 
	
 
	
    Successors and Assigns
	
 
	 
	
    60
	 

	 
	

    Section 10.7.
    

	 
	
 
	
    Waiver of Confidentiality
	
 
	 
	
    61
	 

	 
	

    Section 10.8.
    

	 
	
 
	
    Confidentiality Agreement
	
 
	 
	
    61
	 

	 
	

    Section 10.9.
    

	 
	
 
	
    No Bankruptcy Petition Against Conduit Investors
	
 
	 
	
    61
	 

	 
	

    Section 10.10.
    

	 
	
 
	
    No Recourse Against Stockholders, Officers or Directors
	
 
	 
	
    62
	 

	 
	

    Section 10.11.
    

	 
	
 
	
    Characterization of the Transactions Contemplated by the
    Agreement
	
 
	 
	
    62
	 

    

    ii

 

    SCHEDULES
    

 

	 	 	 	 	 	 	 
	

    SCHEDULE I

	
 
	
    Notice Addresses of Bank Investors
	
 
	 
	
    66
	 

	

    SCHEDULE II

	
 
	
    Commitments of Bank Investors
	
 
	 
	
    67
	 

	
 

	

    EXHIBITS

	

    EXHIBIT A

	
 
	
    Forms of Contracts
	
 
	 
	
    A-1
	 

	

    EXHIBIT B

	
 
	
    Credit and Collection Policies and Practices
	
 
	 
	
    B-1
	 

	

    EXHIBIT C

	
 
	
    List of Special Account Banks, Designated Account Agents and
    Concentration Bank
	
 
	 
	
    C-1
	 

	

    EXHIBIT D-1

	
 
	
    Form of Special Account Letter
	
 
	 
	
    D-1
	 

	

    EXHIBIT D-2

	
 
	
    Form of Concentration Account Agreement
	
 
	 
	
    D-2
	 

	

    EXHIBIT E

	
 
	
    Form of Investor Report
	
 
	 
	
    E-1
	 

	

    EXHIBIT F

	
 
	
    Form of Transfer Certificate
	
 
	 
	
    F-1
	 

	

    EXHIBIT G

	
 
	
    Form of Assignment and Assumption Agreement
	
 
	 
	
    G-1
	 

	

    EXHIBIT H

	
 
	
    List of Actions and Suits (Sections 3.1(g), 3.1(k) and
    3.3(e))
	
 
	 
	
    H-1
	 

	

    EXHIBIT I

	
 
	
    Location of Records
	
 
	 
	
    I-1
	 

	

    EXHIBIT J

	
 
	
    Form of Business Associate Agreement
	
 
	 
	
    J-1
	 

	

    EXHIBIT K

	
 
	
    Forms of Opinions of Counsel
	
 
	 
	
    K-1
	 

	

    EXHIBIT L

	
 
	
    Forms of Secretary’s Certificate
	
 
	 
	
    L-1
	 

	

    EXHIBIT M

	
 
	
    Form of Certificate
	
 
	 
	
    M-1
	 

	

    EXHIBIT N

	
 
	
    List of Approved Fiscal Intermediaries
	
 
	 
	
    N-1
	 

	

    EXHIBIT O

	
 
	
    Form of Transferring Affiliate Letter
	
 
	 
	
    O-1
	 

	

    EXHIBIT P

	
 
	
    Form of Parent Agreement
	
 
	 
	
    P-1
	 

	

    EXHIBIT Q

	
 
	
    List of Transferring Affiliates
	
 
	 
	
    Q-1
	 

	

    EXHIBIT R

	
 
	
    Form of Account Agent Agreement
	
 
	 
	
    R-1
	 

	

    EXHIBIT S

	
 
	
    List of Closing Documents
	
 
	 
	
    S-1
	 

	

    EXHIBIT T

	
 
	
    Form of Agreed Upon Procedures Report
	
 
	 
	
    T-1
	 

	

    EXHIBIT U

	
 
	
    Form of “No Material Weakness” Report
	
 
	 
	
    U-1
	 

    

    iii

 

    FOURTH
    AMENDED AND RESTATED TRANSFER

    AND ADMINISTRATION AGREEMENT

 

    FOURTH AMENDED AND RESTATED TRANSFER AND ADMINISTRATION
    AGREEMENT (this “Agreement”), dated as of
    October 16, 2008, by and among NMC FUNDING CORPORATION, a
    Delaware corporation, as transferor (in such capacity, the
    “Transferor”), NATIONAL MEDICAL CARE, INC., a
    Delaware corporation, as the initial “Collection
    Agent”, PARADIGM FUNDING LLC, a Delaware limited liability
    company (“Paradigm”), as a Conduit Investor,
    GIRO BALANCED FUNDING CORPORATION, a Delaware Corporation
    (“GBFC”), as a Conduit Investor, LIBERTY STREET
    FUNDING LLC, a Delaware limited liability company
    (“Liberty Street”), as a Conduit Investor, the
    FINANCIAL INSTITUTIONS PARTIES HERETO, as Bank Investors,
    BAYERISCHE LANDESBANK, NEW YORK BRANCH
    (“BAYERNLB”), as an Administrative Agent, THE
    BANK OF NOVA SCOTIA (“Scotiabank”), as an
    Administrative Agent, WESTLB AG, NEW YORK BRANCH (formerly known
    as Westdeutsche Landesbank Girozentrale, New York Branch)
    (“WestLB”), as an Administrative Agent and as
    agent (in such capacity, the “Agent”) for the
    Investors.

 

    PRELIMINARY
    STATEMENTS

 

    WHEREAS, the Transferor, the Collection Agent, the Conduit
    Investors, the Bank Investors, the Administrative Agents, and
    the Agent (other than Scotiabank and Liberty Street) are parties
    to that certain Third Amended and Restated Transfer and
    Administration Agreement dated as of October 23, 2003 (as
    amended prior to the date hereof, the “Existing
    TAA”); and

 

    WHEREAS, the parties hereto desire to amend and restate the
    Existing TAA in its entirety.

 

    NOW, THEREFORE, the parties hereby agree as follows:

 

    ARTICLE I

    

 

    DEFINITIONS
    

 

    Section 1.1. Certain
    Defined Terms. As used in this Agreement, the following
    terms shall have the following meanings:

 

    “Account Agent Agreement” means an agreement in
    substantially the form of Exhibit R hereto.

 

    “Administrative Agent” means (i) WestLB
    AG, New York Branch, as administrative agent for the Related
    Group that includes Paradigm, (ii) Bayerische Landesbank,
    New York Branch, as administrative agent for the Related Group
    that includes GBFC or (iii) The Bank of Nova Scotia, as
    administrative agent for the Related Group that includes Liberty
    Street.

 

    “Administration Fee” means the fee payable by
    the Transferor to the Agent pursuant to Section 2.7(iii)
    hereof, the terms of which are set forth in the Agent Fee Letter.

 

    “Adverse Claim” means a lien, security
    interest, charge or encumbrance, or other right or claim in, of
    or on any Person’s assets or properties in favor of any
    other Person (including any UCC financing statement or any
    similar instrument filed against such Person’s assets or
    properties), other than customary rights of set-off and other
    similar claims.

 

    “Affected Assets” means, collectively, the
    Receivables and the Related Security, Collections and Proceeds
    relating thereto.

 

    “Affiliate” means, with respect to any Person,
    any other Person directly or indirectly controlling, controlled
    by, or under direct or indirect common control with, such
    Person. A Person shall be deemed to control another Person if
    the controlling Person possesses, directly or indirectly, the
    power to direct or cause the direction of the management or
    policies of the controlled Person, whether through ownership of
    voting stock, by contract or otherwise.

 

    “Agent” means WestLB, in its capacity as agent
    for the Investors, and any successor thereto appointed pursuant
    to Article IX.

 

    “Agent Fee Letter” means the Amended and
    Restated Agent Fee Letter dated as of the Closing Date between
    the Transferor and the Agent relating to certain fees payable by
    the Transferor to the Agent hereunder, as amended, restated,
    supplemented or otherwise modified from time to time.

 

    “Aggregate Unpaids” means, at any time, an
    amount equal to the sum of (i) the aggregate accrued and
    unpaid Discount with respect to all Tranche Periods at such
    time, (ii) the Net Investment at such time, and
    (iii) all other amounts owed (whether due or accrued)
    hereunder by the Transferor to the Investors at such time.

 

    “Agreement” shall have the meaning specified in
    the Preamble to this Agreement.

 

    “Amendment Agreement” means the amendment
    agreement dated as of the Closing Date among the parties to the
    Existing TAA.

 

    “Applicable Margin” means 2.00%

 

    “Assignment Amount” with respect to a Bank
    Investor shall mean at any time an amount equal to the lesser of
    (i) such Bank Investor’s Pro Rata Share of the Net
    Investment held by the Conduit Investor in the same Related
    Group at such time and (ii) such Bank Investor’s
    unused Commitment.

 

    “Assignment and Assumption Agreement” means an
    Assignment and Assumption Agreement substantially in the form of
    Exhibit G attached hereto.

 

    “Auditor” shall have the meaning specified in
    Section 6.2(c).

 

    “Bank Investors” means each financial
    institution identified as a “Bank Investor” on
    Schedule II and their respective successors and assigns.

 

    “Bankruptcy Code” means the United States
    Bankruptcy Code, 11 U.S.C. § 101 et seq., as
    amended.

 

    “Base Rate” or “BR” means,
    with respect to the Investors in any Related Group, a rate per
    annum equal to the greater of (i) the prime rate of
    interest announced by the Administrative Agent for such Related
    Group from time to time, changing when and as said prime rate
    changes (such rate not necessarily being the lowest or best rate
    charged by such Administrative Agent) and (ii) the sum of
    (a) 1.50% and (b) the rate equal to the weighted
    average of the rates on overnight Federal funds transactions
    with members of the Federal Reserve System arranged by Federal
    funds brokers, as published for such day (or, if such day is not
    a Business Day, for the next preceding Business Day) by the
    Federal Reserve Bank of New York, or, if such rate is not so
    published for any day that is a Business Day, the average of the
    quotations for such day for such transactions received by such
    Administrative Agent from three Federal funds brokers of
    recognized standing selected by it.

 

    “Bayerische Landesbank, Cayman Islands Branch”
    means Bayerische Landesbank, Cayman Islands Branch, together
    with its successors and permitted assigns.

 

    “BayernLB” means Bayerische Landesbank, New
    York Branch, together with its successors and permitted assigns.

 

    “Benefit Plan” means any employee benefit plan
    as defined in Section 3(3) of ERISA in respect of which the
    Transferor, the Seller or any ERISA Affiliate of the Transferor
    or the Seller is, or at any time during the immediately
    preceding six years was, an “employer” as defined in
    Section 3(5) of ERISA.

 

    “BMA” means Bio-Medical Applications Management
    Company, Inc., a Delaware corporation, and its successors and
    permitted assigns.

 

    “BMA Transfer Agreement” means that certain
    Receivables Purchase Agreement dated as of August 28, 1997
    by and between BMA, as seller, and NMC, as purchaser, as the
    same may be amended, restated, supplemented or otherwise
    modified from time to time.

 

    “Business Day” means any day excluding
    Saturday, Sunday and any day on which banks in New York, New
    York are authorized or required by law to close, and, when used
    with respect to the determination of any Eurodollar Rate or any
    notice with respect thereto, any such day which is also a day
    for trading by and between banks in United States dollar
    deposits in the London interbank market.

 

    “BR Tranche” means a Tranche as to which
    Discount is calculated at the Base Rate.

 

    “BR Tranche Period” means, with respect to
    a BR Tranche for the Investors in any Related Group, either
    (i) prior to the Termination Date, a period of up to
    30 days requested by the Transferor and agreed to by the
    Administrative Agent for such Related Group, commencing on a
    Business Day requested by the Transferor and agreed to by such
    Administrative Agent, or (ii) after the Termination Date, a
    period of one day. If such BR Tranche Period would end on a
    day which is not a Business Day, such BR Tranche Period
    shall end on the next succeeding Business Day.

 

    “Capitalized Lease” of a Person means any lease
    of property by such Person as lessee which would be capitalized
    on a balance sheet of such Person prepared in accordance with
    GAAP.

    

    2

 

    “Certificate” means the certificate issued to
    the Agent for the benefit of the Investors pursuant to
    Section 2.2(d) of the Existing TAA.

 

    “CHAMPUS/VA” means, collectively, (i) the
    Civilian Health and Medical Program of the Uniformed Service, a
    program of medical benefits covering retirees and dependents of
    a member or a former member of a uniformed service, provided,
    financed and supervised by the United States Department of
    Defense and established by 10 USC § 1071
    et seq. and (ii) the Civilian Health and
    Medical Program of Veterans Affairs, a program of medical
    benefits covering dependents of veterans, administered by the
    United States Veterans’ Administration and Department of
    Defense and established by 38 USC § 1713
    et seq.

 

    “CHAMPUS/VA Regulations” means collectively,
    all regulations of the Civilian Health and Medical Program of
    the Uniformed Services and the Civilian Health and Medical
    Program of Veterans Affairs, including (a) all federal
    statutes (whether set forth in 10 USC 1071, 38 USC
    1713 or elsewhere) affecting CHAMPUS/VA; and (b) all
    applicable provisions of all rules, regulations (including
    32 CFR 199 and 38 CFR 17.54), manuals, orders, and
    administrative, reimbursement and other guidelines of all
    Governmental Authorities (including, without limitation, HHS,
    the Department of Defense, the Veterans’ Administration,
    the Department of Transportation, the Assistant Secretary of
    Defense (Health Affairs), and the Office of CHAMPUS, or any
    Person or entity succeeding to the functions of any of the
    foregoing) promulgated pursuant to or in connection with any of
    the foregoing (whether or not having the force of law), in each
    case as may be amended, supplemented or otherwise modified from
    time to time.

 

    “Change of Control” means if the general
    partner of the FME KGaA charged with management of FME KGaA
    shall at any time fail to be a Subsidiary of Fresenius SE, or if
    Fresenius SE shall fail at any time to own and control more than
    twenty-five percent (25%) of the Voting Stock of FME KGaA.

 

    “Change of Control Percentage” means the
    greater of (a) thirty-five percent (35%) or (b) the
    percentage of Voting Stock in FME KGaA held and owned by
    Fresenius SE.

 

    “Closing Date” means October 16, 2008.

 

    “CMS” means the Centers for Medicare and
    Medicaid Services (formerly known as the Health Care Financing
    Administration), an agency of the HHS charged with administering
    and regulating, among other things, certain aspects of Medicaid
    and Medicare.

 

    “Code” means the Internal Revenue Code of 1986,
    as amended.

 

    “Collateral Agent” means with respect to the
    Related Group that includes Paradigm, WestLB AG (formerly known
    as Westdeutsche Landesbank Girozentrale), as collateral agent
    for any related Liquidity Provider, any related Credit Support
    Provider, the holders of Commercial Paper issued by Paradigm and
    certain other parties.

 

    “Collection Account” means the account,
    established by the Agent, for the benefit of the Investors,
    pursuant to Section 2.12.

 

    “Collection Agent” means at any time the Person
    then authorized pursuant to Section 6.1 to service,
    administer and collect Receivables.

 

    “Collection Agent Default” has the meaning
    specified in Section 6.4 hereof.

 

    “Collection Delay Period” means 10 days or
    such other number of days as the Agent may select upon three
    Business Days’ notice to the Transferor.

 

    “Collections” means, with respect to any
    Receivable, all cash collections and other cash proceeds of such
    Receivable, including, without limitation, all Finance Charges,
    if any, and cash proceeds of Related Security with respect to
    such Receivable.

 

    “Commercial Obligor” means any Obligor referred
    to in clause (C) or (E) of the definition of
    “Obligor” contained in this Section 1.1 hereof.

 

    “Commercial Paper” means, with respect to any
    Conduit Investor, the promissory notes issued by such Conduit
    Investor in the commercial paper market.

 

    “Commitment” means (i) with respect to
    each Bank Investor party hereto, the agreement of such Bank
    Investor to make acquisitions from the Transferor or the Conduit
    Investor in its Related Group in accordance herewith in an
    amount not to exceed the dollar amount set forth opposite such
    Bank Investor’s name on Schedule II hereto under the
    heading “Commitment”, minus the dollar
    amount of any Commitment or portion thereof assigned pursuant to
    an Assignment and Assumption Agreement plus the dollar
    amount of any

    

    3

 

    increase to such Bank Investor’s Commitment consented to by
    such Bank Investor prior to the time of determination,
    (ii) with respect to any assignee of a Bank Investor party
    hereto taking pursuant to an Assignment and Assumption
    Agreement, the commitment of such assignee to make acquisitions
    from the Transferor or the Conduit Investor in its Related Group
    not to exceed the amount set forth in such Assignment and
    Assumption Agreement minus the dollar amount of any
    Commitment or portion thereof assigned pursuant to an Assignment
    and Assumption Agreement prior to such time of determination and
    (iii) with respect to any assignee of an assignee referred
    to in clause (ii), the commitment of such assignee to make
    acquisitions from the Transferor or the Conduit Investor in its
    Related Group not to exceed the amount set forth in an
    Assignment and Assumption Agreement between such assignee and
    its assign.

 

    “Commitment Termination Date” means
    October 15, 2009, or such later date to which the
    Commitment Termination Date may be extended by Transferor, the
    Agent and the Bank Investors.

 

    “Concentration Account” means a special
    depositary account in the name of the Transferor maintained at a
    bank acceptable to the Agent for the purpose of receiving
    Collections remitted from the Special Accounts and the
    Intermediate Concentration Account.

 

    “Concentration Account Agreement” means an
    agreement substantially in the form attached as
    Exhibit D-2
    hereto among the Transferor, the Concentration Account Bank and
    the Agent.

 

    “Concentration Account Bank” means the bank
    holding the Concentration Account.

 

    “Concentration Account Notice” means a notice,
    in substantially the form of the Notice of Effectiveness
    attached to the Concentration Account Agreement, from the Agent
    to the Concentration Account Bank.

 

    “Concentration Factor” means for any Designated
    Obligor on any date of determination (calculated prior to the
    payment of any Transfer Price to be made on such date but as if
    such payment had been made):

 

    (a) in the case of any Commercial Obligor or Hospital
    Obligor that does not have a Special Concentration Limit (as
    defined below), 2.5% of the Net Receivables Balance outstanding
    on such date; provided that, subject to clause (c)
    below, the Concentration Factor for each of Aetna, Inc., Cigna
    Corp., Wellpoint Inc. and United Healthcare Insurance Company,
    and any successor thereto, shall be (i) for so long as such
    Obligor is rated at least A- by Standard & Poor’s
    and at least A3 by Moody’s and, if rated by Fitch, at least
    A- by Fitch, 10.0% of the Net Receivables Balance outstanding on
    such date and (ii) for so long as clause (i) does not
    apply but such Obligor is rated at least BBB- by
    Standard & Poor’s and at least Baa3 by
    Moody’s and, if rated by Fitch, at least BBB- by Fitch,
    7.0% of the Net Receivables Balance outstanding on such date;

 

    (b) in the case of any US Government Obligor that does not
    have a Special Concentration Limit, 80% of the Net Investment
    outstanding on such date; or

 

    (c) in the case of any Obligor (including any Obligor
    described in clauses (a) and (b)), such higher amount
    determined by the Agent (with the consent of each Administrative
    Agent) or such lower amount determined by any Administrative
    Agent in the reasonable exercise of its good faith judgment and
    disclosed in a written notice delivered to the Transferor and
    the other Administrative Agent (any such higher or lower amount
    being a “Special Concentration Limit”).

 

    “Conduit Investor” means Paradigm, GBFC or
    Liberty Street Funding LLC.

 

    “Confidential Information” shall have the
    meaning specified in Section 5.1(d).

 

    “Contract” means an agreement between an
    Originating Entity and an Obligor (including, without
    limitation, an oral agreement, a written contract, an invoice or
    an open account agreement) pursuant to or under which such
    Obligor shall be obligated to pay for services or merchandise
    from time to time; provided that, in order to be an
    “Eligible Receivable”, a Receivable must arise from a
    Contract which (i) if in writing, is in substantially the
    form of one of the forms of written contract set forth in
    Exhibit A hereto or otherwise approved by each
    Administrative Agent, and (ii) if an open account
    agreement, is evidenced by one of the forms of invoices set
    forth in Exhibit A hereto or otherwise approved by each
    Administrative Agent.

 

    “Contractual Adjustment” means, with respect to
    any Receivable, an amount by which the outstanding principal
    amount of such Receivable is reduced as a result of
    (i) Medicare or Medicaid program funding and fee
    requirements or (ii) any other reasonable and customary
    insurance company or other charge or reimbursement policies or
    procedures.

 

    “Contractual Adjustment Amount” means, with
    respect to any Receivable originated by a member of the Spectra
    Renal Management Group, at any time, an amount equal to
    (i) 75% of the original outstanding

    

    4

 

    principal amount of such Receivable (excluding any accrued and
    outstanding Finance Charges related thereto) minus
    (ii) the amount of any Contractual Adjustments already
    granted with respect to such Receivable.

 

    “CP Rate” means, for any CP Tranche Period
    for any Conduit Investor, the per annum rate equivalent
    to the weighted average cost (as determined by the related
    Administrative Agent, and which shall include (without
    duplication) the fees and commissions of placement agents and
    dealers, incremental carrying costs incurred with respect to
    Commercial Paper maturing on dates other than those on which
    corresponding funds are received by such Conduit Investor, other
    borrowings by such Conduit Investor and any other costs
    associated with the issuance of Commercial Paper) of or related
    to the issuance of Commercial Paper that are allocated, in whole
    or in part, by such Conduit Investor or its related
    Administrative Agent to fund or maintain the related Tranche
    during such CP Tranche Period (and which may also be
    allocated in part to the funding of other assets of the Conduit
    Investor); provided, however, that if any
    component of any such rate is a discount rate, in calculating
    the “CP Rate” for such Tranche for such CP
    Tranche Period, the related Administrative Agent shall for
    such component use the rate resulting from converting such
    discount rate to an interest bearing equivalent rate per
    annum.

 

    “CP Tranche” means a Tranche as to which
    Discount is calculated at a CP Rate.

 

    “CP Tranche Period” means, with respect to
    a CP Tranche for any Conduit Investor, (i) initially, the
    period commencing on (and including) the date such CP Tranche is
    established and ending on (and including) the next succeeding CP
    Tranche Period End Date, and (ii) thereafter, each
    successive period commencing on (but excluding) a CP
    Tranche Period End Date and ending on (and including) the
    next succeeding CP Tranche Period End Date; provided that,
    from and after the Termination Date, each CP Tranche Period
    shall be such period as may be selected pursuant to
    Section 2.3(b).

 

    “CP Tranche Period End Date” means the
    last day of each calendar month.

 

    “Credit and Collection Policy” shall mean the
    Transferor’s credit and collection policy or policies and
    practices, relating to Contracts and Receivables existing on the
    date hereof and referred to in Exhibit B attached hereto,
    as modified from time to time in compliance with
    Section 5.2(c).

 

    “Credit Support Agreement” means, with respect
    to any Conduit Investor, an agreement between such Conduit
    Investor and a Credit Support Provider evidencing the obligation
    of such Credit Support Provider to provide credit support to
    such Conduit Investor in connection with the issuance by such
    Conduit Investor of Commercial Paper.

 

    “Credit Support Provider” means, with respect
    to any Conduit Investor, the Person or Persons who provides
    credit support to such Conduit Investor in connection with the
    issuance by such Conduit Investor of Commercial Paper.

 

    “Deemed Collections” means any Collections on
    any Receivable deemed to have been received pursuant to
    Section 2.9(a) or (b) hereof.

 

    “Default Ratio” means the ratio (expressed as a
    percentage) computed as of the last day of each calendar month
    by dividing (i) the aggregate Outstanding Balance of all
    Receivables that became Defaulted Receivables during such month
    together with all Receivables under the Medicare or Medicaid
    Program that were deemed disputed as provided for in the
    proviso to clause (xi) of the definition of
    “Eligible Receivables” during such month, by
    (ii) the aggregate Outstanding Balance of Receivables that
    shall have been acquired by the Seller during the month
    occurring nine months prior to such calendar month.

 

    “Defaulted Receivable” means a Receivable:
    (i) as to which any payment, or part thereof, remains
    unpaid for over 270 days from the original due date when a
    contract exists with an Originating Entity that is part of the
    dialysis products division of the Parent Group and otherwise
    from the original invoice date for such Receivable; (ii) as
    to which an Event of Bankruptcy has occurred and is continuing
    with respect to the Obligor thereof; (iii) which has been
    identified by the Transferor, any Originating Entity or the
    Collection Agent as uncollectible (including, without
    limitation, any Receivable that is written off by the
    Transferor, any Originating Entity or the Collection Agent); or
    (iv) which, consistent with the Credit and Collection
    Policy, should be written off as uncollectible.

 

    “Delinquent Receivable” means a Receivable:
    (i) as to which any payment, or part thereof, remains
    unpaid for more than 90 days from the original due date
    when a contract exists with an Originating Entity that is part
    of the dialysis products division of the Parent Group and
    otherwise from the original invoice date for such Receivable and
    (ii) which is not a Defaulted Receivable.

    

    5

 

    “Designated Account Agent” means, in the case
    of any Originating Entity, an Affiliate thereof that
    (i) is, directly or indirectly, a wholly-owned Subsidiary
    of FMCH, (ii) has agreed to maintain a deposit account for
    the benefit of such Originating Entity to which Obligors in
    respect of such Originating Entity have been directed to remit
    payments on Receivables, and (iii) shall have executed and
    delivered to the Agent an Account Agent Agreement.

 

    “Designated Obligor” means, at any time, each
    Obligor; provided, however, that any Obligor shall
    cease to be a Designated Obligor upon notice to the Transferor
    from any Administrative Agent, delivered at any time (with a
    copy to the other Administrative Agents).

 

    “Dilution Horizon” means the ratio (expressed
    as a percentage) computed as of the last day of each calendar
    month by dividing (i) the aggregate Outstanding Balance of
    all Receivables acquired by the Transferor during the calendar
    month preceding such calendar month by (ii) the Net
    Receivables Balance as of such last day of such calendar month.

 

    “Dilution Ratio” means, with respect to any
    calendar month, the greater of (a) the ratio (expressed as
    a percentage) computed as of the last day of such calendar month
    by dividing (i) the aggregate amount of any reductions to
    or cancellations of the respective Outstanding Balances of the
    Receivables as a result of any defective, rejected or returned
    merchandise or services and all credits, rebates, discounts,
    disputes, warranty claims, repossessed or returned goods,
    chargebacks, allowances and any other billing and other
    adjustment (whether effected through the granting of credits
    against the applicable Receivables or by the issuance of a check
    or other payment in respect of (and as payment for) such
    reduction) by the Seller, the Transferor or the Collection
    Agent, provided to Obligors in respect of Receivables during
    such month, excluding (w) any Pre-Arranged Contractual
    Adjustment reflected in the initial Outstanding Balance of the
    applicable Receivable, (x) volume rebates paid in cash by
    the Dialysis Products Division and (y) credit memos for
    future purchases (it being understood and agreed that any
    Receivables arising from such purchases will have an initial
    Outstanding Balance that reflects such credit memos) by
    (ii) the aggregate Outstanding Balance of all Receivables
    which arose during the preceding month and (b) 6.0%.

 

    “Dilution Reserve” means, at any time, an
    amount equal to the product of (i) the Dilution Reserve
    Percentage and (ii) the Net Receivables Balance on such
    date.

 

    “Dilution Reserve Percentage” means, on any
    day, an amount equal to:

 

    [ (1.5 x ADR) + [(DS − ADR) x (DS/ADR)]] x DH

 

	 	 	 	 	 
	

    Where:

	
 
	
 
	
 
	
 

	

    ADR

	
 
	
    =
	
 
	
    the average Dilution Ratio in respect of the 12 calendar month
    period then most recently ended.

	

    DS

	
 
	
    =
	
 
	
    the highest Dilution Ratio at any time during the 12 calendar
    month period then most recently ended.

	

    DH

	
 
	
    =
	
 
	
    the Dilution Horizon on such date.

	
 
	
 
	
 
	
 
	
    “Discount” means, with respect to any
    Tranche Period:

 

	 	 	 	 	 	 	 	 	 
	

           

	
 
	
    (TR x
	
 
	
    TNI x
	
 
	
     AD)
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
    360
	
 
	
 

 

	 	 	 	 	 
	

    Where:

	
 
	
 
	
 
	
 

	

    TR

	
 
	
    =
	
 
	
    the Tranche Rate applicable to such Tranche Period.

	

    TNI

	
 
	
    =
	
 
	
    the portion of the Net Investment allocated to such
    Tranche Period.

	

    AD

	
 
	
    =
	
 
	
    the actual number of days during such Tranche Period.

 

    provided, however, that no provision of this
    Agreement shall require the payment or permit the collection of
    Discount in excess of the maximum amount permitted by applicable
    law; and provided, further, that Discount shall
    not be considered paid by any distribution if at any time such
    distribution is rescinded or must be returned for any reason.

 

    “Discount Reserve” means, at any time, an
    amount equal to:

 

    TD + LY

 

    

    6

 

	 	 	 	 	 
	

    Where:

	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 

	

    TD

	
 
	
    =
	
 
	
    the sum of the unpaid Discount for all Tranche Periods to
    which any portion of the Net Investment is allocated.

	

    LY

	
 
	
    =
	
 
	
    the Liquidation Yield.

 

    “Early Collection Fee” means, for any
    Tranche Period (such Tranche Period to be determined
    without regard to the last sentence in Section 2.3(a)
    hereof) during which the portion of the Net Investment that was
    allocated to such Tranche Period is reduced for any reason
    whatsoever, the excess, if any, of (i) the additional
    Discount that would have accrued during such Tranche Period
    (or, in the case of a CP Tranche Period, during the period
    until the maturity date of the Commercial Paper allocated to
    fund or maintain such Net Investment) if such reductions had not
    occurred, minus (ii) the income, if any, received by the
    recipient of such reductions from investing the proceeds of such
    reductions.

 

    “Effective Date” has the meaning specified in
    Section 1.4.

 

    “Eligible Investments” means any of the
    following (a) negotiable instruments or securities
    represented by instruments in bearer or registered or in
    book-entry form which evidence (i) obligations fully
    guaranteed by the United States of America; (ii) time
    deposits in, or bankers acceptances issued by, any depositary
    institution or trust company incorporated under the laws of the
    United States of America or any state thereof and subject to
    supervision and examination by Federal or state banking or
    depositary institution authorities; provided,
    however, that at the time of investment or contractual
    commitment to invest therein, the certificates of deposit or
    short-term deposits, if any, or long-term unsecured debt
    obligations (other than such obligation whose rating is based on
    collateral or on the credit of a Person other than such
    institution or trust company) of such depositary institution or
    trust company shall have a credit rating from Moody’s and
    S&P of at least
    “P-1”
    and
    “A-1”,
    respectively, in the case of the certificates of deposit or
    short-term deposits, or a rating not lower than one of the two
    highest investment categories granted by Moody’s and by
    S&P; (iii) certificates of deposit having, at the time
    of investment or contractual commitment to invest therein, a
    rating from Moody’s and S&P of at least
    “P-1”
    and
    A-1”,
    respectively; or (iv) investments in money market funds
    rated in the highest investment category or otherwise approved
    in writing by the applicable rating agencies; (b) demand
    deposits in any depositary institution or trust company referred
    to in (a) (ii) above; (c) commercial paper (having
    original or remaining maturities of no more than 30 days)
    having, at the time of investment or contractual commitment to
    invest therein, a credit rating from Moody’s and S& P
    of at least
    “P-1”
    and
    “A-1”,
    respectively; and (e) repurchase agreements involving any
    of the Eligible Investments described in clauses (a)(i),
    (a)(iii) and (d) hereof so long as the other party to the
    repurchase agreement has at the time of investment therein, a
    rating from Moody’s and S&P of at least
    “P-1”
    and
    “A-1”,
    respectively.

 

    “Eligible Receivable” means, at any time, any
    Receivable:

 

    (i) which has been (A) originated by the Seller or a
    Transferring Affiliate, (B) sold by the applicable
    Transferring Affiliate to the Seller pursuant to (and in
    accordance with) the Transferring Affiliate Letter or the BMA
    Transfer Agreement, free and clear of any Adverse Claim, in the
    case of a Receivable originated by a Transferring Affiliate, and
    (C) sold to the Transferor pursuant to (and in accordance
    with) the Receivables Purchase Agreement, with the effect that
    the Transferor has good title thereto, free and clear of all
    Adverse Claims;

 

    (ii) which (together with the Collections and Related
    Security related thereto) has been the subject of either a valid
    transfer and assignment from the Transferor to the Agent, on
    behalf of the Investors, of all of the Transferor’s right,
    title and interest therein or the grant of a first priority
    perfected security interest herein (and in the Collections and
    Related Security related thereto), effective until the
    termination of this Agreement;

 

    (iii) the Obligor of which (A) is a United States
    resident, (B) is a Designated Obligor at the time of the
    initial creation of an interest therein hereunder, (C) is
    not an Affiliate of any Originating Entity or any of the parties
    hereto, and (D) other than in the case of any Obligor of
    the type described in clause (A), (B) or (F) of the
    definition herein of “Obligor”, is not a government or
    a governmental subdivision or agency;

 

    (iv) which is not a Defaulted Receivable at the time of the
    initial creation of an interest therein hereunder;

 

    (v) which is not a Delinquent Receivable at the time of the
    initial creation of an interest of the Agent or any Investor
    therein;

    7

 

    (vi) which, (A) arises pursuant to a Contract with
    respect to which each of the Seller and the Transferor has
    performed all material obligations required to be performed by
    it thereunder, including without limitation shipment of the
    merchandise
    and/or the
    performance of the services purchased thereunder; (B) has
    been billed in accordance with the Credit and Collection Policy
    and in accordance with such requirements (including any
    requirements that relate to the timing of billing) as may have
    been imposed by the applicable Obligor thereon (including,
    without limitation, any Official Body associated with any of the
    CHAMPUS/VA, Medicaid or Medicare programs); and
    (C) according to the Contract related thereto, is required
    to be paid in full upon receipt by the Obligor thereof of the
    invoice related thereto or at a later time not to exceed
    90 days from the original billing date therefor;

 

    (vii) which is an “eligible asset” as defined in
    Rule 3a-7
    under the Investment Company Act of 1940, as amended;

 

    (viii) a purchase of which with the proceeds of Commercial
    Paper would constitute a “current transaction” within
    the meaning of Section 3(a)(3) of the Securities Act of
    1933, as amended;

 

    (ix) which is an “account” or “general
    intangible” within the meaning of Article 9 of the UCC
    of all applicable jurisdictions;

 

    (x) which is denominated and payable only in United States
    dollars in the United States;

 

    (xi) which, to the knowledge of the Transferor, the Seller
    and the applicable Transferring Affiliate, after due enquiry in
    accordance with customary practice, (A) arises under a
    Contract that has been duly authorized and that, together with
    the Receivable related thereto, is in full force and effect and
    constitutes the legal, valid and binding obligation of the
    related Obligor enforceable against such Obligor in accordance
    with its terms, (B) is not subject to any litigation,
    dispute, counterclaim or other defense and (C) is not
    subject to any offset other than as set forth in the related
    Contract; provided, however, that for the purposes
    of this clause (xi), any Receivable under the Medicare, Medicaid
    or CHAMPUS/VA program as to which any payment, or part thereof,
    remains unpaid for 270 days or more from the original
    invoice date shall be deemed to be a disputed Receivable and,
    further, any Receivable, for which the Transferor receives a
    partial payment that is below the estimated value of such
    Receivable, net of Contractual Adjustments, shall be deemed to
    be a disputed Receivable;

 

    (xii) which, together with the Contract related thereto,
    does not contravene in any material respect any laws, rules or
    regulations applicable thereto (including, without limitation,
    (A) laws, rules and regulations relating to healthcare,
    insurance, usury, consumer protection, truth in lending, fair
    credit billing, fair credit reporting, equal credit opportunity,
    fair debt collection practices and privacy and
    (B) CHAMPUS/VA Regulations, Medicare Regulations and
    Medicaid Regulations) and with respect to which no part of the
    Contract related thereto is or would, as a result of any of the
    transactions contemplated herein, be in violation of any such
    law, rule or regulation in any material respect and with respect
    to which no Originating Entity or the Transferor, and to the
    best knowledge of the Seller and the Transferor, no other party
    to the Contract related thereto, is in violation of any such
    law, rule or regulation in any material respect;

 

    (xiii) which (A) satisfies in all material respects
    all applicable requirements of the Credit and Collection Policy,
    (B) is assignable as contemplated under the Transaction
    Documents, and (C) complies with such other criteria and
    requirements as any Administrative Agent may from time to time
    specify to the Transferor following five Business Days’
    notice;

 

    (xiv) which was generated in the ordinary course of an
    Originating Entity’s business;

 

    (xv) the Obligor of which has been directed to make all
    payments to a Special Account with respect to which there shall
    be a Special Account Letter (and, if applicable, an Account
    Agent Agreement) in effect;

 

    (xvi) neither the assignment of which under the
    Transferring Affiliate Letter or the BMA Transfer Agreement by
    the applicable Transferring Affiliate, the assignment of which
    under the Receivables Purchase Agreement by the Seller and the
    assignment of which hereunder by the Transferor nor the
    performance or execution of any of the other transactions
    contemplated in any of the Transaction Documents with respect
    thereto violates, conflicts or contravenes any applicable laws,
    rules or regulations (including without limitation, any
    CHAMPUS/VA Regulations, any Medicaid Regulations and any
    Medicare Regulations), orders or writs or any contractual or
    other restriction, limitation or encumbrance;

    

    8

 

    (xvii) which has not been compromised, adjusted or modified
    (including by the extension of time for payment or the granting
    of any discounts, allowances or credits); provided,
    however, that only such portion of such Receivable that
    is the subject of such compromise, adjustment or modifications
    shall be deemed to be ineligible pursuant to the terms of this
    clause (xvii);

 

    (xviii) which, in the case of any Receivable payable by an
    Obligor through a fiscal intermediary or similar entity, is
    payable through one of the Persons in such capacity that is
    specified in Exhibit N hereto or that has otherwise been
    approved by each Administrative Agent; and

 

    (xix) as to which, in the case of any Obligor of the type
    described in clause (C) or (D) of the definition of
    “Obligor” herein, notice of the interest therein of
    the Transferor shall have been given to such Obligor.

 

    “ERISA” means the U.S. Employee Retirement
    Income Security Act of 1974, as amended from time to time, and
    the regulations promulgated and rulings issued thereunder.

 

    “ERISA Affiliate” means, with respect to any
    Person, (i) any corporation which is a member of the same
    controlled group of corporations (within the meaning of
    Section 414(b) of the Code (as in effect from time to time,
    the “Code”)) as such Person; (ii) a trade or
    business (whether or not incorporated) under common control
    (within the meaning of Section 414(c) of the Code) with
    such Person; or (iii) a member of the same affiliated
    service group (within the meaning of Section 414(n) of the
    Code) as such Person, any corporation described in
    clause (i) above or any trade or business described in
    clause (ii) above.

 

    “Estimated Maturity Period” shall mean, at any
    time, the period, rounded upward to the nearest whole number of
    days, equal to the weighted average number of days until due of
    the Receivables as calculated by the Collection Agent in good
    faith and set forth in the most recent Investor Report, such
    calculation to be based on the assumptions that (a) each
    Receivable within a particular aging category (as set forth in
    the Investor Report) will be paid on the last day of such aging
    category and (b) the last day of the last such aging
    category coincides with the last date on which any Outstanding
    Balance of Receivables would be written off as uncollectible or
    charged against any applicable reserve or similar account in
    accordance with the objective requirements of the Credit and
    Collection Policy and the Seller’s and the
    Transferor’s normal accounting practices applied on a basis
    consistent with those reflected in the Seller’s financial
    statements, provided, however, that if the Agent,
    any Administrative Agent or any Investor shall reasonably
    disagree with any such calculation, the Agent may recalculate
    the Estimated Maturity Period, and such recalculation, in the
    absence of manifest error, shall be conclusive.

 

    “Eurodollar Rate” means, with respect to any
    Eurodollar Tranche Period for the Investors in any Related
    Group, a rate which is equal to the sum (rounded upwards, if
    necessary, to the next higher 1/100 of 1%) of (A) the
    Applicable Margin at such time, (B) the rate obtained by
    dividing (i) the applicable LIBOR Rate by (ii) a
    percentage equal to 100% minus the reserve percentage used for
    determining the maximum reserve requirement as specified in
    Regulation D (including, without limitation, any marginal,
    emergency, supplemental, special or other reserves) that is
    applicable to the Administrative Agent for such Related Group
    during such Eurodollar Tranche Period in respect of
    eurocurrency or eurodollar funding, lending or liabilities (or,
    if more than one percentage shall be so applicable, the daily
    average of such percentage for those days in such Eurodollar
    Tranche Period during which any such percentage shall be
    applicable) plus (C) the then daily net annual assessment
    rate (rounded upwards, if necessary, to the nearest 1/100 of 1%)
    as estimated by such Administrative Agent for determining the
    current annual assessment payable by such Administrative Agent
    to the Federal Deposit Insurance Corporation in respect of
    eurocurrency or eurodollar funding, lending or liabilities.

 

    “Eurodollar Tranche” means a Tranche as to
    which Discount is calculated at the Eurodollar Rate.

 

    “Eurodollar Tranche Period” means, with
    respect to a Eurodollar Tranche for the Investors in any Related
    Group, prior to the Termination Date, a period of up to one
    month requested by the Transferor and agreed to by the
    Administrative Agent for such Related Group, commencing on a
    Business Day requested by the Transferor and agreed to by such
    Administrative Agent; provided, however, that if
    such Eurodollar Tranche Period would expire on a day which
    is not a Business Day, such Eurodollar Tranche Period shall
    expire on the next succeeding Business Day; provided,
    further, that if such Eurodollar Tranche Period
    would expire on (a) a day which is not a Business Day but
    is a day of the month after which no further Business Day occurs
    in such month, such Eurodollar Tranche Period shall expire
    on the next preceding Business Day or (b) a Business Day
    for which there is no numerically corresponding day in the
    applicable subsequent calendar month, such Eurodollar
    Tranche Period shall expire on the last Business Day of
    such month.

    

    9

 

    “Event of Bankruptcy” means, with respect to
    any Person, (i) that such Person (a) shall generally
    not pay its debts as such debts become due or (b) shall
    admit in writing its inability to pay its debts generally or
    (c) shall make a general assignment for the benefit of
    creditors; (ii) any proceeding shall be instituted by or
    against such Person seeking to adjudicate it as bankruptcy or
    insolvent, or seeking liquidation, winding up, reorganization,
    arrangements, adjustment, protection, relief or composition of
    it or its debts under any law relating to bankruptcy, insolvency
    or reorganization or relief of debtors, or seeking the entry of
    an order for relief or the appointment of a receiver, trustee or
    other similar official for it or any substantial part of its
    property or (iii) if such Person is a corporation (or other
    business entity), such Person or any Subsidiary shall take any
    corporate (or analogous) action to authorize any of the actions
    set forth in the preceding clauses (i) or (ii).

 

    “Excluded Taxes” shall have the meaning
    specified in Section 8.3 hereof.

 

    “Existing TAA” shall have the meaning specified
    in the Preliminary Statements hereof.

 

    “Face Amount” means, with respect to any
    Commercial Paper, (i) the face amount of any such
    Commercial Paper issued on a discount basis and (ii) the
    principal amount of, plus the amount of all interest accrued and
    to accrue thereon to the stated maturity date of, any such
    Commercial Paper issued on an interest-bearing basis.

 

    “Facility Fee” means, with respect to any
    Conduit Investor, a fee payable by the Transferor to such
    Conduit Investor pursuant to Section 2.7(ii) hereof, the
    terms of which are set forth in the Investor Fee Letter.

 

    “Facility Limit” means $550,000,000;
    provided that such amount may not at any time exceed the
    aggregate Commitments at any time in effect.

 

    “Fee Letter” means the Investor Fee Letter or
    the Agent Fee Letter.

 

    “Finance Charges” means, with respect to a
    Contract, any finance, interest, late or similar charges owing
    by an Obligor pursuant to such Contract.

 

    “FME KGaA” means Fresenius Medical Care
    AG & Co. KgaA., formerly known as Fresenius Medical
    Care AG, a partnership limited by shares organized and existing
    under the laws of the Federal Republic of Germany and its
    successors and permitted assigns.

 

    “FME KGaA Credit Facility” means (i) the
    Bank Credit Agreement dated as of March 31, 2006 among FME
    KGaA, FMCH, the other borrowers identified therein, the
    guarantors identified therein, the lenders party thereto, and
    Bank of America, N.A., as Administrative Agent, and
    (ii) the Term Loan Credit Agreement dated as of
    March 31, 2006 among FME KGaA, FMCH, the other borrowers
    identified therein, the guarantors identified therein, the
    lenders party thereto, and Bank of America, N.A., as
    Administrative Agent, in each case, as amended, restated,
    supplemented, modified, renewed, refunded, replaced or
    refinanced and in effect at any time.

 

    “FMCH” means Fresenius Medical Care Holdings,
    Inc., a New York corporation, and its successors and permitted
    assigns.

 

    “GAAP” means generally accepted accounting
    principles set forth in the opinions and pronouncements of the
    Accounting Principles Board of the American Institute of
    Certified Public Accountants and statements and pronouncements
    of the Financial Accounting Standards Board or in such other
    statements by such accounting profession, which are in effect as
    of the date of this Agreement.

 

    “GBFC” means Giro Balanced Funding Corporation
    together with its successors and permitted assigns.

 

    “Group Majority Investors” has the meaning
    specified in Section 9.8.

 

    “Guaranty” means, with respect to any Person
    any agreement by which such Person assumes, guarantees,
    endorses, contingently agrees to purchase or provide funds for
    the payment of, or otherwise becomes liable upon, the obligation
    of any other Person, or agrees to maintain the net worth or
    working capital or other financial condition of any other Person
    or otherwise assures any other creditor of such other Person
    against loss, including, without limitation, any comfort letter,
    operating agreement or take-or-pay contract and shall include,
    without limitation, the contingent liability of such Person in
    connection with any application for a letter of credit.

 

    “HHS” means the Department of Health and Human
    Services, an agency of the Federal Government of the United
    States.

 

    “Hospital Obligor” means any Obligor referred
    to in clause (D) of the definition of “Obligor”
    contained in this Section 1.1 hereof.

    

    10

 

    “Incremental Transfer” means a Transfer upon
    giving effect to which the Net Investment hereunder shall be
    increased.

 

    “Indebtedness” means, with respect to any
    Person and without duplication, such Person’s
    (i) obligations for borrowed money, (ii) obligations
    representing the deferred purchase price of property other than
    accounts payable arising in the ordinary course of such
    Person’s business on terms customary in the trade,
    (iii) obligations, whether or not assumed, secured by liens
    or payable out of the proceeds or production from property now
    or hereafter owned or acquired by such Person,
    (iv) obligations which are evidenced by notes, acceptances,
    or other instruments, (v) Capitalized Lease obligations and
    (vi) obligations for which such Person is obligated
    pursuant to a Guaranty.

 

    “Indemnified Amounts” has the meaning specified
    in Section 8.1 hereof.

 

    “Indemnified Parties” has the meaning specified
    in Section 8.1 hereof.

 

    “Initial Transfer Documents” shall have the
    meaning specified in Section 5.2(h).

 

    “Interest Component” shall mean, (i) with
    respect to any Commercial Paper issued on an interest-bearing
    basis, the interest payable on such Commercial Paper at its
    maturity (including any dealer commissions) and (ii) with
    respect to any Commercial Paper issued on a discount basis, the
    portion of the face amount of such Commercial Paper representing
    the discount incurred in respect thereof (including any dealer
    commissions).

 

    “Intermediate Concentration Account” means a
    special depositary account in the name of the Transferor
    maintained at a Special Account Bank for the purpose of
    receiving Collections remitted from the Special Account(s)
    maintained at such Special Account Bank.

 

    “Intermediate Concentration Account Agreement”
    means an agreement substantially in the form attached as
    Exhibit D-3
    hereto (or in such other form as may be approved in writing by
    the Agent) among the Transferor, an Intermediate Concentration
    Bank and the Agent.

 

    “Intermediate Concentration Account Bank” means
    a bank holding an Intermediate Concentration Account.

 

    “Intermediate Concentration Account Notice”
    means a notice, in substantially the form of the Notice of
    Effectiveness attached to an Intermediate Concentration Account
    Agreement, from the Agent to the applicable Intermediate
    Concentration Account Bank.

 

    “Investor” means a Conduit Investor or a Bank
    Investor.

 

    “Investor Fee Letter” means the Amended and
    Restated Investor Fee Letter dated as of the Closing Date among
    the Transferor and the Administrative Agents relating to certain
    fees payable by the Transferor to the Administrative Agents, for
    the account of the Investors in their respective Related Groups,
    as amended, restated, supplemented or otherwise modified from
    time to time.

 

    “Investor Report” means a report, in
    substantially the form attached hereto as Exhibit E or in
    such other form as is mutually agreed to by the Transferor and
    each Administrative Agent, furnished by the Collection Agent
    pursuant to Section 2.11 hereof.

 

    “Law” means any law (including common law),
    constitution, statute, treaty, regulation, rule, ordinance,
    order, injunction, writ, decree or award of any Official Body.

 

    “Liberty Street” means Liberty Street Funding
    LLC, a Delaware limited liability company, together with its
    successors and permitted assigns.

 

    “LIBOR Rate” means, with respect to any
    Eurodollar Tranche Period for the Investors in any Related
    Group, the rate at which deposits in dollars are offered to the
    Administrative Agent for such Related Group, in the London
    interbank market at approximately 11:00 a.m. (London time)
    two Business Days before the first day of such Eurodollar
    Tranche Period in an amount approximately equal to the
    Eurodollar Tranche to which the Eurodollar Rate is to apply and
    for a period of time approximately equal to the applicable
    Eurodollar Tranche Period.

 

    “Liquidation Yield” means, at any time, an
    amount equal to:

 

	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
    (RVF x
	
 
	
     LBR x
	
 
	
     NI) x
	
 
	
     (EMP +
	
 
	
    CDF)
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    360

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

    

    11

 

	 	 	 	 	 
	

    Where:

	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 

	

    RVF

	
 
	
    =
	
 
	
    the Rate Variance Factor at such time;

	

    LBR

	
 
	
    =
	
 
	
    the Base Rate at such time which is applicable to the
    liquidation period after a Termination Event;

	

    NI

	
 
	
    =
	
 
	
    the Net Investment at such time;

	

    EMP

	
 
	
    =
	
 
	
    the Estimated Maturity Period of the Receivables; and

	

    CDF

	
 
	
    =
	
 
	
    the Collection Delay Factor.

 

    “Liquidity Provider” means, with respect to any
    Conduit Investor, the Person or Persons who will provide
    liquidity support to such Conduit Investor in connection with
    the issuance by such Conduit Investor of Commercial Paper.

 

    “Liquidity Provider Agreement” means an
    agreement between a Conduit Investor and one or more Liquidity
    Providers evidencing the obligation of each such Liquidity
    Provider to provide liquidity support to such Conduit Investor
    in connection with the issuance by such Conduit Investor of
    Commercial Paper.

 

    “Loss Horizon” means, as of any date, the
    product of (a) a ratio (expressed as a percentage) computed
    by dividing (i) the aggregate Outstanding Balance of all
    Receivables acquired by the Transferor during the two
    (2) most recently ended calendar months by (ii) the
    aggregate Outstanding Balance of all Receivables that are not
    more than 270 days past due as of the last day of the most
    recently ended calendar month times (b) the highest average
    Default Ratio for any consecutive three month period during the
    immediately preceding
    12-month
    period.

 

    “Loss Percentage” means on any day the greater
    of (i) two (2) times the Loss Horizon as of such day
    and (ii) 20%.

 

    “Loss Reserve” means, on any day, an amount
    equal to:

 

    LP x (NRB + DLR + DR + SFR)

 

	 	 	 	 	 
	

    Where:

	
 
	
 
	
 
	
 

	

    LP

	
 
	
    =
	
 
	
    the Loss Percentage at the close of business of the Collection
    Agent on such day;

	

    NRB

	
 
	
    =
	
 
	
    the Net Receivables Balance at the close of business of the
    Collection Agent on such day;

	

    DLR

	
 
	
    =
	
 
	
    the Dilution Reserve at the close of business of the Collection
    Agent on such day;

	

    DR

	
 
	
    =
	
 
	
    the Discount Reserve at the close of business of the Collection
    Agent on such day;

	

    SFR

	
 
	
    =
	
 
	
    the Servicing Fee Reserve at the close of business of the
    Collection Agent on such day

 

    “Loss-to-Liquidation Ratio” means the ratio
    (expressed as a percentage) computed as of the last day of each
    calendar month by dividing (i) the aggregate Outstanding
    Balance of all Receivables which became Defaulted Receivables
    during such month, by (ii) the aggregate amount of
    Collections received by the Collection Agent during such period.

 

    “Majority Investors” means, at any time, those
    Investors which hold Commitments aggregating in excess of 51% of
    the aggregate Commitments of all Investors as of such date.

 

    “Material Adverse Effect” means a material
    adverse effect on any of (i) the collectibility or
    enforceability of a material portion of the Receivables or
    Related Security, (ii) the ability of the Transferor or any
    Originating Entity to charge or collect a material portion of
    the Receivables or Related Security, (iii) the ability of
    (A) the Transferor or any Originating Entity to perform or
    observe in any material respect any provision of this Agreement
    or any other Transaction Document to which it is a party or
    (B) of FME KGaA or FMCH to cause the due and punctual
    performance and observation by the Seller or the Transferor of
    any such provision or, if the Seller or the Transferor shall
    fail to do so, to perform or observe any such provision required
    to be performed or observed by the Seller or the Transferor
    under this Agreement or any other Transaction Document to which
    the Seller or the Transferor is party, in each case pursuant to
    the Parent Agreement, (iv) the ability of (A) any
    Transferring Affiliate to perform or observe in any material
    respect any provision of the Transferring Affiliate Letter or,
    in the case of BMA, the BMA Transfer Agreement or, in the case
    of any Designated Account Agent, the applicable Account Agent
    Agreement, or (B) of FME KGaA or FMCH to cause the due and
    punctual performance and observation by such Transferring
    Affiliate, BMA or such Designated Account Agent of any such
    provision or, if such Transferring Affiliate, BMA or such
    Designated

    12

 

    Account Agent shall fail to do so, to perform or observe any
    such provision, in each case pursuant to the Parent Agreement,
    (v) the financial condition, operations, businesses or
    properties, each on a consolidated basis, of FME KGaA, FMCH, NMC
    or the Transferor or (vi) the interests of the Agent, any
    Administrative Agent or any of the Investors under the
    Transaction Documents.

 

    “Maximum Net Investment” means at any time, an
    amount equal to 98% of the Facility Limit in effect at such time.

 

    “Maximum Percentage Factor” means 98%.

 

    “Medicaid” means the medical assistance program
    established by Title XIX of the Social Security Act
    (42 USC §§ 1396 et seq.) and
    any statutes succeeding thereto.

 

    “Medicaid Regulations” means, collectively,
    (a) all federal statutes (whether set forth in
    Title XIX of the Social Security Act or elsewhere)
    affecting Medicaid; (b) all state statutes and plans for
    medical assistance enacted in connection with such statutes and
    federal rules and regulations promulgated pursuant to or in
    connection with such statutes; and (c) all applicable
    provisions of all rules, regulations manuals, orders and
    administrative, reimbursement and other guidelines of all
    Governmental Authorities (including, without limitation, HHS,
    CMS, the office of the Inspector General for HHS, or any Person
    succeeding to the functions of any of the foregoing) promulgated
    pursuant to or in connection with any of the foregoing (whether
    or not having the force of law), in each case as may be amended,
    supplemented or otherwise modified from time to time.

 

    “Medicare” means the health insurance program
    for the aged and disabled established by Title XVIII of the
    Social Security Act (42 USC §§ 1395 et seq.)
    and any statutes succeeding thereto.

 

    “Medicare Regulations” means, collectively,
    (a) all federal statutes (whether set forth in
    Title XVIII of the Social Security Act or elsewhere)
    affecting Medicare; and (b) all applicable provisions of
    all rules, regulations, manuals, orders and administrative,
    reimbursement and other guidelines of all Governmental
    Authorities (including, without limitation, HHS, CMS, the Office
    of the Inspector General for HHS, or any Person succeeding to
    the functions of any of the foregoing) promulgated pursuant to
    or in connection with the foregoing (whether or not having the
    force of law), as each may be amended, supplemented or otherwise
    modified from time to time.

 

    “Minimum Amount” shall have the meaning
    specified in Section 5.1(h).

 

    “Moody’s” means Moody’s Investors
    Service.

 

    “Multiemployer Plan” means a
    “multiemployer plan” as defined in
    Section 4001(a)(3) of ERISA which is or was at any time
    during the current year or the immediately preceding five years
    contributed to by the Transferor, the Seller or any ERISA
    Affiliate of the Transferor or the Seller on behalf of its
    employees.

 

    “Net Asset Test” shall mean, in connection with
    any assignment by a Conduit Investor of an interest in the Net
    Investment pursuant to Section 9.7 hereof, that on the day
    immediately prior to the day on which such assignment is to take
    effect, the Net Receivables Balance shall be greater than the
    Net Investment.

 

    “Net Investment” means the sum of the cash
    amounts paid to the Transferor for each Incremental Transfer
    less the aggregate amount of Collections received and applied by
    the Agent to reduce such Net Investment pursuant to
    Section 2.5, 2.6 or 2.9 hereof; provided that the
    Net Investment shall be restored and reinstated in the amount of
    any Collections so received and applied if at any time the
    distribution of such Collections is rescinded or must otherwise
    be returned for any reason; and provided further
    that the Net Investment may be increased by the amount described
    in Section 9.7(d) as described therein. A portion of the
    Net Investment shall be deemed to be held by an Investor to the
    extent such portion of the Net Investment shall have been funded
    by, or assigned to, such Investor.

 

    “Net Receivables Balance” means at any time the
    Outstanding Balance of the Eligible Receivables at such time
    reduced, without duplication, by the sum of (i) the
    aggregate amount by which the Outstanding Balance of all
    Eligible Receivables of each Designated Obligor or class of
    Designated Obligors exceeds the Concentration Factor for such
    Designated Obligor or class of Designated Obligors, plus
    (ii) the aggregate Outstanding Balance of all Eligible
    Receivables which are Defaulted Receivables, plus
    (iii) the excess, if any, of (A) the aggregate
    Outstanding Balance of all Eligible Receivables of each Obligor
    referred to in clause (G) of the definition of
    “Obligor” contained in this Section 1.1, over
    (B) an amount equal to 5% of the aggregate Outstanding
    Balance of all Eligible Receivables, plus (iv) the
    aggregate amount by which the Outstanding Balance of all
    Eligible Receivables originated by any member of the Spectra
    Renal Management Group exceeds 7.5% of Eligible Receivables,
    plus (v) the Unrealized Contractual Adjustment Reserve.

    

    13

 

    “NMC” means National Medical Care, Inc., a
    Delaware corporation and owner of 100% of the outstanding stock
    of the Transferor.

 

    “NPRBI” shall have the meaning specified in
    Section 2.13.

 

    “Obligor” of any Receivable means (i) any
    Person obligated to make payments of such Receivable pursuant to
    a Contract
    and/or
    (ii) any Person owing any amount in respect of such
    Receivable, or in respect of any Related Security with respect
    to such Receivable, all such Persons referred to in any of
    clauses (A), (B), (E), (F) and (G) below, and each
    Person referred to in any of clauses (C) and
    (D) below, to be deemed for purposes of this Agreement to
    be one Obligor:

 

    (A): all Persons owing Receivables or Related Security under the
    Medicare program;

 

    (B): all Persons owing Receivables or Related Security under the
    Medicaid program;

 

    (C): each Person which is an insurance company;

 

    (D): each Person which is a hospital or other health care
    provider;

 

    (E): all Persons, other than health care providers or Persons
    referred to in clause (A), (B), (C) or (D) above or
    clause (F) or (G) below, owing Receivables arising
    from the sale of services or merchandise;

 

    (F): all Persons owing Receivables or Related Security under the
    CHAMPUS/VA Program; and

 

    (G): all Persons who receive the services or merchandise the
    sale of which results in Receivables that are not insured,
    guaranteed or otherwise supported in respect thereof by any of
    the Persons referred to in clauses (A) through
    (F) above, including any Person owing any amount in respect
    of Receivables by reason of insurance policy deductibles or
    co-insurance agreements or arrangements.

 

    “Official Body” means any government or
    political subdivision or any agency, authority, bureau, central
    bank, commission, department or instrumentality of any such
    government or political subdivision, or any court, tribunal,
    grand jury or arbitrator, or any accounting board or authority
    (whether or not a part of government) which is responsible for
    the establishment or interpretation of national or international
    accounting principles in each case whether foreign or domestic.

 

    “Original Closing Date” means August 28,
    1997.

 

    “Originating Entity” means any of the Seller
    and any Transferring Affiliate.

 

    “Other Transferor” means, with respect to any
    Conduit Investor, any Person other than the Transferor that has
    entered into a receivables purchase agreement or transfer and
    administration agreement with such Conduit Investor.

 

    “Outstanding Balance” means (i) with
    respect to any Receivable originated by a member of the Spectra
    Renal Management Group, the outstanding principal amount thereof
    (excluding any accrued and outstanding Finance Charges related
    thereto) minus the Contractual Adjustment Amount with
    respect to such Receivable and (ii) with respect to any
    other Receivable, the outstanding principal amount thereof
    (excluding any accrued and outstanding Finance Charges related
    thereto) minus the amount of Pre-Arranged Contractual
    Adjustments that have not yet been applied to reduce such
    outstanding principal amount.

 

    “Paradigm” means, Paradigm Funding LLC, a
    Delaware limited liability company, together with its successors
    and permitted assigns.

 

    “Parent Agreement” means the Amended and
    Restated Parent Agreement, substantially in the form set forth
    as Exhibit P hereto, dated as of the Closing Date made by
    FME KGaA and FMCH in respect of the obligations of the
    Originating Entities and NMC under the Transaction Documents, as
    the same may be amended, restated, supplemented or otherwise
    modified from time to time with the consent of each
    Administrative Agent.

 

    “Parent Group” means, collectively, FME KGaA,
    FMCH, NMC, the Transferor, the Originating Entities and their
    Subsidiaries and Affiliates, and “Parent Group
    Member” means any such Person individually.

 

    “Payor” shall, solely for purposes of
    Section 8.3, have the meaning specified in such section.

 

    “Percentage Factor” shall mean the fraction
    (expressed as a percentage) computed at any time of
    determination as follows:

 

	 	 	 	 	 	 	 	 	 	 	 	 	 
	

           

	
 
	
    NI +
	
 
	
     LR +
	
 
	
    DLR +
	
 
	
    DR +
	
 
	
    SFR
	
 
	
 

	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 

	

    NRB

    

    14

 

	 	 	 	 	 
	

    Where:

	
 
	
 
	
 
	
 

	

    NI

	
 
	
    =
	
 
	
    the Net Investment at the time of such computation;

	

    LR

	
 
	
    =
	
 
	
    the Loss Reserve at the time of such computation;

	

    DLR

	
 
	
    =
	
 
	
    the Dilution Reserve at the time of such computation;

	

    DR

	
 
	
    =
	
 
	
    the Discount Reserve at the time of such computation;

	

    SFR

	
 
	
    =
	
 
	
    the Servicing Fee Reserve at the time of such computation; and

	

    NRB

	
 
	
    =
	
 
	
    the Net Receivables Balance at the time of such computation.

 

    “Person” means any corporation, limited
    liability company, natural person, firm, joint venture,
    partnership, trust, unincorporated organization, enterprise,
    government or any department or agency or any government.

 

    “Potential Termination Event” means an event
    which but for the lapse of time or the giving of notice, or
    both, would constitute a Termination Event.

 

    “Pre-Arranged Contractual Adjustment” means,
    with respect to any Receivable, a Contractual Adjustment that
    was agreed upon by the applicable Originating Entity and the
    applicable Obligor on or prior to the date such Receivable arose.

 

    “Primary Payor” means (i) each Obligor
    referred to in clauses (A), (B), (E), (F) and (G) of
    the definition of “Obligor” contained in this
    Section 1.1, (ii) collectively, all Obligors of the
    type referred to in clause (C) of the definition of
    “Obligor” contained in this Section 1.1 and
    (iii) collectively, all Obligors of the type referred to in
    clause (D) of the definition of “Obligor”
    contained in this Section 1.1.

 

    “Pro Rata Share” means, for a Bank Investor in
    any Related Group, the Commitment of such Bank Investor divided
    by the sum of the Commitments of all Bank Investors in such
    Related Group.

 

    “Proceeds” means “proceeds” as
    defined in
    Section 9-306
    (1) of the UCC as in effect on the date hereof.

 

    “Program Fee” means, with respect to any
    Conduit Investor, the fee payable by the Transferor to such
    Conduit Investor pursuant to Section 2.7(i) hereof, the
    terms of which are set forth in the Investor Fee Letter.

 

    “Purchased Interest” means the interest in the
    Receivables acquired by a Liquidity Provider from a Conduit
    Investor through purchase pursuant to the terms of a Liquidity
    Provider Agreement.

 

    “Purchase Termination Date” means the date upon
    which the Transferor shall cease, for any reason whatsoever, to
    make purchases of Receivables from the Seller under the
    Receivables Purchase Agreement or the Receivables Purchase
    Agreement shall terminate for any reason whatsoever.

 

    “Ratable Share” means (i) in the case of a
    Conduit Investor in any Related Group, a fraction (expressed as
    a percentage) equal to the Related Group Limit of such Related
    Group divided by the Facility Limit and (ii) in the case of
    a Bank Investor, a fraction (expressed as a percentage) equal to
    such Bank Investor’s Commitment divided by the sum of the
    Commitments of all Bank Investors (including Bank Investors from
    other Related Groups).

 

    “Rate Variance Factor” means the number,
    computed from time to time in good faith by the Agent (with the
    written consent of each Administrative Agent), that reflects the
    largest potential variance (from minimum to maximum) in selected
    interest rates over a period of time selected by the Agent from
    time to time, set forth in written notice by the Agent to each
    Administrative Agent, the Transferor and the Collection Agent.

 

    “Rating Agency” means, at any time,
    Moody’s, S&P or any other rating agency chosen by a
    Conduit Investor to rate its commercial paper notes at such time.

 

    “Receivable” means the indebtedness of any
    Obligor, whether constituting an account, chattel paper,
    instrument, insurance claim, investment property or general
    intangible, arising in connection with the sale or lease of
    merchandise, or the rendering of services, by an Originating
    Entity, and includes the right to payment of any Finance Charges
    and other obligations of such Obligor with respect thereto.

 

    “Receivable Systems” has the meaning specified
    in Section 3.1(aa).

 

    “Receivables Purchase Agreement” means the
    Amended and Restated Receivables Purchase Agreement dated as of
    the Closing Date by and between NMC, as seller, and the
    Transferor, as purchaser, as such agreement may be amended,
    modified or supplemented and in effect from time to time.

 

    “Recipient” shall, solely for purposes of
    Section 8.3, have the meaning specified in such section.

    

    15

 

    “Records” means all Contracts and other
    documents, books, records and other information (including,
    without limitation, computer programs, tapes, discs, punch
    cards, data processing software and related property and rights)
    maintained with respect to receivables and the related Obligors.

 

    “Reinvestment Termination Date” means, with
    respect to any Conduit Investor, the second Business Day after
    the delivery by such Conduit Investor to the Transferor of
    written notice that such Conduit Investor elects to commence the
    amortization of its interest in the Net Investment or otherwise
    liquidate its interest in the Transferred Interest.

 

    “Reinvestment Transfer” means a Transfer
    occurring in connection with the reinvestment of Collections
    pursuant to Section 2.2(b) and 2.5.

 

    “Related Group” means any of the following
    groups: (i) Paradigm, as a Conduit Investor, Landesbank
    Hessen-Thueringen Girozentrale, as a Bank Investor and WestLB,
    as a Bank Investor and as an Administrative Agent, together with
    their respective successors and permitted assigns,
    (ii) GBFC, as a Conduit Investor, and Bayerische
    Landesbank, Cayman Islands Branch, as a Bank Investor and
    Bayerische Landesbank, New York Branch, as an Administrative
    Agent, together with their respective successors and permitted
    assigns and (iii) Liberty Street, as a Conduit Investor,
    and Scotiabank, as a Bank Investor and as Administrative Agent,
    together with their respective successors and permitted assigns.

 

    “Related Group Limit” means, with respect to
    any Related Group, the aggregate Commitments of the Bank
    Investors in such Related Group.

 

    “Related Security” means with respect to any
    Receivable, all of the Transferor’s rights, title and
    interest in, to and under:

 

    (i) all of the Seller’s, the Transferor’s or any
    Transferring Affiliate’s interest, if any, in the
    merchandise (including returned or repossessed merchandise), if
    any, the sale of which gave rise to such Receivable;

 

    (ii) all other security interests or liens and property
    subject thereto from time to time, if any, purporting to secure
    payment of such Receivable, whether pursuant to the Contract
    related to such Receivable or otherwise, together with all
    financing statements signed by an Obligor describing any
    collateral securing such Receivable;

 

    (iii) all guarantees, indemnities, warranties, insurance
    (and proceeds and premium refunds thereof) or other agreements
    or arrangements of any kind from time to time supporting or
    securing payment of such Receivable whether pursuant to the
    Contract related to such Receivable or otherwise, including,
    without limitation, insurance, guaranties and other agreements
    or arrangements under the Medicare program, the Medicaid
    program, state renal programs, CHAMPUS/VA, private insurance
    policies, and hospital and other health care programs and health
    care provider arrangements;

 

    (iv) all Records related to such Receivable;

 

    (v) all rights and remedies of the Transferor
    (A) under the Receivables Purchase Agreement, together with
    all financing statements filed by the Transferor against the
    Seller in connection therewith, (B) under the Transferring
    Affiliate Letter, together with all financing statements filed
    in connection therewith against the Transferring Affiliates,
    (C) under the BMA Transfer Agreement, together with all
    financing statements filed in connection therewith against BMA
    and (D) under the Parent Agreement; and

 

    (vi) all Proceeds of any of the foregoing.

 

    “Scotiabank” means The Bank of Nova Scotia,
    together with its successors and permitted assigns.

 

    “Section 8.2 Costs” has the meaning
    specified in Section 8.2(d) hereof.

 

    “Seller” means NMC and its successors and
    permitted assigns.

 

    “Servicing Fee” means the fees payable by the
    Investors in a Related Group to the Collection Agent, with
    respect to a Tranche held by the Investors in such Related
    Group, in an amount equal to 0.25% per annum on the amount of
    the Net Investment allocated to such Tranche pursuant to
    Section 2.3 hereof. Such fee shall accrue from the date of
    the initial purchase of an interest in the Receivables to the
    date on which the Percentage Factor is reduced to zero. Such fee
    shall be payable only from Collections pursuant to, and subject
    to the priority of payments set forth in, Section 2.5
    hereof. After the Termination Date, such fee shall be payable
    only from Collections pursuant to, and subject to the priority
    of payments set forth in, Section 2.6 hereof.

    

    16

 

    “Servicing Fee Reserve” means at any time an
    amount equal to the product of (i) the aggregate
    Outstanding Balance of all Receivables at such time,
    (ii) the Servicing Fee percentage and (iii) a fraction
    having as the numerator, the sum of (a) the Estimated
    Maturity Period plus (b) the Collection Delay
    Period, and as the denominator, 360.

 

    “Social Security Act” means the Social Security
    Act, as amended from time to time, and the regulations
    promulgated and rulings and advisory opinions issued thereunder.

 

    “Special Account” means a special depositary
    account maintained at a bank acceptable to the Agent for the
    purpose of receiving Collections, which account is in the name
    of either (i) the Originating Entity in respect of the
    Receivables giving rise to such Collections or (ii) a
    Designated Account Agent acting on behalf of such Originating
    Entity.

 

    “Special Account Bank” means any of the banks
    holding one or more Special Accounts.

 

    “Special Account Letter” means a letter, in
    substantially the form of
    Exhibit D-1
    hereto, from an Originating Entity (or, if applicable, a
    Designated Account Agent) to any Special Account Bank, executed
    by such Originating Entity (or such Designated Account Agent) to
    such Special Account Bank.

 

    “Spectra Renal Management Group” means,
    collectively, Spectra East, Inc., a Delaware corporation,
    Spectra Laboratories, Inc., a Nevada corporation, as
    Transferring Affiliates, and their respective successors.

 

    “Standard & Poor’s” or
    “S&P” means Standard &
    Poor’s Ratings Services, a division of McGraw-Hill
    Companies, Inc.

 

    “Subordinated Note” shall have the meaning
    specified in the Receivables Purchase Agreement.

 

    “Subsidiary” of a Person means any Person more
    than 50% of the outstanding voting interests of which shall at
    any time be owned or controlled, directly or indirectly, by such
    Person or by one or more Subsidiaries of such Person or any
    similar business organization which is so owned or controlled.

 

    “Taxes” shall have the meaning specified in
    Section 8.3 hereof.

 

    “Termination Date” means the earliest of
    (i) the Business Day designated by the Transferor to each
    Administrative Agent as the Termination Date at any time
    following 60 days’ written notice to each
    Administrative Agent, (ii) the day upon which the
    Termination Date is declared or automatically occurs pursuant to
    Section 7.2(a) hereof, (iii) the Commitment
    Termination Date or (iv) the Purchase Termination Date.

 

    “Termination Event” means an event described in
    Section 7.1 hereof.

 

    “Tranche” means a portion of the Net Investment
    allocated to a Tranche Period pursuant to Section 2.3
    hereof.

 

    “Tranche Period” means a CP
    Tranche Period, a BR Tranche Period or a Eurodollar
    Tranche Period.

 

    “Tranche Rate” means the CP Rate, the Base
    Rate or the Eurodollar Rate.

 

    “Transaction Costs” has the meaning specified
    in Section 8.4(a) hereof.

 

    “Transaction Documents” means, collectively,
    this Agreement, the Receivables Purchase Agreement, the Fee
    Letters, the Special Account Letters, the Concentration Account
    Agreement, the Account Agent Agreement(s), the Certificates, the
    Transfer Certificates, the Transferring Affiliate Letter, the
    BMA Transfer Agreement, the Parent Agreement, the Intermediate
    Concentration Account Agreements, and all of the other
    instruments, documents and other agreements executed and
    delivered by any Originating Entity, FME KGaA, FMCH, NMC or the
    Transferor in connection with any of the foregoing, in each
    case, as the same may be amended, restated, supplemented or
    otherwise modified from time to time.

 

    “Transfer” means a conveyance, transfer and
    assignment by the Transferor to the Agent, for the benefit of
    the Investors, of an undivided percentage ownership interest in
    Receivables hereunder together with Related Security,
    Collections and Proceeds with respect thereto (including,
    without limitation, as a result of any reinvestment of
    Collections in Transferred Interests pursuant to
    Sections 2.2(b) and 2.5).

 

    “Transfer Certificate” has the meaning
    specified in Section 2.2(a) hereof.

 

    “Transfer Date” means, with respect to each
    Transfer, the Business Day on which such Transfer is made.

    

    17

 

    “Transfer Price” means with respect to any
    Incremental Transfer to be made by the Agent, on behalf of the
    Investors participating in such Incremental Transfer, the amount
    paid to the Transferor by such Investors as described in the
    applicable Transfer Certificate.

 

    “Transferor” means NMC Funding Corporation, a
    Delaware corporation, and its successors and permitted assigns.

 

    “Transferred Interest” means, at any time of
    determination, an undivided percentage ownership interest in
    (i) each and every then outstanding Receivable,
    (ii) all Related Security with respect to each such
    Receivable, (iii) all Collections with respect thereto, and
    (iv) other Proceeds of the foregoing, which undivided
    ownership interest shall be equal to the Percentage Factor at
    such time, and only at such time (without regard to prior
    calculations). The Transferred Interest in each Receivable,
    together with Related Security, Collections and Proceeds with
    respect thereto, shall at all times be equal to the Transferred
    Interest in each other Receivable, together with Related
    Security, Collections and Proceeds with respect thereto. To the
    extent that the Transferred Interest shall decrease as a result
    of a recalculation of the Percentage Factor, the Agent, on
    behalf of the applicable Investors, shall be considered to have
    reconveyed to the Transferor (without recourse, representation
    or warranty of any type or kind) an undivided percentage
    ownership interest in each Receivable, together with Related
    Security, Collections and Proceeds with respect thereto, in an
    amount equal to such decrease such that in each case the
    Transferred Interest in each Receivable shall be equal to the
    Transferred Interest in each other Receivable.

 

    “Transferring Affiliate” means a company
    specified on Exhibit Q hereto, as such Schedule may be
    amended from time to time as provided in Section 2.15;
    provided, however, that no such company shall be a
    Transferring Affiliate from and after the occurrence of any
    Event of Bankruptcy by or with respect thereto unless any
    Receivables that arose from sales by such company exist on such
    date, in which case such company shall continue to be a
    Transferring Affiliate until the respective Outstanding Balances
    of all such Receivables shall have been reduced to zero; and
    provided, further, that, solely with respect to
    the Receivables transferred by it to the Seller pursuant to the
    BMA Transfer Agreement, BMA shall constitute a
    “Transferring Affiliate” hereunder.

 

    “Transferring Affiliate Letter” means the
    Amended and Restated Affiliate Letter dated as of the Closing
    Date from the Transferring Affiliates (other than BMA) to the
    Seller, as the same may be amended, restated, supplemented or
    otherwise modified from time to time with the consent of the
    Agent.

 

    “UCC” means, with respect to any state, the
    Uniform Commercial Code as from time to time in effect in such
    state.

 

    “Unrealized Contractual Adjustment Reserve”
    means the reserve maintained by the Collection Agent in
    accordance with its customary practices reflecting the
    difference between the Outstanding Balance of Receivables owing
    by certain commercial insurers and the Collection Agent’s
    estimate of what such commercial insurers will pay in respect of
    such Receivables. It is understood and agreed that Pre-Arranged
    Contractual Adjustments will be reflected in the initial
    Outstanding Balance of the applicable Receivables and
    accordingly will not be included in the Unrealized Contractual
    Adjustment Reserve.

 

    “U.S.” or “United States”
    means the United States of America.

 

    “US Government Obligor” means any Obligor that
    is the federal government of the United States, or any
    subdivision or agency thereof the obligations of which are
    supported by the full faith and credit of the United States, and
    shall include any Obligor referred to in clause (A),(B) or
    (F) of the definition of “Obligor” contained in
    this Section 1.1.

 

    “Voting Stock” shall mean with respect to any
    Person, any capital stock or other equity interests issued by
    such Person which are ordinarily, in the absence of
    contingencies, entitled to vote for the election of directors,
    managing general partners or its equivalent of such Person, or,
    where no board of directors, managing general partners or its
    equivalent exists and where management control of such Person is
    controlled through the ownership of capital stock or other
    equity interests, the right to vote for or assert such
    management control, even though the right to vote for the
    election of directors (or the right to vote for or assert
    management control) has been suspended by the happening of such
    a contingency.

 

    “WestLB” means WestLB AG, New York Branch
    (formerly known as Westdeutsche Landesbank Girozentrale, New
    York Branch), together with its successors and assigns.

    

    18

 

    Section 1.2. Other
    Terms. All accounting terms not specifically defined herein
    shall be construed in accordance with GAAP. All terms used in
    Article 9 of the UCC in the State of New York, and not
    specifically defined herein, are used herein as defined in such
    Article 9.

 

    Section 1.3. Computation
    of Time Periods. Unless otherwise stated in this Agreement,
    in the computation of a period of time from a specified date to
    a later specified date, the word “from” means
    “from and including”, the words “to” and
    “until” each means “to but excluding”, and
    the word “within” means “from and excluding a
    specified date and to and including a later specified date”.

 

    Section 1.4. Amendment
    and Restatement. Subject to the satisfaction of the
    conditions precedent set forth in Section 4.1, this
    Agreement amends and restates the Existing TAA in its entirety.
    This Agreement is not intended to constitute a novation of the
    Existing TAA. Upon the effectiveness of this Agreement (the
    “Effective Date”), each reference to the
    Existing TAA in any other document, instrument or agreement
    executed
    and/or
    delivered in connection therewith shall mean and be a reference
    to this Agreement.

 

    Section 1.5. Funding
    on Effective Date. The parties hereto acknowledge that an
    adjustment to the Net Investment held by the respective Related
    Groups is required to be made on the Effective Date in order to
    ensure that the Net Investment held by the Investors in each
    Related Group is proportional to their respective Related Group
    Limits. Accordingly, on the Effective Date, the Transferor shall
    request such Incremental Transfers, and make such repayments, in
    each case a non-pro rata basis among the Related Groups, such
    that by the close of business on the Effective Date the Net
    Investment held by the Investors in the respective Related
    Groups shall be proportional to their respective Related Group
    Limits.

 

    ARTICLE II
    

 

    PURCHASE AND SETTLEMENTS

 

    Section 2.1. Facility.
    Upon the terms and subject to the conditions herein set forth,
    the Transferor may from time to time prior to the Termination
    Date, at its option, convey, transfer and assign to the Agent,
    on behalf of the Investors, percentage ownership interests in
    the Receivables, together with Related Security, Collections and
    Proceeds with respect thereto. Each such Transfer is made
    without recourse to the Transferor; provided,
    however, that the Transferor shall be liable for all
    representations, warranties, covenants and other agreements made
    by the Transferor pursuant to the terms of this Agreement or any
    other Transaction Document. Each such Transfer shall be made
    among the Related Groups ratably in accordance with their
    respective Related Group Limits. Subject to the terms and
    conditions set forth herein, the Agent shall accept such
    conveyance, transfer and assignment on behalf of the Investors.
    By accepting any conveyance, transfer and assignment hereunder,
    none of the Investors, the Administrative Agents or the Agent
    assumes or shall have any obligations or liability under any of
    the Contracts, all of which shall remain the obligations and
    liabilities of the Transferor and the Seller.

 

    Section 2.2. Transfers;
    Certificates; Eligible Receivables (a) Incremental
    Transfers. Upon the terms and subject to the conditions
    herein set forth the Transferor may, at its option, request that
    an Incremental Transfer be made by the Agent, on behalf of each
    of the applicable Investors. It shall be a condition precedent
    to each Incremental Transfer that (i) after giving effect
    to the payment to the Transferor of the applicable Transfer
    Price, (x) the sum of the Net Investment plus the
    Interest Component of all outstanding Related Commercial Paper,
    would not exceed the Facility Limit, (y) the Percentage
    Factor would not exceed the Maximum Percentage Factor and
    (z) the Net Investment would not exceed the Maximum Net
    Investment; (ii) the representations and warranties set
    forth in Section 3.1 shall be true and correct both
    immediately before and immediately after giving effect to any
    such Incremental Transfer and the payment to the Transferor of
    the Transfer Price related thereto; (iii) an Investor
    Report shall have been delivered prior to such Incremental
    Transfer as required by Section 3.2 hereof and (iv) in
    the case of any Incremental Transfer to be funded by the Bank
    Investors in any Related Group, either (x) such Bank
    Investors shall have previously accepted the assignment by the
    related Conduit Investor of all of its interest in the Affected
    Assets or (y) such Conduit Investor shall have had an
    opportunity to direct that such assignment occur on or prior to
    giving effect to such Incremental Transfer.

 

    The Transferor shall, by notice to the Agent (with a copy to
    each Administrative Agent) given by telecopy, offer to convey,
    transfer and assign to the Agent, on behalf of the Investors,
    undivided percentage ownership interests in the Receivables and
    the other Affected Assets relating thereto at least one
    (1) Business Day prior to the proposed date of any
    Incremental Transfer. Each such notice shall specify,
    (w) with respect to each Related Group, whether such
    request is made to the Agent, on behalf of the Conduit Investor
    in such Related Group or on behalf of the Bank Investors in such
    Related Group (it being understood and agreed that once any
    Transferred Interest hereunder is acquired on behalf of the Bank
    Investors in any Related Group, the Agent, on behalf of Bank
    Investors in such Related Group, shall be required to purchase
    all Transferred Interests held by the Agent on behalf of the

    

    19

 

    Conduit Investor in such Related Group in accordance with
    Section 9.7 and thereafter no additional Incremental
    Transfers shall be acquired on behalf of such Conduit Investor
    hereunder), (x) the desired Transfer Price (which shall be
    at least $1,000,000 or integral multiples of $250,000 in excess
    thereof) or, to the extent that the then available unused
    portion of the Facility Limit is less than such amount, such
    lesser amount equal to such available portion of the Facility
    Limit, (y) the desired date of such Incremental Transfer
    and (z) the desired Tranche Period(s) and allocations
    of the Net Investment of such Incremental Transfer thereto as
    required by Section 2.3. Each Administrative Agent will
    promptly notify the related Conduit Investor or each of the Bank
    Investors in its Related Group, as the case may be, of such
    Administrative Agent’s receipt of any request for an
    Incremental Transfer to be made to the Agent on behalf of such
    Person. To the extent that any such Incremental Transfer is
    requested of the Agent, on behalf of a Conduit Investor, such
    Conduit Investor shall instruct the Agent to accept or reject
    such offer by notice given to the Transferor and the Agent by
    telephone or telecopy by no later than the close of its business
    on the Business Day following its receipt of any such request.
    Each notice of proposed Transfer shall be irrevocable and
    binding on the Transferor and the Transferor shall indemnify
    each Investor against any loss or expense incurred by any
    Investor, either directly or indirectly (including, in the case
    of a Conduit Investor, through the related Liquidity Provider
    Agreement) as a result of any failure for any reason (including
    failure to satisfy any of the conditions precedent in respect
    thereof) by the Transferor to complete such Incremental Transfer
    including, without limitation, any loss (including loss of
    anticipated profits) or expense incurred by any Investor, either
    directly or indirectly (including, in the case of a Conduit
    Investor, pursuant to the related Liquidity Provider Agreement)
    by reason of the liquidation or reemployment of funds acquired
    by any Investor or a related Liquidity Provider (including,
    without limitation, funds obtained by issuing commercial paper
    or promissory notes or obtaining deposits as loans from third
    parties) for any Investor to fund such Incremental Transfer.

 

    The Transferor has previously delivered to the Agent the
    Transfer Certificate in the form of Exhibit F hereto (the
    “Transfer Certificate”). On the date of each
    Incremental Transfer, each Administrative Agent shall send
    written confirmation to the Transferor and to the Agent of the
    Transfer Price, the Tranche Period(s), the Transfer Date
    and the Tranche Rate(s) applicable to the portion of such
    Incremental Transfer made by such Administrative Agent’s
    Related Group. The Agent shall indicate the amount of the
    Incremental Transfer together with the date thereof as well as
    any decrease in the Net Investment on the grid attached to the
    Transfer Certificate. The Transfer Certificate shall evidence
    the Incremental Transfers.

 

    By no later than 3:00 p.m. (New York time) on any Transfer
    Date, each Investor participating in the relevant Transfer shall
    remit its Ratable Share of the aggregate Transfer Price for such
    Transfer either (i) to the account of the related
    Administrative Agent specified therefor from time to time by
    such Administrative Agent by notice to such Investor or
    (ii) if so directed by such Administrative Agent, directly
    to the Transferor. The obligation of each Investor to remit its
    Ratable Share of any such Transfer Price shall be several from
    that of each other Investor, and the failure of any Investor to
    so make such amount available to its related Administrative
    Agent or the Transferor, as applicable, shall not relieve any
    other Investor of its obligation hereunder. If the portion of
    the Transfer Price payable by the Investors in a Related Group
    is remitted to the related Administrative Agent, then, following
    each Incremental Transfer and such Administrative Agent’s
    receipt of funds from the Investors in its Related Group
    participating in such Transfer as aforesaid, such Administrative
    Agent shall remit such portion of the Transfer Price to the
    Transferor’s account at the location indicated in
    Section 10.3 hereof, in immediately available funds. Unless
    an Administrative Agent shall have received notice from any Bank
    Investor in its Related Group participating in an Incremental
    Transfer that such Bank Investor will not make its share of any
    Transfer Price relating to such Incremental Transfer available
    on the applicable Transfer Date therefor, such Administrative
    Agent may (but shall have no obligation to) make such Bank
    Investor’s share of any such Transfer Price available to
    the Transferor in anticipation of the receipt by such
    Administrative Agent of such amount from such Bank Investor. To
    the extent such Bank Investor fails to remit any such amount to
    its Administrative Agent after any such advance by such
    Administrative Agent on such Transfer Date, such Bank Investor,
    on the one hand, and the Transferor, on the other hand, shall be
    required to pay such amount, together with interest thereon at a
    per annum rate equal to the Federal funds rate (as determined in
    accordance with clause (ii) of the definition of “Base
    Rate”), in the case of such Bank Investor, or the otherwise
    applicable Tranche Rate, in the case of the Transferor, to
    such Administrative Agent upon its demand therefor;
    provided that such Administrative Agent shall not be
    permitted to recover more than once for such amount or interest
    thereon. Until such amount shall be repaid, such amount shall be
    deemed to be Net Investment paid by the applicable
    Administrative Agent and such Administrative Agent shall be
    deemed to be the owner of a Transferred Interest hereunder. Upon
    the payment of such amount to such Administrative Agent
    (x) by the Transferor, the amount of the aggregate Net
    Investment shall be reduced by such amount or (y) by such
    Bank Investor, such payment shall constitute such Bank
    Investor’s payment of its share of the applicable Transfer
    Price for such Transfer.

    

    20

 

    (b) Reinvestment Transfers. On each Business Day
    occurring after the initial Incremental Transfer hereunder and
    prior to the Termination Date, the Transferor hereby agrees to
    convey, transfer and assign to the Agent, on behalf of the
    Investors, and in consideration of Transferor’s agreement
    to maintain at all times prior to the Termination Date a Net
    Receivables Balance in an amount at least sufficient to maintain
    the Percentage Factor at an amount not greater than the Maximum
    Percentage Factor, the Agent may, on behalf of each Conduit
    Investor (unless such Conduit Investor has otherwise directed
    the Agent) and shall, on behalf of each of the Bank Investors,
    agree to purchase from the Transferor undivided percentage
    ownership interests in each and every Receivable, together with
    Related Security, Collections and Proceeds with respect thereto,
    to the extent that Collections are available for such Transfer
    in accordance with Section 2.5 hereof, such that after
    giving effect to such Transfer, (i) the amount of the Net
    Investment at the close of business on such Business Day shall
    be equal to the amount of the Net Investment at the close of the
    business on the Business Day immediately preceding such Business
    Day plus the Transfer Price of any Incremental Transfer made on
    such day, if any, and (ii) the Transferred Interest in each
    Receivable, together with Related Security, Collections and
    Proceeds with respect thereto, shall be equal to the Transferred
    Interest in each other Receivable, together with Related
    Security, Collections and Proceeds with respect thereto.

 

    (c) All Transfers. Each Transfer shall constitute a
    purchase by the Agent, on behalf of the Investors, of undivided
    percentage ownership interests in each and every Receivable,
    together with Related Security, Collections and Proceeds with
    respect thereto, then existing, as well as in each and every
    Receivable, together with Related Security, Collections and
    Proceeds with respect thereto, which arises at any time after
    the date of such Transfer. The Agent’s aggregate undivided
    percentage ownership interest in the Receivables, together with
    the Related Security, Collections and Proceeds with respect
    thereto, held on behalf of the Investors, shall equal the
    Percentage Factor in effect from time to time. The Agent shall
    hold the Transferred Interests on behalf of the Investors in
    accordance with each such Investor’s percentage interest in
    the Transferred Interest (determined on the basis of the
    relationship that the portion of the Net Investment funded by
    such Investor bears to the aggregate Net Investment of all
    Investors at such time).

 

    (d) Certificate. The Transferor has issued to the
    Agent the Certificate, in the form of Exhibit M. The
    Certificate remains in full force and effect and is hereby
    ratified and confirmed.

 

    (e) Percentage Factor. The Percentage Factor shall
    be computed by the Collection Agent as of the opening of
    business of the Collection Agent on the effective date of this
    Agreement. Thereafter until the Termination Date, the Collection
    Agent shall recompute the Percentage Factor at the time of each
    Incremental Transfer pursuant to Section 2.2(a) and as of
    the close of business of the Collection Agent on each Business
    Day (other than a day after the Termination Date) and report
    such recomputation to the Agent monthly, in the Investor Report,
    and at such other times as may be requested by the Agent. The
    Percentage Factor shall remain constant from the time as of
    which any such computation or recomputation is made until the
    time as of which the next such recomputation, if any, shall be
    made, notwithstanding any additional Receivables arising, any
    Incremental Transfer made pursuant to Section 2.2(a) or any
    Reinvestment Transfer made pursuant to Sections 2.2(b) and
    2.5 during any period between computations of the Percentage
    Factor. The Percentage Factor, as computed as of the close of
    business on the Business Day immediately preceding the
    Termination Date, shall remain constant at all times on and
    after the Termination Date until the date on which the Net
    Investment has been reduced to zero, and all accrued Discount
    and Servicing Fees have been paid in full and all other
    Aggregate Unpaids have been paid in full at which time the
    Percentage Factor shall be recomputed in accordance with
    Section 2.6.

 

    Section 2.3. Selection
    of Tranche Periods and Tranche Rates.

 

    (a) Prior to the Termination Date; Transferred Interest
    held on behalf of a Conduit Investor. At all times
    hereafter, but prior to the Termination Date with respect to any
    portion of the Net Investment held on behalf of a Conduit
    Investor that is funded through the issuance of Commercial
    Paper, such portion of the Net Investment shall be allocated to
    a CP Tranche Period as set forth in the definition of such
    term. Each Conduit Investor confirms that it is its intention to
    allocate all or substantially all of the Net Investment held on
    behalf of it to CP Tranche Periods, provided that such
    Conduit Investor may determine, from time to time, in its sole
    discretion, that funding such Net Investment through the
    issuance of Commercial Paper is not possible or is not desirable
    for any reason. If, prior to the Termination Date, any portion
    of the Net Investment held on behalf of a Conduit Investor is
    not funded through the issuance of Commercial Paper, then such
    portion of the Net Investment shall be allocated to a BR Tranche
    or a Eurodollar Tranche in accordance with Section 2.3(c)
    in the same manner as if such portion of the Net Investment was
    held by or on behalf of the Bank Investors. In the case of any
    Tranche Period outstanding upon the Termination Date, such
    Tranche Period shall end on such date.

 

    (b) After the Termination Date; Transferred Interest
    Held on behalf of a Conduit Investor. At all times on and
    after the Termination Date, with respect to any portion of the
    Transferred Interest which shall be held by the Agent

    

    21

 

    on behalf of a Conduit Investor, such Conduit Investor or its
    Administrative Agent, as applicable, shall select all
    Tranche Periods and Tranche Rates applicable thereto.

 

    (c) Prior to the Termination Date; Transferred Interest
    Held on Behalf of Bank Investor. At all times with respect
    to any portion of the Transferred Interest held by the Agent on
    behalf of the Bank Investors in any Related Group, but prior to
    the Termination Date, the initial Tranche Period applicable
    to such portion of the Net Investment allocable thereto shall be
    a period of not greater than 7 days and such Tranche shall
    be a BR Tranche. Thereafter, with respect to such portion, and
    with respect to any other portion of the Transferred Interest
    held on behalf of the Bank Investors (or any of them) in any
    Related Group, provided that the Termination Date shall not have
    occurred, the Tranche Period applicable thereto shall be a
    Eurodollar Period and the applicable Tranche shall be a
    Eurodollar Tranche, unless the Transferor has requested and the
    applicable Administrative Agent has approved a
    Tranche Period of less than 7 days, in which case such
    Tranche shall be a BR Tranche. The Transferor shall give the
    Administrative Agent for each Related Group irrevocable notice
    by telephone of the new requested Tranche Period applicable
    to the Bank Investors in such Related Group at least three
    (3) Business Days prior to the expiration of any then
    existing Tranche Period applicable to such Related Group
    and, if the Transferor shall fail to provide such notice (or, if
    the requested Tranche Period is less than 7 days, the
    Administrative Agent does not consent to such request), the
    applicable Administrative Agent on behalf of the Bank Investors
    in such Related Group may, in its sole discretion, select the
    new Tranche Period in respect of the applicable Tranche. In
    the case of any Tranche Period outstanding upon the
    occurrence of the Termination Date, such Tranche Period
    shall end on the date of such occurrence.

 

    (d) After the Termination Date; Transferred Interest
    Held on behalf of Bank Investor. At all times on and after
    the Termination Date, with respect to any portion of the
    Transferred Interest held by the Agent on behalf of the Bank
    Investors in any Related Group, the Administrative Agent for
    such Related Group shall select all Tranche Periods and
    Tranche Rates applicable thereto.

 

    (e) Eurodollar Rate Protection; Illegality.
    (i) If the Administrative Agent for any Related Group is
    unable to obtain on a timely basis the information necessary to
    determine the LIBOR Rate for any proposed Eurodollar Tranche,
    then

 

    (A) such Administrative Agent shall forthwith notify the
    Investors in such Related Group, as applicable, and the
    Transferor that the Eurodollar Rate cannot be determined for
    such Eurodollar Tranche, and

 

    (B) while such circumstances exist, neither such
    Administrative Agent nor any of the Investors in such Related
    Group shall allocate the Net Investment of any additional
    Transferred Interests purchased during such period or reallocate
    the Net Investment allocated to any then existing Tranche ending
    during such period, to a Eurodollar Tranche.

 

    (ii) If, with respect to any outstanding Eurodollar
    Tranche, any Investor on behalf of which the Agent holds any
    Transferred Interest therein notifies its Administrative Agent
    that it is unable to obtain matching deposits in the London
    interbank market to fund its purchase or maintenance of such
    Transferred Interest or that the Eurodollar Rate applicable to
    such Transferred Interest will not adequately reflect the cost
    to such Investor of funding or maintaining its respective
    Transferred Interest for such Tranche Period then such
    Administrative Agent shall forthwith so notify the Transferor,
    whereupon neither such Administrative Agent nor the Investors in
    the Related Group shall, while such circumstances exist,
    allocate any Net Investment of any additional Transferred
    Interest purchased during such period or reallocate the Net
    Investment allocated to any Tranche Period ending during
    such period, to a Eurodollar Tranche and instead such
    Transferred Interest shall be purchased as, or such Net
    Investment shall be allocated to, a BR Tranche (notwithstanding
    any election made by the Transferor pursuant to
    Section 2.3(c) or otherwise).

 

    (iii) Notwithstanding any other provision of this
    Agreement, if any Investor shall notify its Administrative Agent
    that such Investor has determined (or has been notified by any
    Liquidity Provider) that the introduction of or any change in or
    in the interpretation of any law or regulation makes it unlawful
    (either for such Investor or such Liquidity Provider, as
    applicable), or any central bank or other governmental authority
    asserts that it is unlawful, for such Investor or such Liquidity
    Provider, as applicable, to fund the purchases or maintenance of
    Transferred Interests at the Eurodollar Rate, then (x) as
    of the effective date of such notice from such Investor to its
    Administrative Agent, the obligation or ability of the such
    Investor to fund its purchase or maintenance of Transferred
    Interests at the Eurodollar Rate shall be suspended until such
    Investor notifies its Administrative Agent that the
    circumstances causing such suspension no longer exist and
    (y) the Net Investment of each Eurodollar Tranche in which
    such Investor owns an interest shall either (1) if such
    Investor may lawfully continue to maintain such Transferred
    Interest at the Eurodollar Rate until the last day of the
    applicable Tranche Period, be reallocated on the last day
    of such Tranche Period to another Tranche Period in
    respect of which the Net Investment allocated

    

    22

 

    thereto accrues Discount at a Tranche Rate other than the
    Eurodollar Rate or (2) if such Investor shall determine
    that it may not lawfully continue to maintain such Transferred
    Interest at the Eurodollar Rate until the end of the applicable
    Tranche Period, such Investor’s share of the Net
    Investment allocated to such Eurodollar Tranche shall be deemed
    to accrue Discount at the Base Rate from the effective date of
    such notice until the end of such Tranche Period.

 

    (f) Separate Tranches for Related Groups. In no
    event shall portions of the Net Investment held by Investors
    from different Related Groups be allocated to the same Tranche.

 

    Section 2.4. Discount,
    Fees and Other Costs and Expenses. Notwithstanding any
    limitation on recourse contained herein, the Transferor shall
    pay, as and when due in accordance with this Agreement, all fees
    hereunder, Discount (including Discount due any Conduit Investor
    or any Bank Investor), all amounts payable pursuant to
    Article VIII hereof, if any, and the Servicing Fees. On the
    last day of each Tranche Period (or, in the case of a CP
    Tranche Period, by no later than the second Business Day
    following the last day of such CP Tranche Period), the
    Transferor shall pay to each Administrative Agent, on behalf of
    the applicable Investors in its Related Group, an amount equal
    to the accrued and unpaid Discount for such Tranche Period
    together with, in the event the Transferred Interest is held on
    behalf of a Conduit Investor, an amount equal to the discount
    accrued on the Commercial Paper of such Conduit Investor to the
    extent such Commercial Paper was issued in order to fund the
    Transferred Interest in an amount in excess of the Transfer
    Price of an Incremental Transfer. Discount shall accrue with
    respect to each Tranche on each day occurring during the
    Tranche Period related thereto. Nothing in this Agreement
    shall limit in any way the obligations of the Transferor to pay
    the amounts set forth in this Section 2.4.

 

    Section 2.5. Non-Liquidation
    Settlement and Reinvestment Procedures. On each day after
    the date of any Incremental Transfer but prior to the
    Termination Date and provided that no Potential Termination
    Event shall have occurred and be continuing, the Collection
    Agent shall, out of Collections received on or prior to such day
    and not previously applied or accounted for: (i) set aside
    and hold in trust for the Agent, on behalf of the applicable
    Investors (or deposit into the Collection Account if so required
    pursuant to Section 2.12 hereof), an amount equal to all
    Discount and the Servicing Fee accrued through such day and not
    so previously set aside or paid and (ii) apply the balance
    of such Collections remaining after application of Collections
    as provided in clause (i) of this Section 2.5 hereof
    to the Transferor, for the benefit of the Agent, on behalf of
    the applicable Investors, to the purchase of additional
    undivided percentage interests in each Receivable pursuant to
    Section 2.2(b) hereof. Any Collections so set aside as
    described in clause (i) above shall be allocated, among the
    Related Groups ratably in proportion to the accrued Discount and
    Servicing Fee with respect to the Investors in each such Related
    Group. On the last day of each Tranche Period applicable to
    any portion of the Net Investment held by one or more Investors
    in a Related Group (or, in the case of a CP Tranche Period,
    by no later than the second Business Day following the last day
    of such CP Tranche Period), from the amounts set aside as
    described in clause (i) of the first sentence of this
    Section 2.5 hereof that have been allocated to the
    Investors in such Related Group, the Collection Agent shall
    deposit to the applicable Administrative Agent’s account,
    for the benefit of such Investors, an amount equal to the
    accrued and unpaid Discount for such Tranche Period and
    shall deposit to its own account an amount equal to the accrued
    and unpaid Servicing Fee for such Tranche Period. The
    applicable Administrative Agent, upon its receipt of such
    amounts in such Administrative Agent’s account, shall
    distribute such amounts to the applicable Investors entitled
    thereto as set forth above; provided that if such
    Administrative Agent shall have insufficient funds to pay all of
    the above amounts in full on any such date, such Administrative
    Agent shall pay such amounts ratably (based on the amounts owing
    to each such Investor) to all such Investors entitled to payment
    thereof. In addition, the Collection Agent shall remit to the
    Transferor at the end of each Tranche Period, such portion
    of Collections not allocated to the Agent, on behalf of the
    applicable Investors.

 

    Section 2.6. Liquidation
    Settlement Procedures. (a) If at any time on or prior
    to the Termination Date, the Percentage Factor is greater than
    the Maximum Percentage Factor, then the Transferor shall
    immediately pay to the Administrative Agents for the Related
    Groups, for the benefit of the applicable Investors in their
    respective Related Groups, from previously received Collections,
    an aggregate amount equal to the amount such that, when applied
    in reduction of the Net Investment, will result in the
    Percentage Factor being less than or equal to the Maximum
    Percentage Factor. Such aggregate amount shall be paid to such
    Administrative Agents ratably in accordance with the portion of
    the Net Investment held by their respective Related Groups. Any
    amount so paid to an Administrative Agent for a Related Group
    shall be applied to the reduction of the Net Investment of
    Tranche Periods applicable to such Related Group selected
    by such Administrative Agent.

 

    (b) On the Termination Date and on each day thereafter, and
    on each day on which a Termination Event or a Potential
    Termination Event has occurred and is continuing, the Collection
    Agent shall set aside and hold in trust for the Agent, on behalf
    of the Investors (or deposit into the Collection Account if so
    required pursuant to Section 2.12 hereof) all Collections
    received on such day. The Collections so set aside shall be
    allocated, among the Related

    

    23

 

    Groups ratably in accordance with the portion of the Net
    Investment held by each such Related Group. On the Termination
    Date or the day on which a Termination Event or Potential
    Termination Event has occurred and is continuing, the Collection
    Agent shall deposit to each Administrative Agent’s account,
    for the benefit of the applicable Investors, any amounts set
    aside pursuant to Section 2.5 above which have been
    allocated to such Administrative Agent’s Related Group as
    described in Section 2.5. On the last day of each
    Tranche Period to occur on or after the Termination Date,
    during the continuance of a Termination Event or Potential
    Termination Event, the Collection Agent shall deposit to each
    Administrative Agent’s account to the extent not already so
    deposited, for the benefit of the applicable Investors in its
    Related Group, the amounts so set aside that have been allocated
    to the Investors in such Related Group pursuant to this
    Section 2.6, but not to exceed the sum of (i) the
    accrued Discount for such Tranche Period, (ii) the
    portion of the Net Investment allocated to such
    Tranche Period, and (iii) all other Aggregate Unpaids.
    On such day, the Collection Agent shall deposit to its account,
    from the amounts so allocated to the Investors in such Related
    Group pursuant to the preceding sentence which remain after
    payment in full of the aforementioned amounts, the accrued
    Servicing Fee for such Tranche Period. If with respect to
    any Tranche Period there shall be insufficient funds on
    deposit for the Collection Agent to distribute funds in payment
    in full of the aforementioned amounts, the Collection Agent
    shall distribute funds first, in payment of the accrued
    Discount for such Tranche Period, second, if the
    Transferor, the Seller or any Affiliate of the Transferor or the
    Seller is not then the Collection Agent, to the Collection
    Agent’s account, in payment of the Servicing Fee payable to
    the Collection Agent to the extent allocable to such
    Tranche Period, third, in reduction of the Net
    Investment allocated to such Tranche Period fourth,
    in payment of all fees payable by the Transferor hereunder to
    the members of the relevant Related Group, fifth, in
    payment of all other Aggregate Unpaids owing to the members of
    such Related Group and sixth, if the Transferor, the
    Seller or any Affiliate of the Transferor or the Seller is the
    Collection Agent, to its account as Collection Agent, in payment
    of the Servicing Fee payable to such Person as Collection Agent
    to the extent such Servicing Fee is allocable to such
    Tranche Period. The applicable Administrative Agent, upon
    its receipt of such amounts in such Administrative Agent’s
    account, shall distribute such amounts to the Investors in its
    Related Group entitled thereto as set forth above;
    provided that if such Administrative Agent shall have
    insufficient funds to pay all of the above amounts in full on
    any such date, such Administrative Agent shall pay such amounts
    in the order of priority set forth above and, with respect to
    any such category above for which such Administrative Agent
    shall have insufficient funds to pay all amounts owing on such
    date, ratably (based on the amounts in such categories owing to
    such Persons) among all such Persons entitled to payment
    thereof. For purposes of this Section 2.6, the Agent shall
    be deemed to be a member of the Related Group that includes
    Paradigm.

 

    (c) Following the later to occur of the Termination Date
    and the date on which the Net Investment has been reduced to
    zero, all accrued Discount and Servicing Fees have been paid in
    full and all other Aggregate Unpaids have been paid in full,
    (i) the Collection Agent shall recompute the Percentage
    Factor, (ii) the Agent, on behalf of the Investors, shall
    be considered to have reconveyed to the Transferor all of the
    right, title and interest in and to the Affected Assets
    (including the Transferred Interest) without recourse,
    representation or warranty of any type or kind, (iii) the
    Collection Agent shall pay to the Transferor any remaining
    Collections set aside and held by the Collection Agent for the
    Investors pursuant to this Section 2.6 and (iv) the
    Agent, on behalf of the Investors, shall execute and deliver to
    the Transferor, at the Transferor’s expense, such documents
    or instruments as are necessary to terminate the Agent’s
    interests in the Affected Assets. Any such documents shall be
    prepared by or on behalf of the Transferor.

 

    Section 2.7. Fees.
    Notwithstanding any limitation on recourse contained in this
    Agreement, on the last day of each month the Transferor shall
    pay the following non-refundable fees: (i) to each Conduit
    Investor, solely for its own account, the Program Fee with
    respect to such Conduit Investor, (ii) to each Conduit
    Investor, the Facility Fee with respect to the applicable
    Related Group (for distribution to the Bank Investors in such
    Related Group) and (iii) to the Agent the Administration
    Fee.

 

    SECTION 2.8. Protection of Ownership Interest of
    the Investors; Special Accounts, Intermediate Concentration
    Account and Concentration Account. (a) The Transferor
    agrees that it will, and will cause the Seller to, from time to
    time, at its expense, promptly execute and deliver all
    instruments and documents and take all actions as may be
    necessary or as the Agent or any Administrative Agent may
    reasonably request in order to perfect or protect the
    Transferred Interest or to enable the Agent, the Administrative
    Agents or the Investors to exercise or enforce any of their
    respective rights hereunder. Without limiting the foregoing, the
    Transferor will, and will cause the Seller to, upon the request
    of the Agent, any Administrative Agent or any of the Investors,
    in order to accurately reflect this purchase and sale
    transaction, execute and file such financing or continuation
    statements or amendments thereto or assignments thereof as
    permitted pursuant to Section 9.7 hereof as may be
    requested by the Agent, any Administrative Agent or any of the
    Investors and (y) mark its respective master data
    processing records and other documents with a legend describing
    the conveyance to the Transferor of the Receivables (in the case
    of the Seller) and to the Agent, for the benefit of the
    Investors, of the Transferred Interest. The Transferor shall,
    and will cause the

    

    24

 

    Seller to, upon request of the Agent, any Administrative Agent
    or any of the Investors obtain such additional search reports as
    the Agent, any Administrative Agent or any of the Investors
    shall request. To the fullest extent permitted by applicable
    law, the Agent shall be authorized to sign and file financing
    statements , continuation statements and amendments thereto
    relating to the Receivables, Related Security and Collections
    and assignments thereof to the Agent or any successor or
    permitted assign of the Agent without the Transferor’s or
    the Seller’s signature. Carbon, photographic or other
    reproduction of this Agreement or any financing statement shall
    be sufficient as a financing statement. The Transferor shall
    not, and shall not permit the Seller or any Transferring
    Affiliate to, change its respective name, identity or corporate
    structure nor relocate its respective chief executive office or
    jurisdiction of organization or any office where Records are
    kept unless it shall have: (i) given the Agent and each
    Administrative Agent at least thirty (30) days prior notice
    thereof and (ii) prepared at Transferor’s expense and
    delivered to the Agent all financing statements, instruments and
    other documents necessary to preserve and protect the
    Transferred Interest or requested by the Agent or any
    Administrative Agent in connection with such change or
    relocation; provided that the jurisdiction of
    organization for the Transferor, the Seller and each
    Transferring Affiliate shall at all times be a State within the
    United States. Any filings under the UCC or otherwise that are
    occasioned by such change in name or location shall be made at
    the expense of Transferor.

 

    (b) The Agent is hereby authorized at any time to date, and
    to deliver (i) to the Concentration Account Bank, the
    Concentration Account Notice and (ii) to each Intermediate
    Concentration Account Bank an Intermediate Concentration Account
    Notice. The Transferor hereby, when the Agent shall deliver the
    Concentration Account Notice to the Concentration Account Bank
    or an Intermediate Concentration Account Notice to any
    Intermediate Concentration Account Bank, transfers to the Agent
    the exclusive ownership and control of the Concentration Account
    or the applicable Intermediate Concentration Account, as the
    case may be, and shall take any further action that the Agent
    may reasonably request to effect such transfer. In case any
    authorized signatory of the Transferor whose signature shall
    appear on the Concentration Account Agreement or any
    Intermediate Concentration Account Agreement shall cease to have
    such authority before the delivery of the Concentration Account
    Notice or Intermediate Concentration Account Notice, as the case
    may be, such signature shall nevertheless be valid and
    sufficient for all purposes as if such authority had remained in
    force at the time of such delivery. The Agent shall, at the time
    it delivers the Concentration Account Notice to the
    Concentration Account Bank or an Intermediate Concentration
    Account Notice to any Intermediate Concentration Account Bank,
    provide a copy thereof to the Transferor; provided that
    the failure on the part of the Agent to provide such notice to
    the Transferor shall not affect the validity or effectiveness of
    the Concentration Account Notice or Intermediate Concentration
    Account Notice, as applicable, or impair any rights of the
    Agent, any Administrative Agent or any of the Investors
    hereunder.

 

    (c) In addition and without limiting the authority of the
    Agent set forth in subsection (b) above, but subject to
    subsection (d) below, the Transferor shall (i) cause
    each Originating Entity to instruct any or all of the Special
    Account Banks (which instructions shall be maintained in full
    force and effect at all times) to transfer directly to the
    Concentration Account or to an Intermediate Concentration
    Account all Collections from time to time on deposit in the
    applicable Special Accounts on a daily basis in accordance with
    the terms set forth in the applicable Special Account Letter and
    (ii) instruct each Intermediate Concentration Account Bank
    (which instructions shall be maintained in full force and effect
    at all times) to transfer directly to the Concentration Account
    all Collections from time to time on deposit in the applicable
    Intermediate Concentration Accounts on a daily basis in
    accordance with the terms set forth in the applicable
    Intermediate Concentration Account Agreement. In the event the
    Transferor shall at any time determine, for any of the reasons
    described in subsection (d) below, that the Transferor or
    any Originating Entity shall be unable to comply fully with the
    requirements of this subsection (c), the Transferor shall
    promptly so advise the Agent and each Administrative Agent, and
    the Transferor, the Agent and each Administrative Agent shall
    commence discussions with a view toward implementing an
    alternative arrangement therefor satisfactory to the Agent and
    each Administrative Agent.

 

    (d) Anything to the contrary herein notwithstanding, all
    Medicare or Medicaid payments which are made by an Obligor with
    respect to any Receivables shall be collected from such Obligor
    only by (i) the applicable Originating Entity or
    (ii) an agent of such Originating Entity, except to
    the extent that an Obligor may be required to submit any such
    payments directly to a Person other than such Originating Entity
    pursuant to a court-ordered assignment which is valid, binding
    and enforceable under applicable federal and state Medicare
    Regulations and Medicaid Regulations; and neither this Agreement
    nor any other Transaction Document shall be construed to permit
    any other Person, in violation of applicable Medicare
    Regulations or Medicaid Regulations to collect or receive, or to
    be entitled to collect or receive, any such payments prior to
    such Originating Entity’s or such agent’s receipt
    thereof.

 

    Section 2.9. Deemed
    Collections; Application of Payments. (a) If on any day
    the Outstanding Balance of a Receivable is either
    (x) reduced as a result of any defective, rejected or
    returned merchandise or services, any discount, credit,
    Contractual Adjustment, rebate, dispute, warranty claim,
    repossessed or returned goods,

    

    25

 

    chargeback, allowance, any billing adjustment or other
    adjustment, or (y) reduced or canceled as a result of a
    setoff or offset in respect of any claim by any Person (whether
    such claim arises out of the same or a related transaction or an
    unrelated transaction), the Transferor shall be deemed to have
    received on such day a Collection of such Receivable in the
    amount of such reduction or cancellation and the Transferor
    shall pay to the Collection Agent an amount equal to such
    reduction or cancellation and such amount shall be applied by
    the Collection Agent as a Collection in accordance with
    Section 2.5 or 2.6 hereof, as applicable. The Net
    Investment shall be reduced by the amount of such payment
    applied to the reduction of the Net Investment and actually
    received by the applicable Administrative Agent.

 

    (b) If on any day it is determined that (i) any of the
    representations or warranties in Article III was untrue
    with respect to a Receivable as of the date such representation
    or warranty was made or (ii) any of the representations or
    warranties set forth in Section 3.1(d) or
    Section 3.1(j) becomes untrue with respect to a Receivable
    (whether on or after the date of any transfer of an interest
    therein to the Agent or any of the Investors as contemplated
    hereunder) or (iii) a Receivable that was formerly treated
    as or represented to be an Eligible Receivable does not satisfy
    the requirements in paragraph (xi) of the definition of
    Eligible Receivable, the Transferor shall be deemed to have
    received on such day a Collection on such Receivable in full and
    the Transferor shall on such day pay to the Collection Agent an
    amount equal to the Outstanding Balance of such Receivable and
    such amount shall be allocated and applied by the Collection
    Agent as a Collection allocable to the Transferred Interest in
    accordance with Section 2.5 or 2.6 hereof, as applicable.
    The Net Investment shall be reduced by the amount of such
    payment applied to the reduction of the Net Investment and
    actually received by the applicable Administrative Agent.

 

    (c) Any payment by an Obligor in respect of any
    indebtedness owed by it to the Transferor or the Seller shall,
    except as otherwise specified by such Obligor or otherwise
    required by contract or law and unless otherwise instructed by
    each Administrative Agent, be applied as a Collection of any
    Receivable of such Obligor included in the Transferred Interest
    (starting with the oldest such Receivable) or the extent of any
    amounts then due and payable thereunder before being applied to
    any other receivable or other indebtedness of such Obligor.

 

    Section 2.10. Payments
    and Computations, Etc. All amounts to be paid or deposited
    by the Transferor or the Collection Agent hereunder shall be
    paid or deposited in accordance with the terms hereof no later
    than 12 p.m. (New York City time) on the day when due in
    immediately available funds; if such amounts are payable to the
    Agent or any Administrative Agent (whether on behalf of any of
    the Investors or otherwise) they shall be paid or deposited in
    the applicable account indicated in Section 10.3 hereof,
    until otherwise notified by the Agent or such Administrative
    Agent, as the case may be. The Transferor shall, to the extent
    permitted by law, pay to each Administrative Agent, for the
    benefit of itself and the Investors in its Related Group, upon
    demand, interest on all amounts owing to such Administrative
    Agent or such Investors not paid or deposited when due hereunder
    at a rate equal to 2% per annum plus the Base Rate. All
    computations of Discount, interest and all per annum fees
    hereunder shall be made on the basis of a year of 360 days
    for the actual number of days (including the first but excluding
    the last day) elapsed. Any computations by an Administrative
    Agent of amounts payable by the Transferor hereunder to such
    Administrative Agent or any Investor in its Related Group shall
    be binding upon all parties hereto absent manifest error.

 

    Section 2.11. Reports.
    On or prior to the last Business Day of each month, the
    Collection Agent shall prepare and forward to the Agent and each
    Administrative Agent (i) an Investor Report as of the end
    of the last day of the immediately preceding month, (ii) a
    listing by Primary Payor of all Receivables together with an
    analysis as to the aging of such Receivables as of such last
    day, but only to the extent the Receivable Systems of the
    Collection Agent are able to generate such information,
    (iii) written confirmation that all payments in cash, by
    way of credits to intercompany accounts (in the case of
    purchases made by the Seller from any Transferring Affiliate) or
    by way of application of proceeds of advances made under the
    Subordinated Note (in the case of purchases made by the
    Transferor from the Seller) have been made by the Transferor
    under the Receivables Purchase Agreement or by the Seller under
    the Transferring Affiliate Letter or the BMA Transfer Agreement,
    as applicable, in accordance with the respective terms of such
    agreement, and (iv) such other information as the Agent or
    any Administrative Agent may reasonably request.

 

    Section 2.12. Collection
    Account. The Collection Agent has established and shall
    maintain with the Agent a segregated account (the
    “Collection Account”), bearing a designation
    clearly indicating that the funds deposited therein are held for
    the benefit of the Agent, on behalf of the Investors. During the
    continuance of a Collection Agent Default or a Termination Event
    or a Potential Termination Event, the Collection Agent shall
    remit daily within forty-eight hours of receipt to the
    Collection Account all Collections received with respect to any
    Receivables. Funds on deposit in the Collection Account (other
    than investment earnings) shall be invested by the Agent in
    Eligible Investments that will mature so that such funds will be
    available prior to the last day of each successive
    Tranche Period following such investment. On the last day
    of each Tranche Period, such funds on deposit, together

    

    26

 

    with all interest and earnings (net of losses and investment
    expenses) thereon, in the Collection Account shall be made
    available for application in accordance with the terms of
    Section 2.6 or otherwise for application toward payments
    required to be made hereunder (including Discount) by the
    Transferor. On the date on which the Net Investment is zero, all
    accrued Discount and Servicing Fees have been paid in full and
    all other Aggregate Unpaids have been paid in full, any funds
    remaining on deposit in the Collection Account shall be paid to
    the Transferor.

 

    Section 2.13. Sharing
    of Payments, Etc. If any Investor (for purposes of this
    Section only, being a “NPRBI”) shall obtain any
    payment (whether voluntary, involuntary, through the exercise of
    any right of setoff, or otherwise) on account of Transferred
    Interest owned by it (other than pursuant to Section 2.7,
    or Article VIII and other than as a result of the
    differences in the timing of the applications of Collections
    pursuant to Section 2.5 or 2.6) in excess of its ratable
    share of payments on account of Transferred Interest obtained by
    the Investors entitled thereto, such NPRBI shall forthwith
    purchase from the other Investors entitled to a share of such
    amount participations in the Transferred Interests owned by such
    other Investors the excess payment ratably with each such other
    Investor entitled thereto; provided, however, that
    if all or any portion of such excess payment is thereafter
    recovered from such NPRBI, such purchase from each such other
    Investor shall be rescinded and each such other Investor shall
    repay to the NPRBI the purchase price paid by such NPRBI for
    such participation to the extent of such recovery, together with
    an amount equal to such other Investor’s ratable share
    (according to the proportion of (a) the amount of such
    other Investor’s required payment to (b) the total
    amount so recovered from the NPRBI) of any interest or other
    amount paid or payable by the NPRBI in respect of the total
    amount so recovered.

 

    Section 2.14. Right
    of Setoff. Without in any way limiting the provisions of
    Section 2.13, each Investor is hereby authorized (in
    addition to any other rights it may have) at any time after the
    occurrence of the Termination Date or during the continuance of
    a Potential Termination Event to setoff, appropriate and apply
    (without presentment, demand, protest or other notice which are
    hereby expressly waived) any deposits (other than any deposits
    then being held in any Special Account maintained by an Investor
    as to which deposits the Investors waive their rights of set-off
    in respect of the Aggregate Unpaid) and any other indebtedness
    held or owing by any Investor to, or for the account of, the
    Transferor against the amount of the Aggregate Unpaids owing by
    the Transferor to such Investor or to the Agent or any
    Administrative Agent on behalf of such Investor (even if
    contingent or unmatured).

 

    Section 2.15. Additional
    Transferring Affiliates. (a) If (i) one or more
    direct or indirect wholly-owned subsidiaries of FMCH (other than
    the Transferring Affiliates) now owned or hereafter acquired, is
    primarily engaged in the same business as is conducted on the
    date hereof by the Originating Entities or (ii) FMCH
    reorganizes its corporate structure such that facilities
    generating Receivables on the date hereof (or acquired as
    contemplated by clause (i)) are owned by one or more additional
    wholly-owned subsidiaries of FMCH, any or all of the
    wholly-owned subsidiaries referred to in clauses (i) and
    (ii) may, with the prior written consent of each
    Administrative Agent (which consent shall not be unreasonably
    withheld or delayed), become Transferring Affiliates under this
    Agreement upon delivery to each Administrative Agent of
    (x) counterparts of the Transferring Affiliate Letter duly
    executed by such subsidiary or subsidiaries and (y) the
    documents relating to such subsidiary or subsidiaries of the
    kind delivered by or on behalf of the Transferring Affiliates
    (other than BMA) pursuant to Section 4.1, together with
    such other instruments, documents and agreements as any
    Administrative Agent may reasonably request in connection
    therewith.

 

    (b) Upon the addition of any wholly-owned subsidiary of
    FMCH as a Transferring Affiliate pursuant to subsection (a)
    above, the provisions of this Agreement, including
    Exhibit Q, shall, without further act or documentation, be
    deemed amended to apply to such subsidiary to the same extent as
    the same apply to the Transferring Affiliates as of the date
    hereof and the term “Transferring Affiliate” in this
    Agreement shall mean and refer to such subsidiary as well as
    each then existing Transferring Affiliate.

 

    (c) The Transferor may terminate RenaLab, Inc. as a
    Transferring Affiliate at any time prior to March 31, 2007
    so long as (i) at the time of such termination, the
    aggregate Outstanding Balance of the Receivables originated by
    RenaLab, Inc. does not exceed $15,000,000 and (ii) all of
    the equity interests in RenaLab, Inc. have been (or will be, at
    the time of termination) sold to a third party that is not an
    Affiliate of the Transferor. Any such termination shall be made
    upon written notice to the Administrative Agents from the
    Collection Agent and the Transferor (i) stating that
    Renalab, Inc. has been terminated as a Transferring Affiliate
    and (ii) indicating the effective date of such termination.
    On the effective date of such termination Exhibit Q, shall,
    without further act or documentation, be deemed amended to
    remove Renalab, Inc. from the list of Transferring Affiliates
    set forth therein; provided that Renalab, Inc. shall
    continue to be a “Transferring Affiliate” with respect
    to any Receivables that arose prior to such effective date.

 

    Section 2.16. Optional
    Repurchase of Transferred Interest. The Transferor may at
    any time at its option elect to repurchase the Transferred
    Interest on not less than sixty (60) days’ prior
    written notice to each Administrative

    

    27

 

    Agent (a “Repurchase Notice”) specifying the
    date on which such repurchase shall occur (the
    “Repurchase Date”) and that such Repurchase
    Date shall be the Termination Date hereunder. By no later than
    11:00 a.m. (New York time) on the Repurchase Date, the
    Transferor shall pay to each Administrative Agent, for the
    account of the members of its Related Group, an amount (the
    “Repurchase Price”) equal to the sum of
    (i) the portion of the Net Investment funded by the
    Investors in such Related Group, (ii) all Discount accrued
    and to accrue thereon through the last day of the applicable
    Tranche Period(s) to which such Net Investment has been
    allocated and (iii) all other Aggregate Unpaids owing to
    the members of such Related Group or any related Indemnified
    Party under the Transaction Documents accrued through the date
    of such payment. The Repurchase Price payable with respect to
    any Related Group shall be calculated by the related
    Administrative Agent and notified to the Transferor, which
    calculation shall be conclusive and binding absent manifest
    error. By delivering a Repurchase Notice the Transferor shall be
    deemed to have designated the Repurchase Date as the
    “Termination Date” as contemplated by clause (i)
    of the definition of such term.

 

    ARTICLE III

    

 

    REPRESENTATIONS
    AND WARRANTIES
    

 

    Section 3.1. Representations
    and Warranties of the Transferor. The Transferor
    represents and warrants to the Agent, each Administrative Agent
    and each Investor that:

 

    (a) Corporate Existence and Power. The Transferor is
    a corporation duly organized, validly existing and in good
    standing under the laws of its jurisdiction of incorporation and
    has all corporate power and all material governmental licenses,
    authorizations, consents and approvals required to carry on its
    business in each jurisdiction in which its business is now
    conducted. The Transferor is duly qualified to do business in,
    and is in good standing in, every other jurisdiction in which
    the nature of its business requires it to be so qualified,
    except where the failure to be so qualified or in good standing
    would not have a Material Adverse Effect.

 

    (b) Corporate and Governmental Authorization;
    Contravention. The execution, delivery and performance by
    the Transferor of this Agreement, the Receivables Purchase
    Agreement, the Fee Letters, the Certificates, the Transfer
    Certificates and the other Transaction Documents to which the
    Transferor is a party are within the Transferor’s corporate
    powers, have been duly authorized by all necessary corporate
    action, require no action by or in respect of, or filing with,
    any Official Body or official thereof (except as contemplated by
    Section 2.8 hereof), and do not contravene, or constitute a
    default under, any provision of applicable law, rule or
    regulation (including, without limitation, any CHAMPUS/VA
    Regulation, any Medicaid Regulation or any Medicare Regulation)
    or of the Certificate of Incorporation or Bylaws of the
    Transferor or of any agreement, judgment, injunction, order,
    writ, decree or other instrument binding upon the Transferor or
    result in the creation or imposition of any Adverse Claim on the
    assets of the Transferor or any of its Subsidiaries (except as
    contemplated by Section 2.8 hereof).

 

    (c) Binding Effect. Each of this Agreement, the
    Receivables Purchase Agreement, the Fee Letters, the
    Certificates and the other Transaction Documents to which the
    Transferor is a party constitutes and the Transfer Certificate
    upon payment of the Transfer Price set forth therein will
    constitute the legal, valid and binding obligation of the
    Transferor, enforceable against it in accordance with its terms,
    subject to applicable bankruptcy, insolvency, moratorium or
    other similar laws affecting the rights of creditors generally.

 

    (d) Perfection. Immediately preceding each Transfer
    hereunder, the Transferor shall be the owner of all of the
    Receivables, free and clear of all Adverse Claims. On or prior
    to each Transfer and each recomputation of the Transferred
    Interest, all financing statements and other documents required
    to be recorded or filed, or notices to Obligors to be given, in
    order to perfect and protect the Agent’s Transferred
    Interest against all creditors of and purchasers from the
    Transferor and the Seller will have been duly filed in each
    filing office necessary for such purpose and all filing fees and
    taxes, if any, payable in connection with such filings shall
    have been paid in full.

 

    (e) Accuracy of Information. All information
    heretofore furnished by the Transferor (including without
    limitation, the Investor Reports, any reports delivered pursuant
    to Section 2.11 hereof and the Transferor’s financial
    statements) to any Investor, the Agent or any Administrative
    Agent for purposes of or in connection with this Agreement or
    any transaction contemplated hereby is, and all such information
    hereafter furnished by the Transferor to the any Investor, the
    Agent or any Administrative Agent will be, true and accurate in
    every material respect, on the date such information is stated
    or certified.

 

    (f) Tax Status. The Transferor has filed all tax
    returns (federal, state and local) required to be filed and has
    paid or made adequate provision for the payment of all taxes,
    assessments and other governmental charges.

    

    28

 

    (g) Action, Suits. Except as set forth in
    Exhibit H hereof, there are no actions, suits or
    proceedings pending, or to the knowledge of the Transferor
    threatened, in or before any court, arbitrator or other body,
    against or affecting (i) the Transferor or any of its
    properties or (ii) any Affiliate of the Transferor or its
    respective properties, which may, in the case of proceedings
    against or affecting any such Affiliate, individually or in the
    aggregate, have a Material Adverse Effect.

 

    (h) Use of Proceeds. No proceeds of any Transfer
    will be used by the Transferor to acquire any security in any
    transaction which is subject to Section 13 or 14 of the
    Securities Exchange Act of 1934, as amended.

 

    (i) Place of Business. The principal place of
    business and chief executive office of the Transferor are
    located at the address of the Transferor indicated in
    Section 10.3 hereof and the offices where the Transferor
    keeps substantially all its Records, are located at the
    address(es) described on Exhibit I or such other locations
    notified to each Administrative Agent in accordance with
    Section 2.8 hereof in jurisdictions where all action
    required by Section 2.8 hereof has been taken and
    completed. The principal place of business and chief executive
    office of each Originating Entity is located at the address of
    such Originating Entity indicated in Exhibit I hereof and
    the offices where the each Originating Entity keeps
    substantially all its Records are located at the address(es)
    specified on Exhibit I with respect to such Originating
    Entity or such other locations notified to each Administrative
    Agent in accordance with Section 2.8 hereof in
    jurisdictions where all action required by Section 2.8
    hereof has been taken and completed. The jurisdiction of
    organization of each of the Seller and the Transferor is the
    State of Delaware. The jurisdiction of organization for each
    Transferring Affiliate is the state specified opposite such
    Transferring Affiliate’s name on Exhibit Q.

 

    (j) Good Title. Upon each Transfer and each
    recomputation of the Transferred Interest, the Agent shall
    acquire a valid and perfected first priority undivided
    percentage ownership interest to the extent of the Transferred
    Interest or a first priority perfected security interest in each
    Receivable that exists on the date of such Transfer and
    recomputation and in the Related Security and Collections with
    respect thereto free and clear of any Adverse Claim.

 

    (k) Tradenames, Etc. As of the date hereof:
    (i) the Transferor’s chief executive office is located
    at the address for notices set forth in Section 10.3
    hereof; (ii) the Transferor has no subsidiaries or
    divisions; (iii) the Transferor has, within the last five
    (5) years, not operated under any tradename, and, within
    the last five (5) years, has not changed its name, merged
    with or into or consolidated with any other corporation or been
    the subject of any proceeding under Title 11, United States
    Code (Bankruptcy); and (iv) none of the Originating
    Entities has, within the last five (5) years, operated
    under any tradename other than Fresenius Medical Care North
    America or Spectra Renal Management or, within the last five
    (5) years, changed its name, merged with or into or
    consolidated with any other Person or been the subject of any
    proceeding under Title 11, United States Code
    (Bankruptcy), except in each case as described on Exhibit H.

 

    (l) Nature of Receivables. Each Receivable
    (x) represented by the Transferor or the Collection Agent
    to be an Eligible Receivable (including in any Investor Report
    or other report delivered pursuant to Section 2.11 hereof)
    or (y) included in the calculation of the Net Receivables
    Balance is an “eligible asset” as defined in
    Rule 3a-7
    under the Investment Company Act, of 1940, as amended and, in
    the case of clause (y) above, is not a Receivable of the
    type described in clauses (i) through (iii) of the
    definition of “Net Receivables Balance.”

 

    (m) Coverage Requirement; Amount of Receivables. The
    Percentage Factor does not exceed the Maximum Percentage Factor.

 

    (n) Credit and Collection Policy. Since
    September 1, 2008, there have been no material changes in
    the Credit and Collection Policy other than as permitted
    hereunder. Since such date, no material adverse change has
    occurred in the overall rate of collection of the Receivables.

 

    (o) Collections and Servicing. Since
    September 1, 2008, there has been no material adverse
    change in the ability of the Collection Agent (to the extent it
    is the Seller, the Transferor or any Subsidiary or Affiliate of
    any of the foregoing) to service and collect the Receivables.

 

    (p) No Termination Event. No event has occurred and
    is continuing and no condition exists which constitutes a
    Termination Event or a Potential Termination Event.

 

    (q) Not an Investment Company. The Transferor is
    not, and is not controlled by, an “investment company”
    within the meaning of the Investment Company Act of 1940, as
    amended, or is exempt from all provisions of such Act.

 

    (r) ERISA. Each of the Transferor and its ERISA
    Affiliates is in compliance in all material respects with ERISA
    and no lien exists in favor of the Pension Benefit Guaranty
    Corporation on any of the Receivables.

    

    29

 

    (s) Special Account Banks, Intermediate Concentration
    Account Banks and Concentration Bank. The names and
    addresses of all the Special Account Banks (and, if applicable,
    the Designated Account Agent in respect thereof), the
    Intermediate Concentration Account Banks and the Concentration
    Account Bank, together with the account numbers of the Special
    Accounts at such Special Account Banks, the account numbers of
    the Intermediate Concentration Accounts at such Intermediate
    Concentration Account Banks and the account number of the
    Concentration Account of the Transferor at the Concentration
    Account Bank, are specified in Exhibit C hereto (or at such
    other Special Account Banks, Intermediate Concentration Account
    Banks or Concentration Account Bank, with such other Special
    Accounts, Intermediate Concentration Accounts or Concentration
    Account or with such other Designated Account Agents as have
    been notified to each Administrative Agent in accordance with
    Section 5.2(e)). This Agreement, together with the
    Concentration Account Agreement and the Intermediate
    Concentration Account Agreements, is effective to, and does,
    transfer to the Agent, for the benefit of the Investors, all
    right, title and interest of the Transferor in and to the
    Concentration Account and each Intermediate Concentration
    Account. The Transferor has not granted to any Person (other
    than the Agent under the Concentration Account Agreement and the
    Intermediate Concentration Account Agreements) dominion and
    control over the Concentration Account or any Intermediate
    Concentration Account, or the right to take dominion and control
    over the Concentration Account or any Intermediate Concentration
    Account at a future time or upon the occurrence of a future
    event; neither the Transferor nor any other Parent Group Member
    has granted to any Person dominion and control over any Special
    Account, or the right to take dominion or control over any
    Special Account at a future time or upon the occurrence of a
    future event; and the Concentration Account, each Intermediate
    Concentration Account and each Special Account is otherwise free
    and clear of any Adverse Clam.

 

    (t) Bulk Sales. No transaction contemplated hereby
    or by the Receivables Purchase Agreement requires compliance
    with any bulk sales act or similar law.

 

    (u) Transfers Under Receivables Purchase Agreement.
    With respect to each Receivable, and Related Security, if any,
    with respect thereto, originally owed to the Seller or acquired
    by the Seller from any Transferring Affiliate, the Transferor
    purchased such Receivable and Related Security from the Seller
    under the Receivables Purchase Agreement, such purchase was
    deemed to have been made on the date such Receivable was
    credited or acquired by the Seller and such purchase was made
    strictly in accordance with the terms of the Receivables
    Purchase Agreement.

 

    (v) Preference; Voidability (Receivables Purchase
    Agreement). The Transferor has given reasonably equivalent
    value to the Seller in consideration for each transfer to the
    Transferor of Receivables and Related Security from the Seller,
    and no such transfer has been made for or on account of an
    antecedent debt owed by the Seller to the Transferor and no such
    transfer is or may be voidable under any Section of the
    Bankruptcy Code.

 

    (w) Transfers by Transferring Affiliates. With
    respect to each Receivable, and Related Security, if any, with
    respect thereto, originally owed to any Transferring Affiliate,
    the Seller (i) purchased such Receivable and Related
    Security from such Transferring Affiliate under the Transferring
    Affiliate Letter or from BMA under the BMA Transfer Agreement,
    such purchase being deemed to have been made on the date such
    Receivable was created (or, in the case of a Receivable
    outstanding on the Original Closing Date, on the Original
    Closing Date), (ii) by the last Business Day of the month
    following the month in which such purchase was so made, paid to
    the applicable Transferring Affiliate in cash or by way of a
    credit to such Transferring Affiliate in the appropriate
    intercompany account, an amount equal to the face amount of such
    Receivable and (iii) settled from time to time each such
    credit, by way of payments in cash, or by way of credits in
    amounts equal to cash expended, obligations incurred or the
    value of services or property provided by or on behalf of the
    Seller, in each case for the benefit of such Transferring
    Affiliate, to the account of such Transferring Affiliate in
    accordance with the Seller’s and such Transferring
    Affiliate’s cash management and accounting policies.

 

    (x) Preference; Voidability (Transferring
    Affiliates). The Seller has given reasonably equivalent
    value to each Transferring Affiliate in consideration for each
    transfer to the Seller of Receivables and Related Security from
    such Transferring Affiliate, and no such transfer has been made
    for or on account of an antecedent debt owed by such
    Transferring Affiliate to the Seller and no such transfer is or
    may be voidable under any Section of the Bankruptcy Code.

 

    (y) Ownership. FME KGaA owns, directly or indirectly
    through a wholly-owned Subsidiary, all of the issued and
    outstanding common stock of (and such stock comprises more than
    80% of the Voting Stock of) FMCH, free and clear of any Adverse
    Claim except to the extent such stock is pledged in connection
    with the FME KGaA Credit Facility or is subject to put/call
    agreements, forward agreements or other similar arrangements
    among FME KGaA and its subsidiaries. All of the issued and
    outstanding stock of each

    

    30

 

    Originating Entity is owned directly or indirectly by FMCH, free
    and clear of any Adverse Claim except to the extent such stock
    is pledged in connection with the FME KGaA Credit Facility or is
    subject to put/call agreements, forward agreements or other
    similar arrangements among FME KGaA and its subsidiaries;
    provided, however, that FME KGaA may own directly or indirectly
    stock that is not Voting Stock in subsidiaries of FMCH. All of
    the issued and outstanding stock of the Transferor is owned by
    NMC, free and clear of any Adverse Claim.

 

    (z) Representations and Warranties of the Seller.
    Each of the representations and warranties of the Seller set
    forth in Section 3.1 of the Receivables Purchase Agreement
    are true and correct in all material respects and the Transferor
    hereby remakes all such representations and warranties for the
    benefit of the Agent, each of the Investors and each
    Administrative Agent.

 

    Any document, instrument, certificate or notice delivered by the
    Transferor to any Conduit Investor, Administrative Agent or the
    Agent hereunder shall be deemed a representation and warranty by
    the Transferor.

 

    Section 3.2. Reaffirmation
    of Representations and Warranties by the Transferor. On
    each day that a Transfer is made hereunder, the Transferor, by
    accepting the proceeds of such Transfer, whether delivered to
    the Transferor pursuant to Section 2.2(a) or
    Section 2.5 hereof, shall be deemed to have certified that
    all representations and warranties described in Section 3.1
    hereof are correct on and as of such day as though made on and
    as of such day. Each Incremental Transfer shall be subject to
    the further conditions precedent that:

 

    (a) prior to the date of such Incremental Transfer, the
    Collection Agent shall have delivered to the Agent and each
    Administrative Agent, in form and substance satisfactory to the
    Agent and each Administrative Agent, a completed Investor Report
    dated within ten (10) days prior to the date of such
    Incremental Transfer, together with a listing by Primary Payor
    of all Receivables, and such additional information as may be
    reasonably requested by any Administrative Agent or the Agent;

 

    (b) on date of such Incremental Transfer, either
    (i) FMCH’s long-term public senior debt securities are
    rated as least B- by Standard & Poor’s and B3 by
    Moody’s, or if neither Standard & Poor’s nor
    Moody’s shall rate such securities, FMCH’s long-term
    senior debt shall have a deemed rating of at least B as
    determined by each Administrative Agent using its standard bond
    rating methodology, or (ii) FME KGaA’s long-term
    public senior debt securities are rated as least B- by
    Standard & Poor’s and B3 by Moody’s, or if
    neither Standard & Poor’s nor Moody’s shall
    rate such securities, FME KGaA’s long-term senior debt
    shall have deemed rating of at least B as determined by each
    Administrative Agent using its standard bond rating methodology,

 

    and the Transferor shall be deemed to have represented and
    warranted that such conditions precedent have been satisfied.

 

    Section 3.3. Representations
    and Warranties of the Collection Agent. The Collection
    Agent represents and warrants to the Agent, each Administrative
    Agent and each of the Investors that:

 

    (a) Corporate Existence and Power. The Collection
    Agent is a corporation duly organized, validly existing and in
    good standing under the laws of its jurisdiction of
    incorporation and has all corporate power and all material
    governmental licenses, authorizations, consents and approvals
    required to carry on its business in each jurisdiction in which
    its business is now conducted. The Collection Agent is duly
    qualified to do business in, and is in good standing in, every
    other jurisdiction in which the nature of its business requires
    it to be so qualified, except where the failure to be so
    qualified or in good standing would not have a Material Adverse
    Effect.

 

    (b) Corporate and Governmental Authorization;
    Contravention. The execution, delivery and performance by
    the Collection Agent of this Agreement are within the Collection
    Agent’s corporate powers, have been duly authorized by all
    necessary corporate action, require no action by or in respect
    of, or filing with, any Official Body or official thereof, and
    do not contravene, or constitute a default under, any provision
    of applicable law, rule or regulation (including, without
    limitation, any CHAMPUS/VA Regulation, any Medicaid Regulation
    or any Medicare Regulation) or of the Certificate of
    Incorporation or Bylaws of the Collection Agent or of any
    agreement, judgment, injunction, order, writ, decree or other
    instrument binding upon the Collection Agent or result in the
    creation or imposition of any Adverse Claim on the assets of the
    Collection Agent or any of its Subsidiaries.

 

    (c) Binding Effect. This Agreement constitutes the
    legal, valid and binding obligation of the Collection Agent,
    enforceable in accordance with its terms, subject to applicable
    bankruptcy, insolvency, moratorium or similar laws affecting the
    rights of creditors.

    

    31

 

    (d) Accuracy of Information. All information
    heretofore furnished by the Collection Agent to the Agent, any
    Investor or any Administrative Agent for the purposes of or in
    connection with this Agreement or any transaction contemplated
    hereby is, and all such information hereafter furnished by the
    Collection Agent to the Agent, any Investor or any
    Administrative Agent will be, true and accurate in every
    material respect, on the date such information is stated or
    certified.

 

    (e) Action, Suits. Except as set forth in
    Exhibit H, there are no actions, suits or proceedings
    pending, or to the knowledge of the Collection Agent threatened,
    against or affecting the Collection Agent or any Affiliate of
    the Collection Agent or their respect properties, in or before
    any court, arbitrator or other body, which may, individually or
    in the aggregate, have a Material Adverse Effect.

 

    (f) Nature of Receivables. Each Receivable included
    in the calculation of the Net Receivables Balance is not a
    Receivable of the type described in clauses (i) through
    (iii) of the definition of “Net Receivables
    Balance”.

 

    (g) Amount of Receivables. The Percentage Factor
    does not exceed the Maximum Percentage Factor.

 

    (h) Credit and Collection Policy. Since
    September 1, 2008, there have been no material changes in
    the Credit and Collection Policy other than as permitted
    hereunder. Since such date, no material adverse change has
    occurred in the overall rate of collection of the Receivables.

 

    (i) Collections and Servicing. Since
    September 1, 2008, there has been no material adverse
    change in the ability of the Collection Agent to service and
    collect the Receivables.

 

    (j) Not an Investment Company. The Collection Agent
    is not, and is not controlled by, an “investment
    company” within the meaning of the Investment Company Act
    of 1940, as amended, or is exempt from all provisions of such
    Act.

 

    (k) Special Accounts, Intermediate Concentration
    Accounts and Concentration Account. The names and addresses
    of all the Special Account Banks (and, if applicable, the
    Designated Account Agent in respect thereof), the Intermediate
    Concentration Account Banks and the Concentration Account Bank,
    together with the account numbers of the Special Accounts at
    such Special Account Banks, the Intermediate Concentration
    Accounts at such Intermediate Concentration Account Banks and
    the account number of the Concentration Account of the
    Transferor at the Concentration Account Bank, are specified in
    Exhibit C hereto (or at such other Special Account Banks,
    Intermediate Concentration Account Banks or Concentration
    Account Bank, with such other Special Accounts, Intermediate
    Concentration Accounts or Concentration Account or with such
    other Designated Account Agents as have been notified to the
    Agent in accordance with Section 5.2(e)).

 

    ARTICLE IV

    

 

    CONDITIONS
    PRECEDENT
    

 

    Section 4.1. Conditions
    to Closing. The effectiveness of this Agreement shall
    be subject to the conditions precedent that (i) all fees
    required to be paid on or prior to the date hereof pursuant to
    the Fee Letters or the separate renewal or up-front fee letters
    entered into between the Transferor and the respective
    Administrative Agents shall have been paid in full,
    (ii) ABN AMRO Bank N.V. shall have received payment in full
    of the Payout Amount under (and as defined in) the Amendment
    Agreement and (iii) each Administrative Agent (or, in the
    case of clause (n) below, the Administrative Agent(s) for
    the relevant Conduit Investor(s)) shall have received the
    following documents, instruments and agreements all of which
    shall be in a form and substance acceptable to each
    Administrative Agent:

 

    (a) A copy of the resolutions of the Board of Directors of
    the Transferor certified by its Secretary approving the
    execution, delivery and performance by the Transferor of this
    Agreement, the Receivables Purchase Agreement and the other
    Transaction Documents to be delivered by the Transferor
    hereunder or thereunder.

 

    (b) A copy of the resolutions of the Board of Directors of
    the Collection Agent certified by its Secretary approving the
    execution, delivery and performance by the Collection Agent of
    this Agreement and the other Transaction Documents to be
    delivered by the Collection Agent hereunder or thereunder.

 

    (c) The Certificates of Incorporation of the Transferor
    certified by the Secretary of the Transferor dated a date
    reasonably prior to the Closing Date.

 

    (d) The Certificate of Incorporation of the Collection
    Agent certified by the Secretary of the Collection Agent dated a
    date reasonably prior to the Closing Date.

    

    32

 

    (e) A Good Standing Certificate for the Transferor issued
    by the Secretary of State or a similar official of the
    Transferor’s jurisdiction of incorporation and certificates
    of qualification as a foreign corporation issued by the
    Secretaries of State or other similar officials of each
    jurisdiction where such qualification is material to the
    transactions contemplated by this Agreement and the other
    Transaction Documents, in each case, dated a date reasonably
    prior to the Closing Date.

 

    (f) A Good Standing Certificate for the Collection Agent
    issued by the Secretary of State or a similar official of the
    Collection Agent’s jurisdiction of incorporation and
    certificates of qualification as a foreign corporation issued by
    the Secretaries of State or other similar officials of each
    jurisdiction when such qualification is material to the
    transactions contemplated by this Agreement and the Receivables
    Purchase Agreement and the other Transaction Documents, in each
    case, dated a date reasonably prior to the Closing Date.

 

    (g) A Certificate of the Secretary of the Transferor
    substantially in the form of Exhibit L attached hereto.

 

    (h) A Certificate of the Secretary of the Collection Agent
    substantially in the form of Exhibit L attached hereto.

 

    (i) If requested by the Agent, copies of proper financing
    statements
    (Form UCC-1),
    dated a date reasonably near to the Closing Date naming the
    Transferor as the debtor in favor of the Agent, for the benefit
    of the Investors, as the secured party or other similar
    instruments or documents as may be necessary or in the
    reasonable opinion of the Agent desirable under the UCC of all
    appropriate jurisdictions or any comparable law to perfect the
    Agent’s undivided percentage interest in all Receivables
    and the Related Security and Collections relating thereto.

 

    (j) An opinion of Douglas G. Kott, Vice President/Deputy
    General Counsel for FMCH, NMC and each Transferring Affiliate,
    acting as counsel to FMCH, the Transferor, the Collection Agent
    and the Originating Entities, in the respective form attached in
    Exhibit K hereto.

 

    (k) An opinion of Arent Fox LLP special counsel to FME
    KGaA, FMCH, the Transferor and the Seller, covering certain
    bankruptcy and general corporate matters in the respective forms
    attached in Exhibit K hereto.

 

    (l) An executed copy of this Agreement and each of the
    other Transaction Documents to be executed by the Transferor,
    any Originating Entity or the Collection Agent.

 

    (m) Amendments to the Parent Agreement, the Receivables
    Purchase Agreement, the Transferring Affiliate Letter and the
    Concentration Account Agreement, in the respective forms
    attached hereto as Exhibit P, duly executed by each of the
    parties thereto.

 

    (n) To the extent requested by any Conduit Investor,
    confirmation from each Rating Agency rating the Commercial Paper
    of such Conduit Investor that the execution and delivery of this
    Agreement and the transactions contemplated hereby will not
    result in the reduction or withdrawal of the then current rating
    of the Commercial Paper issued by such Conduit Investor.

 

    (o) Drafts of (i) the agreed upon procedures report
    from KPMG in substantially the form attached as Exhibit T
    and (ii) the “not material weakness” report from
    KPMG in substantially the form attached as Exhibit U, in
    each case satisfactory to the Administrative Agents.

 

    (p) Such other documents, instruments, certificates and
    opinions as the Agent or any Administrative Agent shall
    reasonably request including each of the documents, instruments,
    certificates and opinion identified on the List of Closing
    Documents attached hereto as Exhibit S.

    

    33

 

    ARTICLE V

    

 

    COVENANTS
    

 

    Section 5.1. Affirmative
    Covenants of Transferor. At all times from the date
    hereof to the later to occur of (i) the Termination Date or
    (ii) the date on which the Net Investment has been reduced
    to zero, all accrued Discount and Servicing Fees shall have been
    paid in full and all other Aggregate Unpaids shall have been
    paid in full, in cash, unless each Administrative Agent shall
    otherwise consent in writing:

 

    (a) Financial Reporting. The Transferor will, and
    will cause the Seller and each of the Transferring Affiliates
    to, maintain, for itself and each of its respective
    Subsidiaries, a system of accounting established and
    administered in accordance with GAAP, and furnish to each
    Administrative Agent:

 

    (i) Annual Reporting. As soon as available, but in
    any event within ninety-five (95) days after the end of
    each fiscal year of the Transferor, financial statements for the
    Transferor, including a balance sheet as of the end of such
    period, the related statement of income, retained earnings,
    shareholders’ equity and cash flows for such year prepared
    by the Transferor in accordance with GAAP, all certified by one
    of its officers.

 

    (ii) Quarterly Reporting. As soon as available, but
    in any event within fifty (50) days after the end of each
    of the first three quarterly periods of the Transferor’s
    fiscal years, financial statements for the Transferor, including
    a balance sheet as at the close of each such period and a
    related statement of income and retained earnings for the period
    from the beginning of such fiscal year to the end of such
    quarter, all certified by one of its officers.

 

    In the case of each of the financial statements required to be
    delivered under clause (i) or (ii) above, such
    financial statement shall set forth in comparative form the
    figures for the corresponding period or periods of the preceding
    fiscal year or the portion of the fiscal year ending with such
    period, as applicable (but not for any period prior to
    September 27, 1996), in each case subject to normal
    recurring year-end audit adjustments. Each such financial
    statement shall be prepared in accordance with GAAP consistently
    applied.

 

    (iii) Compliance Certificate. Together with the
    financial statements required hereunder, a compliance
    certificate signed by the Transferor’s chief executive
    officer or its senior financial officer stating that
    (x) the attached financial statements have been prepared in
    accordance with GAAP and accurately reflect the financial
    condition of the Transferor and (y) to the best of such
    Person’s knowledge, no Termination Event or Potential
    Termination Event exists, or if any Termination Event or
    Potential Termination Event exists, stating the nature and
    status thereof and (z) such Person has reviewed each
    Investor Report prepared by the Collection Agent since the end
    of the last day of the immediately preceding monthly period of
    the Transferor’s fiscal year and the information upon which
    each such Investor Report was based and, based on such review,
    such Person has concluded that (1) the calculation of the
    Net Receivables Balance (including, without limitation, the
    calculation of each of the items described in clauses (i)
    through (iv) of the definition of “Net Receivables
    Balance”) by the Collection Agent in each such Investor
    Report is accurate and complete in all material respects and
    (2) each such Investor Report is otherwise accurate and
    complete in all material respects.

 

    (iv) Notice of Termination Events or Potential
    Termination Events. As soon as possible and in any event
    within two (2) days (or the next Business Day thereafter if
    such day is not a Business Day) after the occurrence of each
    Termination Event or each Potential Termination Event, a
    statement of the chief executive officer or the senior financial
    officer of the Transferor setting forth details of such
    Termination Event or Potential Termination Event and the action
    which the Transferor proposes to take with respect thereto.

 

    (v) Change in Credit and Collection Policy and Debt
    Ratings. Within ten (10) days after the date any
    material change in or amendment to the Credit and Collection
    Policy is made, a copy of the Credit and Collection Policy then
    in effect indicating such change or amendment.

 

    (vi) Credit and Collection Policy. Within ninety
    (90) days after the close of each of the Seller’s and
    the Transferor’s fiscal years, a complete copy of the
    Credit and Collection Policy then in effect.

 

    (vii) ERISA. Promptly after the filing or receiving
    thereof, copies of all reports and notices with respect to any
    Reportable Event (as defined in Article IV of ERISA) which
    the Transferor, the Seller or any ERISA Affiliate of the
    Transferor or the Seller files under ERISA with the Internal
    Revenue Service, the Pension Benefit Guaranty Corporation or the
    U.S. Department of Labor or which the Transferor, the

    

    34

 

    Seller or any ERISA Affiliates of the Transferor or the Seller
    receives from the Internal Revenue Service, the Pension Benefit
    Guaranty Corporation or the U.S. Department of Labor.

 

    (viii) Notices under Transaction Documents.
    Forthwith upon its receipt thereof, a copy of each notice,
    report, financial statement, certification, request for
    amendment, directive, consent, waiver or other modification or
    any other writing issued under or in connection with any other
    Transaction Document by any party thereto (including, without
    limitation, by the Transferor).

 

    (ix) Investigations and Proceedings. Unless
    prohibited by either (i) the terms of the subpoena, request
    for information or other document referred to below,
    (ii) law (including, without limitation, rules and
    regulations) or (iii) restrictions imposed by the
    U.S. federal or state government or any agency or
    instrumentality thereof and subject to the execution by the
    applicable Administrative Agent of a confidentiality agreement
    in form and substance satisfactory to both the Transferor and
    such Administrative Agent, as soon as possible and in any event
    (A) within three Business Days after the Transferor (or
    within five Business Days after any Originating Entity) receives
    any subpoena, request for information, or any other document
    relating to any possible violation by the Transferor or any
    Originating Entity of, or failure by the Transferor or any
    Originating Entity to comply with, any rule, regulation or
    statute from HHS or any other governmental agency or
    instrumentality, notice of such receipt and, if requested by the
    Agent, the information contained in, or copies of, such
    subpoena, request or other document, and (B) periodic
    updates and other management reports relating to the subpoenas,
    requests for information and other documents referred to in
    clause (A) above as may be reasonably requested by any
    Administrative Agent unless such updates or requests could
    reasonably be deemed a contravention or waiver of any available
    claim of legal privilege, or would otherwise materially impair
    available defenses, of the Transferor or any Originating Entity.

 

    (x) Other Information. Such other information
    (including non-financial information) as the Agent or any
    Administrative Agent may from time to time reasonably request
    with respect to the Seller, the Transferor, any party to the
    Parent Agreement, any Transferring Affiliate or any Subsidiary
    of any of the foregoing.

 

    (b) Conduct of Business. The Transferor
    (i) will carry on and conduct its business in substantially
    the same manner and in substantially the same fields of
    enterprise as it is presently conducted and do all things
    necessary to remain duly incorporated, validly existing and in
    good standing as a domestic corporation in its jurisdiction of
    incorporation and maintain all requisite authority to conduct
    its business in each jurisdiction in which its business is
    conducted and (ii) will cause each Originating Entity to do
    each of the foregoing in respect of such Originating Entity.

 

    (c) Compliance with Laws. The Transferor will, and
    will cause each Originating Entity to, comply with all laws,
    rules and regulations (including, without limitation, all
    CHAMPUS/VA Regulations, Medicaid Regulations and Medicare
    Regulations), and all orders, writs, judgments, injunctions,
    decrees or awards to which it or its respective properties may
    be subject.

 

    (d) Furnishing of Information and Inspection of
    Records. The Transferor will, and will cause each
    Originating Entity to, furnish to each Administrative Agent from
    time to time such information with respect to the Receivables as
    such Administrative Agent may reasonably request, including,
    without limitation, listings identifying the Obligor and the
    Outstanding Balance for each Receivable. The Transferor will,
    and will cause each Originating Entity to, at any time and from
    time to time during regular business hours permit any
    Administrative Agent, or its agents or representatives,
    (i) to examine and make copies of and take abstracts from
    Records and (ii) to visit the offices and properties of the
    Transferor or such Originating Entity, as applicable, for the
    purpose of examining such Records, and to discuss matters
    relating to Receivables or the Transferor’s or such
    Originating Entity’s performance hereunder and under the
    other Transaction Documents to which such Person is a party with
    any of the officers, directors, employees or independent public
    accountants of the Transferor or such Originating Entity, as
    applicable, having knowledge of such matters.

 

    (e) Keeping of Records and Books of Account. The
    Transferor will, and will cause each Originating Entity to,
    maintain and implement administrative and operating procedures
    (including, without limitation, an ability to recreate records
    evidencing Receivables in the event of the destruction of the
    originals thereof), and keep and maintain, all documents, books,
    records and other information reasonably necessary or advisable
    for the collection of all Receivables (including, without
    limitation, records adequate to permit the daily identification
    of each new Receivable and all Collections of and adjustments to
    each existing Receivable). The Transferor will, and will cause
    each Originating Entity to, give each Administrative Agent
    notice of any

    

    35

 

    material change in the administrative and operating procedures
    of the Transferor or such Originating Entity, as applicable,
    referred to in the previous sentence.

 

    (f) Performance and Compliance with Receivables and
    Contracts. The Transferor, at its expense, will, and will
    cause each Originating Entity to, timely and fully perform and
    comply with all material provisions, covenant and other promises
    required to be observed by the Transferor or such Originating
    Entity under the Contracts related to the Receivables.

 

    (g) Credit and Collection Policies. The Transferor
    will, and will cause each Originating Entity to, comply in all
    material respects with the Credit and Collection Policy in
    regard to each Receivable and the related Contract.

 

    (h) Special Accounts; Intermediate Concentration
    Accounts; Concentration Account. The Transferor shall
    (i) cause each Originating Entity to establish and maintain
    Special Accounts with Special Account Banks, or to engage a
    Designated Account Agent to maintain a Special Account with a
    Special Account Bank on its behalf, (ii) instruct, and
    cause each Originating Entity to instruct, all Obligors to cause
    all collections to be deposited directly into a Special Account,
    (iii) report, and cause each Originating Entity to report,
    on each banking day to the Concentration Account Bank, the
    amount of all Collections on deposit on such banking day in the
    Special Accounts at each Special Account Bank or, if an
    Intermediate Concentration Account has been established at such
    Special Account Bank, the amount of all Collections on deposit
    on such banking day in such Intermediate Concentration Account,
    (iv) establish and maintain a Concentration Account with
    the Concentration Account Bank, (v) instruct, and cause
    each Originating Entity to instruct (or to cause the applicable
    Designated Account Agent to instruct), each Special Account Bank
    to transfer to the Concentration Account or an Intermediate
    Concentration Account prior to the close of business on such
    banking day all Collections on deposit during such banking day
    in the Special Accounts at such Special Account Bank,
    (vi) instruct each Intermediate Concentration Account Bank
    to transfer to the Concentration Account prior to the close of
    business on such banking day all Collections on deposit during
    such banking day in the Intermediate Concentration Accounts at
    such Intermediate Concentration Account Banks and
    (vii) instruct the Concentration Account Bank to give to
    each Special Account Bank on each banking day notice to transfer
    to the Concentration Account all Collections on deposit during
    such banking day in the Special Accounts at such Special Account
    Bank (or, if an Intermediate Concentration Account has been
    established at such Special Account Bank, in the Intermediate
    Concentration Account at such Special Account Bank);
    provided, however, that if the Collections on
    deposit in any Special Account during such banking day shall be
    less than $20,000.00 (the “Minimum Amount”),
    the Special Account Bank shall transfer such Collections to the
    Concentration Account or the applicable Intermediate
    Concentration Account on the next succeeding banking day on
    which Collections in such Special Account first exceed the
    Minimum Amount. With respect to any Special Account that is
    located at or maintained by a Bank Investor hereunder, the
    Transferor shall, by not later than the date that occurs six
    months after the Original Closing Date, cause the applicable
    Originating Entity to close such Special Account and shall
    instruct, and shall cause each applicable Originating Entity to
    instruct, all Obligors theretofore remitting payments to such
    Special Account to remit all future payments on Receivables and
    Related Security to a Special Account located at and maintained
    by a financial institution that is not a Bank Investor.

 

    “(i) Collections Received. The Transferor shall, and
    shall cause each Originating Entity to, segregate and hold in
    trust, and deposit, immediately, but in any event not later than
    the day that occurs forty-eight (48) hours thereafter (or,
    if such day is not a Business Day, the next Business Day) after
    its receipt thereof, to either the Intermediate Concentration
    Account or the Concentration Account all Collections received
    from time to time by the Transferor or such Originating Entity,
    as the case may be.”

 

    (j) Sale Treatment. The Transferor will not, and
    will not permit any Originating Entity to, account for
    (including for accounting and tax purposes), or otherwise treat,
    the transactions contemplated by the Receivables Purchase
    Agreement, the Transferring Affiliate Letter or the BMA Transfer
    Agreement in any manner other than as a sale of Receivables by
    the applicable Originating Entity to the Seller or Transferor,
    as applicable. In addition, the Transferor shall, and shall
    cause each Originating Entity to, disclose (in a footnote or
    otherwise) in all of its respective financial statements
    (including any such financial statements consolidated with any
    other Persons’ financial statements) the existence and
    nature of the transaction contemplated hereby, by the
    Receivables Purchase Agreement, by the Transferring Affiliate
    Letter and by the BMA Transfer Agreement, and the interest of
    the Transferor (in the case of the Seller’s financial
    statements), and the Agent, on behalf of the Investors, in the
    Affected Assets.

 

    (k) Separate Business. The Transferor shall at all
    times (a) to the extent the Transferor’s office is
    located in the offices of any Parent Group Member, pay fair
    market rent for its executive office space located in the

    

    36

 

    offices of such Parent Group Member, (b) have at all times
    at least one member of its board of directors which is not and
    has never been an employee, officer or director of any Parent
    Group Member or of any major creditor of any Parent Group Member
    and is a person who is and has experience with asset
    securitization, (c) maintain the Transferor’s books,
    financial statements, accounting records and other corporate
    documents and records separate from those of any Parent Group
    Member or any other entity, (d) not commingle the
    Transferor’s assets with those of any Parent Group Member
    or any other entity, (e) act solely in its corporate name
    and through its own authorized officers and agents,
    (f) make investments directly or by brokers engaged and
    paid by the Transferor its agents (provided that if any such
    agent is an Affiliate of the Transferor it shall be compensated
    at a fair market rate for its services), (g) separately
    manage the Transferor’s liabilities from those of the
    Parent Group and pay its own liabilities, including all
    administrative expenses, from its own separate assets, except
    that the Seller may pay the organizational expenses of the
    Transferor, and (h) pay from the Transferor’s assets
    all obligations and indebtedness of any kind incurred by the
    Transferor. The Transferor shall abide by all corporate
    formalities, including the maintenance of current minute books,
    and the Transferor shall cause its financial statements to be
    prepared in accordance with GAAP in a manner that indicates the
    separate existence of the Transferor and its assets and
    liabilities. The Transferor shall (i) pay all its
    liabilities, (ii) not assume the liabilities of any Parent
    Group Member, (iii) not lend funds or extend credit to any
    Parent Group Member except pursuant to the Receivables Purchase
    Agreement in connection with the purchase of Receivables
    thereunder and (iv) not guarantee the liabilities of any
    Parent Group Member. The officers and directors of the
    Transferor (as appropriate) shall make decisions with respect to
    the business and daily operations of the Transferor independent
    of and not indicated by any controlling entity. The Transferor
    shall not engage in any business not permitted by its
    Certificate of Incorporation as in effect on the Closing Date.
    The Transferor shall, in addition to the foregoing, take such
    other actions as are necessary on its part to ensure that the
    facts and assumptions set forth in the opinions issued by Arent
    Fox LLP, as counsel for the Transferor, in connection with the
    closing or initial Transfer under this Agreement and relating to
    “non-consolidation” issues and “true sale”
    issues, and in the certificates accompanying such opinions,
    remain true and correct in all material respects at all times.

 

    (l) Corporate Documents. The Transferor shall only
    amend, alter, change or repeal any provision of the Third,
    Fifth, Seventh, Tenth, Eleventh or Twelfth Article of its
    Certificate of Incorporation with the prior written consent of
    each Administrative Agent.

 

    (m) Payment to the Originating Entities. With
    respect to any Receivable purchased by the Transferor from the
    Seller, such sale shall be effected under, and in strict
    compliance with the terms of, the Receivables Purchase
    Agreement, including, without limitation, the terms relating to
    the amount and timing of payments to be made to the Seller by
    the Transferor in respect of the purchase price for such
    Receivable. With respect to any Receivable purchased by the
    Seller from any Transferring Affiliate, the Transferor shall
    cause such sale to be effected under, and in strict compliance
    with the terms of, the Transferring Affiliate Letter and the BMA
    Transfer Agreement, as applicable, including, without
    limitation, the terms relating to the amount and timing of
    payments to be made to each Transferring Affiliate in respect of
    the purchase price for such Receivable.

 

    (n) Performance and Enforcement of the Receivables
    Purchase Agreement, etc. The Transferor shall timely perform
    the obligations required to be performed by the Transferor, and
    shall vigorously enforce the rights and remedies accorded to the
    Transferor, under the Receivables Purchase Agreement. The
    Transferor shall cause the Seller to timely perform the
    obligations required to be performed by the Seller, and shall
    cause the Seller to vigorously enforce the rights and remedies
    accorded to the Seller, under each of the Transferring Affiliate
    Letter and the BMA Transfer Agreement. The Transferor shall take
    all actions to perfect and enforce its rights and interests (and
    the rights and interests of the Agent, each Administrative Agent
    and each of the Investors, as assignees of the Transferor) under
    the Receivables Purchase Agreement as any Administrative Agent
    may from time to time reasonably request, including, without
    limitation, making claims to which it may be entitled under any
    indemnity, reimbursement or similar provision contained in the
    Receivables Purchase Agreement. The Transferor shall cause the
    Seller to take all actions to perfect and enforce the
    Seller’s rights and interests (and the rights and interests
    of the Transferor, the Agent, the Administrative Agent and each
    of the Investors, as assignees of the Seller) under the
    Transferring Affiliate Letter or the BMA Transfer Agreement as
    any Administrative Agent may from time to time reasonably
    request, including, without limitation, making claims to which
    it may be entitled under any indemnity, reimbursement or similar
    provision contained in the Transferring Affiliate Letter or the
    BMA Transfer Agreement.

 

    Section 5.2. Negative
    Covenants of the Transferor. At all times from the date
    hereof to the later to occur of (i) the Termination Date or
    (ii) the date on which the Net Investment has been reduced
    to zero, all accrued Discount

    

    37

 

    and Servicing Fees shall have been paid in full and all other
    Aggregate Unpaids shall have been paid in full, in cash, unless
    each Administrative Agent shall otherwise consent in writing:

 

    (a) No Sales, Liens, Etc. Except as otherwise
    provided herein and in the Receivables Purchase Agreement, the
    Transferor will not, and will not permit any Originating Entity
    to, sell, assign (by operation of law or otherwise) or otherwise
    dispose of, or create or suffer to exist any Adverse Claim upon
    (or the filing of any financing statement) or with respect to
    (x) any of the Affected Assets, (y) any inventory or
    goods, the sale of which may give rise to a Receivable or any
    Receivable or related Contract, or (z) any Special Account,
    any Intermediate Concentration Account or the Concentration
    Account or any other account to which any Collections of any
    Receivable are sent, or assign any right to receive income in
    respect thereof.

 

    (b) No Extension or Amendment of Receivables. Except
    as otherwise permitted in Section 6.2 hereof, the
    Transferor will not, and will not permit any Originating Entity
    to, extend, amend or otherwise modify the terms of any
    Receivable, or amend, modify or waive any term or condition of
    any Contract related thereto.

 

    (c) No Change in Business or Credit and Collection
    Policy. The Transferor will not, and will not permit any
    Originating Entity to, make any change in the character of its
    business or in the Credit and Collection Policy, which change
    would, in either case, impair the collectibility of any
    Receivable or otherwise have a Material Adverse Effect.

 

    (d) No Mergers, Etc. The Transferor will not, and
    will not permit any Originating Entity to, merge with or into or
    consolidate with or into, or convey, transfer, lease or
    otherwise dispose of (whether in one transaction or in a series
    of transactions), all or substantially all of its assets
    (whether now owned or hereafter acquired and except as
    contemplated in the Transaction Documents) to any Person, except
    that (i) any Transferring Affiliate may merge or
    consolidate with any other Transferring Affiliate and
    (ii) the Seller may merge or consolidate with any other
    Person if, but only if, (x) immediately after giving effect
    to such merger or consolidation, no Termination Event or
    Potential Termination Event would exist and (y) if the
    Seller is not the surviving corporation, each Administrative
    Agent shall have received a written agreement, in form and
    substance satisfactory to such Administrative Agent, executed by
    the Person resulting from such merger or consolidation, under
    which agreement such Person shall become the Seller and
    Collection Agent, and shall assume the duties, obligations and
    liabilities of the Seller, under the Receivables Purchase
    Agreement, this Agreement (in its capacity as Collection Agent
    hereunder), the Special Account Letters and each other
    Transaction Document to which the Seller is party (whether in
    its individual capacity or as Collection Agent), together with
    the documents relating to the Seller of the kind delivered by or
    on behalf of the Seller pursuant to Section 3.1.

 

    (e) Change in Payment Instructions to Obligors, Special
    Account Banks, Designated Account Agents and Concentration
    Account. The Transferor will not, and will not permit any
    Originating Entity to:

 

    (i) add or terminate any bank as a Special Account Bank
    from those listed in Exhibit C hereto, or make any change
    in its instructions to Obligors regarding payments to be made to
    any Special Account Bank; provided that the Transferor
    may permit the (A) addition of any bank as a Special
    Account Bank for purposes of this Agreement at any time
    following delivery to each Administrative Agent of written
    notice of such addition and a Special Account Letter duly
    executed by such bank, and (B) termination of any Special
    Account Bank at any time following delivery to each
    Administrative Agent of written notice of such termination and
    evidence satisfactory to each Administrative Agent that the
    affected Obligors shall have been instructed to remit all
    subsequent Collections to another Special Account; or

 

    (ii) add, terminate or change the Concentration Account, or
    any bank as the Concentration Account Bank, from that listed in
    Exhibit C hereto, or make any change in the instructions
    contained in any Special Account Letter or any change in the
    instructions to the Concentration Account Bank; provided,
    however, that the Transferor may terminate the then
    existing Concentration Account Bank and appoint a new
    Concentration Account Bank if, prior to such termination and
    appointment, each Administrative Agent shall receive
    (i) ten Business Days’ prior notice of such
    termination and appointment and (ii) prior to the effective
    date of such termination and appointment, (x) for each
    Special Account where the Special Account Bank was previously
    remitting Collections directly to the Concentration Account, an
    executed copy of a Special Account Letter (executed by the
    applicable Originating Entity and the applicable Special Account
    Bank) instructing such Special Account Bank to transfer to the
    new Concentration Account or an Intermediate Concentration
    Account prior to the close of business on each banking day all
    Collections on deposit during such banking day in such Special
    Account; (y) for each Intermediate Concentration Account,
    an executed amendment to the applicable Intermediate
    Concentration Account Agreement (executed by the Transferor and
    the applicable Intermediate Concentration Account Bank)
    instructing such Intermediate Concentration Account Bank to
    transfer to the new Concentration Account

    

    38

 

    prior to the close of business on each banking day all
    Collections on deposit during such banking day in such
    Intermediate Concentration Account, and (z) a copy of a
    Concentration Account Agreement executed by the new
    Concentration Account Bank and the Transferor; or

 

    (iii) add or terminate any Person as a Designated Account
    Agent from those listed in Exhibit C hereto, or make any
    change in its instructions to such Designated Account Agent
    regarding the handling of the Collections in the applicable
    Special Account; provided that the Transferor may permit
    the (A) addition of any Person that satisfies the
    requirements set forth herein of a “Designated Account
    Agent” as a Designated Account Agent for purposes of this
    Agreement at any time following delivery to each Administrative
    Agent of written notice of such addition and an Account Agent
    Agreement duly executed by such Person, and (B) termination
    of any Designated Account Agent at any time following delivery
    to each Administrative Agent of written notice of such
    termination and evidence satisfactory to each Administrative
    Agent that either an Originating Entity or a new Designated
    Account Agent shall have been added in accordance with the terms
    of this Agreement to succeed such terminated Designated Account
    Agent in respect of the applicable Special Account or the
    affected Obligors shall have been instructed to remit all
    subsequent Collections to another Special Account; or

 

    (iv) add, terminate or change any Intermediate
    Concentration Account, or any bank as an Intermediate
    Concentration Account Bank, or make any change in the
    instructions to any Intermediate Concentration Account Bank;
    provided, however, that the Transferor may
    terminate any then existing Intermediate Concentration Account
    Bank or appoint a new Intermediate Concentration Account Bank
    if, prior to such termination or appointment, each
    Administrative Agent shall receive (i) ten Business
    Days’ prior notice of such termination or appointment and
    (ii) prior to the effective date of such termination or
    appointment, (x) executed copies of Special Account Letters
    (in each case, executed by the applicable Originating Entity and
    the applicable Special Account Bank with which the Intermediate
    Concentration Account that is being terminated or added was or
    is to be maintained) instructing the Special Account Bank to
    transfer to the new Intermediate Concentration Account at such
    Special Account Bank or directly to the Concentration Account,
    in either case prior to the close of business on each banking
    day, all Collections on deposit during such banking day in the
    Special Accounts at such Special Account Bank, and (y) in
    the case of the addition of a new Intermediate Concentration
    Account, a copy of an Intermediate Concentration Account
    Agreement executed by the new Intermediate Concentration Account
    Bank and the Transferor; and provided, further,
    that the Transferor may change its instructions to any
    Intermediate Concentration Account Bank as and to the extent
    required pursuant to clause (ii) above in connection with
    the establishment of any new Concentration Account.

 

    (f) Deposits to Special Accounts and the Concentration
    Account. The Transferor will not, and will not permit any of
    the Originating Entities or Designated Account Agents to,
    deposit or otherwise credit, or cause or permit to be so
    deposited or credited, to any Special Account, any Intermediate
    Concentration Account or the Concentration Account cash or cash
    proceeds other than Collections of Receivables.

 

    (g) Change of Name, Etc. The Transferor will not,
    and will not permit any Originating Entity to, change its name,
    identity or structure or the location of its chief executive
    office or jurisdiction of organization, unless at least
    10 days prior to the effective date of any such change the
    Transferor delivers to each Administrative Agent (i) such
    documents, instruments or agreements, executed by the Transferor
    and/or the
    affected Originating Entities, as are necessary to reflect such
    change and to continue the perfection of the Agent’s
    ownership interests or security interest in the Affected Assets
    and (ii) new or revised Special Account Letters executed by
    the Special Account Banks which reflect such change and enable
    the Agent to continue to exercise its rights contained in
    Section 2.8 hereof. The Transferor will not, and will not
    permit any Originating Entity to, change its jurisdiction of
    organization to a jurisdiction other than a State within the
    United States.

 

    (h) Amendment to Receivables Purchase Agreement,
    Etc.. The Transferor will not, and will not permit any
    Originating Entity to, (i) amend, modify, or supplement the
    Receivables Purchase Agreement, the Transferring Affiliate
    Letter, the BMA Transfer Agreement or any instrument, document
    or agreement executed in connection therewith (collectively the
    “Initial Transfer Documents”), (ii) terminate or
    cancel any Initial Transfer Document, (iii) issue any
    consent or directive under any Initial Transfer Document,
    (iv) undertake any enforcement proceeding in respect of any
    of the Initial Transfer Documents, or (v) waive, extend the
    time for performance or grant any indulgence in respect of any
    provision of any Initial Transfer Document, in each case except
    with the prior written consent of the Agent and each
    Administrative Agent; nor shall the Transferor take, or permit
    any Originating Entity to take, any other action under any of
    the Initial Transfer Documents that shall have a material
    adverse affect on the Agent, any Administrative Agent or any
    Investor or which is inconsistent with the terms of this
    Agreement.

    

    39

 

    (i) Other Debt. Except as provided for herein, the
    Transferor will not create, incur, assume or suffer to exist any
    indebtedness whether current or funded, or any other liability
    other than (i) indebtedness of the Transferor representing
    fees, expenses and indemnities arising hereunder or under the
    Receivables Purchase Agreement for the purchase price of the
    Receivables under the Receivables Purchase Agreement, and
    (ii) other indebtedness incurred in the ordinary course of
    its business in an amount not to exceed $50,000 at any time
    outstanding.

 

    (j) ERISA Matters. The Transferor will not, and will
    not permit any Originating Entity to, (i) engage or permit
    any of its respective ERISA Affiliates to engage in any
    prohibited transaction (as defined in Section 4975 of the
    Code and Section 406 of ERISA) for which an exemption is
    not available or has not previously been obtained from the
    U.S. Department of Labor; (ii) permit to exist any
    accumulated funding deficiency (as defined in
    Section 302(a) of ERISA and Section 412(a) of the
    Code) or funding deficiency with respect to any Benefit Plan
    other than a Multiemployer Plan; (iii) fail to make any
    payments to any Multiemployer Plan that the Transferor, such
    Originating Entity or any ERISA Affiliate thereof is required to
    make under the agreement relating to such Multiemployer Plan or
    any law pertaining thereto; (iv) terminate any Benefit Plan
    so as to result in any liability; or (v) permit to exist
    any occurrence of any reportable event described in
    Title IV of ERISA which represents a material risk of a
    liability to the Transferor, such Originating Entity or any
    ERISA Affiliate thereof under ERISA or the Code, if such
    prohibited transactions, accumulated funding deficiencies,
    payments, terminations and reportable events occurring within
    any fiscal year of the Transferor, in the aggregate, involve a
    payment of money or an incurrence of liability by the
    Transferor, any Originating Entity or any ERISA Affiliate
    thereof, in an amount in excess of $500,000.

 

    Section 5.3. Affirmative
    Covenants of the Collection Agent. At all times from
    the date hereof to the later to occur of (i) the
    Termination Date or (ii) the date on which the Net
    Investment has been reduced to zero, all accrued Discount and
    Servicing Fees shall have been paid in full and all other
    Aggregate Unpaids shall have been paid in full, in cash, unless
    each Administrative Agent shall otherwise consent in writing.

 

    (a) Conduct of Business. The Collection Agent will
    carry on and conduct its business in substantially the same
    manner and in substantially the same fields of enterprise as it
    is presently conducted and do all things necessary to remain
    duly incorporated, validly existing and in good standing as a
    domestic corporation in its jurisdiction of incorporation and
    maintain all requisite authority to conduct its business in each
    jurisdiction in which its business is conducted.

 

    (b) Compliance with Laws. The Collection Agent will
    comply with all laws, rules and regulations (including, without
    limitation, all CHAMPUS/VA Regulations, Medicaid Regulations and
    Medicare Regulations), and all orders, writs, judgments,
    injunctions, decrees or awards to which it or its respective
    properties may be subject.

 

    (c) Furnishing of Information and Inspection of
    Records. The Collection Agent will furnish to each
    Administrative Agent from time to time such information with
    respect to the Receivables as such Administrative Agent may
    reasonably request, including, without limitation, listings
    identifying the Obligor and the Outstanding Balance for each
    Receivable. The Collection Agent will, at any time and from time
    to time during regular business hours permit any Administrative
    Agent, or its agents or representatives, (i) to examine and
    make copies of and take abstracts from all Records and
    (ii) to visit the offices and properties of the Collection
    Agent for the purpose of examining such records, and to discuss
    matters relating to Receivables or the Transferor’s, the
    Originating Entities’ or the Collection Agent’s
    performance hereunder and under the other Transaction Documents
    to which such Person is a party with any of the officers,
    directors, employees or independent public accountants of the
    Collection Agent having knowledge of such matters.

 

    (d) Keeping of Records and Books of Account. The
    Collection Agent will maintain and implement administrative and
    operating procedures (including, without limitation, an ability
    to recreate records evidencing Receivables in the event of the
    destruction of the originals thereof), and keep and maintain,
    all documents, books, records and other information reasonably
    necessary or advisable for the collection of all Receivables
    (including, without limitation, records adequate to permit the
    daily identification of each new Receivable and all Collections
    of and adjustments to each existing Receivable). The Collection
    Agent will give each Administrative Agent notice of any material
    change in the administrative and operating procedures of the
    Collection Agent referred to in the previous sentence.

 

    (e) Notice of Agent’s Interest. The Collection
    Agent shall cause its master data processing records, computer
    tapes, files and other documents or instruments provided to,
    developed by or otherwise maintained by the Collection Agent in
    connection with any Transfer or otherwise for purposes of the
    transactions

    

    40

 

    contemplated in this Agreement to disclose conspicuously the
    Transferor’s ownership of the Receivables and the
    Agent’s interest therein.

 

    (f) Credit and Collection Policies. The Collection
    Agent will comply in all material respects with the Credit and
    Collection Policy in regard to each Receivable and the related
    Contract.

 

    (g) Collections. The Collection Agent shall instruct
    all Obligors to cause all Collections to be deposited directly
    to a Special Account and shall take, or omit to take, all
    actions in respect of Obligors, the Special Account Banks,
    Intermediate Concentration Account Banks and the Concentration
    Account Bank solely in a manner that is consistent with the
    terms of this Agreement, including, without limitation,
    Sections 2.8, 5.1(h), 5.2(e) and 5.2(f) hereof.

 

    (h) Collections Received. The Collection Agent shall
    segregate and hold in trust, and deposit, immediately, but in
    any event not later than the day that occurs forty-eight
    (48) hours thereafter (or, if such day is not a Business
    Day, the next Business Day) after its receipt thereof, either to
    the Intermediate Concentration Account or to the Concentration
    Account all Collections received from time to time by the
    Collection Agent.

 

    Section 5.4. Negative
    Covenants of the Collection Agent. At all times from
    the date hereof to the later to occur of (i) the
    Termination Date or (ii) the date on which the Net
    Investment has been reduced to zero, all accrued Discount and
    Servicing Fees shall have been paid in full and all other
    Aggregate Unpaids shall have been paid in full, in cash, unless
    each Administrative Agent shall otherwise consent in writing:

 

    (a) No Extension or Amendment of Receivables. Except
    as otherwise permitted in Section 6.2 hereof, the
    Collection Agent will not extend, amend or otherwise modify the
    terms of any Receivable, or amend, modify or waive any term or
    condition of any Contract related thereto.

 

    (b) No Change in Business or Credit and Collection
    Policy. The Collection Agent will not make any change in the
    character of its business or in the Credit and Collection
    Policy, which change would, in either case, impair the
    collectibility of any Receivable or otherwise have a Material
    Adverse Effect.

 

    (c) No Mergers, Etc. Except as otherwise permitted
    under Section 5.2(d), the Collection Agent will not
    (i) consolidate or merge with or into any other Person, or
    (ii) sell, lease or transfer all or substantially all of
    its assets to any other Person.

 

    (d) Deposits to Accounts. The Collection Agent will
    not deposit or otherwise credit, or cause or permit to be so
    deposited or credited, to any Special Account or Concentration
    Account cash or cash proceeds other than Collections of
    Receivables.

 

    ARTICLE VI

    

 

    ADMINISTRATION
    AND COLLECTION
    

 

    Section 6.1. Appointment
    of Collection Agent. The servicing, administering and
    collection of the Receivables shall be conducted by such Person
    (the “Collection Agent”) so designated from
    time to time in accordance with this Section 6.1. Until the
    Agent gives notice to the Transferor of the designation of a new
    Collection Agent, NMC is hereby designated as, and hereby agrees
    to perform the duties and obligations of, the Collection Agent
    pursuant to the terms hereof. The Collection Agent may not
    delegate any of its rights, duties or obligations hereunder, or
    designate a substitute Collection Agent, without the prior
    written consent of each Administrative Agent; provided
    that the Collection Agent may from time to time delegate to any
    Originating Entity such of its rights, duties and obligations
    hereunder as relate to the servicing, administering and
    collection of the Receivables originated by such Originating
    Entity; provided further that (i) any such
    delegation shall be terminated upon the replacement of the
    Collection Agent hereunder and (ii) the Collection Agent
    shall continue to remain solely liable for the performance of
    the duties as Collection Agent hereunder notwithstanding any
    such delegation hereunder. The Agent may, and upon the direction
    of the Majority Investors the Agent shall, after the occurrence
    of a Collection Agent Default or any other Termination Event
    designate as Collection Agent any Person (including itself) to
    succeed NMC or any successor Collection Agent, on the conditions
    in each case that any such Person so designated shall agree to
    perform the duties and obligations of the Collection Agent
    pursuant to the terms hereof and such designation of such Person
    is permitted by applicable law (including, without limitation,
    applicable CHAMPUS/VA Regulations, Medicaid Regulations and
    Medicare Regulations) or any order of a court of competent
    jurisdiction. The Agent may notify any Obligor as to the
    ownership interest therein that shall have been transferred to
    the Transferor and, except as otherwise provided hereunder, as
    to the Transferred Interest hereunder.

    

    41

 

    Section 6.2. Duties
    of Collection Agent.

 

    (a) The Collection Agent shall take or cause to be taken
    all such action as may be necessary or advisable to collect each
    Receivable from time to time, all in accordance with applicable
    laws, rules and regulations (including, without limitation, all
    CHAMPUS/VA Regulations, Medicaid Regulations and Medicare
    Regulations), with reasonable care and diligence, and in
    accordance with the Credit and Collection Policy. Each of the
    Transferor, the Agent, the Administrative Agents and the
    Investors hereby appoints as its agent the Collection Agent,
    from time to time designated pursuant to Section 6.1
    hereof, to enforce its respective rights and interests in and
    under the Affected Assets. To the extent permitted by applicable
    law, the Transferor hereby grants to any Collection Agent
    appointed hereunder an irrevocable power of attorney to take any
    and all steps in the Transferor’s
    and/or any
    Originating Entity’s name and on behalf of the Transferor
    necessary or desirable, in the reasonable determination of the
    Collection Agent, to collect all amounts due under any and all
    Receivables, including, without limitation, endorsing the
    Transferor’s
    and/or any
    Originating Entity’s name on checks and other instruments
    representing Collections and enforcing such Receivables and the
    related Contracts. The Transferor represents and warrants that
    the foregoing power of attorney, in the case of any Originating
    Entity, has been duly granted to the Transferor under the
    Receivables Purchase Agreement and the Transferor is authorized
    under the Receivables Purchase Agreement, to the extent
    permitted by applicable law, to authorize the Collection Agent
    hereunder to exercise such power. The Collection Agent shall set
    aside for the account of the Transferor and the Agent (for the
    benefit of the Investors) their respective allocable shares of
    the Collections of Receivables in accordance with
    Sections 2.5 and 2.6 hereof. The Collection Agent shall
    segregate and deposit to each Administrative Agent’s
    account such Administrative Agent’s allocable share of
    Collections of Receivables when required pursuant to
    Article II hereof. So long as no Termination Event shall
    have occurred and be continuing, the Collection Agent may, in
    accordance with the Credit and Collection Policy, extend the
    maturity or adjust the Outstanding Balance of any Defaulted
    Receivable as the Collection Agent may determine to be
    appropriate to maximize Collections thereof; provided,
    however, that such extension or adjustment shall not
    alter the status of such Receivable as a Defaulted Receivable.
    The Transferor shall deliver to the Collection Agent and the
    Collection Agent shall hold in trust for the Transferor, and the
    Agent, on behalf of the Investors, in accordance with their
    respective interests, all Records which evidence or relate to
    Receivables or Related Security. Notwithstanding anything to the
    contrary contained herein, the Agent shall have the absolute and
    unlimited right to direct the Collection Agent (whether the
    Collection Agent is NMC or any other Person) to commence or
    settle any legal action to enforce collection of any Receivable
    or to foreclose upon or repossess any Related Security. The
    Collection Agent shall not make the Agent, any Administrative
    Agent or any of the Investors a party to any litigation without
    the prior written consent of such Person.

 

    (b) The Collection Agent shall, as soon as practicable
    following receipt thereof, turn over to the Transferor any
    collections of any indebtedness of any Person which is not on
    account of a Receivable. If the Collection Agent is not NMC or
    an Affiliate thereof, the Collection Agent, by giving three
    Business Days’ prior written notice to the Agent, may
    revise the percentage used to calculate the Servicing Fee so
    long as the revised percentage will not result in a Servicing
    Fee that exceeds 110% of the reasonable and appropriate out-of
    pocket costs and expenses of such Collection Agent incurred in
    connection with the performance of its obligations hereunder as
    documented to the reasonable satisfaction of each Administrative
    Agent, provided, however, that at any time after
    the Percentage Factor equals or exceeds 98%, any compensation to
    the Collection Agent in excess of the Servicing Fee initially
    provided for herein shall be an obligation of the Transferor and
    shall not be payable, in whole or in part, from the Collections
    allocated to or for the benefit of any of the Investors
    hereunder. The Collection Agent, if other than NMC, shall as
    soon as practicable upon demand, deliver to the Transferor all
    Records in its possession which evidence or relate to
    indebtedness of an Obligor which is not a Receivable.

 

    (c) On or before September 30 of each calendar year, the
    Collection Agent shall cause a firm of independent public
    accountants (who may also render other services to the
    Collection Agent, the Transferor, the Seller or any Affiliates
    of any of the foregoing), or such other Person as may be
    approved by each Administrative Agent (any of the foregoing
    being an “Auditor”), to furnish a report to each
    Administrative Agent in accordance with the procedures set forth
    on Exhibit T.

 

    (d) Notwithstanding anything to the contrary contained in
    this Article VI, the Collection Agent, if not the
    Transferor or NMC, shall have no obligation to collect, enforce
    or take any other action described in this Article VI with
    respect to any indebtedness that is not included in the
    Transferred Interest other than to deliver to the Transferor the
    collections and documents with respect to any such indebtedness
    as described in Section 6.2 (b) hereof.

    

    42

 

    Section 6.3. Right
    After Designation of New Collection Agent. At any time
    following the designation of a Collection Agent (other than the
    Transferor, the Seller or any Affiliate of the Transferor or the
    Seller) pursuant to Section 6.1 hereof:

 

    (i) The Agent may direct that payment of all amounts
    payable under any Receivable be made directly to the Agent or
    its designee.

 

    (ii) The Transferor shall, at the Agent’s request and
    at the Transferor’s expense, give notice of the
    Agent’s, the Transferor’s
    and/or the
    Bank Investors’ ownership of Receivables to each Obligor
    and direct that payments be made directly to the Agent or its
    designee.

 

    (iii) The Transferor shall, at the Agent’s request,
    (A) assemble all of the Records, and shall make the same
    available to the Agent or its designee at a place selected by
    the Agent or its designee, and (B) segregate all cash,
    checks and other instruments received by it from time to time
    constituting Collections of Receivables in a manner acceptable
    to the Agent and shall, promptly upon receipt, remit all such
    cash, checks and instruments, duly endorsed or with duly
    executed instruments of transfer, to the Agent or its designee.

 

    (iv) The Transferor hereby authorizes the Agent to take, to
    the extent permitted by applicable law, any and all steps in the
    Transferor’s or any Originating Entity’s name (which
    power, in the case of each Originating Entity, the Transferor is
    authorized to grant pursuant to authority granted to the
    Transferor under the Receivables Purchase Agreement) and on
    behalf of the Transferor and such Originating Entity necessary
    or desirable, in the determination of the Agent, to collect all
    amounts due under any and all Receivables, including, without
    limitation, endorsing the Transferor’s or such Originating
    Entity’s name on checks and other instruments representing
    Collections and enforcing such Receivables and the related
    Contracts.

 

    Notwithstanding the foregoing clauses (i), (ii), (iii) and
    (iv), the Agent shall not at any time direct, or cause the
    Transferor or any Originating Entity to direct, Obligors of
    Receivables or Related Security payable under the Medicare or
    Medicaid program to make payment of amounts due or to become due
    to the Transferor or any Originating Entity in respect of such
    Receivables or Related Security directly to either the
    Intermediate Concentration Account or the Concentration Account
    or to the Agent or its designee, except for any such
    payment in respect of such Receivables or Related Security or
    any assignment thereof that is established by, or made pursuant
    to, the order of a court of competent jurisdiction.

 

    Section 6.4. Collection
    Agent Default. The occurrence of any one or more of the
    following events shall constitute a Collection Agent Default:

 

    (a) (i) the Collection Agent or, to the extent that
    the Transferor, the Seller or any Affiliate of the Transferor or
    the Seller is then acting as Collection Agent, the Transferor,
    the Seller or such Affiliate, as applicable, shall fail to
    observe or perform any term, covenant or agreement to be
    observed or performed (A) under Section 5.3(d), 5.3(g)
    or 5.3(h) or Section 5.4, or (B) under
    Section 5.3 (other than subsection (d), (g) or
    (h) thereof) and such failure shall continue for five
    (5) days, or (ii) the Collection Agent or, to the
    extent that the Transferor, the Seller or any Affiliate of the
    Transferor, or the Seller is then acting as Collection Agent,
    the Transferor, the Seller or such Affiliate, as applicable,
    shall fail to observe or perform any term, covenant or agreement
    hereunder (other than as referred to in clause (i) or
    (iii) of this Section 6.4(a)) or under any of the
    other Transaction Documents to which such Person is a party or
    by which such Person is bound, and such failure shall remain
    unremedied for ten (10) days, or (iii) the Collection
    Agent or, the extent that the Transferor, the Seller or any
    Affiliate of the Transferor, or the Seller is then acting as
    Collection Agent, the Transferor, the Seller or such Affiliate,
    as applicable, shall fail to make any payment or deposit
    required to be made by it hereunder when due or the Collection
    Agent shall fail to observe or perform any term, covenant or
    agreement on the Collection Agent’s part to be performed
    under Section 2.8(b) hereof; or

 

    (b) any representation, warranty, certification or
    statement made by the Collection Agent or the Transferor, the
    Seller or any Affiliate of the Transferor or the Seller (in the
    event that the Transferor, the Seller or such Affiliate is then
    acting as the Collection Agent) in this Agreement, the
    Receivables Purchase Agreement, the Transferring Affiliate
    Letter, the BMA Transfer Agreement or in any of the other
    Transaction Documents or in any certificate or report delivered
    by it pursuant to any of the foregoing shall prove to have been
    incorrect in any material respect when made or deemed
    made; or

 

    (c) failure of the Collection Agent or any of its
    Subsidiaries, FME KGaA, or FMCH to pay when due any amounts due
    under any agreement under which any Indebtedness greater that
    $50,000,000 is governed; or the default by the Collection Agent
    or any of its Subsidiaries, FME KGaA or FMCH in the performance
    of any term, provision of condition contained in any agreement
    under which any Indebtedness greater than $50,000,000 was
    created or is governed, regardless of whether such event is an
    “event of default” or “default”

    

    43

 

    under any such agreement; or any Indebtedness of the Collection
    Agent or any of its Subsidiaries, FME KGaA or FMCH greater than
    $50,000,000 shall be declared to be due and payable or required
    to be prepaid (other than by a regularly scheduled payment and
    other than in the case of an instrument stated to be payable on
    demand) prior to the scheduled date of maturity thereof; or

 

    (d) any Event of Bankruptcy shall occur with respect to the
    Collection Agent or any of its Subsidiaries; provided
    that in the case of any immaterial Subsidiary of the Collection
    Agent, if an Event of Bankruptcy shall have occurred by reason
    of any institution of an involuntary proceeding against such
    Subsidiary, such Event of Bankruptcy shall not constitute a
    Collection Agent Default unless such proceeding shall have
    remained undismissed or unstayed for a period of
    60 days; or

 

    (e) there shall have occurred any material adverse change
    in the operations of the Collection Agent since the end of the
    last fiscal year ending prior to the date of its appointment as
    Collection Agent hereunder or any other event shall have
    occurred which, in the commercially reasonably judgment of the
    Agent, materially and adversely affects the Collection
    Agent’s ability to either collect the Receivables or to
    perform under this Agreement.

 

    Section 6.5. Responsibilities
    of the Transferor. Anything herein to the contrary
    notwithstanding, the Transferor shall,
    and/or shall
    cause each Originating Entity to, (i) perform all of each
    Originating Entity’s obligations under the Contracts
    related to the Receivables to the same extent as if interests in
    such Receivables had not been sold hereunder and under the
    Transferring Affiliate Letter, the BMA Transfer Agreement
    and/or the
    Receivables Purchase Agreement, as applicable, and the exercise
    by the Agent, any Administrative Agent and the Investors of
    their rights hereunder and under the Transferring Affiliate
    Letter, the BMA Transfer Agreement and the Receivables Purchase
    Agreement shall not relieve the Transferor or the Seller from
    such obligations and (ii) pay when due any taxes, including
    without limitation, any sales taxes payable in connection with
    the Receivables and their creation and satisfaction. Neither the
    Agent nor any of the Investors or the Administrative Agents
    shall have any obligation or liability with respect to any
    Receivable or related Contracts, nor shall it be obligated to
    perform any of the obligations of the Seller thereunder.

 

    ARTICLE VII

    

 

    TERMINATION
    EVENTS
    

 

    Section 7.1. Termination
    Events. The occurrence of any one or more of the
    following events shall constitute a Termination Event:

 

    (a) the Transferor or the Collection Agent shall fail to
    make any payment or deposit to be made by it hereunder or under
    the Receivables Purchase Agreement when due hereunder or
    thereunder; or

 

    (b) any representation, warranty, certification or
    statement made or deemed made by the Transferor in this
    Agreement, by FME KGaA or FMCH under the Parent Agreement, or by
    the Transferor, FME KGaA, FMCH or any other Parent Group Member
    in any other Transaction Document to which it is a party or in
    any other document certificate or other writing delivered
    pursuant hereto or thereto, shall prove to have been incorrect
    in any material respect when made or deemed made; or

 

    (c) the Transferor or the Collection Agent shall default in
    the performance of any payment or undertaking (other than those
    covered by clause (a) above) to be performed or observed
    under:

 

    (i) Section 5.1(a)(iv); provided that, in the
    case of any failure to provide any such notice relating to a
    Potential Termination Event that shall have ceased to exist
    prior to the date such notice was required to have been given
    under Section 5.1(a)(iv), the failure to give such notice shall
    not constitute a Termination Event unless a senior officer of
    the Seller or the Transferor (including, in each case, the
    Treasurer, any Assistant Treasurer, General Counsel or any
    assistant or associate general counsel of such Person) shall
    have known of the occurrence of such Potential Termination Event
    during such period; or

 

    (ii) any of Sections 5.1(a)(v), 5.1 (a)(x), 5.1
    (a)(ix), 5.1(b)(i), 5.1(f), 5.1(g), 5.1(h), 5.1(i), 5.1(k),
    5.1(l), 5.2(a), 5.2(c), 5.2(d), 5.2(e), 5.2(f), 5.2(g), 5.2(h),
    5.2(i) or 6.3; or

 

    (iii) Section 5.1(b)(ii), and such default shall
    continue for 2 Business Days; or

 

    (iv) any other provision hereof and such default in the
    case of this clause (iv) shall continue for ten
    (10) days;

 

    (d) (i) failure of the Transferor to pay when due any
    amounts due under any agreement relating to Indebtedness to
    which it is a party; or the default by the Transferor in the
    performance of any term, provision or

    

    44

 

    condition contained in any agreement relating to Indebtedness to
    which it is a party regardless of whether such event is an
    “event of default” or “default” under any
    such agreement; or any Indebtedness owing by the Transferor
    shall be declared to be due and payable or required to be
    prepaid (other than by a regularly scheduled payment) prior to
    the date of maturity thereof; or (ii) failure of the
    Seller, FMCH, FME KGaA or any Transferring Affiliate to pay when
    due any amounts due under any agreement to which any such Person
    is a party and under which any Indebtedness greater than
    $50,000,000 is governed; or the default by the Seller, FMCH, FME
    KGaA or any Transferring Affiliate in the performance of any
    term, provision or condition contained in any agreement to which
    any such Person is a party and under which any Indebtedness
    owing by the Seller, FMCH, FME KGaA or any Transferring
    Affiliate greater than $50,000,000 was created or is governed,
    regardless of whether such event is an “event of
    default” or “default” under any such agreement;
    or any Indebtedness owing by the Seller, FMCH, FME KGaA or any
    Transferring Affiliate greater than $50,000,000 shall be
    declared to be due and payable or required to be prepaid (other
    than by a regularly scheduled payment and other than in the case
    of an instrument stated to be payable on demand) prior to the
    date of maturity thereof; or

 

    (e) any Event of Bankruptcy shall occur with respect to the
    Transferor, any Originating Entity, FME KGaA, FMCH or NMC;
    provided that, in the case of any Event of Bankruptcy
    relating to any Transferring Affiliate, such Event of Bankruptcy
    shall not constitute a Termination Event hereunder if at such
    time the Percentage Factor does not exceed the Maximum
    Percentage Factor after reducing the Net Receivables Balance by
    an amount equal to the aggregate Outstanding Balance of all
    Receivables otherwise included in the calculation of Net
    Receivables Balance which either (i) have been originated
    by such Transferring Affiliate or (ii) are owing from any
    Obligor that shall have been directed to remit payments thereon
    to a Special Account that is a Special Account to which Obligors
    in respect of the Transferring Affiliate that is the subject of
    such Event of Bankruptcy shall have been directed to remit
    payments; or

 

    (f) the Agent, on behalf of the Investors, shall, for any
    reason, fail or cease to have a valid and perfected first
    priority ownership or security interest in the Affected Assets
    free and clear of any Adverse Claims; or the Transferor shall,
    for any reason, fail or cease to have all right, title and
    interest in and to all Receivables, Related Security and
    Collections, free and clear of any Adverse Claim, subject only
    to the interests therein of the Agent, on behalf of the
    Investors; or

 

    (g) a Collection Agent Default shall have occurred; or

 

    (h) the Transferring Affiliate Letter, the BMA Transfer
    Agreement, the Receivables Purchase Agreement or any other
    Transaction Document shall have terminated; or any material
    provision thereof shall cease for any reason to be valid and
    binding on any party thereto or any party shall so state in
    writing; or any party to any Transaction Document (other than
    the Agent, any Administrative Agent or any Investor) shall fail
    to perform any material term, provision or condition contained
    in any Transaction Document on its part to be performed or a
    default shall otherwise occur thereunder; or

 

    (i) any of FMCH, NMC, the Transferor or the Seller shall
    enter into any transaction or merger whereby it is not the
    surviving entity; or

 

    (j) there shall have occurred any material adverse change
    in the operations of any of FMCH, NMC, the Transferor or the
    Seller since December 31, 2002 or any other Material
    Adverse Effect shall have occurred; or

 

    (k) any Liquidity Provider or Credit Support Provider shall
    have given notice that an event of default has occurred and is
    continuing under any of its respective agreements with a Conduit
    Investor; or

 

    (l) the Commercial Paper issued by a Conduit Investor or
    its Related Issuer shall not be rated at least
    “A-2”
    by Standard & Poor’s and at least
    “P-2”
    by Moody’s, unless any rating of such Commercial Paper
    shall be lower than such level solely as a result of the
    correspondingly lower rating of the Credit Support Provider for
    such Conduit Investor; or

 

    (m) (i) the Percentage Factor exceeds the Maximum
    Percentage Factor unless the Transferor reduces the Net
    Investment or increases the balance of the Affected Assets on
    the next Business Day so as to reduce the Percentage Factor to
    less than or equal to the Maximum Percentage Factor;
    (ii) the Percentage Factor equals or exceeds 100.0% at any
    time unless the Transferor reduces the Net Investment or
    increases the balance of the Affected Assets on the next
    Business Day so as to reduce the Percentage Factor to less than
    or equal to 100%; or (iii) the portion of the Net
    Investment held by the Investors in any Related Group plus, in
    the case where any portion of such Net Investment is held by a
    Conduit Investor, the Interest Component of all outstanding
    Related Commercial Paper with respect to such Conduit Investor,
    shall exceed the applicable Related Group Limit at any
    time; or

    

    45

 

    (n) the Dilution Ratio for any month exceeds 10%; or

 

    (o) the Loss-to-Liquidation Ratio for any month exceeds
    8%; or

 

    (p) the Default Ratio for any month exceeds 9%; or

 

    (q) a default shall occur under the Parent Agreement; or
    the Parent Agreement shall for any reason terminate; or any
    material provision thereof shall cease to be valid and binding
    on any party thereto or any party thereto shall so state in
    writing; or

 

    (r) (i) the Seller shall cease to own, free and clear
    of any Adverse Claim all of the outstanding shares of capital
    stock of the Transferor on a fully diluted basis; or
    (ii) FMCH shall cease to own, directly or indirectly, free
    and clear of any Adverse Claim, (other than a pledge made
    pursuant to the FME KGaA Credit Facility and put/call
    agreements, forward agreements or other similar arrangements
    among FME KGaA and its subsidiaries), all of the outstanding
    shares of capital stock of any of the Originating Entities or
    the Collection Agent on a fully diluted basis; provided that FME
    KGaA may own directly or indirectly stock that is not Voting
    Stock in subsidiaries of FMCH; or (iii) FME KGaA shall
    cease to own, directly or indirectly, free and clear of any
    Adverse Claim (other than a pledge made pursuant to the FME KGaA
    Credit Facility and put/call agreements, forward agreements or
    other similar arrangements among FME KGaA and its subsidiaries),
    all of the Voting Stock of FMCH other than the preferred stock
    of FMCH outstanding as of the date hereof (which preferred stock
    outstanding as of the date hereof shall not represent more than
    20% of the total Voting Stock of FMCH); or (iv) a Change of
    Control shall occur; or

 

    (s) both (i) FMCH’s long-term public senior debt
    securities shall be rated lower than B+ by Standard &
    Poor’s or B1 by Moody’s, or if neither
    Standard & Poor’s nor Moody’s shall rate
    such securities, FMCH’s long-term senior debt shall have a
    deemed rating of lower than B+ as determined by the Agent using
    its standard bond rating methodology, and (ii) FME
    KGaA’s long-term public senior debt securities shall be
    rated lower than B+ by Standard & Poor’s or B1 by
    Moody’s, or if neither Standard & Poor’s nor
    Moody’s shall rate such securities, FME KGaA’s
    long-term senior debt shall have a deemed rating of lower than
    B+ as determined by the Agent using its standard bond rating
    methodology; or

 

    (t) the Administrative Agents shall not have received, by
    no later than November 21, 2003 (i) a final agreed
    upon procedures report from KPMG substantially in the form
    attached as Exhibit T with results satisfactory to each
    Administrative Agent and (ii) a final “no material
    weakness” report from KPMG substantially in the form
    attached as Exhibit U with results satisfactory to each
    Administrative Agent.

 

    Section 7.2. Termination. (a) Upon
    the occurrence of any Termination Event, the Agent may, and at
    the direction of any Administrative Agent or the Majority
    Investors shall, by notice to the Transferor and the Collection
    Agent declare the Termination Date to have occurred;
    provided, however, that in the case of any event
    described in Section 7.1(e), 7.1(f), 7.1(m)(ii),
    7.1(m)(iii) or 7.1(r) above, the Termination Date shall be
    deemed to have occurred automatically upon the occurrence of
    such event. Upon any such declaration or automatic occurrence,
    the Agent shall have, in addition to all other rights and
    remedies under this Agreement or otherwise, all other rights and
    remedies provided under the UCC of the applicable jurisdiction
    and other applicable laws, all of which rights shall be
    cumulative.

 

    (b) At all times after the declaration or automatic
    occurrence of the Termination Date pursuant to
    Section 7.2(a), the Base Rate plus 2.00% shall be the
    Tranche Rate applicable to the Net Investment for all
    existing and future Tranches.

 

    ARTICLE VIII

    

 

    INDEMNIFICATION;
    EXPENSES; RELATED MATTERS
    

 

    Section 8.1. Indemnities
    by the Transferor. Without limiting any other rights
    which the Agent, the Administrative Agents or the Investors may
    have hereunder or under applicable law, the Transferor hereby
    agrees to indemnify the Investors, the Agent, the Administrative
    Agents, the Collateral Agents, the Liquidity Providers and the
    Credit Support Providers and their respective successors and
    permitted assigns and their respective officers, directors and
    employees (collectively, “Indemnified Parties”)
    from and against any and all damages, losses, claims,
    liabilities, costs and expenses, including, without limitation,
    reasonable attorneys’ fees (which such attorneys may be
    employees of a Liquidity Provider, a Credit Support Provider,
    the Agent, an Administrative Agent or a Collateral Agent, as
    applicable) and disbursements (all of the foregoing being
    collectively referred to as “Indemnified
    Amounts”) awarded against or incurred by any of them in
    any action or proceeding between the Transferor or any Parent
    Group Member (including any Parent Group Member, in its capacity
    as the Collection Agent) and any of the Indemnified Parties or
    between any of the

    

    46

 

    Indemnified Parties and any third party or otherwise arising out
    of or as a result of this Agreement, the other Transaction
    Documents, the ownership or maintenance, either directly or
    indirectly, by the Agent or any Investor of the Transferred
    Interest or any of the other transactions contemplated hereby or
    thereby, excluding, however, (i) Indemnified Amounts to the
    extent resulting from gross negligence or willful misconduct on
    the part of an Indemnified Party or (ii) recourse (except
    as otherwise specifically provided in this Agreement) for
    uncollectible Receivables. Without limiting the generality of
    the foregoing, the Transferor shall indemnify each Indemnified
    Party for Indemnified Amounts relating to or resulting from:

 

    (i) any representation or warranty made by any Parent Group
    Member (including any Parent Group Member, in its capacity as
    the Collection Agent) or any officers of any Parent Group Member
    (including any Parent Group Member, in its capacity as the
    Collection Agent) under or in connection with this Agreement,
    the Receivable Purchase Agreement, the Parent Agreement, the
    Transferring Affiliate Letter, the BMA Transfer Agreement, any
    of the other Transaction Documents, any Investor Report or any
    other information or report delivered by any Parent Group Member
    pursuant to or in connection with any Transaction Document,
    which shall have been false or incorrect in any material respect
    when made or deemed made;

 

    (ii) the failure by any Parent Group Member (including any
    Parent Group Member, in its capacity as the Collection Agent) to
    comply with any applicable law, rule or regulation (including,
    without limitation, any CHAMPUS/VA Regulation, any Medicaid
    Regulation or any Medicare Regulation), including with respect
    to any Receivable or the related Contract, or the nonconformity
    of any Receivable or the related Contract with any such
    applicable law, rule or regulation;

 

    (iii) the failure (x) to vest and maintain vested in
    the Agent, on behalf of the Investors, an undivided first
    priority, perfected percentage ownership interest (to the extent
    of the Transferred Interest) in the Affected Assets free and
    clear of any Adverse Claim or (y) to create or maintain a
    valid and perfected first priority security interest in favor of
    the Agent, for the benefit of the Investors, in the Affected
    Assets as contemplated pursuant to Section 10.11, free and
    clear of any Adverse Claim;

 

    (iv) the failure to file, or any delay in filing, financing
    statements, continuation statements, or other similar
    instruments or documents under the UCC of any applicable
    jurisdiction or other applicable laws with respect to any of the
    Affected Assets;

 

    (v) any dispute, claim, offset or defense (other than
    discharge in bankruptcy) of the Obligor to the payment of any
    Receivable (including, without limitation, a defense based on
    such Receivable or the related Contract not being the legal,
    valid and binding obligation of such Obligor enforceable against
    it in accordance with its terms), or any other claim resulting
    from the sale of merchandise or services related to such
    Receivable or the furnishing or failure to furnish such
    merchandise or services;

 

    (vi) any failure of the Collection Agent to perform its
    duties or obligations in accordance with the provisions
    hereof; or

 

    (vii) any products liability claim or personal injury or
    property damage suit or other similar or related claim or action
    of whatever sort arising out of or in connection with
    merchandise or services which are the subject of any Receivable;

 

    (viii) the transfer of an ownership interest in any
    Receivable other than an Eligible Receivable;

 

    (ix) the failure by any Parent Group Member (individually
    or as Collection Agent) to comply with any term, provision or
    covenant contained in this Agreement or any of the other
    Transaction Documents to which it is a party or to perform any
    of its respective duties under the Contracts;

 

    (x) the Percentage Factor exceeding the Maximum Percentage
    Factor at any time;

 

    (xi) the failure of any Originating Entity to pay when due
    any taxes, including without limitation, sales, excise or
    personal property taxes payable in connection with any of the
    Receivables;

 

    (xii) any repayment by any Indemnified Party of any amount
    previously distributed in reduction on Net Investment which such
    Indemnified Party believes in good faith is required to be made;

 

    (xiii) the commingling by the Transferor, any Originating
    Entity or the Collection Agent of Collections of Receivables at
    any time with other funds;

 

    (xiv) any investigation, litigation or proceeding
    instituted by or against a Person other than such Indemnified
    Party related to this Agreement, any of the other Transaction
    Documents, the use of proceeds of Transfers by the Transferor or
    any Originating Entity, the ownership of Transferred Interests,
    or any Receivable, Related Security or Contract;

    

    47

 

    (xv) the failure of any Special Account Bank, Designated
    Account Agent, Intermediate Concentration Account Bank or the
    Concentration Account Bank to remit any amounts held by it
    pursuant to the instructions set forth in the applicable Special
    Account Letter, Intermediate Concentration Account Agreement or
    Concentration Account Agreement or any instruction of the
    Collection Agent, the Transferor, any Originating Entity or the
    Agent (to the extent such Person is entitled to give such
    instructions in accordance with the terms hereof and of any
    applicable Special Account Letter, Intermediate Concentration
    Account Agreement or Concentration Account Agreement) whether by
    reason of the exercise of set-off rights or otherwise;

 

    (xvi) any inability to obtain any judgment in or utilize
    the court or other adjudication system of, any state in which an
    Obligor may be located as a result of the failure of the
    Transferor or the Seller to qualify to do business or file any
    notice of business activity report or any similar report;

 

    (xvii) any failure of the Transferor to give reasonably
    equivalent value to the Seller in consideration of the purchase
    by the Transferor from the Seller of any Receivable, any failure
    of the Seller to give reasonably equivalent value to any
    Transferring Affiliate in consideration of the purchase by the
    Seller from such Transferring Affiliate of any Receivable, or
    any attempt by any Person to void, rescind or set-aside any such
    transfer under statutory provisions or common law or equitable
    action, including, without limitation, any provision of the
    Bankruptcy Code;

 

    (xviii) any action taken by the Transferor, any Originating
    Entity or the Collection Agent (if a Parent Group Member or
    designee thereof) in the enforcement or collection of any
    Receivable; provided, however, that if any Conduit
    Investor enters into agreements for the purchase of interests in
    receivables from one or more Other Transferors, such Conduit
    Investor shall allocate such Indemnified Amounts which are in
    connection with a Credit Support Agreement or the credit support
    furnished by the Credit Support Provider to the Transferor and
    each Other Transferor; and provided, further, that
    if such Indemnified Amounts are attributable to any Parent Group
    Member and not attributable to any Other Transferor, the
    Transferor shall be solely liable for such Indemnified Amounts
    or if such Indemnified Amounts are attributable to Other
    Transferors and not attributable to any Parent Group Member,
    such Other Transferors shall be solely liable for such
    Indemnified Amounts;

 

    (xix) any reduction or extinguishment of, or any failure by
    any Obligor to pay (in whole or in part), any Receivable or any
    Related Security with respect thereto as a result of or on
    account of any violation of or prohibition under any law, rule
    or regulation now or hereafter in effect from time to time,
    including without limitation and CHAMPUS/VA Regulation, any
    Medicaid Regulation or any Medicare Regulation, or as a result
    of or on account of the entering of any judicial or regulatory
    order or agreement adversely affecting the Transferor or any
    Parent Group Member; or

 

    (xx) any failure by the Transferor or any Parent Group
    Member to maintain all governmental and other authorization and
    approvals necessary to render the services, or sell the
    merchandise, resulting in Receivables.

 

    Section 8.2. Indemnity
    for Taxes, Reserves and Expenses. (a) If after the
    date hereof, the adoption of any Law or bank regulatory
    guideline or any amendment or change in the interpretation of
    any existing or future Law or bank regulatory guideline by any
    Official Body charged with the administration, interpretation or
    application thereof, or the compliance with any directive of any
    Official Body (in the case of any bank regulatory guideline,
    whether or not having the force of Law):

 

    (i) shall subject any Indemnified Party to any tax, duty or
    other charge (other than Excluded Taxes) with respect to this
    Agreement, the other Transaction Documents, the ownership,
    maintenance or financing of the Transferred Interest, the
    Receivables or payments of amounts due hereunder, or shall
    change the basis of taxation of payments to any Indemnified
    Party of amounts payable in respect of this Agreement, the other
    Transaction Documents, the ownership, maintenance or financing
    of the Transferred Interest, the Receivables or payments of
    amounts due hereunder or its obligation to advance funds
    hereunder, under a Liquidity Provider Agreement or the credit
    support furnished by a Credit Support Provider or otherwise in
    respect of this Agreement, the other Transaction Documents, the
    ownership, maintenance or financing of the Transferred Interest
    or the Receivables (except for changes in the rate of general
    corporate, franchise, net income or other income tax imposed on
    such Indemnified Party by the jurisdiction in which such
    Indemnified Party’s principal executive office is located);

 

    (ii) shall impose, modify or deem applicable any reserve,
    special deposit or similar requirement (including, without
    limitation, any such requirement imposed by the Board of
    Governors of the Federal Reserve System) against assets of,
    deposits with or for the account of, or credit extended by, any
    Indemnified Party or shall impose on any Indemnified Party or on
    the United States market for certificates of deposit or the
    London interbank market any other condition affecting this
    Agreement, the other Transaction Documents, the

    

    48

 

    ownership, maintenance or financing of the Transferred Interest,
    the Receivables or payments of amounts due hereunder or its
    obligation to advance funds hereunder under a Liquidity Provider
    Agreement or the credit support provided by a Credit Support
    Provider or otherwise in respect of this Agreement, the other
    Transaction Documents, the ownership, maintenance or financing
    of the Transferred Interest or the Receivables; or

 

    (iii) imposes upon any Indemnified Party any other expense
    (including, without limitation, reasonable attorneys’ fees
    and expenses, and expenses of litigation or preparation therefor
    in contesting any of the foregoing) with respect to this
    Agreement, the other Transaction Documents, the ownership,
    maintenance or financing of the Transferred Interest, the
    Receivables or payments of amounts due hereunder or its
    obligation to advance funds hereunder under a Liquidity Provider
    Agreement or the credit support furnished by a Credit Support
    Provider or otherwise in respect to this Agreement, the other
    Transaction Documents, the ownership, maintenance or financing
    of the Transferred Interests or the Receivables, and the result
    of any of the foregoing is to increase the cost to such
    Indemnified Party with respect to this Agreement, the other
    Transaction Documents, the ownership, maintenance or financing
    of the Transferred Interest, the Receivables, the obligations
    hereunder, the funding of any purchases hereunder, a Liquidity
    Provider Agreement or a Credit Support Agreement, by an amount
    deemed by such Indemnified Party to be material,

 

    then, within ten (10) days after demand by such Indemnified
    Party through any Administrative Agent, the Transferor shall pay
    to such Administrative Agent for the benefit of such Indemnified
    Party, such additional amount or amounts as will compensate such
    Indemnified Party for such tax, increased cost or reduction.

 

    (b) If any Indemnified Party shall have determined that
    after the date hereof, the adoption of any applicable Law or
    bank regulatory guideline regarding capital adequacy or
    accounting principles, or any change therein, or any change in
    the interpretation or administration thereof by any Official
    Body, or any request or directive regarding capital adequacy (in
    each case of any bank regulatory guideline or accounting
    principles, whether or not having the force of law) of any such
    Official Body, has or would have the effect of reducing the rate
    of return on capital of such Indemnified Party (or its parent)
    as a consequence of such Indemnified Party’s obligations
    hereunder or with respect hereto or otherwise as a consequence
    of the transactions contemplated hereby to a level below that
    which such Indemnified Party (or its parent) could have achieved
    but for such adoption, change, request or directive (taking into
    consideration its policies with respect to capital adequacy) by
    an amount deemed by such Indemnified Party to be material, then
    from time to time, within ten (10) days after demand by
    such Indemnified Party through any Administrative Agent, the
    Transferor shall pay to such Administrative Agent, for the
    benefit of such Indemnified Party, such additional amount or
    amounts as will compensate such Indemnified Party (or its
    parent) for such reduction. For avoidance of doubt, any
    interpretation of Accounting Research Bulletin No. 51
    by the Financial Accounting Standards Board shall constitute an
    adoption, change, request or directive subject to this
    Section 8.2(b).

 

    (c) Each Administrative Agent will promptly notify the
    Transferor of any event of which it has knowledge, occurring
    after the date hereof, which will entitle an Indemnified Party
    to compensation pursuant to this Section 8.2. A notice by
    an Administrative Agent or the applicable Indemnified Party
    claiming compensation under this Section and setting forth the
    additional amount or amounts to be paid to it hereunder shall be
    conclusive in the absence of manifest error. In determining such
    amount, such Administrative Agent or any applicable Indemnified
    Party may use any reasonable averaging and attributing methods.

 

    (d) Anything in this Section 8.2 to the contrary
    notwithstanding, if a Conduit Investor enters into agreements
    for the acquisition of interests in receivables from one or more
    Other Transferors, such Conduit Investor shall allocate the
    liability for any amounts under this Section 8.2 which are
    in connection with a Credit Support Agreement or the credit
    support provided by the Credit Support Provider
    (“Section 8.2 Costs”) to the Transferor
    and each Other Transferor; provided, however, that
    if such Section 8.2 Costs are attributable to any Parent
    Group Member and not attributable to any Other Transferor, the
    Transferor shall be solely liable for such Section 8.2
    Costs or if such Section 8.2 Costs are attributable to
    Other Transferors and not attributable to any Parent Group
    Member, such Other Transferors shall be solely liable for such
    Section 8.2 Costs.

 

    (e) If any Indemnified Party in a Related Group makes a
    claim for payment pursuant to this Section 8.2, then the
    Transferor may, at its option, remove such Related Group and
    terminate the Commitments of the Investors in such Related Group
    by paying to the Administrative Agent for such Related Group an
    amount (the “Payoff Amount”) equal to the sum of
    (i) the portion of the Net Investment funded by the
    Investors in such Related Group, (ii) all Discount accrued
    and to accrue thereon through the last day of the applicable
    Yield Period(s) to which such Net Investment has been allocated
    and (iii) all other Aggregate Unpaids owing to the members
    of such Related Group under the Transaction Documents accrued
    through the date of such payment (including, without limitation,
    amounts payable pursuant to this Section 8.2 accrued
    through the date of payment). Any such removal and termination
    shall be made upon not less than five (5) Business Days
    notice delivered by the Transferor to the applicable
    Administrative Agent. The Payoff Amount for any Related Group
    shall be calculated by the

    

    49

 

    Administrative Agent and notified to the Transferor, which
    calculation shall be conclusive and binding absent manifest
    error. Upon such removal and termination, (x) the members
    of such Related Group shall cease to be parties to this
    Agreement and the Commitments of all Bank Investors in such
    Related Group shall be reduced to zero, (y) the Facility
    Limit will be reduced by an amount equal to the Commitments
    (determined immediately prior to such termination) of the Bank
    Investors, in such Related Group and (z) the Maximum Net
    Investment shall be reduced to 98% of the Facility Limit
    (determined after giving effect to the reduction thereof as
    described above).

 

    Section 8.3. Taxes. (a) All
    payments made hereunder by the Transferor or the Collection
    Agent (each, a “Payor”) to any Investor, any
    Administrative Agent or the Agent (each, a
    “Recipient”) shall be made free and clear of and
    without deduction for any present or future income, excise,
    stamp or franchise taxes and any other taxes, fees, duties,
    withholdings or other charges of any nature whatsoever imposed
    by any taxing authority on any recipient (or any assignee of
    such parties) (such non-excluded items being called
    “Taxes”), but excluding franchise taxes and taxes
    imposed on or measured by the recipient’s net income or
    gross receipts (“Excluded Taxes”). In the event that
    any withholding or deduction from any payment made by the Payor
    hereunder is required in respect of any Taxes, then such Payor
    shall:

 

    (i) pay directly to the relevant authority the full amount
    required to be so withheld or deducted;

 

    (ii) promptly forward to each Administrative Agent an
    official receipt or other documentation satisfactory to the
    Administrative Agent evidencing such payment to such
    authority; and

 

    (iii) pay to the Recipient such additional amount or
    amounts as is necessary to ensure that the net amount actually
    received by the Recipient will equal the full amount such
    Recipient would have received had no such withholding or
    deduction been required.

 

    Moreover, if any Taxes are directly asserted against any
    Recipient with respect to any payment received by such Recipient
    hereunder, the Recipient may pay such Taxes and the Payor will
    promptly pay such additional amounts (including any penalties,
    interest or expenses) as shall be necessary in order that the
    net amount received by the Recipient after the payment of such
    Taxes (including any Taxes on such additional amount) shall
    equal the amount such Recipient would have received had such
    Taxes not been asserted. Notwithstanding the foregoing, the
    Payor shall not be obligated to pay any such additional amounts
    pursuant to clause (iii) above or pursuant to the
    immediately preceding sentence to a Bank Investor that is not
    organized under the laws of the United States of America or a
    state thereof if such Bank Investor shall have failed to comply
    with the requirements of paragraph (b) of this
    Section 8.3 as of the time such Taxes are due and payable.

 

    If the Payor fails to pay any Taxes when due to the appropriate
    taxing authority or fails to remit to the Recipient the required
    receipts or other required documentary evidence, the Payor shall
    indemnify the Recipient for any incremental Taxes, interest, or
    penalties that may become payable by any Recipient as a result
    of any such failure.

 

    (b) Each Investor that is not incorporated under the laws
    of the United States of America or a state thereof shall:

 

    (X) (i) on or before the date of any payment by a
    Payor to such Investor, deliver to such Payor, the Agent and the
    Administrative Agent for its Related Group (A) two
    (2) duly completed copies of United States Internal Revenue
    Service Form 1001 or 4224, or successor applicable form, as
    the case may be, certifying that it is entitled to receive
    payments hereunder without deduction or withholding of any
    United States federal income taxes and (B) an Internal
    Revenue Service
    Form W-8
    or W-9, or
    successor applicable form, as the case may be, certifying that
    it is entitled to an exemption from United States backup
    withholding tax;

 

    (ii) deliver to each Payor, the Agent and the
    Administrative Agent for its Related Group two (2) further
    copies of any such form or certification on or before the date
    that any such form or certification expires or becomes obsolete
    and after the occurrence of any event requiring a change in the
    most recent form previously delivered by it to such
    Payor; and

 

    (iii) obtain such extensions of time for filing and
    complete such forms or certifications as may reasonably be
    requested by either Payor, the Agent or the Administrative Agent
    for its Related Group; or

 

    (Y) Each Investor or transferee that is not a
    “bank” under Section 881(c)(3)(A) of the Internal
    Revenue Code thereof shall:

 

    (i) on or before the date it becomes a party hereto (or, in
    the case of a participant, on or before the date such
    participant becomes a participant hereunder), deliver to each
    Payor, the Agent and the Administrative Agent for its Related
    Group (i) a statement under penalties of perjury that such
    Investor or transferee (x) is not a “bank” under
    Section 881(c)(3)(A) of the Internal Revenue Code, is not
    subject to regulatory or other legal requirements as a bank in
    any jurisdiction, and has not been treated as a bank for

    

    50

 

    purposes of any tax, securities law or other filing or
    submission made to any governmental authority, any application
    made to a rating agency or qualification for any exemption from
    tax, securities law or other legal requirements, (y) is not
    a 10-percent shareholder within the meaning of
    Section 811(c)(3)(B) of the Internal Revenue Code and
    (z) is not a controlled foreign corporation receiving
    interest from a related person within the meaning of
    Section 881(c)(3)(C) of the Internal Revenue Code and
    (ii) a properly completed and duly executed Internal
    Revenue Service
    Form W-8
    or applicable successor form;

 

    (ii) deliver to each Payor, the Agent and its
    Administrative Agent two further properly completed and duly
    executed copies of such
    Form W-8
    expires or becomes obsolete or after the occurrence of any event
    requiring a change in the most recent form previously delivered
    by it to such Payor or upon the request of such Payor; and

 

    (iii) obtain such extensions of time for filing and
    completing such forms or certifications as may be reasonably
    requested by either Payor, the Agent or its Administrative Agent;

 

    unless in any such case any change in treaty, law or regulation
    has occurred after the date such Person becomes an Investor
    hereunder which renders all such forms inapplicable or which
    would prevent such Investor from duly completing and delivering
    any such form with respect to it and such Investor so advises
    each Payor, the Agent and its Administrative Agent. Each Person
    that shall become an Investor or a participant of an Investor
    pursuant to subsection 10.6 shall, upon the effectiveness of the
    related transfer, be required to provide all of the forms,
    certifications and statements required pursuant to this
    subsection, provided that in the case of a participant of
    an Investor the obligations of such participant of an Investor
    pursuant to this subsection (b) shall be determined as if
    the participant of an Investor were an Investor except that such
    participant of an Investor shall furnish all such required
    forms, certifications and statements to the Investor from which
    the related participation shall have been purchased.

 

    Section 8.4. Other
    Costs, Expenses and Related Matters. (a) The
    Transferor agrees, upon receipt of a written invoice, to pay or
    cause to be paid, and to save the Investors, the Administrative
    Agents and the Agent harmless against liability for the payment
    of, all reasonable out-of-pocket expenses (including, without
    limitation, attorneys’, accountants’ and other third
    parties’ fees and expenses, any filing fees and expenses
    incurred by officers or employees of any of the Investors, the
    Administrative Agents
    and/or the
    Agent) or intangible, documentary or recording taxes incurred by
    or on behalf of any Investor, any Administrative Agent or the
    Agent (i) in connection with the negotiation, execution,
    delivery and preparation of this Agreement, the other
    Transaction Documents and any documents or instruments delivered
    pursuant hereto and thereto and the transactions contemplated
    hereby or thereby (including, without limitation, the perfection
    or protection of the Transferred Interest) and (ii) from
    time to time (a) relating to any amendments, waivers or
    consents under this Agreement and the other Transaction
    Documents, (b) arising in connection with any
    Investor’s, any Administrative Agent’s, the
    Agent’s or any Collateral Agent’s enforcement or
    preservation of rights (including, without limitation, the
    perfection and protection of the Transferred Interest under this
    Agreement), or (c) arising in connection with any audit,
    dispute, disagreement, litigation or preparation for litigation
    involving this Agreement or any of the other Transaction
    Documents (all of such amounts, collectively,
    “Transaction Costs”).

 

    (b) With respect to any Tranche to which all or any portion
    of the Net Investment held by any of the Investors in a Related
    Group has been allocated, the Transferor shall pay to the
    Administrative Agent for such Related Group, for the account of
    each applicable Investor, on demand any Early Collection Fee due
    on account of the reduction of such Tranche on a day prior to
    the last day of its Tranche Period (or, in the case of a CP
    Tranche Period, on or prior to the maturity date for the
    Commercial Paper allocated to fund or maintain such Net
    Investment).

 

    Section 8.5. Reconveyance
    Under Certain Circumstances. The Transferor agrees to
    accept the reconveyance from the Agent, on behalf of the
    applicable Investors, of the Transferred Interest if the Agent
    or any Administrative Agent notifies Transferor of a material
    breach of any representation or warranty made or deemed made
    pursuant to Article III of this Agreement and Transferor
    shall fail to cure such breach within 15 days (or, in the
    case of the representations and warranties in
    Sections 3.1(d) and 3.1(j), 3 days) of such notice.
    The reconveyance price shall be paid by the Transferor to the
    Agent, for the account of the applicable Investors, as
    applicable, in immediately available funds on such 15th day
    (or 3rd day, if applicable) in an amount equal to the
    Aggregate Unpaids; provided that if such 15th day
    (or 3rd day) is not a Business Day, such reconveyance and
    the related payment shall be made on the next following Business
    Day.

    

    51

 

    ARTICLE IX

    

 

    THE AGENT;
    BANK COMMITMENT; THE ADMINISTRATIVE AGENTS
    

 

    Section 9.1. Authorization
    and Action. (a) Each Investor hereby appoints and
    authorizes the Agent to take such action as agent on its behalf
    and to exercise such powers under this Agreement and the other
    Transaction Documents as are delegated to the Agent by the terms
    hereof and thereof, together with such powers as are reasonably
    incidental thereto. In furtherance, and without limiting the
    generality, of the foregoing, each Investor hereby appoints the
    Agent as its agent to execute and deliver all further
    instruments and documents, and take all further action that the
    Agent may deem necessary or appropriate or that any Investor may
    reasonably request in order to perfect, protect or more fully
    evidence the interests transferred or to be transferred from
    time to time by the Transferor hereunder, or to enable any of
    them to exercise or enforce any of their respective rights
    hereunder, including, without limitation, the execution by the
    Agent as secured party/assignee of such financing or
    continuation statements, or amendments thereto or assignments
    thereof, relative to all or any of the Receivables now existing
    or hereafter arising, and such other instruments or notices, as
    may be necessary or appropriate for the purposes stated
    hereinabove. The Majority Investors may direct the Agent to take
    any such incidental action hereunder. With respect to other
    actions which are incidental to the actions specifically
    delegated to the Agent hereunder, the Agent shall not be
    required to take any such incidental action hereunder, but shall
    be required to act or to refrain from acting (and shall be fully
    protected in acting or refraining from acting) upon the
    direction of the Majority Investors; provided,
    however, the Agent shall not be required to take any
    action hereunder if the taking of such action, in the reasonable
    determination of the Agent, shall be in violation of any
    applicable law, rule or regulation or contrary to any provision
    of this Agreement or shall expose the Agent to liability
    hereunder or otherwise. Upon the occurrence and during the
    continuance of any Termination Event or Potential Termination
    Event, the Agent shall take no action hereunder (other than
    ministerial actions or such actions as are specifically provided
    for herein) without the prior consent of the Majority Investors
    (which consent shall not be unreasonably withheld or delayed).
    The Agent shall not, without the prior written consent of all
    Bank Investors, agree to (i) amend, modify or waive any
    provision of this Agreement in any way which would
    (A) reduce or impair Collections or the payment of Discount
    or fees payable hereunder to the Investors or delay the
    scheduled dates for payment of such amounts, (B) increase
    the Servicing Fee (other than as permitted pursuant to
    Section 6.2(b)), (C) modify any provisions of this
    Agreement or the Receivables Purchase Agreement or the Parent
    Agreement relating to the timing of payments required to be made
    by the Transferor, any Originating Entity, FME KGaA or FMCH or
    the application of the proceeds of such payments,
    (D) permit the appointment of any Person (other than the
    Agent) as successor Collection Agent, (E) release any
    property from the lien provided by this Agreement (other than as
    expressly contemplated herein) or (F) extend or permit the
    extension of the Commitment Termination Date without the consent
    of each Bank Investor. The Agent shall not, without the prior
    written consent of each Administrative Agent, agree to amend,
    modify or waive any provision of this Agreement, the
    Transferring Affiliate Letter, the BMA Transfer Agreement, the
    Receivables Purchase Agreement or the Parent Agreement. The
    Agent shall not agree to any amendment of this Agreement which
    increases the dollar amount of any Investor’s Commitment
    without the prior consent of such Investor. In addition, the
    Agent shall not agree to any amendment of this Agreement not
    specifically described in the two preceding sentences without
    the consent of the Majority Investors (which consent shall not
    be unreasonably withheld or delayed). In the event the Agent
    requests any Investor’s consent pursuant to the foregoing
    provisions and the Agent does not receive a consent (either
    positive or negative) from such Investor within 10 Business Days
    of such Investor’s receipt of such request, then such
    Investor (and its percentage interest hereunder) shall be
    disregarded in determining whether the Agent shall have obtained
    sufficient consent hereunder.

 

    (b) The Agent shall exercise such rights and powers vested
    in it by this Agreement and the other Transaction Documents, and
    use the same degree of care and skill in their exercise, as a
    prudent person would exercise or use under the circumstances in
    the conduct of such person’s own affairs.

 

    SECTION 9.2. Agent’s Reliance, Etc. Neither the
    Agent nor any of its directors, officers, agents or employees
    shall be liable for any action taken or omitted to be taken by
    it or them as Agent under or in connection with this Agreement
    or any of the other Transaction Documents, except for its or
    their own gross negligence or willful misconduct. Without
    limiting the foregoing, the Agent: (i) may consult with
    legal counsel (including counsel for any Parent Group Member),
    independent public accountants and other experts selected by it
    and shall not be liable for any action taken or omitted to be
    taken in good faith by it in accordance with the advice of such
    counsel, accountants or experts; (ii) makes no warranty or
    representation to any Investor and shall not be responsible to
    any Investor for any statements, warranties or representations
    made in or in connection with this Agreement; (iii) shall
    not have any duty to ascertain or to inquire as to the
    performance or observance of any of the terms, covenants or
    conditions of this Agreement or any of the other Transaction
    Documents on the part of any Parent Group Member or the
    Collection Agent or to inspect the property (including the books
    and records) of any Parent Group Member or

    

    52

 

    the Collection Agent; (iv) shall not be responsible to any
    Investor for the due execution, legality, validity,
    enforceability, genuineness, sufficiency or value of this
    Agreement, any of the other Transaction Documents or any other
    instrument or document furnished pursuant hereto or thereto; and
    (v) shall incur no liability under or in respect of this
    Agreement or any of the other Transaction Documents by acting
    upon any notice (including notice by telephone), consent,
    certificate or other instrument or writing (which may be by
    telex) believed by it to be genuine and signed or sent by the
    proper party or parties.

 

    Section 9.3. Credit
    Decision. Each Investor acknowledges that it has,
    independently and without reliance upon the Agent, any
    Administrative Agent, any Affiliate of an Administrative Agent
    or any other Investor and based upon such documents and
    information as it has deemed appropriate, made its own
    evaluation and decision to enter into this Agreement and the
    other Transaction Documents to which it is a party and, if it so
    determines, to accept the transfer to the Agent on its behalf of
    any undivided ownership interest in the Affected Assets
    hereunder. Each Investor also acknowledges that it will,
    independently and without reliance upon the Agent, any of the
    Agent’s Affiliates or any other Investor and based on such
    documents and information as it shall deem appropriate at the
    time, continue to make its own decisions in taking or not taking
    action under this Agreement and the other Transaction Documents
    to which it is a party.

 

    Section 9.4. Indemnification
    of the Agent. The Bank Investors agree to indemnify the
    Agent (to the extent not reimbursed by the Transferor), ratably
    in accordance with their respective Commitments, from and
    against any and all liabilities, obligations, losses, damages,
    penalties, actions, judgments, suits, costs, expenses or
    disbursements of any kind or nature whatsoever which may be
    imposed on, incurred by, or asserted against the Agent in any
    way relating to or arising out of this Agreement or any action
    taken or omitted by the Agent, any of the other Transaction
    Documents hereunder or thereunder, provided that the Bank
    Investors shall not be liable for any portion of such
    liabilities, obligations, losses, damages, penalties, actions,
    judgments, suits, costs, expenses or disbursements resulting
    from the Agent’s gross negligence or willful misconduct.
    Without limitation of the foregoing, the Bank Investors agree to
    reimburse the Agent, ratably in accordance with their respective
    Commitments, promptly upon demand for any out-of-pocket expenses
    (including counsel fees) incurred by the Agent in connection
    with the administration, modification, amendment or enforcement
    (whether through negotiations, legal proceedings or otherwise)
    of, or legal advice in respect of rights or responsibilities
    under, this Agreement and the other Transaction Documents, to
    the extent that such expenses are incurred in the interests of
    or otherwise in respect of the Bank Investors hereunder
    and/or
    thereunder and to the extent that the Agent is not reimbursed
    for such expenses by the Transferor.

 

    Section 9.5. Successor
    Agent. The Agent may resign at any time by giving
    written notice thereof to each Investor and the Transferor and
    may be removed at any time with cause by the Majority Investors.
    Upon any such resignation or removal, the Majority Investors
    shall appoint a successor Agent. Each Investor agrees that it
    shall not unreasonably withhold or delay its approval of the
    appointment of a successor Agent. If no such successor Agent
    shall have been so appointed, and shall have accepted such
    appointment, within 30 days after the retiring Agent’s
    giving of notice of resignation or the Majority Investors’
    removal of the retiring Agent, then the retiring Agent may, on
    behalf of the Investors, appoint a successor Agent which
    successor Agent shall be either (i) a commercial bank
    organized under the laws of the United States or of any state
    thereof and have a combined capital and surplus of at least
    $50,000,000 or (ii) an Affiliate of such a bank. Upon the
    acceptance of any appointment as Agent hereunder by a successor
    Agent, such successor Agent shall thereupon succeed to and
    become vested with all the rights, powers, privileges and duties
    of the retiring Agent, and the retiring Agent shall be
    discharged from its duties and obligations under this Agreement.
    After any retiring Agent’s resignation or removal hereunder
    as Agent, the provisions of this Article IX shall continue
    to inure to its benefit as to any actions taken or omitted to be
    taken by it while it was Agent under this Agreement.

 

    Section 9.6. Payments
    by the Agent. All amounts received by the Agent on
    behalf of the Investors shall be paid by the Agent to the
    Investors (at their respective accounts specified in their
    respective Assignment and Assumption Agreements) on the Business
    Day received by the Agent, unless such amounts are received
    after 12:00 noon on such Business Day, in which case the
    Agent shall use its reasonable efforts to pay such amounts to
    the Investors on such Business Day, but, in any event, shall pay
    such amounts to the Investors not later than the following
    Business Day. All amounts received by the Agent hereunder on
    behalf of the Investors shall be allocated among the Related
    Groups in accordance with Sections 2.5
    and/or 2.6,
    as applicable. For purposes of the foregoing, the Agent shall be
    deemed to be a member of the Related Group that includes
    Paradigm.

 

    Section 9.7. Bank
    Commitment; Assignment to Bank Investors.

 

    (a) Bank Commitment. At any time on or prior to the
    Commitment Termination Date, in the event that a Conduit
    Investor does not effect an Incremental Transfer as requested
    under Section 2.2(a), then at any time, the Transferor
    shall have the right to require such Conduit Investor to assign
    its interest in the Net Investment in whole

    

    53

 

    to the Bank Investors in its Related Group pursuant to this
    Section 9.7. In addition, at any time on or prior to the
    Commitment Termination Date, (i) upon the occurrence of a
    Termination Event that results in the Termination Date or
    (ii) if a Conduit Investor elects to give notice to the
    Transferor of a Reinvestment Termination Date, the Transferor
    hereby requests and directs that such Conduit Investor assign
    its interest in the Net Investment in whole to the Bank
    Investors in its Related Group pursuant to this Section 9.7
    and the Transferor hereby agrees to pay the amounts described in
    Section 9.7(d) below. Provided that the Net Asset Test is
    satisfied, upon any such election by a Conduit Investor or any
    such request by the Transferor to such Conduit Investor, such
    Conduit Investor shall make such assignment and the Bank
    Investors in its Related Group shall accept such assignment and
    shall assume all of such Conduit Investor’s obligations
    hereunder. In connection with any assignment from a Conduit
    Investor to the Bank Investors in its Related Group pursuant to
    this Section 9.7, each Bank Investor shall, on the date of
    such assignment, pay to such Conduit Investor an amount equal to
    its Assignment Amount. Upon any assignment by a Conduit Investor
    to the Bank Investors in its Related Group as contemplated
    hereunder, such Conduit Investor shall cease to make any
    additional Incremental Transfers hereunder.

 

    (b) Assignment. No Bank Investor may assign all or a
    portion of its interests in the Net Investment, the Receivables,
    and Collections, Related Security and Proceeds with respect
    thereto and its rights and obligations hereunder to any Person
    unless approved in writing by the Administrative Agent for its
    Related Group, on behalf of the related Conduit Investor.
    Without limiting the generality of the foregoing, it is
    understood for the avoidance of doubt that an Administrative
    Agent may condition any approval on its receipt of written
    confirmation from each applicable Rating Agency that such
    assignment will not result in the reduction or withdrawal of the
    then current rating of the Commercial Paper issued by the
    related Conduit Investor. In the case of an assignment by a
    Conduit Investor to the Bank Investors or by a Bank Investor to
    another Person, the assignor shall deliver to the assignee(s) an
    Assignment and Assumption Agreement in substantially the form of
    Exhibit G attached hereto, duly executed, assigning to the
    assignee a pro rata interest in the Net Investment, the
    Receivables, and Collections, Related Security and Proceeds with
    respect thereto and the assignor’s rights and obligations
    hereunder and the assignor shall promptly execute and deliver
    all further instruments and documents, and take all further
    action, that the assignee may reasonably request, in order to
    protect, or more fully evidence the assignee’s right, title
    and interest in and to such interest and to enable the Agent, on
    behalf of such assignee, to exercise or enforce any rights
    hereunder and under the other Transaction Documents to which
    such assignor is or, immediately prior to such assignment, was a
    party. Upon any such assignment, (i) the assignee shall
    have all of the rights and obligations of the assignor hereunder
    and under the other Transaction Documents to which such assignor
    is or, immediately prior to such assignment, was a party with
    respect to such interest for all purposes, it being understood
    that the Bank Investors, as assignees, shall (x) be
    obligated to fund Incremental Transfers under
    Section 2.2(a) in accordance with the terms thereof,
    notwithstanding that related Conduit Investor was not so
    obligated and (y) not have the right to elect the
    commencement of the amortization of the Net Investment pursuant
    to the definition of “Reinvestment Termination Date”,
    notwithstanding that the related Conduit Investor had such
    right) and (ii) the assignor shall relinquish its rights
    with respect to such interest for all purposes of this Agreement
    and under the other Transaction Documents to which such assignor
    is or, immediately prior to such assignment, was a party. No
    such assignment shall be effective unless a fully executed copy
    of the related Assignment and Assumption Agreement shall be
    delivered to the Agent, the Administrative Agent for the
    applicable Related Group and the Transferor. All costs and
    expenses of the Agent, the applicable Administrative Agent and
    the assignor and assignee incurred in connection with any
    assignment hereunder shall be borne by the Transferor and not by
    the assignor or any such assignee. No Bank Investor shall assign
    any portion of its Commitment hereunder without also
    simultaneously assigning an equal portion of its interest in the
    applicable Liquidity Provider Agreement.

 

    (c) Effects of Assignment. By executing and
    delivering an Assignment and Assumption Agreement, the assignor
    and assignee thereunder confirm to and agree with each other and
    the other parties hereto as follows: (i) other than as
    provided in such Assignment and Assumption Agreement, the
    assignor makes no representation or warranty and assumes no
    responsibility with respect to any statements, warranties or
    representations made in or in connection with this Agreement,
    the other Transaction Documents or any other instrument or
    document furnished pursuant hereto or thereto or the execution,
    legality, validity, enforceability, genuineness, sufficiency or
    value of this Agreement, the other Transaction Documents or any
    such other instrument or document; (ii) the assignor makes
    no representation or warranty and assumes no responsibility with
    respect to the financial condition of the Transferor, any Parent
    Group Member or the Collection Agent or the performance or
    observance by the Transferor, any Parent Group Member or the
    Collection Agent of any of their respective obligations under
    this Agreement, the Receivables Purchase Agreement, the
    Transferring Affiliate Letter, the BMA Transfer Agreement, the
    Parent Agreement, the other Transaction Documents or any other
    instrument or document furnished pursuant hereto;
    (iii) such assignee confirms that it has received a copy of
    this Agreement, the Receivables Purchase Agreement, the
    Transferring Affiliate Letter, the BMA Transfer Agreement, the
    Parent Agreement, and such other instruments, documents and
    information as it has deemed appropriate to make its own credit
    analysis and decision to enter into such Assignment

    

    54

 

    and Assumption Agreement and to purchase such interest;
    (iv) such assignee will, independently and without reliance
    upon the Agent, any Administrative Agent, or any of their
    respective Affiliates, or the assignor and based on such
    agreements, documents and information as it shall deem
    appropriate at the time, continue to make its own credit
    decisions in taking or not taking action under this Agreement
    and the other Transaction Documents; (v) such assignee
    appoints and authorizes the Agent to take such action as agent
    on its behalf and to exercise such powers under this Agreement,
    the other Transaction Documents and any other instrument or
    document furnished pursuant hereto or thereto as are delegated
    to the Agent by the terms hereof or thereof, together with such
    powers as are reasonably incidental thereto and to enforce its
    respective rights and interests in and under this Agreement, the
    other Transaction Documents, the Receivables, the Contracts and
    the Related Security; (vi) such assignee appoints and
    authorizes the applicable Administrative Agent to take such
    action as agent on its behalf and to exercise such powers under
    this Agreement, the other Transaction Documents and any other
    instrument or document furnished pursuant hereto or thereto as
    are delegated to the Administrative Agent by the terms hereof or
    thereof, together with such powers as are reasonably incidental
    thereto and to enforce its respective rights and interests in
    and under this Agreement, the other Transaction Documents, the
    Receivables, the Contracts and the Related Security,
    (vii) such assignee agrees that it will perform in
    accordance with their terms all of the obligations which by the
    terms of this Agreement and the other Transaction Documents are
    required to be performed by it as the assignee of the assignor;
    and (viii) such assignee agrees that it will not institute
    against any Conduit Investor any proceeding of the type referred
    to in Section 10.9 prior to the date which is one year and
    one day after the payment in full of all Commercial Paper issued
    by such Conduit Investor.

 

    (d) Transferor’s Obligation to Pay Certain Amounts;
    Additional Assignment Amount. The Transferor shall pay to
    the Administrative Agent for a Conduit Investor or, in the case
    of GBFC, to such Conduit Investor, for the account of such
    Conduit Investor, in connection with any assignment by such
    Conduit Investor to the Bank Investors in its Related Group
    pursuant to this Section 9.7, an aggregate amount equal to
    all Discount to accrue through the end of each outstanding
    Tranche Period plus all other Aggregate Unpaids (other than
    the Net Investment) owing to such Conduit Investor. To the
    extent that such Discount relates to interest or discount on
    Related Commercial Paper, if the Transferor fails to make
    payment of such amounts at or prior to the time of assignment by
    such Conduit Investor to the Bank Investors in its Related
    Group, such amount shall be paid by such Bank Investors (in
    accordance with their respective Pro Rata Shares) to such
    Conduit Investor as additional consideration for the interests
    assigned to such Bank Investors and the amount of the “Net
    Investment” hereunder held by such Bank Investors shall be
    increased by an amount equal to the additional amount so paid by
    such Bank Investors.

 

    (e) Administration of Agreement After Assignment.
    After any assignment by a Conduit Investor to the Bank Investors
    in its Related Group pursuant to this Section 9.7 (and the
    payment of all amounts owing to such Conduit Investor in
    connection therewith), all rights of the related Collateral
    Agent set forth herein shall be deemed to be afforded to the
    Administrative Agent for such Related Group on behalf of such
    Bank Investors instead of such Collateral Agent.

 

    (f) Payments. After any assignment by a Conduit
    Investor to the Bank Investors in its Related Group pursuant to
    this Section 9.7, all payments to be made hereunder by the
    Transferor or the Collection Agent to such Conduit Investor
    shall be made to the applicable Administrative Agent’s
    account as such account shall have been notified to the
    Transferor and the Collection Agent.

 

    (g) Downgrade of Bank Investor. If (at any time
    prior to any assignment by a Conduit Investor to the Bank
    Investors in its Related Group as contemplated pursuant to this
    Section 9.7) the short term debt rating of any Bank
    Investor in such Related Group shall be
    “A-2”
    or
    “P-2”
    from Standard & Poor’s or Moody’s,
    respectively, with negative credit implications, such Bank
    Investor, upon request of the applicable Administrative Agent,
    shall, within 30 days of such request, assign its rights
    and obligations hereunder to another financial institution
    (which institution’s short term debt shall be rated at
    least
    “A-2”
    and
    “P-2”
    from Standard & Poor’s and Moody’s,
    respectively, and which shall not be so rated with negative
    credit implications). If the short term debt rating of a Bank
    Investor in a Related Group shall be
    “A-3”
    or
    “P-3”,
    or lower, from Standard & Poor’s or Moody’s,
    respectively (or such rating shall have been withdrawn by
    Standard & Poor’s or Moody’s), such Bank
    Investor, upon request of the applicable Administrative Agent,
    shall, within five (5) Business Days of such request,
    assign its rights and obligations hereunder to another financial
    institution (which institution’s short term debt shall be
    rated at least
    “A-2”
    and
    “P-2”
    from Standard & Poor’s and Moody’s,
    respectively, and which shall not be so rated with negative
    credit implications). In either such case, if any such Bank
    Investor in a Related Group shall not have assigned its rights
    and obligations under this Agreement within the applicable time
    period described above, the related Conduit Investor shall have
    the right to require such Bank Investor to accept the assignment
    of such Bank Investor’s Pro Rata Share of the Net
    Investment; such assignment shall occur in accordance with the
    applicable provisions of this Section 9.7. Such Bank
    Investor shall be obligated to pay to such Conduit Investor, in
    connection with such assignment, in addition to the Pro Rata
    Share of the Net Investment, an amount equal to the Interest
    Component of

    

    55

 

    the outstanding Commercial Paper issued to fund the portion of
    the Net Investment being assigned to such Bank Investor, as
    reasonably determined by the applicable Administrative Agent.
    Notwithstanding anything contained herein to the contrary, upon
    any such assignment to a downgraded Bank Investor as
    contemplated pursuant to the immediately preceding sentence, the
    aggregate available amount of the applicable Related Group
    Limit, solely as it relates to new Incremental Transfers to such
    Conduit Investor, shall be reduced by the amount of unused
    Commitment of such downgraded Bank Investor; it being understood
    and agreed, that nothing in this sentence or the two preceding
    sentences shall affect or diminish in any way any such
    downgraded Bank Investor’s Commitment to the Transferor or
    such downgraded Bank Investor’s other obligations and
    liabilities hereunder and under the other Transaction Documents.

 

    Section 9.8. Appointment
    of Administrative Agents. (a) Each Investor in a
    Related Group hereby appoints and authorizes the Administrative
    Agent for its Related Group to take such action as agent on its
    behalf and to exercise such powers under this Agreement and the
    other Transaction Documents as are delegated to such
    Administrative Agent by the terms hereof and thereof, together
    with such powers as are reasonably incidental thereto. In
    furtherance, and without limiting the generality, of the
    foregoing, each Investor in a Related Group hereby appoints the
    Administrative Agent for its Related Group as its agent to
    execute and deliver all further instruments and documents, and
    take all further action that such Administrative Agent may deem
    necessary or appropriate or that any Investor may reasonably
    request to enable any of them to exercise or enforce any of
    their respective rights hereunder. Bank Investors representing
    at least 66 and 2/3% of the aggregate Commitments of all Bank
    Investors in a Related Group (the “Group Majority
    Investors” for such Related Group) may direct the
    Administrative Agent for such Related Group to take any such
    incidental action hereunder. With respect to other actions which
    are incidental to the actions specifically delegated to an
    Administrative Agent hereunder, such Administrative Agent shall
    not be required to take any such incidental action hereunder,
    but shall be required to act or to refrain from acting (and
    shall be fully protected in acting or refraining from acting)
    upon the direction of the Group Majority Investors;
    provided, however, no Administrative Agent shall
    be required to take any action hereunder if the taking of such
    action, in the reasonable determination of such Administrative
    Agent, shall be in violation of any applicable law, rule or
    regulation or contrary to any provision of this Agreement or
    shall expose such Administrative Agent to liability hereunder or
    otherwise. Upon the occurrence and during the continuance of any
    Termination Event or Potential Termination Event, the
    Administrative Agent for a Related Group shall take no action
    hereunder (other than ministerial actions or such actions as are
    specifically provided for herein) without the prior consent of
    the Group Majority Investors (which consent shall not be
    unreasonably withheld or delayed). The Administrative Agent for
    a Related Group shall not, without the prior written consent of
    all Bank Investor, in such Related Group, agree to
    (i) amend, modify or waive any provision of this Agreement
    in any way which would (A) reduce or impair Collections or
    the payment of Discount or fees payable hereunder to the Bank
    Investors, in such Related Group or delay the scheduled dates
    for payment of such amounts, (B) increase the Servicing Fee
    (other than as permitted pursuant to Section 6.2(b)),
    (C) modify any provisions of this Agreement or the
    Receivables Purchase Agreement or the Parent Agreement relating
    to the timing of payments required to be made by the Transferor,
    any Originating Entity, FME KGaA or FMCH or the application of
    the proceeds of such payments, (D) permit the appointment
    of any Person (other than the Agent) as successor Collection
    Agent, (E) release any property from the lien provided by
    this Agreement (other than as expressly contemplated herein) or
    (F) extend or permit the extension of the Commitment
    Termination Date without the consent of each Bank Investor, in
    such Related Group. The Administrative Agent for a Related Group
    shall not agree to any amendment of this Agreement which
    increases the dollar amount of the Commitment of a Bank Investor
    in such Related Group without the prior consent of such Bank
    Investor. In addition, no Administrative Agent shall agree to
    any amendment of this Agreement not specifically described in
    the two preceding sentences without the consent of the related
    Group Majority Investors (which consent shall not be
    unreasonably withheld or delayed). In the event an
    Administrative Agent requests any Investor’s consent
    pursuant to the foregoing provisions and such Administrative
    Agent does not receive a consent (either positive or negative)
    from such Investor within 10 Business Days of such
    Investor’s receipt of such request, then such Investor (and
    its percentage interest hereunder) shall be disregarded in
    determining whether such Administrative Agent shall have
    obtained sufficient consent hereunder.

 

    (b) Each Administrative Agent shall exercise such rights
    and powers vested in it by this Agreement and the other
    Transaction Documents, and use the same degree of care and skill
    in their exercise, as a prudent person would exercise or use
    under the circumstances in the conduct of such person’s own
    affairs.

 

    Section 9.9. Administrative
    Agent’s Reliance, Etc. Neither any Administrative
    Agent nor any directors, officers, agents or employees of an
    Administrative Agent shall be liable for any action taken or
    omitted to be taken by it or them as Administrative Agent under
    or in connection with this Agreement or any of the other
    Transaction Documents, except for its or their own gross
    negligence or willful misconduct. Without limiting the
    foregoing, each Administrative Agent: (i) may consult with
    legal counsel (including counsel for any Parent Group Member),

    

    56

 

    independent public accountants and other experts selected by it
    and shall not be liable for any action taken or omitted to be
    taken in good faith by it in accordance with the advice of such
    counsel, accountants or experts; (ii) makes no warranty or
    representation to any Investor and shall not be responsible to
    any Investor for any statements, warranties or representations
    made in or in connection with this Agreement; (iii) shall
    not have any duty to ascertain or to inquire as to the
    performance or observance of any of the terms, covenants or
    conditions of this Agreement or any of the other Transaction
    Documents on the part of any Parent Group Member or the
    Collection Agent or to inspect the property (including the books
    and records) of any Parent Group Member or the Collection Agent;
    (iv) shall not be responsible to any Investor for the due
    execution, legality, validity, enforceability, genuineness,
    sufficiency or value of this Agreement, any of the other
    Transaction Documents or any other instrument or document
    furnished pursuant hereto or thereto; and (v) shall incur
    no liability under or in respect of this Agreement or any of the
    other Transaction Documents by acting upon any notice (including
    notice by telephone), consent, certificate or other instrument
    or writing (which may be by telex) believed by it to be genuine
    and signed or sent by the proper party or parties.

 

    Section 9.10. Indemnification
    of the Administrative Agents. The Bank Investors, in
    each Related Group agree to indemnify the Administrative Agent
    for such Related Group (to the extent not reimbursed by the
    Transferor), ratably in accordance with their Pro Rata Shares,
    from and against any and all liabilities, obligations, losses,
    damages, penalties, actions, judgments, suits, costs, expenses
    or disbursements of any kind or nature whatsoever which may be
    imposed on, incurred by, or asserted against such Administrative
    Agent in any way relating to or arising out of this Agreement or
    any action taken or omitted by such Administrative Agent, any of
    the other Transaction Documents hereunder or thereunder,
    provided that the Bank Investors, in a Related Group shall not
    be liable for any portion of such liabilities, obligations,
    losses, damages, penalties, actions, judgments, suits, costs,
    expenses or disbursements resulting from the applicable
    Administrative Agent’s gross negligence or willful
    misconduct. Without limitation of the foregoing, the Bank
    Investors, in each Related Group agree to reimburse the
    Administrative Agent for such Related Group, ratably in
    accordance with their Pro Rata Shares, promptly upon demand for
    any out-of-pocket expenses (including counsel fees) incurred by
    such Administrative Agent in connection with the administration,
    modification, amendment or enforcement (whether through
    negotiations, legal proceedings or otherwise) of, or legal
    advice in respect of rights or responsibilities under, this
    Agreement and the other Transaction Documents, to the extent
    that such expenses are incurred in the interests of or otherwise
    in respect of such Bank Investors, hereunder
    and/or
    thereunder and to the extent that such Administrative Agent is
    not reimbursed for such expenses by the Transferor.

 

    Section 9.11. Successor
    Administrative Agents. Any Administrative Agent may
    resign at any time by giving written notice thereof to the
    Agent, each Investor in its Related Group and the Transferor and
    may be removed at any time with cause by the applicable Group
    Majority Investors. Upon any such resignation or removal, the
    Group Majority Investors for such Related Group shall appoint a
    successor Administrative Agent. Each Investor agrees that it
    shall not unreasonably withhold or delay its approval of the
    appointment of a successor Administrative Agent. If no such
    successor Administrative Agent shall have been so appointed for
    such Related Group, and shall have accepted such appointment,
    within 30 days after the retiring Administrative
    Agent’s giving of notice of resignation or the Group
    Majority Investors’ removal of the retiring Administrative
    Agent, then the retiring Administrative Agent may, on behalf of
    the Investors in such Related Group, appoint a successor
    Administrative Agent for such Related Group which successor
    Administrative Agent shall be either (i) a commercial bank
    having a combined capital and surplus of at least $50,000,000 or
    (ii) an Affiliate of such a bank. Upon the acceptance of
    any appointment as Administrative Agent hereunder by a successor
    Administrative Agent, such successor Administrative Agent shall
    thereupon succeed to and become vested with all the rights,
    powers, privileges and duties of the retiring Administrative
    Agent, and the retiring Administrative Agent shall be discharged
    from its duties and obligations under this Agreement. After any
    retiring Administrative Agent’s resignation or removal
    hereunder as Administrative Agent, the provisions of this
    Article IX shall continue to inure to its benefit as to any
    actions taken or omitted to be taken by it while it was
    Administrative Agent under this Agreement.

 

    Section 9.12. Payments
    by the Administrative Agents. Unless specifically
    allocated to an Investor pursuant to the terms of this
    Agreement, all amounts received by an Administrative Agent on
    behalf of the Investors in its Related Group shall be paid by
    such Administrative Agent to the Investors in its Related Group
    (at their respective accounts specified in their respective
    Assignment and Assumption Agreements) in accordance with their
    respective related pro rata interests in the Net Investment on
    the Business Day received by such Administrative Agent, unless
    such amounts are received after 12:00 noon on such Business Day,
    in which case such Administrative Agent shall use its reasonable
    efforts to pay such amounts to the Investors in its Related
    Group on such Business Day, but, in any event, shall pay such
    amounts to such Investors in accordance with their respective
    related pro rata interests in the Net Investment not later than
    the following Business Day.

    

    57

 

    ARTICLE X

    

 

    MISCELLANEOUS
    

 

    Section 10.1. Term
    of Agreement. This Agreement shall terminate on the
    date following the Termination Date upon which the Net
    Investment has been reduced to zero, all accrued Discount and
    Servicing Fees have been paid in full and all other Aggregate
    Unpaids have been paid in full, in each case, in cash;
    provided, however, that (i) the rights and
    remedies of the Agent, the Investors and the Administrative
    Agents with respect to any representation and warranty made or
    deemed to be made by the Transferor pursuant to this Agreement,
    (ii) the indemnification and payment provisions of
    Article VIII, and (iii) the agreement set forth in
    Section 10.9 hereof, shall be continuing and shall survive
    any termination of this Agreement.

 

    Section 10.2. Waivers;
    Amendments. No failure or delay on the part of the
    Agent, any Investor or any Administrative Agent in exercising
    any power, right or remedy under this Agreement shall operate as
    a waiver thereof, nor shall any single or partial exercise of
    any such power, right or remedy preclude any other further
    exercise thereof or the exercise of any other power, right or
    remedy. The rights and remedies herein provided shall be
    cumulative and nonexclusive of any rights or remedies provided
    by law. Any provision of this Agreement may be amended or waived
    if, but only if, in the case of any amendment, such amendment is
    in writing and is signed by the Transferor, the Agent, each
    Administrative Agent and the Majority Investors and in the case
    of any waiver, such waiver is granted in writing by each
    Administrative Agent. Without limiting the generality of the
    foregoing, it is understood for the avoidance of doubt that an
    Administrative Agent may condition its consent to any amendment
    or waiver on its receipt of written confirmation from S&P
    and Moody’s that such amendment or waiver will not result
    in the reduction or withdrawal of the then current rating of the
    Commercial Paper issued by its related Conduit Investor.

 

    Section 10.3. Notices. Except
    as provided below, all communications and notices provided for
    hereunder shall be in writing (including telecopy or electronic
    facsimile transmission or similar writing) and shall be given to
    the other party at its address or telecopy number set forth
    below or at such other address or telecopy number as such party
    may hereafter specify for the purposes of notice to such party.
    Each such notice or other communication shall be effective
    (i) if given by telecopy when such telecopy is transmitted
    to the telecopy number specified in this Section 10.3 and
    confirmation is received, (ii) if given by mail 3 Business
    Days following such posting, postage prepaid,
    U.S. certified or registered, (iii) if given by
    overnight courier, one (1) Business Day after deposit
    thereof with a national overnight courier service, or
    (iv) if given by any other means, when received at the
    address specified in this Section 10.3. However, anything
    in this Section to the contrary notwithstanding, the Transferor
    hereby authorizes each Investor, each Administrative Agent and
    the Agent to effect Transfers, Tranche Period and
    Tranche Rate selections based on telephonic notices made by
    any Person which such Investor, such Administrative Agent or the
    Agent, as applicable, in good faith believes to be acting on
    behalf of the Transferor. The Transferor agrees to deliver
    promptly to each such Investor or Administrative Agent or the
    Agent, as applicable, a written confirmation of each telephonic
    notice directed to such Person signed by an authorized officer
    of Transferor. However, the absence of such confirmation shall
    not affect the validity of such notice. If the written
    confirmation differs in any material respect from the action
    taken by the Agent or the applicable Investor or Administrative
    Agent, the records of such Investor or Administrative Agent or
    the Agent, as applicable shall govern absent manifest error.

 

    If to the Transferor:

 

    (NMC Funding Corporation)

    920 Winter Street

    Waltham, MA 02451

    Telephone:
    (781) 699-2668

    Telecopy:
    (781) 699-9756

    Attn: Mark Fawcett

    Payment Information:

    Chase Manhattan Bank, N.A.

    ABA
    021-000-021

    Account
    323-0-76823

 

    If to the Collection Agent:

 

    National Medical Care, Inc.

    920 Winter Street

    Waltham, MA 02451

    Telephone:
    (781) 699-2668

    Telecopy:
    (781) 699-9756

    Attn: Mark Fawcett

    

    58

 

    If to the Agent:

 

    WestLB AG, New York Branch

    1211 Avenue of the Americas

    New York, New York 10036

    Attention: Asset Securitization Group

    Telephone:
    (212) 852-6000

    Telecopy:
    (212) 597-1423

 

    If to Paradigm:

 

    c/o AMACAR
    Group, L.L.C.

    6525 Morrison Boulevard Suite 318

    Charlotte, North Carolina 28211

    Attention: Douglas Johnson

    Telephone:
    704-365-0569

    Telecopy:
    704-365-1362

 

    If to the Administrative Agent for Paradigm:

 

    c/o WestLB
    AG, New York Branch

    1211 Avenue of the Americas

    New York, New York 10036

    Attention: Asset Securitization Group

    Telephone:
    (212) 852-6000

    Telecopy:
    (212) 597-1423

 

    If to GBFC:

 

    Giro Balanced-Funding Corporation

    c/o Global
    Securitization Services

    68 South Service Road, Suite 120

    Melville, NY 11747

    Attention: Damian Perez

    Tel: 631/587-4700

    Telecopy: 212/302-8767

 

    If to BayernLB:

 

    Bayerische Landesbank, New York Branch

    560 Lexington Avenue

    New York, New York 10022

    Attention: Customer Securitization

    Tel: 212/310-9878

    Telecopy: 212/230-9020

 

    If to Liberty Street:

 

    c/o Global
    Securitization Services, LLC

    68 South Service Road, Suite 120

    Melville, NY 11747

    Attention: Andrew Stidd

    Telephone:
    (631) 587-4700

    Telecopy:
    (212) 302-8767

 

    If to the Administrative Agent for Liberty Street:

 

    The Bank of Nova Scotia

    One Liberty Plaza

    New York, NY 10006

    Attention: Michael Eden

    Tel: 212/225-5237

    Fax: 212/225-5274

    

    59

 

    with a copy to:

 

    The Bank of Nova Scotia

    One Liberty Plaza

    New York, NY 10006

    Attention: Vilma Pindling

    Tel: 212/225-5410

    Fax: 212/225-6465

 

    If to the Bank Investors, at their respective addresses set
    forth on Schedule I or in the Assignment and Assumption
    Agreement pursuant to which it became a party hereto.

 

    Section 10.4. Governing
    Law; Submission to Jurisdiction; Integration.

 

    (a) THIS AGREEMENT SHALL BE GOVERNED BY AND CONSTRUED IN
    ACCORDANCE WITH THE LAWS OF THE STATE OF NEW YORK. THE
    TRANSFEROR HEREBY SUBMITS TO THE NONEXCLUSIVE JURISDICTION OF
    THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF
    NEW YORK AND OF ANY NEW YORK STATE COURT SITTING IN THE CITY OF
    NEW YORK FOR PURPOSES OF ALL LEGAL PROCEEDINGS ARISING OUT OF OR
    RELATING TO THIS AGREEMENT OR THE TRANSACTIONS CONTEMPLATED
    HEREBY. Each of the Transferor and the Collection Agent hereby
    irrevocably waives, to the fullest extent it may effectively do
    so, any objection which it may now or hereafter have to the
    laying of the venue of any such proceeding brought in such a
    court and any claim that any such proceeding brought in such a
    court has been brought in an inconvenient forum. Nothing in this
    Section 10.4 shall affect the right of any Investor to
    bring any action or proceeding against the Transferor or the
    Collection Agent or any of their respective properties in the
    courts of other jurisdictions.

 

    (b) EACH OF THE PARTIES HERETO HEREBY WAIVES ANY RIGHT TO
    HAVE A JURY PARTICIPATE IN RESOLVING ANY DISPUTE, WHETHER
    SOUNDING IN CONTRACT, TORT OR OTHERWISE AMONG ANY OF THEM
    ARISING OUT OF, CONNECTED WITH, RELATING TO OR INCIDENTAL TO THE
    RELATIONSHIP BETWEEN THEM IN CONNECTION WITH THIS AGREEMENT OR
    THE OTHER TRANSACTION DOCUMENTS.

 

    (c) This Agreement contains the final and complete
    integration of all prior expressions by the parties hereto with
    respect to the subject matter hereof and shall constitute the
    entire Agreement among the parties hereto with respect to the
    subject matter hereof superseding all prior oral or written
    understandings.

 

    (d) The Transferor and NMC each hereby appoint Arent Fox
    LLP, located at 1675 Broadway, New York, New York 10019 as
    the authorized agent upon whom process may be served in any
    action arising out of or based upon this Agreement, the other
    Transaction Documents to which such Person is a party or the
    transactions contemplated hereby or thereby that may be
    instituted in the United States District Court for the Southern
    District of New York and of any New York State Court sitting in
    the City of New York by any Administrative Agent, the Agent, any
    Investor, any Collateral Agent or any assignee of any of them.

 

    Section 10.5. Severability;
    Counterparts. This Agreement may be executed in any
    number of counterparts and by different parties hereto in
    separate counterparts, each of which when so executed shall be
    deemed to be an original and all of which when taken together
    shall constitute one and the same Agreement. Any provisions of
    this Agreement which are prohibited or unenforceable in any
    jurisdiction shall, as to such jurisdiction, be ineffective to
    the extent of such prohibition or unenforceability without
    invalidating the remaining provisions hereof, and any such
    prohibition or unenforceability in any jurisdiction shall not
    invalidate or render unenforceable such provision in any other
    jurisdiction.

 

    Section 10.6. Successors
    and Assigns. (a) This Agreement shall be binding
    on the parties hereto and their respective successors and
    assigns; provided, however, that neither the
    Transferor nor the Collection Agent may assign any of its rights
    or delegate any of its duties hereunder or under any of the
    other Transaction Documents to which it is a party without the
    prior written consent of each Administrative Agent. No provision
    of this Agreement shall in any manner restrict the ability of
    any Conduit Investor, any Bank Investor to assign, participate,
    grant security interests in, or otherwise transfer any portion
    of the Transferred Interest.

 

    (b) Each of the Transferor and the Collection Agent hereby
    agrees and consents to the assignment by any Conduit Investor
    from time to time of all or any part of its rights under,
    interest in and title to this Agreement and the Transferred
    Interest to any Liquidity Provider for such Conduit Investor. In
    addition, each of the Transferor and the Collection Agent hereby
    consents to and acknowledges the assignment by any Conduit
    Investor of all of its rights under, interest in and title to
    this Agreement and the Transferred Interest to the related
    Collateral Agent.

    

    60

 

    Section 10.7. Waiver
    of Confidentiality. The Transferor hereby consents to
    the disclosure of any non-public information with respect to it
    received by any Conduit Investor, the Agent, any Bank Investor
    or any Administrative Agent to any of the Conduit Investors, the
    Agent, any nationally recognized rating agency rating the
    Commercial Paper of such Conduit Investor, any Administrative
    Agent, any Collateral Agent, any Bank Investor or potential Bank
    Investor, any Liquidity Provider or any Credit Support Provider
    in relation to this Agreement.

 

    Section 10.8. Confidentiality
    Agreement. (a) Each of the parties hereto hereby
    agrees that, from the commencement of discussions with respect
    to the transactions contemplated by the Transaction Documents
    (the “Transaction”), each of the parties hereto
    (and each of their respective, and their respective affiliates,
    employees, officers, directors, advisors, representatives and
    agents) are permitted to disclose to any and all Persons,
    without limitation of any kind, the structure and tax aspects
    (as such terms are used in Internal Revenue Code
    Sections 6011, 6111 and 6112 and the regulations
    promulgated thereunder) of the Transaction, and all materials of
    any kind (including opinions or other tax analyses) that are
    provided to any party related to such structure and tax aspects.
    In this regard, the parties hereto acknowledge and agree that
    the disclosure of the structure or tax aspects of the
    Transaction is not limited in any way by an express or implied
    understanding or agreement, oral or written (whether or not such
    understanding or agreement is legally binding). Furthermore,
    each of the parties hereto acknowledges and agrees that it does
    not know or have reason to know that its use or disclosure of
    information relating to the structure or tax aspects of the
    Transaction is limited in any other manner (such as where the
    Transaction is claimed to be proprietary or exclusive) for the
    benefit of any other Person.

 

    (b) Subject to Section 10.8(a), each of the Transferor
    and the Collection Agent hereby agrees that it will not
    disclose, and the Transferor will cause each Parent Group Member
    to refrain from disclosing, the contents of this Agreement or
    any other proprietary or confidential information of any Conduit
    Investor, the Agent, any Administrative Agent, any Collateral
    Agent, any Liquidity Provider or any Bank Investor to any other
    Person except (i) as required by federal or state
    securities laws, (ii) its auditors and attorneys, employees
    or financial advisors (other than any commercial bank) and any
    nationally recognized rating agency provided such
    auditors, attorneys, employees financial advisors or rating
    agencies are informed of the highly confidential nature of such
    information or (iii) following notice thereof to each
    Administrative Agent, as otherwise required by other applicable
    law or order of a court of competent jurisdiction.

 

    (c) Each Administrative Agent, each Investor and the Agent
    acknowledges that it or its agents or representatives may, from
    time to time, obtain knowledge of information, practices, books,
    correspondence and records (“Confidential
    Information”) identified to it in writing as being of a
    confidential nature or in which the Transferor or an Originating
    Entity has a proprietary interest. Subject to
    Section 10.8(a), each Administrative Agent, each Investor
    and the Agent agrees that all such Confidential Information so
    obtained by it is to be regarded as confidential information and
    that such Confidential Information may be subject to laws, rules
    and regulations regarding patient confidentiality, and agrees
    that (x) it shall retain in confidence, and shall ensure
    that its agents and representatives retain in confidence, and
    will not disclose, any of such Confidential Information without
    the prior written consent of the Transferor and (y) it will
    not, and will ensure that its agents and representatives will
    not, make any use whatsoever (other than for purposes of this
    Agreement) of any of such Confidential Information without the
    prior written consent of the Transferor; provided,
    however, that such Confidential Information may be
    disclosed to the extent that such Confidential Information
    (i) may be or becomes generally available to the public
    (other than as a breach of this Section 10.8(c),
    (ii) is required or appropriate in response to any summons
    or subpoena in connection with any litigation or (iii) is
    required by law to be disclosed; and provided,
    further, however, that such Confidential
    Information may be disclosed to (A) the Agent, any
    Administrative Agent, any Investor, any Credit Support Provider
    and any Liquidity Provider, subject to the terms of this
    Section 10.8(c), (B) any such Person’s legal
    counsel, auditors and other business advisors, (C) any such
    Person’s government regulators and (D) the rating
    agencies rating any Commercial Paper issued by a Conduit
    Investor, provided that the Person making such disclosure
    shall advise each recipient thereof referred to in clauses (A),
    (B), (C) and (D) above that such Confidential
    Information is to be regarded and maintained as confidential
    information and that each Administrative Agent has agreed to
    keep confidential such Confidential Information as provided in
    clauses (x) and (y) above. Notwithstanding anything
    herein to the contrary, the parties hereto agree that the
    Transferor and the Collection Agent shall not be required to
    furnish any patient specific medical information to the extent
    the disclosure of such information would violate applicable law,
    unless and until the recipient of such information executes and
    delivers a business associate agreement in substantially the
    form attached as Exhibit J.

 

    Section 10.9. No
    Bankruptcy Petition Against Conduit Investors. Each of
    the Transferor and the Collection Agent hereby covenants and
    agrees that, prior to the date which is one year and one day
    after the payment in full of all outstanding Commercial Paper or
    other indebtedness of any Conduit Investor, it will not, and the
    Transferor will cause each Parent Group Member to not, institute
    against, or encourage, assist or join any other Person in
    instituting against, such Conduit Investor any bankruptcy,
    reorganization, arrangement insolvency or liquidation
    proceedings

    

    61

 

    or other similar proceeding under the laws of the United States
    or any state of the United States or any other proceedings
    related to an Event of Bankruptcy. Notwithstanding any provision
    contained in this Agreement to the contrary, no Conduit Investor
    shall, nor shall any Conduit Investor be obligated to, pay any
    amount pursuant to this Agreement unless (i) the Conduit
    Investor has received funds which may be used to make such
    payment in accordance with such Conduit Investor’s
    commercial paper program documents, which funds are not required
    to repay its Commercial Paper when due; and (ii) after
    giving effect to such payment, either (x) there is
    sufficient liquidity available (determined in accordance with
    such program documents) to pay the Face Amount of all its
    Commercial Paper, (y) the Conduit Investor is not rendered
    insolvent or (z) its Commercial Paper has been repaid in
    full. Any amount which the Conduit Investor does not pay
    pursuant to the operation of the preceding sentence shall not
    constitute a claim (as defined in Section 101 of the United
    States Bankruptcy Code) against or a corporate obligation of the
    Conduit Investor for any insufficiency. The provisions of this
    Section shall survive the termination of this Agreement.

 

    Section 10.10. No
    Recourse Against Stockholders, Officers or
    Directors. No recourse under any obligation, covenant
    or agreement of any Conduit Investor contained in this Agreement
    shall be had against Global Securitization Services, LLC (nor
    any affiliate thereof), AMACAR Group L.L.C. (nor any affiliate
    thereof), or any stockholder, officer or director of such
    Conduit Investor, as such, by the enforcement of any assessment
    or by any legal or equitable proceeding, by virtue of any
    statute or otherwise; it being expressly agreed and understood
    that this Agreement is solely a corporate obligation of such
    Conduit Investor, and that no personal liability whatsoever
    shall attach to or be incurred by Global Securitization
    Services, LLC (or any affiliate thereof), AMACAR Group L.L.C.
    (or any affiliate thereof), or the stockholders, officers, or
    directors of such Conduit Investor, as such, or any of them,
    under or by reason of any of the obligations, covenants or
    agreements of such Conduit Investor contained in this Agreement,
    or implied therefrom, and that any and all personal liability
    for breaches by a Conduit Investor of any of such obligations,
    covenants or agreements, either at common law or at equity, or
    by statute or constitution, of Global Securitization Services ,
    LLC (or any affiliate thereof), AMACAR Group L.L.C. (or any
    affiliate thereof) and every such stockholder, officer or
    director of such Conduit Investor is hereby expressly waived as
    a condition of and consideration for the execution of this
    Agreement.

 

    Section 10.11. Characterization
    of the Transactions Contemplated by the Agreement. It
    is the intention of the parties that the transactions
    contemplated hereby constitute the sale of the Transferred
    Interest, conveying good title thereto free and clear of any
    Adverse Claims to the Agent, on behalf of the Investors, and
    that the Transferred Interest not be part of the
    Transferor’s estate in the event of an insolvency. If,
    notwithstanding the foregoing, the transactions contemplated
    hereby should be deemed a financing, the parties intend that the
    Transferor shall be deemed to have granted to the Agent, on
    behalf of the Investors, and the Transferor hereby grants to the
    Agent, on behalf of the Investors, a first priority perfected
    and continuing security interest in all of the Transferor’s
    right, title and interest in, to and under the Receivables,
    together with Related Security, Collections and Proceeds with
    respect thereto, and together with all of the Transferor’s
    rights under the Receivables Purchase Agreement, the
    Transferring Affiliate Letter, the BMA Transfer Agreement and
    all other Transaction Documents with respect to the Receivables
    and with respect to any obligations thereunder of any
    Originating Entity with respect to the Receivables, and that
    this Agreement shall constitute a security agreement under
    applicable law. The Transferor hereby assigns to the Agent, on
    behalf of the Investors, all of its rights and remedies under
    the Receivables Purchase Agreement, the Transferring Affiliate
    Letter and the BMA Transfer Agreement (and all instruments,
    documents and agreements executed in connection therewith) with
    respect to the Receivables and with respect to any obligations
    thereunder of any Originating Entity with respect to the
    Receivables.

 

    [REMAINDER OF PAGE INTENTIONALLY LEFT BLANK]

    

    62

 

    IN WITNESS WHEREOF, the parties hereto have executed and
    delivered this Transfer and Administration Agreement as of the
    date first written above.

 

    PARADIGM FUNDING LLC,

    as a Conduit Investor

 

    By: /s/  Doris
    J. Hearn

    Name:     Doris J. Hearn

    Title: Vice President

 

 

    GIRO BALANCED FUNDING CORPORATION,

    as a Conduit Investor

 

 

    By: /s/  Damian
    A. Perez

    Name:     Damian A. Perez

    Title: Vice President

 

 

    LIBERTY STREET FUNDING LLC,

    as a Conduit Investor

 

 

    By: /s/  Jill
    A. Russo

    Name:     Jill A. Russo

    Title: Vice President

 

    NMC FUNDING CORPORATION,

    as Transferor

 

 

    By: /s/  Mark
    Fawcett

    Name:     Mark Fawcett

    Title: Vice President and Treasurer

 

    NATIONAL MEDICAL CARE, INC.,

    as Collection Agent

 

 

    By: /s/  Mark
    Fawcett

    Name:     Mark Fawcett

    Title: Vice President and Treasurer

    

    63

 

    WESTLB AG, NEW YORK BRANCH, as Agent, an Administrative
    Agent and as a Bank Investor

 

 

    By: /s/  Matthew
    Tallo

    Name:     Matthew Tallo

    Title: Executive Director

 

    By: /s/  Vesselina
    Koleva

    Name:     Vesselina Koleva

    Title: Director

 

    BAYERISCHE LANDESBANK, NEW YORK BRANCH, as an
    Administrative Agent

 

 

    By: /s/  Alexander
    Kohnert

    Name:     Alexander Kohnert

    Title: Senior Vice President

 

    By: /s/  Lori-Ann
    Wynter

    Name:     Lori-Ann Wynter

    Title: Vice President

 

    BAYERISCHE LANDESBANK, CAYMAN ISLANDS BRANCH, as a Bank
    Investor

 

 

    By: /s/  Lori-Ann
    Wynter

    Name:     Lori-Ann Wynter

    Title: Vice President

 

    By: /s/  Jana
    Schmiedel

    Name:     Jana Schmiedel

    Title: Second Vice President

 

    

    64

 

    THE BANK OF NOVA SCOTIA,

     as an Administrative Agent and as a Bank Investor

 

    By: /s/  Michael
    Eden

    Name:     Michael Eden

    Title: Director

 

    LANDESBANK HESSEN-THUERINGEN GIROZENTRALE, as a Bank
    Investor

 

    By: /s/  Martin
    Scheeze

    Name:     Martin Scheeze

    Title: Senior Vice President

 

    By: /s/  Stefan
    Brandauer

    Name:     Stefan Brandauer

    Title: Vice President

    

    65

 

 

    SCHEDULE I

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

    TRANSFER
    AND ADMINISTRATION AGREEMENT

 

    NOTICE
    ADDRESSES FOR BANK INVESTORS

 

    WESTLB AG, NEW YORK BRANCH

    1211 Avenue of the Americas

    New York, New York 10036

    Attention: Asset Securitization Group

    Telephone:
    (212) 852-6000

    Telecopy:
    (212) 597-1423

 

    BAYERISCHE LANDESBANK, CAYMAN ISLANDS BRANCH

    560 Lexington Avenue

    New York, New York 10022

    Attention: Alexander Kohnert

    Tel: 212/310-9878

    Telecopy: 212/230-9020

 

    LANDESBANK HESSEN — THUERINGEN GIROZENTRALE

    Neue Mainzer Strasse
    52-58

    D-60297 Frankfurt am Main

    Germany

    Attention: Martin Scheele

    Tel:
    01149-69-9132-3183

    Fax:
    01149-69-9132-4190

 

    THE BANK OF NOVA SCOTIA

    One Liberty Plaza

    New York, NY 10006

    Attention: Michael Eden

    Tel: 212/225-5237

    Fax: 212/225-5274

 

    with a copy to:

 

    The Bank of Nova Scotia

    One Liberty Plaza

    New York, NY 10006

    Attention: Vilma Pindling

    Tel: 212/225-5410

    Fax: 212/225-6465

    

    66

 

    SCHEDULE II

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

    TRANSFER
    AND ADMINISTRATION AGREEMENT

 

    COMMITMENTS
    OF BANK INVESTORS

 

	 	 	 	 	 
	
    Bank Investor
	
 
	
    Commitment
	
 

	 

	

    WestLB AG, New York Branch

	
 
	
    $
	
    185,000,000
	
 

	

    Bayerische Landesbank, Cayman Islands Branch

	
 
	
    $
	
    167,000,000
	
 

	

    The Bank of Nova Scotia

	
 
	
    $
	
    143,000,000
	
 

	

    Landesbank Hessen — Thueringen Girozentrale

	
 
	
    $
	
    55,000,000
	
 

    

    67

 

 

    Exhibit 10.2

 

    EXECUTION
    VERSION

 

 

    FOURTH
    AMENDED AND RESTATED

    TRANSFER AND ADMINISTRATION AGREEMENT

    among

    PARADIGM FUNDING LLC,

    GIRO BALANCED FUNDING CORPORATION,

    LIBERTY STREET FUNDING LLC,

    as Conduit Investors

    NMC FUNDING CORPORATION,

    as Transferor

    NATIONAL MEDICAL CARE, INC.,

    as Collection Agent

    THE FINANCIAL INSTITUTIONS PARTIES HERETO,

    as Bank Investors

    BAYERISCHE LANDESBANK, NEW YORK BRANCH,

    as an Administrative Agent

    THE BANK OF NOVA SCOTIA

    as an Administrative Agent

    and

    WESTLB AG, NEW YORK BRANCH,

    as an Administrative Agent and as Agent

    Dated as of October 16, 2008

 

 

    EXHIBIT A

 

    EXHIBIT A

    to

    FOURTH AMENDED AND RESTATED

    TRANSFER AND ADMINISTRATION AGREEMENT

    FORMS OF CONTRACTS

 

	 	 	 
	
    
	
 
	
    SUPPLY AGREEMENT

    BETWEEN FRESENIUS USA MARKETING, INC.

    &

    «COMPANY»

 

    This Agreement, dated «Date», is made by and between
    Fresenius USA Marketing, Inc., a Delaware corporation
    (“FUSA”) with its principal office located at 920
    Winter Street, Waltham, Massachusetts
    02451–1457;
    and «Company», a «State» corporation, with
    its principal office located at «Address»,
    «City», «State» «Zip»
    (“PURCHASER”).

 

    Definitions:  The following definitions apply
    within this Supply Agreement. PRODUCT(S) shall mean EQUIPMENT
    and DISPOSABLES. DISPOSABLES shall mean any hemodialysis or
    peritoneal dialysis product other than EQUIPMENT. EQUIPMENT
    shall mean hemodialysis machines, peritoneal dialysis cyclers,
    and other related equipment.

 

    Section 1.0  Purchase
    Commitment; Pricing; Payment Terms

 

    1.1 The Attachments, Schedules, and Exhibits listed below
    are incorporated herein as though part of this Agreement.

 

			
	 	    1.2 
	
    Attachment 1.0 — Order/Delivery Policy

    Attachment 2.0 — Volume Commitments

    Attachment 3.0 — Rebates

	 
	 	    1.3 
	
    Schedule A — Peritoneal Dialysis, Specific
    Terms

    Schedule B — Hemodialysis Equipment, Specific
    Terms

	 
	 	    1.4 
	
    Exhibit 1 — Hemodialysis Disposables Pricing,
    Dialyzers

    Exhibit 2 — Hemodialysis Disposables Pricing,
    Bloodlines and Fistula Needles

    Exhibit 3 — Hemodialysis Disposables Pricing,
    Concentrate

    Exhibit 4 — Hemodialysis Disposables Pricing,
    Saline (Not Applicable)

    Exhibit 5 — Peritoneal Dialysis Products
    Pricing

    Exhibit 6 — Hemodialysis Equipment Pricing

    Exhibit 7 — Miscellaneous Products Pricing

 

    1.5 Subject to the terms and conditions set forth in this
    Agreement and on the Attachments, Schedules, and Exhibits
    attached hereto, FUSA agrees to sell to PURCHASER, and PURCHASER
    agrees to purchase from FUSA at the commitment levels and prices
    noted herein, the PRODUCT(S) referenced herein.

 

    1.6 The price which PURCHASER shall pay for the PRODUCT(S)
    shall be as indicated on the Exhibits. Such prices are exclusive
    of any applicable state and local sales tax, which if
    applicable, shall be paid by PURCHASER. At any time after the
    [*] of the EFFECTIVE DATE of this Agreement, FUSA may [*] listed
    on the attached EXHIBITS at a [*], provided that such [*]. For
    purposes of this Agreement, CONTRACT YEAR shall mean the period
    of time from the EFFECTIVE DATE to the first anniversary thereof
    and thereafter from anniversary date to next such anniversary
    date. EFFECTIVE DATE shall mean the date the Agreement is
    countersigned and deemed accepted by FUSA.

 

    1.7 Payment terms shall be Net [*] Days from the date of
    FUSA’S invoice. Invoices that are not paid pursuant to the
    terms of this Agreement may be subject to a late payment charge
    of [*] percent ([*]%) per month. Additionally, FUSA, in addition
    to all other rights available to it, reserves the right to
    require payment in advance of shipment in the event that
    PURCHASER is delinquent in its payment for past purchases. To
    the extent that the Agreement provides for rebate or discounts,
    [*].

 

    1.8 Drug and Service State Licensing Requirements:
    PURCHASER agrees to obtain and maintain all state-mandated
    licenses
    and/or
    permits required for the purpose of purchase, use, and
    distribution of FUSA PRODUCT(S). PURCHASER shall provide all
    applicable license and permit information to FUSA upon request.

 

    1.9 Tax Exempt Status: A PURCHASER that is exempt from
    taxation is required to provide appropriate certification to
    FUSA’S Finance Department. PURCHASER shall enclose a copy
    of its tax exemption certificate with the executed Agreement, if
    applicable.

 

    1.10 PRODUCT(S) sold under this Agreement are exclusively
    for use in [*] facilities and for the [*] of those facilities.
    PURCHASER may not distribute, resell, or otherwise transfer to
    any third party any PRODUCT(S)

 

    purchased from FUSA under this Agreement. Any such transfer
    shall be a material breach of this Agreement and shall permit
    FUSA to terminate this Agreement pursuant to Section 2.2.

 

    1.11 PRODUCT(S) sold herein is/are not for resale.

 

    1.12 Upon acceptance of this Agreement, a mutually agreed
    upon forecast of [*] requirements may be established to assist
    with production planning.

 

    Section 2.0  Term
    and Termination

 

    2.1 Unless earlier terminated pursuant to Section 2.2
    below, this Agreement shall be for a term of [*], commencing on
    the EFFECTIVE DATE.

 

    2.2 If either party fails to meet any of its material
    obligations or otherwise materially breaches this Agreement, the
    other party may, at its option, terminate this Agreement and any
    other Agreement between FUSA and PURCHASER with [*] written
    notice, if the failure to meet the obligation or cure the breach
    of either party is unable to be remedied in that timeframe.

 

    Section 3.0  Discounts;
    Disclosure

 

    3.1 Prices invoiced for the goods purchased reflect any
    negotiated discounts, and rebates may apply to purchases. Any
    discounts, rebates or deductions from FUSA’S list price or
    other concessions received by PURCHASER from FUSA are
    “Discounts or Other Reductions in Price” under
    42 U.S.C.
    § 1320a-7b(b)(3)(A).
    The parties shall comply with all laws and regulations
    (including 42 C.F.R. 1001.952(h)) regarding reporting of
    any discount, rebate, or other concession in the fiscal year of
    the PURCHASER in which it was earned or the year after, and
    report any discount, rebate, or other concession, consistent
    with applicable rules. FUSA shall provide additional information
    requested by the applicable Medicare or state health care
    program to assist PURCHASER in meeting its reporting requirement.

 

    3.2 PURCHASER acknowledges and represents that PRODUCT(S)
    purchased under this Agreement shall not be utilized for [*].
    Upon request PURCHASER shall provide FUSA with an annual
    certification of its adherence to this requirement.

 

    3.3 PURCHASER agrees that [*] for all purchases made
    through a [*].

 

    Section 4.0  Order/Delivery
    Policy

 

    4.1 PURCHASER agrees to abide by the Order/Delivery Policy
    described on Attachment 1.0.

 

    4.2 All orders shall be subject to the terms and conditions
    of this Agreement and shall not be subject to the terms,
    conditions, or provisions of any order confirmation, except to
    the extent that such confirmation specifies quantities.

 

    Section 5.0  Return
    Goods Policy

 

    5.1 Due to the nature of FUSA’S PRODUCTS, the contents
    are subject to damage in transit to PURCHASER. All orders must
    be counted and inspected for damage prior to acceptance of
    delivery from the carrier. Any exception should be noted on
    PURCHASER’S copy of the carrier’s freight bill, and
    the driver must countersign the freight bill. Exceptions must be
    reported within [*] to the designated Customer Service
    representative in order to receive all authorized credits.

 

    5.2 All returns must be arranged through FUSA’S
    Customer Service Department. Purchaser must ensure that Products
    are packed for shipment. All PRODUCTS returned to FUSA must have
    a Returned Goods Authorization (RGA) number. Any PRODUCT
    returned to FUSA without a corresponding RGA number shall not be
    credited.

 

    5.3 DISPOSABLES

 

    5.3a This policy applies to all DISPOSABLES originally delivered
    to [*] unless otherwise indicated. DISPOSABLES must be returned
    in the original, unopened carton.

 

    5.3b DISPOSABLES that have not been stored in a sanitary
    manner or in accordance with PRODUCT(S) storage statements
    cannot be returned or credited. Verification of proper storage
    may be required for credit.

 

    5.3c DISPOSABLES provided [*], but are still subject to the
    terms of this Agreement.

 

    5.3d Prior notification and approval by FUSA is required to
    return any DISPOSABLES. Credit shall not be issued without prior
    notification of the return and unless returned in accordance
    with this Section 5.0. Approval to return DISPOSABLES does
    not guarantee credit. FUSA does not assume liability for
    DISPOSABLES returned without prior notification.

    

    2

 

    5.3e All DISPOSABLES returned to FUSA may be subject to a
    restocking fee of [*] per [*]. The only exception to the
    restocking fee is DISPOSABLES shipped in error by FUSA, provided
    the PURCHASER reports the error within [*] of delivery.

 

    5.3f All returns must be arranged through FUSA’S
    Customer Service department. PURCHASER must ensure that
    DISPOSABLES are packed for shipping.

 

    5.3g DISPOSABLES shipped in error by FUSA must be reported
    within [*] and returned within [*] of shipment to receive [*]
    percent ([*]%) credit.

 

    5.3h DISPOSABLES ordered in error by PURCHASER must be
    reported within [*] and returned within [*] of shipment to
    receive [*] percent ([*]%) credit, with the exception of [*]
    returned from [*] (which may not be returned for credit). All
    such returns must be arranged through FUSA’S Customer
    Service department, and PURCHASER is fully responsible for all
    associated costs.

 

    5.3i DISPOSABLES returned after [*] of shipment but within
    [*] of shipment shall be considered EXCESS STOCK. Return of
    EXCESS STOCK must be arranged through FUSA’S Customer
    Service department, and PURCHASER is fully responsible for all
    associated costs. DISPOSABLES returned after [*] from shipment
    are not eligible for credit.

 

    5.3j EXCESS STOCK shall be eligible for return or credit
    under the following circumstances:

 

    a) EXCESS STOCK with less than [*] remaining to expiration
    may not be returned for credit.

 

    b) EXCESS STOCK returned from a [*] shall be credited at
    [*] percent ([*]%). EXCESS STOCK returned from [*], with the
    exception of [*] (which may not be returned for credit) shall be
    credited at [*] percent ([*]%) only in the instances of death,
    transplantation, or permanent return to center.

 

    5.4 EQUIPMENT

 

    5.4a Purchased EQUIPMENT is not returnable unless [*].
    Leased, rental, trade-in,
    and/or
    evaluation equipment may be returned as governed by the terms of
    the applicable Agreement.

 

    5.4b All EQUIPMENT returns are at PURCHASER’S expense,
    and EQUIPMENT must be in the same condition as when delivered to
    PURCHASER, normal wear and tear excepted. PURCHASER shall
    deliver the EQUIPMENT to such place or on board such carrier,
    packed for shipping, as FUSA may specify. PURCHASER is fully
    responsible for return of EQUIPMENT including all associated
    charges with the exception of return due to equipment shipped in
    error by FUSA. PURCHASER shall give FUSA prior written notice
    that it is returning EQUIPMENT. Any/all credits are subject to
    final credit approval.

 

    5.4c Due to the nature of FUSA’S PRODUCTS, the
    contents are subject to damage in transit to PURCHASER. All
    orders must be counted and inspected for damage prior to
    acceptance of delivery from the carrier. Any exception should be
    noted on PURCHASER’S copy of the carrier’s freight
    bill, and the driver must countersign the freight bill.
    Exceptions must be reported within [*] to the designated
    Customer Service representative in order to receive all
    authorized credits.

 

    5.4d Exchangeable parts must be returned to FUSA within [*]
    of purchase date to receive proper credit. Parts must be
    repairable
    and/or
    reusable. An RGA number must be requested at the time of the
    purchase or within [*] of the purchase. Parts returned after
    ninety (90) days shall not be credited, and the associated
    RGA form shall be canceled. Return freight charges are the
    responsibility of PURCHASER.

 

    5.4e Warranty Parts: Defective parts must be returned to
    FUSA within [*] of PURCHASER’S receipt of replacement part
    to receive proper credit. To place an order for a replacement
    part under parts warranty, PURCHASER must supply the serial
    number of the machine, purchase order number, invoice number, or
    order number under which the part was originally purchased at
    the time the order is placed. An RGA shall be issued at the time
    the order is placed for the defective part. If the defective
    part is not returned [*] from the date of the RGA, PURCHASER
    agrees to pay for the replaced part at [*]. Returned parts that
    are not actually under warranty, based on the manufacture date,
    shall also be invoiced at [*]. All warranties in this Agreement
    shall be construed to comply with the Warranty Safe Harbor found
    at 42 C.F.R. 1001.952(g) for reporting purposes.

 

    5.4f Each part returned to FUSA must have a corresponding
    Material Travel Tag completed and attached securely to the part.
    If either the Material Travel Tag or the RGA form is not
    enclosed with the replacement part(s), PURCHASER must contact
    the Parts Customer Service Department to obtain the RGA number
    to be recorded on the Material Traveler Tag.

    

    3

 

    5.4g Spare parts ordered by PURCHASER may be subject to a
    restocking fee of [*] percent ([*]%). Return freight charges are
    the responsibility of PURCHASER. PURCHASER must request an RGA
    to return items.

 

    Section 6.0  FUSA
    Performance

 

    6.1 FUSA shall use commercially reasonable efforts to fill
    orders, but FUSA shall not be liable for
    non-performance or
    delays caused by a supply shortage of raw materials,
    manufacturing problems, delivery or labor problems, acts of
    regulatory agencies, discontinuation of a product line, Acts of
    God, or causes beyond its control. PURCHASER agrees that in such
    events, FUSA may [*].

 

    Section 7.0  Warranty

 

    7.1 FUSA warrants that the PRODUCT(S) manufactured by
    Fresenius Medical Care North America, when used in accordance
    with the [*]. The applicable manufacturer under the
    manufacturer’s warranty will cover PRODUCTS not
    manufactured by Fresenius Medical Care North America, and FUSA
    provides no warranty for PRODUCTS not manufactured by Fresenius
    Medical Care North America.

 

    7.2 The Warranty does not apply to any PRODUCT that is
    misused, abused, neglected, tampered with or damaged by
    accident, flood, fire or other hazard. If the PRODUCT(S) is not
    used in accordance with manufacturer’s instructions, the
    product warranties are void and of no effect. There are no other
    express or implied warranties, including any warranty of
    merchantability or fitness for a particular purpose. FUSA shall
    not be liable for [*].

 

    7.3 All warranties in this Agreement shall be construed to
    comply with the [*].

 

    7.4 THE WARRANTY IN THIS SECTION 7 SHALL BE IN LIEU OF
    ANY OTHER WARRANTY EXPRESSED, OR IMPLIED OR STATUTORY,
    RESPECTING PRODUCTS, AND FUSA MAKES NO IMPLIED WARRANTY OF
    MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. THE
    PURCHASER’S SOLE AND EXCLUSIVE REMEDY IN CONTRACT, TORT OR
    UNDER ANY OTHER THEORY AGAINST FRESENIUS MEDICAL CARE NORTH
    AMERICA PRODUCTS AND THEIR USE SHALL BE THE [*] AND NO OTHER
    REMEDY (INCLUDING, WITHOUT LIMITATION, CONSEQUENTIAL AND
    INCIDENTAL DAMAGES) SHALL BE AVAILABLE TO PURCHASER. FUSA SHALL
    HAVE NO FURTHER OBLIGATION OR LIABILITY WITH RESPECT TO THE
    PRODUCTS, PARTS OR ITS SALE, OPERATION AND USE, AND PURCHASER
    NEITHER ASSUMES, NOR AUTHORIZES THE ASSUMPTION OF, ANY
    OBLIGATION OR LIABILITY IN CONNECTION WITH SUCH PRODUCTS.

 

    7.5 EQUIPMENT

 

    7.5a FUSA warrants to PURCHASER that EQUIPMENT delivered is
    free from defects in material or workmanship for the periods
    [*], provided the EQUIPMENT is used and maintained in accordance
    with the manufacturer’s operating instructions. Parts
    installed which have been purchased from vendors other than FUSA
    shall void all applicable warranties.

 

    7.5b The Warranty does not apply to any equipment that is
    misused, abused, neglected, tampered with, damaged by accident,
    flood, water, fire or other hazard, subjected to abnormal or
    unusual electrical or fluid stress, improperly installed or
    operated, or not maintained in accordance with the routine
    maintenance schedule set forth in the Operator’s and
    Technician’s manual for the equipment. [*] is not covered
    under the Warranty. Warranty does not provide [*] during the
    period that PURCHASER’S equipment is inoperative.

 

    7.5c FUSA shall [*], any parts subject to this warranty
    that are proven defective in materials or workmanship. Such [*]
    shall be made [*] PURCHASER and FUSA reserves the right to
    determine the [*] at which the [*].

 

    7.5d Warranty Parts: Defective parts must be returned to
    FUSA within [*] of PURCHASER’S receipt of replacement part
    to receive proper credit. To place an order for a replacement
    part under parts warranty, PURCHASER must supply the serial
    number of the machine, purchase order number, invoice number, or
    order number under which the part was originally purchased at
    the time the order is placed. An RGA shall be issued at the time
    the order is placed for the defective part. If the defective
    part is not returned [*] from the date of the RGA, PURCHASER
    agrees to pay for the replaced part at [*]. Returned parts that
    are not actually under warranty, based on the manufacture date,
    shall also be invoiced at [*].

 

    Section 8.0  Confidentiality

 

    8.1 All information in this Agreement relating to [*] is
    confidential and, except as provided in Section 3.0,
    PURCHASER shall not disclose any such information to any third
    party without FUSA’S prior written consent.

    

    4

 

    Section 9.0  General
    Provisions

 

    9.1 This Agreement contains the entire Agreement between
    FUSA and PURCHASER and supersedes all prior understandings or
    Agreements of the parties, whether written or oral. No
    modification of, nor amendment to, this Agreement shall be
    effective unless in writing and signed by FUSA and PURCHASER.
    The Attachments, Schedules, and Exhibits attached are
    incorporated herein.

 

    9.2 The rights and obligations of the parties shall inure
    to the benefit of, and shall be binding upon the parties hereto
    and their respective successors and assigns, provided that
    neither party shall assign its rights and obligations hereunder
    without the prior written consent of the other. The sale or
    transfer of substantially all of the assets of PURCHASER, the
    sale or transfer of more than fifty percent (50%) of the
    outstanding stock of PURCHASER, and the merger of PURCHASER into
    another entity constitute an assignment for which this section
    applies. PURCHASER expressly acknowledges that any assignment to
    entities controlled by, controlling, or under common ownership
    with FUSA or originating out of any merger or consolidation of
    FUSA shall not require the consent of PURCHASER.

 

    9.3 Either party may terminate this Agreement, effective
    immediately with written notice if: The other shall file for
    bankruptcy, or shall be adjudicated bankrupt, or shall take
    advantage of any applicable insolvency law, or shall make an
    assignment for the benefit of creditors, or shall be dissolved,
    or shall have a receiver appointed for its property.

 

    9.4 This Agreement is deemed to be executed in, shall be
    governed by and construed according to the laws of the
    Commonwealth of Massachusetts without reference to conflict of
    law principles. Each party agrees to submit to the jurisdiction
    of the courts of Massachusetts for the purpose of resolving any
    dispute hereunder. If particular portions of this Agreement are
    ruled unenforceable, such portions shall be deemed modified to
    the extent necessary to render such portions enforceable and to
    preserve to the fullest extent permissible the intent and
    agreement of the parties herein set forth. In the event that any
    future changes in federal or state law or regulations applicable
    to the performance of the Agreement shall, in the reasonable
    opinion of legal counsel for either party, make any portion of
    this Agreement invalid or illegal, either party may terminate
    this Agreement upon thirty (30) days written notice to the
    other, if within said thirty (30)-day period the parties are not
    able to agree on a mutually acceptable addendum to the Agreement.

 

    9.5 FUSA’S failure to insist on performance of any of
    the terms or conditions herein, or to exercise any right, or
    privilege, or FUSA’S waiver of any breach hereunder shall
    not thereafter waive any other term, condition, right, or
    privilege.

 

    9.6 Upon request, PURCHASER shall supply the following [*]:
    Complete [*] and [*].

 

    9.7 Any notice required to be given under this Agreement
    shall be given by certified mail, return receipt requested,
    postage prepaid, or by nationally recognized overnight courier
    service, to the appropriate party at its address first set forth
    above or to any other address subsequently provided. A required
    copy of any notice to FUSA should be sent to the Law
    Department/RTG, Fresenius Medical Care North America, 920 Winter
    Street, Waltham, Massachusetts
    02451–1457.

 

    FUSA shall notify PURCHASER of the EFFECTIVE DATE of this
    Agreement.

 

    PURCHASER
    does          
    does not
    have          
    tax-exempt status (NOTE: Tax Exempt certificate must be
    included with signed Agreement if applicable).

 

    PURCHASER’S fiscal year is reported
    as          (REQUIRED).

    

    5

 

    IN WITNESS WHEREOF, the parties hereto have executed this
    Supply Agreement.

 

	 	 	 	 	 	 	 
	

    PURCHASER: «Company» 

    «City», «State»

	
 
	
    Fresenius USA Marketing, Inc. 

    Waltham, Massachusetts

	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    By:

	
 
	
    

	
 
	
    By:
	
 
	
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
    

	
 
	
 
	
 
	
    

	
 
	
 
	
    (print name)
	
 
	
 
	
 
	
    (print name)

	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
    

	
 
	
 
	
 
	
    

	
 
	
 
	
    (print title)
	
 
	
 
	
 
	
    (print title)

	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
    

	
 
	
 
	
 
	
    

	
 
	
 
	
    (date)
	
 
	
 
	
 
	
    (date)

    

    6

 

 

    ATTACHMENT
    1.0

    

 

    ORDER/DELIVERY
    POLICY

 

    Section 1.0  Freight
    and Distribution

 

    1.1 Published prices for [*] include [*] as long as the
    order is placed [*] prior to the scheduled delivery date. All
    [*] orders that are less than [*] may be subject to a [*].
    Published prices for [*] do not include [*]. These [*] shall be
    arranged and billed separately.

 

    1.2 All deliveries may be subject to shipping
    and/or other
    charges in accordance with the applicable provisions of
    FUSA’s Dialysis Products Catalog located at
    www.fmcna.com, and are subject to change with sixty
    (60) days notice.

 

    1.3 PURCHASER is responsible for all [*] for all [*] when
    expedited order processing and delivery is required unless
    specifically provided in this Agreement in Sections 2.4 and
    3.2 below.

 

    1.4 All shipments are considered “contiguous USA
    only” unless otherwise mutually agreed to in writing by
    PURCHASER and FUSA.

 

    1.5 All [*] shall be sold [*]. All other [*] sold hereunder
    shall be sold [*] as long as the [*] are delivered in accordance
    with the Order/Delivery Policy.

 

    Section 2.0  Scheduled
    Deliveries

 

    2.1 PURCHASER and FUSA shall develop a mutually agreeable
    delivery schedule, and PURCHASER’S delivery days will be
    set according to such schedule. Altering this delivery schedule
    represents an exception and may be discussed with the FUSA Sales
    representative
    and/or
    Customer Service, who shall review any proposed changes with
    Distribution prior to making changes.

 

    2.2 All delivery frequencies and days shall be maintained
    in FUSA’s transaction management system to determine if an
    order represents a scheduled or unscheduled delivery. All home
    patients shall receive a calendar indicating their ordering days
    and scheduled delivery days. Units/clinics may request a
    calendar at any time.

 

    2.3 All orders delivered on a scheduled delivery date which
    are placed with Customer Service no later than [*] prior to the
    scheduled delivery date are shipped [*]. Orders may be placed by
    telephone, by fax, or by U.S. Mail. All originators of
    faxed orders shall receive a faxed Sales Order Confirmation.
    Scheduled orders received or existing orders changed with less
    than [*] prior to the scheduled delivery date may be subject to
    a [*].

 

    2.4 Should FUSA initiate a modification in delivery
    schedules due to route realignment, holiday shipping schedules,
    or pre-negotiated accelerated orders or special orders,
    PURCHASER shall not incur [*] for the shipment of these items,
    even if shipped commercially.

 

    Section 3.0  Off-Schedule Deliveries

 

    3.1 Orders requiring off-schedule delivery shall be shipped
    [*]. Commercially reasonable attempts shall be made to make the
    off-schedule delivery on the FUSA Fleet. [*] deliveries made on
    the FUSA Fleet may be subject to a freight charge.

 

    3.2 All other off-schedule deliveries shall be shipped
    commercial carrier, [*], and all actual incurred freight charges
    shall be added to the invoice. Freight charges shall be [*] for
    any off-schedule delivery due to the following:

 

    a) [*];

 

    b) [*];

 

    c) [*]; or

 

    d) [*]. Every effort should be made to minimize the amount
    of additional product required until the next scheduled delivery
    date for the patient.

 

    Section 4.0  Acute
    Hospital Freight Policies

 

    4.1 Recognizing that acute hospitals have unique delivery
    and service requirements, they may select one of the following
    three (3) options regarding their deliveries:

 

    a) FUSA and PURCHASER negotiate a mutually agreeable
    delivery frequency but not to exceed [*]. All shipments shall be
    [*].

    

    7

 

    b) Utilize a third-party distributor when delivery
    frequency greater than [*] is required. All fees with
    third-party distributor are at the PURCHASER’S expense.

 

    c) Orders placed and shipped as requested by the account
    with no pre-determined delivery schedule or frequency. All
    shipments shall be [*]. If the delivery can be made on the FUSA
    Fleet, the account may be subject to a delivery fee. If the
    delivery cannot be made on the FUSA Fleet, a common carrier
    shall be used, and all commercial carrier charges shall be
    invoiced to PURCHASER.

 

    Section 5.0  Receipt
    and Verification

 

    5.1 All deliveries must be verified within [*] from receipt
    in order to receive credit for shortages or to have PRODUCT(S)
    replaced without incurring delivery charges. After the [*]
    period, standard return goods policies are in effect. It is
    incumbent upon the clinic and patients to verify their
    deliveries to ensure that all items ordered and shipped are
    received.

 

    Section 6.0  Proof
    of Shipment

 

    6.1 The FUSA invoice and packing list must be retained as
    proof of delivery. Subject to availability and within [*]
    following the date of shipment, requests for additional
    documentation of delivery (i.e., carrier delivery logs) may be
    subject to a service charge.

    

    8

 

    ATTACHMENT
    2.0

    

 

    VOLUME
    COMMITMENTS

 

    Section 1.0  The
    general terms and conditions for purchases of [*] are described
    in the Supply Agreement.

 

    1.1 Compliance with minimum volume purchase commitments
    shall be calculated on [*]. [*] shall mean [*] for products
    contained herein [*].

 

    1.2 PURCHASER shall purchase a minimum volume of [*] from
    FUSA in each [*] as follows:

 

    a) Total [*] of [*] shall be at least $[*] per year.

 

    b) Total [*] of [*] shall be at least $[*] per year.

 

    c) Total [*] of [*], consisting of [*] shall be at least
    $[*] per year.

 

    d) Total [*] of [*] shall be at least $[*] per year.

 

    e) Total [*] of [*], including [*] shall be at least $[*]
    per year.

 

    f) Total [*] of [*] shall be at least $[*] per year.

 

    g) Total [*] of [*] shall be at least $[*] per year.

 

    1.3 PURCHASER shall pay to FUSA an amount equal to [*].

 

    1.4 Purchase commitments for [*] shall be measured [*], and
    a [*].

 

    1.5 FUSA shall calculate the annual [*] and notify
    PURCHASER within [*] of the end of the [*], and payment of any
    amounts owing shall be due to FUSA within [*] of notice.

 

    1.6 [*].

    

    9

 

 

    ATTACHMENT
    3.0

    

 

    REBATES

 

    Section 1.0  The
    general terms and conditions for purchase of [*] are described
    in the Supply Agreement.

 

    1.1 Rebate programs are subject to the following:

 

    a) Unless specifically stated herein, rebates shall be [*].

 

    b) Rebates are calculated based on [*]. [*] shall mean [*]
    for [*] contained herein [*].

 

    c) Any rebate earned and not claimed by PURCHASER [*] shall
    be null and void.

 

    d) In order to receive the rebates referenced in this
    Agreement, PURCHASER must [*], and PURCHASER must [*] under this
    Agreement.

 

    Section 2.0  Non-Reuse
    Dialyzer Rebates

 

    2.1 Dialyzer rebates shall be earned based on [*] of all
    non-reuse dialyzers. The earned rebate shall be a percentage,
    which shall be applied to the [*] of all non-reuse dialyzers
    purchased within the rebate period. Rebate periods shall
    commence on the [*] and shall thereafter coincide with the [*].

 

    2.2 Earned rebates shall be processed by FUSA no later than
    [*] the rebate period.

 

    2.3 The [*] required to earn a dialyzer rebate are as
    follows:

 

	 	 	 
	
    [*]
	
 
	
    Rebate

	 

	

    $0 to $???

	
 
	
    X%

	

    $??? to $???

	
 
	
    Y%

	

    $??? +

	
 
	
    Z%

 

    Section 3.0  Hemodialysis
    Equipment Rebates

 

    3.1 Equipment rebates shall be earned based on [*] of all
    hemodialysis machines. The earned rebate shall be an amount
    applied to the [*] of all hemodialysis machines purchased within
    the rebate period. Rebate periods shall commence on the [*] and
    shall thereafter coincide with the [*].

 

    3.2 Earned rebates shall be processed by FUSA no later than
    [*] the rebate period.

 

    3.3 The [*] required to earn an equipment rebate are as
    follows:

 

	 	 	 
	
    [*]
	
 
	
    Rebate

	 

	

    0 to ?? [*]

	
 
	
    No Rebate

	

    ?? to ?? [*]

	
 
	
    $X

	

    ?? to ?? [*]

	
 
	
    $X

	

    More than ?? [*]

	
 
	
    $X

 

    Section 4.0  Peritoneal
    Dialysis Volume Rebates

 

    4.1 Peritoneal dialysis rebates shall be earned based on
    [*] of all peritoneal dialysis solution PRODUCTS purchased
    within the [*]. The earned rebate shall be a percentage, which
    shall be applied to the [*] of all peritoneal dialysis solution
    PRODUCTS purchased within the rebate period. Rebate periods
    shall commence on the [*] and shall thereafter coincide with the
    [*].

 

    4.2 Earned rebates shall be processed by FUSA no later than
    [*] the rebate period.

 

    4.3 The[*] required to earn a peritoneal dialysis rebate
    are as follows:

 

	 	 	 
	
    [*]
	
 
	
    Rebate

	 

	

    $0 to $??

	
 
	
    No Rebate

	

    $?? to $??

	
 
	
    X%

 

    Section 5.0  Peritoneal
    Dialysis [*] Rebates

 

    5.1 Peritoneal dialysis [*] rebates shall be earned based
    on [*] of all peritoneal dialysis solution PRODUCTS purchased
    within the [*]. The earned rebate shall be an amount paid to
    PURCHASER and shall be utilized by PURCHASER for [*] purposes
    only. Documentation (e.g. [*]) shall be required of PURCHASER
    confirming that such rebate is being utilized for [*] purposes
    only.

 

    5.2 Earned rebates shall be processed by FUSA no later than
    [*] the rebate period.

 

    5.3 The [*] required to earn a peritoneal dialysis [*]
    rebate are as follows:

 

	 	 	 
	
    [*]
	
 
	
    Rebate

	 

	

    $?? to $??

	
 
	
    X%

	

    $?? to $??

	
 
	
    Y%

    

    10

 

    SCHEDULE A

    

 

    PERITONEAL
    DIALYSIS PRODUCTS

 

    Section 1.0  The
    general terms and conditions for purchases of peritoneal
    dialysis PRODUCT(S) are described in the Supply Agreement. Items
    specific to peritoneal dialysis are listed below.

 

    Section 2.0  Added
    Value Provisions

 

    2.1 FUSA shall provide [*], in appropriate quantities, [*].

 

    Section 3.0  Cycler
    Shipping and Pickup

 

    3.1 A [*] shipping charge of [*] shall apply to all rental
    cyclers.

 

    3.2 A [*] pickup charge of [*] shall apply to all rental
    cyclers

 

    Section 4.0  New
    and Retrained Patients

 

    4.1 All new FUSA patients shall receive [*].

 

    4.2 All retrained FUSA patients [*] shall receive [*].

 

    Section 5.0  Damaged
    or Lost PD Cycler

 

    5.1 PURCHASER shall assume the entire risk of loss of or
    damage to the Cycler.

 

    5.2 If cycler is lost or damaged, PURCHASER will be
    invoiced a fee of [*] to cover the costs of such a loss.

 

    5.3 If cycler is not returned according to the FUSA policy
    (located at www.fmcna.com) within [*], the fee shall be invoiced
    and be payable to FUSA immediately.

 

    Section 6.0  PD
    Vacation Cyclers

 

    6.1 If PURCHASER would like to order a cycler for delivery
    to an alternative location, a [*] will apply.

 

    6.2 Al applicable cycler delivery/shipping/pickup charges
    apply.

 

    6.3 If the cycler is not returned within [*], the standard
    monthly rental fee (above) will be charged.

 

    6.4 The damaged or lost cycler fee of [*] applies.

    

    11

 

    SCHEDULE A-l

    

 

    PERITONEAL
    DIALYSIS PRODUCTS

 

    Section 1.0  Training
    Supplies

 

    1.1 Upon PURCHASER’s request FUSA shall provide, [*]
    as follows:

 

 

    [*]

 

 

    NOTE: [*]

    

    12

 

    SCHEDULE A-2

    

 

    PERITONEAL
    DIALYSIS PRODUCTS

 

    Section 1.0  Retraining
    Supplies

 

    1.1 Upon PURCHASER’s request FUSA shall provide, [*]
    as follows:

 

    [*]

 

    NOTE: [*]

    

    13

 

    SCHEDULE B

    

 

    HEMODIALYSIS
    EQUIPMENT

 

    Section 1.0  The
    general terms and conditions for purchases of hemodialysis
    equipment are described in the Supply Agreement. Items specific
    to hemodialysis EQUIPMENT are listed below.

 

    1.1 Upon acceptance of this Agreement, a mutually agreed
    upon [*] requirements may be established to assist with
    production planning.

 

    Section 2.0  CRRT
    Requirements

 

    2.1 CRRT Field Installation: The CRRT program requires 8.02
    software or greater prior to installation. PURCHASER shall
    contact the Spare Parts department when ordering the CRRT to
    verify the requirements of the system.

 

    2.2 CRRT Training:  FUSA shall provide [*]
    technical and clinical in-service required for the operation of
    CRRT. [*].

 

    Section 3.0  Financing
    or Lease Arrangements

 

    3.1 Financing or lease arrangements and related credit
    approvals must be in place prior to shipment and installation of
    the equipment. FUSA reserves the right to assign lease to
    leasing agency of FUSA’S choice.

 

    Section 4.0  Installation

 

    4.1 FUSA shall provide reasonably required
    on-site
    technical and clinical in-service required for installation and
    operation of the FUSA system. [*].

 

    Section 5.0  Purchase
    Orders

 

    5.1 Purchase orders received at the Waltham Office of FUSA
    shall be confirmed by fax within two (2) business days. If
    confirmation has not been received within [*], PURCHASER shall
    contact FUSA’S Hemodialysis Equipment Specialist at
    (800) 662-1237,
    Extension 4589, Fax Number
    (781) 699-9735.

 

    Section 6.0  Orders
    Cancelled by PURCHASER

 

    6.1 PURCHASER may cancel its order only upon written notice
    to FUSA and upon payment to FUSA of reasonable and proper
    cancellation charges prior to shipment and delivery of the
    equipment.

 

    Section 7.0  Technical
    Training 2008K Machines

 

    7.1 [*], FUSA shall [*] a regularly-scheduled FUSA
    Level One technical training class held in Coppell
    (Dallas), Texas, or Chicago, Illinois. [*]. PURCHASER shall be
    responsible for [*] expenses associated with this technical
    training class (e.g., shuttle, meals).

    

    14

 

    DATE

 

    NAME

    TITLE

    FACILITY

    ADDRESS

    CITY, ST ZIP

 

    Dear ????:

 

    Fresenius USA Marketing, Inc. is pleased to offer FACILITY the
    enclosed Agreement. Please sign and return the entire Agreement
    to the Contracts Management Department at the address below:

 

    FUSA CONTRACTS DEPARTMENT

    Fresenius USA Marketing, Inc. an affiliate of

    Fresenius Medical Care North America

    920 Winter Street,
    4th

    Floor

    Waltham, MA
    02451-1457

 

    The effective date of this Agreement will be the date it is
    accepted and signed by Fresenius USA Marketing, Inc’s
    corporate office in Waltham, Massachusetts. If this Agreement is
    not received and accepted by DATE, this Agreement will be
    considered withdrawn.

 

    We, at Fresenius USA Marketing, Inc., offer our commitment to
    quality sales and service to FACILITY. If I may be of any
    assistance, please do not hesitate to contact me.

 

    Sincerely,

 

    SALES REP

    Regional Sales Manager

 

    /??

 

    Enclosure

    

    15

 

    WARRANTY

 

    Section 1.0  Warranty

 

    1.1 FUSA warrants to Purchaser that EQUIPMENT delivered is
    free from defects in material or workmanship for the periods
    [*], provided the EQUIPMENT is used and maintained in accordance
    with the manufacturer’s operating instructions. Parts
    installed which have been purchased from vendors other than FUSA
    shall void all applicable warranties.

 

    1.2 The Warranty does not apply to any equipment that is
    misused, abused, neglected, tampered with, damaged by accident,
    flood, water, fire or other hazard, subjected to abnormal or
    unusual electrical or fluid stress, improperly installed or
    operated, or not maintained in accordance with the routine
    maintenance schedule set forth in the Operator’s and
    Technician’s manual for the equipment. Periodic
    preventative maintenance required to maintain proper machine
    operation [*]. Warranty does not provide replacement [*] during
    the period that Purchaser’s equipment is inoperative.

 

    1.3 FUSA shall [*], any parts subject to this warranty that
    are proven defective in materials or workmanship. Such [*] shall
    be made [*] to Purchaser and FUSA reserves the right to
    determine the [*] at which the [*].

 

    1.4 All warranties in this Agreement shall be construed to
    comply with the [*].

 

    1.5 THE WARRANTY IN THIS SECTION 1 SHALL BE IN LIEU OF
    ANY OTHER WARRANTY EXPRESSED, OR IMPLIED OR STATUTORY,
    RESPECTING PRODUCTS, AND FUSA MAKES NO IMPLIED WARRANTY OF
    MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. THE
    PURCHASER’S SOLE AND EXCLUSIVE REMEDY IN CONTRACT, TORT OR
    UNDER ANY OTHER THEORY AGAINST FUSA PRODUCTS AND THEIR USE SHALL
    BE THE [*] OF THE PRODUCTS AND NO OTHER REMEDY (INCLUDING,
    WITHOUT LIMITATION, CONSEQUENTIAL AND INCIDENTAL DAMAGES) SHALL
    BE AVAILABLE TO PURCHASER. FUSA SHALL HAVE NO FURTHER OBLIGATION
    OR LIABILITY WITH RESPECT TO THE PRODUCTS, PARTS OR ITS SALE,
    OPERATION AND USE, AND PURCHASER NEITHER ASSUMES, NOR AUTHORIZES
    THE ASSUMPTION OF, ANY OBLIGATION OR LIABILITY IN CONNECTION
    WITH SUCH PRODUCTS.

    

    16

 

    SCHEDULE B

    

 

    HEMODIALYSIS
    EQUIPMENT

 

    Section 1.0  The
    general terms and conditions for purchases of hemodialysis
    equipment are described in the Supply Agreement. Items specific
    to hemodialysis EQUIPMENT are listed below.

 

    1.1 Upon acceptance of this Agreement, a mutually agreed
    upon [*] requirements may be established to assist with
    production planning.

 

    Section 2.0  CRRT
    Requirements

 

    2.1 CRRT Field Installation: The CRRT program requires 8.02
    software or greater prior to installation. PURCHASER shall
    contact the Spare Parts department when ordering the CRRT to
    verify the requirements of the system.

 

    2.2 CRRT Training: FUSA shall provide [*] technical and
    clinical in-service required for the operation of CRRT. [*].

 

    Section 3.0  Financing
    or Lease Arrangements

 

    3.1 Financing or lease arrangements and related credit
    approvals must be in place prior to shipment and installation of
    the equipment. FUSA reserves the right to assign lease to
    leasing agency of FUSA’S choice.

 

    Section 4.0  Installation

 

    4.1 FUSA shall provide reasonably required
    on-site
    technical and clinical in-service required for installation and
    operation of the FUSA system. [*].

 

    Section 5.0  Purchase
    Orders

 

    5.1 Purchase orders received at the Waltham Office of FUSA
    shall be confirmed by fax within two (2) business days. If
    confirmation has not been received within [*], PURCHASER shall
    contact FUSA’S Hemodialysis Equipment Specialist at
    (800) 662-1237,
    Extension 4589, Fax Number
    (781) 699-9735.

 

    Section 6.0  Orders
    Cancelled by PURCHASER

 

    6.1 PURCHASER may cancel its order only upon written notice
    to FUSA and upon payment to FUSA of reasonable and proper
    cancellation charges prior to shipment and delivery of the
    equipment.

 

    Section 7.0  Technical
    Training [*] Machines

 

    7.1 [*], FUSA shall [*] a regularly-scheduled FUSA
    Level One technical training class held in Coppell
    (Dallas), Texas, or Chicago, Illinois. [*]. PURCHASER shall be
    responsible for [*] expenses associated with this technical
    training class (e.g., shuttle, meals).

    

    17

 

    ATTACHMENT
    1.0

    

 

    ORDER/DELIVERY
    POLICY

 

    Section 1.0  Freight
    and Distribution

 

    1.1 Published prices for [*] include [*] as long as the
    order is placed [*] prior to the scheduled delivery date. All
    [*] orders that are less than [*] may be subject to a [*].
    Published prices for [*] do not include [*]. These [*] shall be
    arranged and billed separately.

 

    1.2 All deliveries may be subject to shipping
    and/or other
    charges in accordance with the applicable provisions of
    FUSA’s Dialysis Products Catalog located at www.fmcna.com,
    and are subject to change with sixty (60) days notice.

 

    1.3 PURCHASER is responsible for all [*] for all [*] when
    expedited order processing and delivery is required unless
    specifically provided in this Agreement in Sections 2.4 and
    3.2 below.

 

    1.4 All shipments are considered “contiguous USA
    only” unless otherwise mutually agreed to in writing by
    PURCHASER and FUSA.

 

    1.5 All [*] shall be sold [*]. All other [*] sold hereunder
    shall be sold [*] as long as the [*] are delivered in accordance
    with the Order/Delivery Policy.

 

    Section 2.0  Scheduled
    Deliveries

 

    2.1 PURCHASER and FUSA shall develop a mutually agreeable
    delivery schedule, and PURCHASER’S delivery days will be
    set according to such schedule. Altering this delivery schedule
    represents an exception and may be discussed with the FUSA Sales
    representative
    and/or
    Customer Service, who shall review any proposed changes with
    Distribution prior to making changes.

 

    2.2 All delivery frequencies and days shall be maintained
    in FUSA’s transaction management system to determine if an
    order represents a scheduled or unscheduled delivery. All home
    patients shall receive a calendar indicating their ordering days
    and scheduled delivery days. Units/clinics may request a
    calendar at any time.

 

    2.3 All orders delivered on a scheduled delivery date which
    are placed with Customer Service no later than [*] prior to the
    scheduled delivery date are shipped [*]. Orders may be placed by
    telephone, by fax, or by U.S. Mail. All originators of
    faxed orders shall receive a faxed Sales Order Confirmation.
    Scheduled orders received or existing orders changed with less
    than [*] prior to the scheduled delivery date may be subject to
    a [*].

 

    2.4 Should FUSA initiate a modification in delivery
    schedules due to route realignment, holiday shipping schedules,
    or pre-negotiated accelerated orders or special orders,
    PURCHASER shall not incur [*] for the shipment of these items,
    even if shipped commercially.

 

    Section 3.0  Off-Schedule Deliveries

 

    3.1 Orders requiring off-schedule delivery shall be shipped
    [*]. Commercially reasonable attempts shall be made to make the
    off-schedule delivery on the FUSA Fleet. [*] deliveries made on
    the FUSA Fleet may be subject to a freight charge.

 

    3.2 All other off-schedule deliveries shall be shipped
    commercial carrier, [*], and all actual incurred freight charges
    shall be added to the invoice. Freight charges shall be [*] for
    any off-schedule delivery due to the following:

 

    a) [*];

 

    b) [*];

 

    c) [*]; or

 

    d) [*]. Every effort should be made to minimize the amount
    of additional product required until the next scheduled delivery
    date for the patient.

 

    Section 4.0  Acute
    Hospital Freight Policies

 

    4.1 Recognizing that acute hospitals have unique delivery
    and service requirements, they may select one of the following
    three (3) options regarding their deliveries:

 

    a) FUSA and PURCHASER negotiate a mutually agreeable
    delivery frequency but not to exceed [*]. All shipments shall be
    [*].

    

    18

 

    b) Utilize a third-party distributor when delivery
    frequency greater than [*] is required. All fees with
    third-party distributor are at the PURCHASER’S expense.

 

    c) Orders placed and shipped as requested by the account
    with no pre-determined delivery schedule or frequency. All
    shipments shall be [*]. If the delivery can be made on the FUSA
    Fleet, the account may be subject to a delivery fee. If the
    delivery cannot be made on the FUSA Fleet, a common carrier
    shall be used, and all commercial carrier charges shall be
    invoiced to PURCHASER.

 

    Section 5.0  Receipt
    and Verification

 

    5.1 All deliveries must be verified within [*] from receipt
    in order to receive credit for shortages or to have PRODUCT(S)
    replaced without incurring delivery charges. After the [*]
    period, standard return goods policies are in effect. It is
    incumbent upon the clinic and patients to verify their
    deliveries to ensure that all items ordered and shipped are
    received.

 

    Section 6.0  Proof
    of Shipment

 

    6.1 The FUSA invoice and packing list must be retained as
    proof of delivery. Subject to availability and within [*]
    following the date of shipment, requests for additional
    documentation of delivery (i.e., carrier delivery logs) may be
    subject to a service charge.

    

    19

 

    SCHEDULE A

    

 

    PERITONEAL
    DIALYSIS PRODUCTS

 

    Section 1.0  The
    general terms and conditions for purchases of peritoneal
    dialysis PRODUCT(S) are described in the Supply Agreement. Items
    specific to peritoneal dialysis are listed below.

 

    Section 2.0  Added
    Value Provisions

 

    2.1 FUSA shall provide [*], in appropriate quantities, [*].

 

    Section 3.0  Cycler
    Shipping and Pickup

 

    3.1 A [*] shipping charge of [*] shall apply to all rental
    cyclers.

 

    3.2 A [*] pickup charge of [*] shall apply to all rental
    cyclers

 

    Section 4.0  New
    and Retrained Patients

 

    4.1 All new FUSA patients shall receive [*].

 

    4.2 All retrained FUSA patients [*] shall receive [*].

 

    Section 5.0  Damaged
    or Lost PD Cycler

 

    5.1 PURCHASER shall assume the entire risk of loss of or
    damage to the Cycler.

 

    5.2 If cycler is lost or damaged, PURCHASER will be
    invoiced a fee of [*] to cover the costs of such a loss.

 

    5.3 If cycler is not returned according to the FUSA policy
    (located at www.fmcna.com) within [*], the fee shall be invoiced
    and be payable to FUSA immediately.

 

    Section 6.0  PD
    Vacation Cyclers

 

    6.1 If PURCHASER would like to order a cycler for delivery
    to an alternative location, a [*] will apply.

 

    6.2 Al applicable cycler delivery/shipping/pickup charges
    apply.

 

    6.3 If the cycler is not returned within [*], the standard
    monthly rental fee (above) will be charged.

 

    6.4 The damaged or lost cycler fee of [*] applies.

    

    20

 

    SCHEDULE A-l

    

 

    PERITONEAL
    DIALYSIS PRODUCTS

 

    Section 1.0  Training
    Supplies

 

    1.1 Upon PURCHASER’S request FUSA shall provide, [*]
    as follows:

 

 

    [*]

 

 

    NOTE: [*]

    

    21

 

    SCHEDULE A-2

    

 

    PERITONEAL
    DIALYSIS PRODUCTS

 

    Section 1.0  Retraining
    Supplies

 

    1.1 Upon PURCHASER’s request FUSA shall provide, [*]
    as follows:

 

 

    [*]

 

 

    NOTE: [*]

    

    22

 

	 	 	 
	
    
	
 
	
 

	
 
	
 
	
 

	
 
	
 
	
 

	

    NEW ACCOUNT

    CREDIT APPLICATION FORM

	
 
	
    EVERY

    ACCOUNT

    MUST HAVE

    THIS FORM

	
 
	
 
	
 

 

    FULL LEGAL TRADE NAME:
    ­
    ­ TRADE
    TYPE: ­
    ­

 

		
	    ADDRESS: 	
    

 

    CITY: ­
    ­ STATE: ­
    ­ ZIP: ­
    ­

 

    TELEPHONE
    #: ­
    ­ FAX
    #: ­
    ­ FEDERAL TAX ID
    #: ­
    ­

 

    Composition of Business (Check One)

 

    o  PROPRIETORSHIP          o  PARTNERSHIP    o  CORPORATION
    (STATE
    OF ­
    ­

 

    OWNERS, PARTNERS OR OFFICERS

 

    NAME: ­
    ­  RES.
    ADDRESS: ­
    ­

 

    TELEPHONE
    #: ­
    ­
    FAX#: ­
    ­
    SOC.SEC.#: ­
    ­

 

    NAME: ­
    ­ RES.
    ADDRESS: ­
    ­

 

    TELEPHONE
    #: ­
    ­ FAX
    #: ­
    ­
    SOC.SEC.#: ­
    ­

 

    DATE BUSINESS
    STARTED: ­
    ­ UNDER PRESENT CONTROL
    SINCE ­
    ­
    

 

    PRIOR BUSINESS EXPERIENCE OF PRINCIPAL(S)

 

 

 

 

    BANK
    REFERENCES (Bank Account # needed for references
    request)

 

	 	 	 	 	 	 	 	 	 
	
 
	
 
	
    NAME
    
	
 
	
    CONTACT PERSON
    
	
 
	
    ACCOUNT #
    
	
 
	
    TEL # / FAX #
    

	

    1.

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    2.

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    3.

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

    TRADE
    REFERENCES

 

	 	 	 	 	 	 	 	 	 
	
 
	
 
	
    NAME
    
	
 
	
    CONTACT PERSON
    
	
 
	
    ACCOUNT #
    
	
 
	
    TEL # / FAX #
    

	

    1.

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    2.

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    3.

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    4.

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

    IS BUSINESS LISTED WITH ANY CREDIT REPORTING AGENCY?

    SHOW NAMES(S), ADDRESS(ES) AND ACCOUNT #(S).

 

    1.
    
     

    2.
    
     

 

 

    Credit Department

    Fresenius Medical Core North America
    

    Corporate Headquarters: 920 Winter
    Street, MA 02451-1457-Tel (781)-699-9000 / Fax (781)-699-9087
    

    

    Page 1 of 2

 

    MORTGAGEE OR LANDLORD

 

 

    NAME: ­
    ­ ADDRESS: ­
    ­ TEL
    #: ­
    ­

 

    MONTHLY
    PAYMENT: 
     

 

 

    INSURANCE CO.

 

 

    NAME: ­
    ­ ADDRESS: ­
    ­ TEL
    #: ­
    ­

 

 

    AGENT
    NAME: ­
    ­ ADDRESS: ­
    ­ TEL
    #: ­
    ­

 

    EXTENT OF
    COVERAGE: 
     

 

 

    ** APPLICATION IS NOT COMPLETE
    WITHOUT [*]**
    

 

    IF THIS IS A NEW
    BUSINESS — ATTACH AN [*].
    

    IF THIS IS AN ONGOING
    BUSINESS — ATTACH THE [*].
    

 

 

    APPLICATION’S SIGNATURE ATTESTS FINANCIAL RESPONSIBILITY,
    ABILITY AND WILLINGNESS TO PAY INVOICES IN ACCORDANCE WITH
    TERMS. SIGNATURE IS NECESSARY TO VALIDATE APPLICATION AND ALLOW
    CONSIDERATION TO PROCESS ORDERS.

 

    PLEASE NOTE: IT IS OUR POLICY TO CHARGE INTEREST ON LATE PAYMENT
    OF INVOICES [*].

 

    ADDITIONALLY: THE UNDERSIGNED SHALL BE RESPONSIBLE FOR ALL
    COLLECTION COSTS AND ATTORNEY’S FEES IN CONNECTION WITH ANY
    DELINQUENT AMOUNTS.

 

    THE UNDERSIGNED ALSO AGREES TO PROVIDE CREDITOR UPDATED
    FINANCIAL INFORMATION ON REQUEST AND TO PROVIDE [*] TO CREDITOR
    AS A CONDITION OF THE CONTINUATION OF CREDIT.

 

    THE INFORMATION IS GIVEN FOR THE PURPOSE OF OBTAINING CREDIT AND
    IS WARRANTED TO BE TRUE. I/WE HEREBY AUTHORIZE FRESENIUS MEDICAL
    CARE TO INVESTIGATE THE REFERENCES LISTED PERTAINING TO MY/OUR
    CREDIT AND FINANCIAL RESPONSIBILITY.

 

    FIRM
    NAME: 
     

 

 

    BY: 
     

    PARTNER/OFFICER                    DATE

 

 

    BY: 
     

    PARTNER/OFFICER                    DATE

 

 

    Credit Department

    Fresenius Medical Care North America

    Corporate Headquarters: 920 Winter Street, MA
    02451-1457-Tel
    ( 781)-699-9000 / Fax (781)-699-9087

    

    Page 2 of 2

 

    Exhibit B

 

    EXHIBIT B

 

    to

    

    FOURTH AMENDED AND RESTATED

    TRANSFER AND ADMINISTRATION AGREEMENT

    

    CREDIT AND COLLECTION POLICIES AND PRACTICES

 

			
	
	 	Procedure

Fresenius Medical Services

Patient Admissions and Readmissions

	 	 	 

	Purpose

	 	The purpose of this document:
	 

	 	•     Outlines
the steps that the [*], Facility and Billing Group [*]
staff completes upon referral of a prospective patient.

	 

	 	•     Facilitates the admissions process for all patient admissions.

	 

	 	•     Ensures that complete and accurate financial information is
obtained.

	 

	 	•     Outlines the process for ascertaining all avenues of full
insurance coverage for patients who qualify.

	Facility

	 	Each facility must:
	Responsibility

	 	•     Be assigned to a [*] that will be responsible for coordinating
the referral and facility placement process.

•     Assign someone as the Facility [*], who is responsible for:

•     Interviewing the patient

•     Assisting the patient in completing the required patient admission
forms

•     Obtaining all necessary back-up documentation and required signatures.

	 

	 	The Facilities must utilize the approved forms documented in this
procedure and in the [*]. The most current version of the [*] will be
distributed by the [*] or be posted on the Intranet for Facilities not
assigned to a [*].

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT
	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]
	 	 	XX
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group
	 	 	PAGE
	 	 	1 of 19	 
	 	©2007, Fresenius Medical Care Holdings, Inc.
All Rights Reserved.	 
	 

 

 

			
	
	 	Procedure

Fresenius Medical Services

	 	 	 

	Billing Group Responsibility

	 	The Billing Group is
responsible for verifying insurance
and financially clearing the patient
for admission.
	 

	 	Please Note:
	 

	 	•     The Billing Group does not
have the authority to accept or deny
admission.

	 

	 	•     The final decision
concerning the admission of a
patient, for financial reasons, is
the responsibility of the [*]. This
includes the approval of all
patients with no insurance.

	 

	 	•     All referrals for [*]
patients must be approved by the
[*], prior to accepting the patient.

	 

	 	The Billing Groups must utilize the
approved forms documented in this
procedure. The most current version
of approved forms is posted on the
Intranet.

	 
	 	 
	Types of
Patients

	 	This procedure contains information generic to following types of patients:

•     In-Center

•     Acute Renal Failure

•     Home

•     Transient

	 
	 	 
	Overview

	 	The primary steps in this procedure are the following.

	 	 	 	 	 
	Description	 	See Page	 
	Collecting Data At Referral
	 	 	3	 
	Verifying Insurance
	 	 	5	 
	Conducting the Admission Interview
	 	 	9	 
	Admitting the Patient
	 	 	16	 
	Documentation Retention
	 	 	19	 

	 	 	 

	 

	 	Note: It is always
mandatory that the Facility [*] form and the Medicare
Secondary Payer Questionnaire are completed, signed and
transmitted via scan or fax to [*] at [*] upon patient
signature, which should be prior to [*]. Billing cannot be
performed until these completed forms are signed and sent to
[*].

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT
	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]
	 	 	XX
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group
	 	 	PAGE
	 	 	2 of 19	 
	 	©2007, Fresenius Medical Care Holdings, Inc.
All Rights Reserved.	 
	 

 

 

			
	
	 	Procedure

Fresenius Medical Services

Collecting Data at Referral

	 	 	 

	Purpose

	 	The [*] will determine if the patient can be
accommodated at an FMCNA facility and begin the admission
process.
	 
	 	 
	Timing

	 	Complete the steps in this financial procedure when
the [*] notifies the Facility and Billing Group [*] that a
new patient is being referred.
	 
	 	 
	Indigent
Waiver Acceptance

	 	Indigent status approved by one FMCNA Facility
should be honored by all other FMCNA facilities. A
copy of the approved waiver should be retrieved from
the [*] to determine if it is still in effect.
	 
	 	 
	 

	 	& Refer to the Indigent Waiver Policy for details.

	 
	 	 
	Procedure

	 	Follow the steps below to collect data once a referral is received.

Note: For Home Patients this is normally done once notification of
catheter placement is received.

	 	 	 	 	 
	Step	 	Who	 	Action
	1

	 	[*]
	 	Obtains all demographic and insurance information from the referral source:
	 

	 	 	 	•     [*]

	 

	 	 	 	•     Physician

	 

	 	 	 	•     Home Facility

	 

	 	 	 	•     [*]. (See [*] for further details.)

Continued on next page

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT
	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]
	 	 	XX
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group
	 	 	PAGE
	 	 	3 of 19	 
	 	©2007, Fresenius Medical Care Holdings, Inc.
All Rights Reserved.	 
	 

 

 

			
	
	 	Procedure

Fresenius Medical Services

Collecting Data at Referral, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	2

	 	[*]
	 	Once the patient has been conditionally accepted by the [*] (see [*]):
	 

	 	 	 	•     The [*] e-mails the Facility and the Billing Group [*] an [*] Form which contains all the referral information.

	3

	 	Facility [*]
	 	Once notification of [*] and [*] date are received:
	 

	 	 	 	•     Enter the patient into the appropriate system.

	 

	 	 	 	•     Enter the demographic and employment information (patient and spouse / parent) from the [*] form.

	 

	 	 	 	•     Insurance information is always entered by the Billing Group.

	4

	 	Facility [*]
	 	The Facility [*] is to ensure:
	 

	 	 	 	•     All completed forms and documentation acquired during the
admission process are filed in the Medical Record or distributed
according to the [*].

	5

	 	Billing Group [*]
	 	Once the patient is entered into the system, enter the
insurance information into the system.

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT
	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]
	 	 	XX
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group
	 	 	PAGE
	 	 	4 of 19	 
	 	©2007, Fresenius Medical Care Holdings, Inc.
All Rights Reserved.	 
	 

 

 

			
	
	 	Procedure

Fresenius Medical Services

Verifying Insurance

	 	 	 

	Purpose

	 	The purpose is to:
	 

	 	•     Determine if insurance coverage information received
from the [*] is active and covers dialysis and related services.

	 

	 	•     Determine if there are any pre-authorization / referral requirements.

	 

	 	•     Determine if there are any coverage gaps.

	 

	 	•     Establish which insurance is primary.

	Responsibility

	 	The Billing Group or [*] representative is responsible for:
	 

	 	•     Verifying insurance.

	 

	 	•     Reporting financial clearance back to the [*].

	 

	 	•     If the Billing Group is unable to financially clear the
patient due to gaps in coverage or missing information, this
must be reported to the [*], who will refer the admission to
the [*].

	 

	 	•     If a [*] is required, refer to the [*] or [*],
depending on your [*] policy.

	Procedure

	 	Verify the patient’s insurance coverage (s) following the steps below.

	 	 	 	 	 
	Step	 	Who	 	Action
	1

	 	Billing Group [*]
	 	The [*] form, which contains patient referral information, will be received from the [*].
	2

	 	Billing Group [*]
	 	Immediately upon receipt of the [*] form:
	 

	 	 	 	•     Begin the verification of all insurance information.

Continued on next page

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT
	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]
	 	 	XX
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group
	 	 	PAGE
	 	 	5 of 19	 
	 	©2007, Fresenius Medical Care Holdings, Inc.
All Rights Reserved.	 
	 

 

 

			
	
	 	Procedure

Fresenius Medical Services

Verifying Insurance, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	2 cont’d

	 	Billing Group [*]
	 	FMCNA will not routinely contact employers to verify or re-verify
insurance coverage or employment except in situations where there is a specific reason related to payment.
Examples of situations where it is acceptable to contact employers are:
	 

	 	 	 	•     During the preadmission or re-verification process, if you are required to answer questions [*] and
or [*] on the [*] worksheet.

	 

	 	 	 	•     If there is an [*].

	 

	 	 	 	•     If the patients’ insurance plan is a [*].

	 

	 	 	 	•     If the employer must be contacted for preauthorization or referral purposes (oftentimes if the
insurance is through [*]).

	 

	 	 	 	Where FMCNA wants to contact employers to verify or re-verify insurance coverage or employment and there is not a
clear cut payment “need,” then FMCNA will obtain an authorization from the patient. In these situations, the
patient would be required to sign the FMCNA [*]. It would need to be clearly explained that the authorization is
not required as a condition for treatment.
	3

	 	Billing Group [*]
	 	Complete the Billing Group [*] Worksheet to determine which insurance is primary.

Continued on next page

 
	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT
	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]
	 	 	XX
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group
	 	 	PAGE
	 	 	6 of 19	 
	 	©2007, Fresenius Medical Care Holdings, Inc.
All Rights Reserved.	 
	 

 

 

			
	
	 	Procedure

Fresenius Medical Services

Verifying Insurance, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	4

	 	Billing Group [*]
	 	On completion of Step 3:
	 

	 	 	 	•     On page 3 of the Insurance Verification form, for Primary,
Secondary and Tertiary insurance plans other than Medicare or Medicaid,
enter the correct:

	 

	 	 	 	–     [*] Code

	 

	 	 	 	–     [*] Code

	 

	 	 	 	–     [*] Code

	 

	 	 	 	–     [*] Code

	 

	 	 	 	(& For coding information, see the [*].
	5

	 	[*]
	 	Import the following forms into [*]:
	 

	 	 	 	•     Insurance Verification Form

	 

	 	 	 	•     [*]

	 

	 	 	 	•     Billing Group [*] Worksheet

	 

	 	 	 	Importing of these forms into [*] signifies final approval of the verification
and must be performed by the [*] (or Designee).
	6

	 	Billing Group [*]
	 	Determine if any gaps in coverage exist based on the insurance
verification and [*] determination.

Continued on next page

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT
	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]
	 	 	XX
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group
	 	 	PAGE
	 	 	7 of 19	 
	 	©2007, Fresenius Medical Care Holdings, Inc.
All Rights Reserved.	 
	 

 

 

			
	
	 	Procedure

Fresenius Medical Services

Verifying Insurance, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	7

	 	Billing Group [*]
	 	Make sure:
	 

	 	 	 	•     To enter an [*] in the system with “Insurance Verification” as the subject.

	 

	 	 	 	•     That the body of the note includes:

	 

	 	 	 	–     each insurance

	 

	 	 	 	–     the priority (primary / secondary)

	 

	 	 	 	–     other important benefit information including but not limited to:

	 

	 	 	 	§     Deductible

	 

	 	 	 	§     out of pocket

	 

	 	 	 	§     co-pay, referral / pre-authorization requirements

	 

	 	 	 	§     benefit maximums

	 

	 	 	 	§     [*] information

	 

	 	 	 	§     filing limits

	 

	 	 	 	§     EGHP Coordination Period information, if applicable (in

MM this should also be entered into [*])

	8

	 	Billing Group [*]
	 	Make sure to:
	 

	 	 	 	•     Notify the [*] whether the patient is financially cleared.

	 

	 	 	 	•     Complete the Insurance Verification Fax Coversheet.

	 

	 	 	 	•     Fax or email the Insurance Verification Fax Coversheet to the [*] or [*]
once notification of the facility is received.

 
	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT
	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]
	 	 	XX
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group
	 	 	PAGE
	 	 	8 of 19	 
	 	©2007, Fresenius Medical Care Holdings, Inc.
All Rights Reserved.	 
	 

 

 

			
	
	 	Procedure

Fresenius Medical Services

Conducting the Admission Interview

	 	 	 

	Purpose /

Responsibility

	 	The [*] admission interview will be conducted
by the Facility [*], or the [*] in the case of a
home patient, and should accomplish the following:
	 

	 	•     Complete and sign all forms

	 

	 	•     Collect any additional information from the
patient, such as insurance cards

	 

	 	•     Answer all of the patient’s questions.

	When Patient
has Gaps in
Coverage or
Insurance Questions

	 	•     In cases of less than [*]% coverage, the [*] or [*] will discuss the
gaps in coverage and plans for closing gaps.

•     [*] will be provided as a contact to consult whenever:

•     patients are considering insurance coverage changes

•     if they have difficulty making premium or account balance payments.

	Procedure

	 	Conduct an interview with the patient and or family member following the guidelines below.

Continued on next page

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT
	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]
	 	 	XX
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group
	 	 	PAGE
	 	 	9 of 19	 
	 	©2007, Fresenius Medical Care Holdings, Inc.
All Rights Reserved.	 
	 

 

 

			
	 	 	 
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Conducting the Admission Interview, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	1

	 	Facility [*]
	 	Review, complete and have the patient or legal
guardian / Power of Attorney sign all required
forms [*] to the patient’s [*].
	 
	 	 	 	 
	 

	 	 	 	Note: Only the patient or legal
guardian / Power
of Attorney / Healthcare Proxy, can sign
the admission forms. Proof of guardianship / Power
of Attorney / Healthcare Proxy must be
provided. When there is no legal guardian / Power
of Attorney / Healthcare Proxy in place
and there are questions regarding the [*],
contact your [*] who will [*], as, depending
on the particular state, it may not be
sufficient [*] signature [*].
	 

	 	 	 	The following forms are required to be signed
by all patients [*] to the patient’s [*]:
	 

	 	 	 	Except as noted below, scan or fax to [*] upon
signature.

	 	•	 	[*] (pertinent to modality chosen)
	 
	 	•	 	[*] (pertinent to modality chosen) —

	 	 	 	 	 

	 

	 	 	 	Not sent to [*].

	 	•	 	FMCNA [*]
	 
	 	•	 	Facility [*]. (The [*] date entered
on the form must be [*] the date of [*] at the
Facility. The signature date must be the date
the [*] is signed.)
	 
	 	•	 	[*]- Not sent to [*]. Instead fax to
the [*] or [*]. Note on fax coversheet if
this is a readmission. Facility will

Continued on next page

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

    Financial Manual — Facility/Billing group
	
 
	
 
	
    PAGE
	
 
	
 
	
    10 of 19

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ©2007,
    Fresenius Medical Care Holdings, Inc. All Rights Reserved.

	 	 	 	 	 	 	 	 	 	 

 

 

			
	 	 	 
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Conducting the Admission Interview, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	1 cont’d

	 	Facility [*]
	 	then attach copies of all insurance cards and forward
to [*] along with original form.

	 	•	 	MSP Questionnaire
	 
	 	 	 	Note: If you are able to obtain the MSPQ initiated by
the [*] within the [*], this form can be utilized as
long as the information is verified with the patient.

	 	 	 	 	 

	 

	 	 	 	Home Patients Only:

	 	•	 	ESRD Beneficiary Selection Form (HCFA 382) -
Billing Group will enter the appropriate method
selection into the [*] system.

	 	•	 	FMCNA only provides Method 1 services for home
patients, with the following exceptions:

	 	•	 	Patients in [*] Facilities where the owner
wishes to continue providing Method 2 support.
Supplies are obtained through a non-FMCNA DME supplier.
	 
	 	•	 	Method 2 patients admitted due to an
acquisition and who do not qualify for a Medicare
mid-year exception, may remain Method 2 until December
31st of the year in which they are admitted.
Arrangements must be made for a non-FMCNA DME Supplier.

	 	•	 	[*] worksheet must be completed and signed by
physician. Not sent to [*].

	 	•	 	If vendor is FMCNA, original goes to [*].
	 
	 	•	 	If vendor is NOT FMCNA original goes to vendor
and a copy goes to [*].

Continued on next page

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

    Financial Manual — Facility/Billing group
	
 
	
 
	
    PAGE
	
 
	
 
	
    11 of 19

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ©2007,
    Fresenius Medical Care Holdings, Inc. All Rights Reserved.

	 	 	 	 	 	 	 	 	 	 

 

 

			
	 	 	 
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Conducting the Admission Interview, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	1 cont’d

	 	Facility [*]
	 	Facility Note:
	 

	 	 	 	The Facility [*] and MSPQ must be signed and scanned or
faxed to [*] upon signature. It is very important that
the Facility [*] is dated and that the [*]date is [*]
the date of [*]. The patient’s insurance cannot be
billed until the Billing Group receives these forms.
	 

	 	 	 	Billing Group Note:
	 

	 	 	 	If a patient is discharged prior to obtaining a signed
Facility [*] and all efforts to obtain one have been
exhausted, the Billing Group must change [*] of the [*]
to [*], indicating that we do not have an [*]. Billing
without a signed [*] is not an [*] for an active
patient. If a patient is discharged prior to obtaining
a signed MSPQ and the patient is Medicare primary,
charges may be submitted to Medicare providing that the
[*].
	2

	 	[*]
	 	Using the Insurance Verification Fax Coversheet as a

guide, discuss the items below:

	 	•	 	Insurance limitations or exclusions, such as:

	 	•	 	co-pay
	 
	 	•	 	deductible
	 
	 	•	 	out of pocket
	 
	 	•	 	benefit maximums
	 
	 	•	 	Medicaid [*]

Continued on next page

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.

	 	 	 	 	 	 	 	 	 	 

 

 

			
	 	 	 
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Conducting the Admission Interview, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	2 cont’d

	 	[*]
	 	•   Importance of obtaining / maintaining insurance
coverage and the effect of dropping coverage, such as:

	 	•	 	initiation of patient statements
	 
	 	•	 	patient’s financial obligations

	 	•	 	Medicare application process.
	 
	 	 	 	An ESRD patient may choose to:

	 	•	 	immediately enroll in both Medicare Parts A and
B or
	 
	 	•	 	delay enrollment in both until the end of the
coordination period (or earlier if they lose their EGHP
coverage).
	 
	 	 	 	A consideration in the choice to delay enrollment is
whether the EGHP covers 100% of their healthcare bills.
If they choose to delay enrollment and their EGHP has
deductibles, or out of pocket expenses they will be
financially responsible for these balances.

	 	•	 	If applicable, discuss Medigap options
available in the State. Federal law does not require
companies to sell Medigap policies to people under age
65; however, some states do require this under certain
circumstances. Call your [*] Insurance Assistance
Program for more information.
	 
	 	•	 	Assist the patient with assembling and
completing the forms for all insurance and / or
assistance programs.

Continued on next page

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.

	 	 	 	 	 	 	 	 	 	 

 

 

			
	 	 	 
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Conducting the Admission Interview, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	2 cont’d

	 	[*]
	 	•    For [*] patients:

	 	•	 	determine the patient’s ability to pay for
services.
	 
	 	•	 	explain that prompt payment is expected
	 
	 	•	 	assess whether the patient qualifies for an
indigent waiver — See note below.

	 	•	 	Discuss available [*], such as:

	 	•	 	[*]
	 
	 	•	 	[*]

	 	 	 	 	 

	 

	 	 	 	Note: A [*] should be completed for any patient with
identified gaps in coverage in order to assess the
patient’s ability to meet his / her financial
obligation. If the assessment indicates that the
patient qualifies for an indigent waiver per the
FMCNA Indigent Waiver Guidelines, request the
required documentation in order to have a waiver
approved.
	3

	 	Facility [*]
	 	Photocopy both sides of any insurance cards presented
during the admission interview, including Medicaid if
applicable.

Continued on next page

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.

	 	 	 	 	 	 	 	 	 	 

 

 

			
	 	 	 
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Conducting the Admission Interview, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	4

	 	Facility [*]
	 	Orient the patient to FMCNA and dialysis using the FMCNA [*]. The
FMCNA [*] should be given to the patient. Insert Facility specific information into the back pocket
of the [*]. These inserts should contain the following:
	 

	 	 	 	•    A [*] letter which should include the dates and time of scheduled treatments, a
contact name and telephone number at the Billing Group. The letter should also state
that the patient can telephone the Billing Group from the Facility or call collect.

	 

	 	 	 	•    [*] brochure.

	 

	 	 	 	•    The Facility’s policies and procedures for [*].

	 

	 	 	 	•    The Facility’s variations to the policies and procedures listed in the FMCNA
[*].

	 

	 	 	 	•    [*]

	 

	 	 	 	•    Staff names, titles, schedules and phone numbers.

	 

	 	 	 	•    Physicians’ locations and phone numbers.

	 

	 	 	 	•    [*].

	 

	 	 	 	•    [*].

	 

	 	 	 	•    [*].

	 
	 	 	 	 
	 

	 	 	 	Materials on subjects such as [*] and [*] should also be provided at this time.
	 
	 	 	 	 
	 

	 	 	 	Show patient [*] such as [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Admitting the Patient

	 	 	 

	Purpose

	 	The purpose of this section is to document how to timely
and accurately process all admission documents.
	Responsibility

	 	Facility [*] is responsible for getting all forms
/ documentation acquired during the admission process
into [*].
	Procedure

	 	Follow the steps below to admit the patient.

	 	 	 	 	 
	Step	 	Who	 	Action
	1

	 	Facility [*]
	 	All admission forms and other documentation, (as
required in this policy) should be scanned or faxed to the [*] upon signature
but no later than [*] after the patient’s admission.
	 

	 	 	 	•    NOTE: Since the ESRD Network allows 45 days to complete the CMS-2728
Medical Evidence Report, this form may not be available to be included within
the [*].

Continued on next page

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Admitting the Patient, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	2

	 	Billing Group[*]
	 	•    Utilizing the [*] in [*], confirm that all the following required forms are complete and accounted for:

	 

	 	 	 	•    Facility [*] — must be received prior to billing (see note below).

	 

	 	 	 	•    MSPQ — must be received prior to billing Medicare (see note below).

	 

	 	 	 	•    FMCNA [*]

	 

	 	 	 	•    [*] (pertinent to modality chosen)

	 

	 	 	 	•    Insurance Cards

	 

	 	 	 	•    Medical Evidence Report (Form CMS-2728)

	 

	 	 	 	•    ESRD Beneficiary Selection Form (CMS-382) (Home pts only).

	 

	 	 	 	Note: If the [*] and MSPQ (for Medicare patients) forms are not received in time for the
[*] billing:
	 

	 	 	 	•    Follow-up with the [*]

	 

	 	 	 	•    Request the missing documentation within [*].

	 

	 	 	 	•    If the documentation is not received within [*], request the okay from
the [*] to set patient up as [*].

	 

	 	 	 	•    For the remainder of the documentation, if not received in [*] within
[*] of admission, follow-up with the [*] and assign a [*].

	 

	 	 	 	•    Written follow-up should occur [*] until all documentation is received.

	 

	 	 	 	After the initial follow-up, the [*] should be copied on any further notices.

Continued on next page

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	

Continued on next page

Admitting the Patient, continued

	 	 	 	 	 
	Step	 	Who	 	Action
	2 cont’d

	 	Billing Group [*]
	 	•    Each [*] should establish its own protocol for follow-up.

	 

	 	 	 	•    Admission forms and other documentation are stored on-line in [*] for query
purposes.

	 

	 	 	 	•    The Billing Group is no longer required to maintain a [*] patient admission file.

	 

	 	 	 	•    Any original documents can be stored offsite for future disposal in accordance with
the FMCNA [*] policy.

	3

	 	[*]
	 	[*] to the Billing Group the dates on which applications were filed and the status of
applications for insurance and / or assistance programs.
	4

	 	Billing Group [*]
	 	Document all ongoing communication with the Facility in the system in [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Document Retention

	 	 	 

	Purpose

	 	Records are to be kept for present and future reference
and compliance purposes, consistent with FMCNA’s document
retention guidelines.

 

END OF DOCUMENT

 

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
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	 	Policy

Fresenius Medical Services

Patient Admissions and Readmissions

	 	 	 	 	 

	Who does this
policy apply to?	 	In-Center, Home and Transient Patients

FMCNA admits and treats patients needing dialysis without regard to race,
creed, color, age, sex or national origin.
	 	 	All services provided by FMCNA are available to all patients:
	 

	 	•
	 	for whom they are medically suitable,
	 

	 	•
	 	based on the clinical judgment of the patient’s doctor and
	 

	 	•
	 	the willingness of the responsible party to pay for such service.
	 

	 	Note:
	 	(1). Each patient must complete medical and financial records before
admission to a Facility.
	 

	 	 	 	(2). Transient dialysis patients must be evaluated by a member of the
medical staff before treatment.

	 	 	 	 	 

	Patients with

no insurance 

coverage	 	If a Facility identifies that a patient does not have or no longer
has insurance coverage, steps will be taken to determine whether viable
coverage options exist.
	 	 	Where no options exist, FMCNA has an Indigent Waiver Program that
provides [*] for qualifying patients who lack the means to pay for
services. Many patients participate in this program since Medigap
insurance, which covers the [*] Medicare co-insurance, is not
available to all patients, and ESRD is a lifelong expensive therapy
beyond the means of many.
	 	 	In addition, FMCNA may, under certain circumstances, accept [*]
patients who lack insurance and are unable to pay for their care. The
[*] may restrict the number of [*] patients who can be admitted into
a particular Facility.
	 

	 	Important:
	 	Requests for admission or continuation of care for [*]
patients must be reviewed and approved by the [*].

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	XX
	 	 	[*]
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	 	©2007, Fresenius Medical
Care Holdings, Inc. All
Rights Reserved.
	 
	 

 

 

	 	 	 

	

	 	Policy

	 	 	 	 	 

	[*]

transient patients

	 	•
	 	[*] transient patients do not qualify for the
Indigent Waiver Program.
	 

	 	•
	 	A request, by a [*] transient patient, to pay anything
[*] must be reviewed and approved, on a case-by-case basis, by
the [*].

	 	 	 	 	 

	Patient Emergencies	 	Certain emergencies, such as
emergency travel necessitated by
death or serious illness of a family
member, can create exceptions from
the specified admission timeline.
All required patient admission forms
must still be completed and signed,
prior to the start of dialysis.

	 	 	 	 	 	 	 	 	 

	When to utilize	 	When a facility experiences emergencies caused by:
	utilize Facility	 	•	 	Severe weather
	Emergency Transfer?	 	•	 	Fire
	 	 	•	 	Other serious facility operating problems such as:
	 	 	 	 	•	 	Water treatment failure or other unexpected problems

that may require:
	 

	 	 	 	 	 	•
	 	Construction or repairs that are believed to be
short-lived and may necessitate closure of a Facility.
	 

	 	 	 	 	 	•
	 	Inability of facilities to provide services can result
in the need for subsequent temporary arrangements for patients
to be dialyzed at another FMCNA “host” Facility.
	 

	 	 	 	 	 	•
	 	In addition, patients may require temporary care at
another FMCNA “host” Facility based on their inability to
safely get to their “home” facility.

	 	 	 	 	 

	Duration of	 	Emergency Transfer can be categorized as that of:
	Emergency Transfer

	 	•
	 	[*] days or less
	 

	 	•
	 	Exceeds [*] days

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	XX
	 	 	[*]
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	 	 	PAGE
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	 	©2007, Fresenius Medical
Care Holdings, Inc. All
Rights Reserved.
	 
	 

 

 

	 	 	 

	

	 	Policy

Fresenius Medical Services

	 	 	 	 	 

	If Emergency
Transfer is [*]
days or less	 	If the emergency transfer is not expected to
extend beyond [*] days and the patients are
expected to return to their “home” Facility:
	 

	 	•
	 	The patients do not have to be [*].
	 

	 	•
	 	The treating Facility or “host” Facility
will provide services for the “home” facility
according to the company wide agreement [*]
(established by the Corporate Law Department- see
[*] Policy # [*]).
	 

	 	•
	 	All services performed must be entered into
[*] in the home Facility, as if the home Facility
[*].

	 	 	 	 	 	 	 

	If Emergency	 	If the Facility closure / emergency transfer exceed [*] days:
	Transfer exceeds

[*] days	 	•	 	The continued provision of services under this emergency
transfer protocol must be reviewed / approved.
	 	 	•	 	Provide a report on the status of the “home” facility.
	 	 	•	 	The [*] must contact:
	 

	 	 	 	•
	 	The FMCNA [*] and
	 

	 	 	 	•
	 	The FMCNA [*]

	 	 	 	 	 	 	 

	Extending the time
of the [*]	 	The need to extend the time of the [*]
will be approved on a case-by-case basis.
	 	 	•	 	If it is determined that temporary care
under this emergency transfer protocol should be
[*] “host” facility
	 	 	•	 	Each patient must be [*]
	 	 	•	 	Each patient must sign a new :
	 

	 	 	 	•
	 	[*] form
	 

	 	 	 	•
	 	FMCNA [*] form
	 

	 	 	 	•
	 	[*] form
	 

	 	 	 	•
	 	[*] form.
	 	 	The remaining forms required to complete the
[*] can be retrieved from [*].

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	XX
	 	 	[*]
	 	 	[*]	 
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	 	 	PAGE
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Rights Reserved.
	 
	 

 

 

	 	 	 

	

	 	Policy

 

    Fresenius
    Medical Services

	 	 	 	 	 	 	 

	When transfer	 	The Billing Group must obtain:
	is complete

	 	•	 	 
	 	The new [*] form.
	 

	 	•	 	 
	 	Retrieve original MSPQ from [*]
system prior to billing the patient’s
insurance from the new facility.
	 

	 	•	 	 
	 	Billing personnel can retrieve
images of the home Facility’s insurance
verification from the [*] system for use
with entering the patient’s insurance in
[*].

							
	Return from	 	If a patient returns from a temporary absence that is greater than [*] days:
	Temporary

	 	•	 	 
	 	The Facility should print the [*].
	Absence/

	 	•	 	 
	 	Verify with the patient that the
demographic and insurance information is current.
	Readmissions

	 	•	 	 
	 	[*] should be updated with any demographic changes.
	 

	 	•	 	 
	 	The Facility should notify the Billing Group of the patient’s
return for purposes of reverification of coverage.
	 

	 	•	 	 
	 	[*] is required for patients who return from a temporary absence
within [*] days.

							
	What does a 
discharged
	 	Regardless of how much time has passed, all
patients, including transients, who return after
being discharged from a Facility must sign a new:
	 patient need to

	 	•	 	 
	 	[*] (appropriate for modality chosen)
	 do?

	 	•	 	 
	 	[*]
	 

	 	•	 	 
	 	FMCNA [*]
	 

	 	•	 	 
	 	[*] (appropriate for modality chosen)

							
	What does the	 	The Billing Group must verify:
	patient’s Billing Group

	 	•	 	 
	 	Receipt of the new [*] form.
	need to do?

	 	•	 	 
	 	Existence of the original MSPQ from a
previous admission, in the [*] system, prior
to billing the patient’s insurance.
	 

	 	•	 	 
	 	If the patient has been discharged for
greater than [*] days, re-verification of the
demographic and insurance information should
be performed as outlined above.

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
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    [*]

	
 
	
 
	
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    Admissions and Readmissions 

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	 	Policy

 

    Fresenius
    Medical Services

	 	 	 	 	 	 	 

	Modality 	 	If a patient changes modality, the following forms must be
signed pertinent to the patient’s new modality:
	Change

	 	•	 	 
	 	[*]
	 

	 	•	 	 
	 	[*]
	 

	 	•	 	 
	 	ESRD Beneficiary Selection Form (CMS-382), if applicable
	 

	 	•	 	 
	 	Any other additional clinically required forms.

							
	Insurance
	 	Upon receipt of a [*] form from the [*], the following actions should
be taken:
	Verification

	 	•	 	 
	 	The Billing Group should complete the verification within [*].
	 

	 	•	 	 
	 	If a problem is encountered with finalizing the verification of a
patient’s insurance, such as:
	 

	 	 	 	 	 	     -     unable to obtain authorization
	 

	 	 	 	 	 	     -     additional [*] information required
	 

	 	 	 	 	 	The Billing Group should provide a
[*] verification within [*]
	 

	 	•	 	 
	 	Documenting potential problems or concerns to the [*], with a [*]
verification completed and reported to the [*] within [*].
	 

	 	•	 	 
	 	 The mission of the [*] is to provide “[*]” of a patient to the
referral source in no more than [*] from the receipt of the referral.

							
	Admissions 	 	The Billing Group
cannot financially clear the patient for admission when:
	Clearance

	 	•	 	 
	 	Financial clearance is denied by primary or secondary payor sources.
	Denial

	 	•	 	 
	 	The patient is uninsured and cannot obtain Medicare or other insurance
coverage.
	 

	 	•	 	 
	 	The referral is an [*] patient. All [*] patients must follow the [*],
updated on [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
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    Admissions and Readmissions 

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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

	 	 	 

	

	 	Policy

 

    Fresenius
    Medical Services

	 	 	 	 	 	 	 

	Steps to take	 	If one of the above conditions is present:
	when patient is 

	 	•	 	 
	 	The Billing Group must immediately notify the [*].
	not financially
 cleared

	 	•	 	 
	 	If the patient cannot be financially cleared based on
insurance verification, the [*] will notify the [*] to obtain
ultimate approval or denial of the patient’s admission.

					
	Forms to be

completed	 	The following forms are generated as part of the admission
process. Refer to the details in the procedure that follows or to
the [*] for distribution and/or filing requirements for each form.
	 	 	Facility [*] Admissions Forms
	 

	 	•
	 	[*] Form
	 

	 	•
	 	[*] (appropriate to modality chosen)
	 

	 	•
	 	FMCNA [*]
	 

	 	•
	 	[*] (appropriate for modality chosen);
	 

	 	•
	 	FMCNA [*]
	 

	 	•
	 	Medicare Secondary Payer Questionnaire (MSPQ)
	 

	 	•
	 	[*]
	 

	 	•
	 	Medical Evidence Report (CMS-2728)
	 

	 	•
	 	ESRD Beneficiary Selection Form (CMS-382) (Home Patients
Only)
	 	 	Billing Group [*] Verification Forms
	 

	 	•
	 	Insurance Verification or Insurance Verification [*]
	 

	 	•
	 	Insurance Verification Fax Coversheet
	 

	 	•
	 	Billing Group [*] Worksheet
	 	 	& Both the Facilities and the Billing Groups must utilize the
approved forms documented in this policy. The most current version
of the [*] will be distributed by the [*].

END OF DOCUMENT

 

	 	 	 	 	 	 	 	 	 	 
	
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    Admissions and Readmissions 

    Financial Manual — Facility/Billing group

	
 
	
 
	
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    ©2007,

    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

	 	 	 

	FMCNA Financial Procedures Manual — Facility/Billing Group

	 	Rev. [*]
	Home Program

	 	[*]

OVERVIEW

	 	 	 

	Introduction

	 	This policy outlines the steps involved with billing Home Program services. The topics include:
	 

	 	•    Facility and Billing Group Responsibilities

	 

	 	•    [*] Charge Entry

	 

	 	•    Treatments/Training

	 

	 	•    Support Services

	 

	 	•    Medications self-administered in the home.

	Policy

	 	Services are manually entered into [*] by the billing group, as information entered into [*] by
the facility does not currently [*]. The facility is responsible for entering all services
provided or performed into [*] timely and accurately. The billing group is required to review
[*] home program reports for abnormalities, review and select billable procedures, correctly
code billable procedures and ailments, as well as perform data entry into [*].
	 

	 	FACILITY RESPONSIBILITIES
	 

	 	The facility is required to enter
all services provided to a home patient on the date that the
services are performed. This includes support services (whether the support is due to a clinic
visit, home visit or telephone contact), medications, EPOGEN, training, ancillaries and drawn
labs. Temporary absences should be updated timely and verified for accuracy. The facility is
also required to calculate and enter home treatment counts at month-end, as well as at other
intervals that may be required by local A/R management (i.e. twice a month, weekly, etc.).
Month-end treatment counts must be entered no later than [*] on the [*] of every month. As home
program services do not [*], all corrections to [*] (including changes to treatment counts) must
immediately upon discovery be reported to the billing group using the [*] form. In addition to
the form, a new [*] or [*] report must be generated and printed to a designated billing group
printer whenever a change occurs.
	 

	 	BILLING GROUP RESPONSIBILITIES
	 

	 	Billing Group staff must manually
enter charges utilizing the [*] Report and the [*] report as
the data entry source. Although it is the facility’s responsibility to review the reports for
accuracy, the billing group should also make reasonable efforts to review reports for errors or
abnormalities prior to entering charges. Except for month-end deadlines, the intervals in which
the billing group enters charges from the reports into [*] is at the discretion of local AR
management. The facility should have month-end treatment counts and final services made
available for entry by [*] on the [*] of every month. All home charges must be entered and
balanced by the [*] at a time designated by the local [*]. [*] forms received from the facility
must be reviewed and compared to the new [*] or [*] report generated by the facility. All
changes to services already entered into [*] must be corrected through [*] (if prior to [*]),
[*] void [*] or void [*].

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	FMCNA Financial Procedures Manual — Facility/Billing Group

	 	Rev. [*]
	Home Program

	 	[*]

	 	 	 

	Objectives

	 	This procedure explains the interaction between the facility and the billing office in regards
to entering charges for the items and services rendered to Home Dialysis Program patients. It
will define time guidelines for entry of services into [*] and [*], as well as define billing
procedures for the billing office.
	Procedure Steps

	 	The primary steps in this procedure are:
	 

	 	•    Entry of items and services rendered into [*] by the Facility.

	 

	 	•    Evaluation and coding of all home program reports by the Billing Group.

	 

	 	•    Charge entry into [*] by the Billing Group.

	 

	 	•    Billing group balancing and filing of reports generated by the
billing process.

	In this Procedure

	 	This procedure contains the following topics.

	 	 	 	 	 
	Topic	 	See Page	 
	General Information
	 	 	 	 
	Modalities: CAPD, CCPD, Home IPD, Home Hemodialysis/Staff
Assist/Nocturnal
	 	 	3	 
	What is Peritoneal Dialysis?
	 	 	4	 
	Medicare Eligibility for Home Dialysis Patients
	 	 	4	 
	Medicare Payment Guidelines for Home Dialysis Patients
	 	 	4	 
	Facility Responsibilities
	 	 	 	 
	Patient Admission
	 	 	 	 
	New Patient
	 	 	6	 
	In-Center Patient Converting to Home
	 	 	6	 
	Method Selection (CMS-382)
	 	 	6	 
	[*] Entry
	 	 	 	 
	Entry of Items and Services Rendered
	 	 	8	 
	Monthly Treatment Counts
	 	 	10	 
	Treatment Count Calculations/Deductions
	 	 	10	 
	[*] Hemodialysis
	 	 	10	 
	Temporary Absence/Hospital Spans
	 	 	11	 
	Traveling/Seasonal Patients
	 	 	11	 
	Reporting
Schedule ([*] Report [*] Report to Billing Group)
	 	 	12	 
	Corrections to Items and Services Rendered ([*] form)
	 	 	12	 
	Billing Group Responsibilities:
	 	 	 	 
	Patient Admission
	 	 	 	 
	New Patient
	 	 	12	 
	In-Center Patient Converting to Home
	 	 	12	 
	Medicare Eligibility
	 	 	12	 
	Method Selection
	 	 	13	 
	[*] Charge Entry
	 	 	 	 
	Reports Utilized
	 	 	13	 
	[*] Report
	 	 	13	 
	Billable Services
	 	 	 	 
	Medicare
	 	 	15	 
	Commercial
	 	 	16	 

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	FMCNA Financial Procedures Manual — Facility/Billing Group

	 	Rev. [*]
	Home Program

	 	[*]

	 	 	 	 	 
	Topic	 	See Page	 
	[*] Home Validation Fields
	 	 	16	 
	In-Center and Training Treatments Within Same Day
	 	 	19	 
	Ailment Coding
	 	 	 	 
	Value Codes
	 	 	19	 
	Condition Codes
	 	 	19	 
	Comment/Reference Coding
	 	 	21	 
	Influenza/Pneumococcal
	 	 	21	 
	Hospital Spans — Ailment Entry
	 	 	21	 
	[*] Report Review/Coding
	 	 	 	 
	Reporting Schedule (from Facility)
	 	 	22	 
	Treatment Count Review
	 	 	22	 
	Treatment Count Coding
	 	 	23	 
	Medicare Method 1, Medicaid and Commercial
	 	 	23	 
	Medicare Method 2
	 	 	24	 
	Multiple Treatment Modalities
	 	 	24	 
	Corrections to Monthly Treatment Counts
	 	 	25	 
	Balancing and Filing
	 	 	 	 
	Balancing
[*] to [*]
	 	 	25	 
	Report Filing
	 	 	28	 

GENERAL INFORMATION

	 	 	 

	Modality Types

	 	Though usually not a frequent occurrence, there is no
restriction to the number of times a patient may
change modalities. The facility should report each
event to the ESRD Network, but CMS does not require
[*]. Upon each change, the facility should also
complete an [*] on the FMS Intranet.
	 

	 	CAPD
	 

	 	Continuous Ambulatory Peritoneal Dialysis. CAPD is a
continuous dialysis process using the patient’s
peritoneal membrane as a dialyzer. The patient
performs manual exchanges (dialysis) 4-5 times
throughout the day.
	 

	 	CCPD
	 

	 	Continuous Cycler Peritoneal Dialysis. The patient has a machine that
performs the exchanges (dialysis) throughout the night. Generally, there
are 4 exchanges occurring at intervals of 2 1/2 — 3 hours. This is
sometimes also referred to as APD (Automated Peritoneal Dialysis)
	 

	 	Home IPD — Intermittent Peritoneal Dialysis
	 

	 	IPD is similar to CCPD as a machine is used to perform dialysis exchanges
using the peritoneal cavity. However, rather than exchanges occurring
continuously throughout the night, they are accomplished intermittently
with the option of several different schedules. For instance, home IPD
may be furnished every day for 10 hours per day, every other day for 15
hours per day, every night for 8 hours per night, etc. The total weekly
dialysis time may vary from 50 to 80 hours

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	Home Program

	 	[*]

	 	 	 

	 

	 	Home Hemodialysis — Traditional
	 

	 	This option uses the traditional hemodialysis machine in a home setting.
The patient either performs the treatment alone or with a caregiver.
Normally the treatment lasts 3-4 hours and is performed 3 times per week
	 

	 	Home Hemodialysis-Staff Assist
	 

	 	This option is identical in function as traditional home hemodialysis,
except that a clinical professional assists the patient in the patient’s
home. In addition to the home hemodialysis charge, a separate charge for
staff assistance is billed to commercial primary carriers or directly to a
patient’s secondary carrier when Medicare is primary. The separate
staff-assistance charge is not billable to Medicare and it is the
patient’s responsibility if not covered by other insurance.
	 

	 	Nocturnal Home Hemodialysis
	 

	 	Nocturnal Home Hemodialysis is essentially the same service as traditional
home hemodialysis, except it has an increased treatment time of 6-8 hours
and occurs every other night (versus 3 times per week). For increased
patient safety, the machine is set-up with a special CPU that is connected
to a centralized remote monitoring station via the Internet. A trained
observer monitors the patient’s data and will contact the patient if a
problem is detected. If there is no response, the monitoring station will
contact a local EMT service.
	What is Peritoneal
Dialysis?

	 	Peritoneal dialysis uses the peritoneum space in the abdomen as a dialyzer.
The space is lined by a thin layer of tissue called the peritoneal membrane which acts as a filter. A
special fluid called dialysate is infused into the abdomen and stays there for several hours. Waste
products move through the peritoneal membrane into the dialysate. The fluid is then drained and replaced
with fresh dialysate. This is done 4-5 times per day for CAPD patients who perform the exchanges
themselves or with a caregiver. In CCPD, a machine performs the exchanges for the patient overnight while
the patient sleeps. Finally, home IPD uses a machine to perform exchanges at intermittent schedules.
	Medicare Eligibility
for Home Dialysis
Patients

	 	A home patient’s Medicare ESRD entitlement waiting period is waived when a
patient begins training for home dialysis within the first three months of chronic
dialysis. If an ESRD Medical Evidence form (CMS-2728) was initially completed while the patient was
in-center,and the patient begins a training program within the first 3 months of chronic dialysis, the
facility should submit a corrected CMS-2728 to the local Social Security office. The corrected form
should have the home training portion completed in order to obtain correct eligibility dates.
	Medicare Payment
Guidelines for Home
Dialysis Patients

	 	CAPD/CCPD/HOME IPD

CAPD, CCPD and Home IPD payment does not depend upon the number of
exchanges performed per day or the actual number of days per week that the patient actually performs home
dialysis. The weekly rate (billed at an equivalent daily rate) is based on the equivalency of one week of
CAPD/CCPD/Home IPD to one week of hemodialysis. This means that if a patient chooses to perform exchanges
only 4 days per week, the provider should still bill the entire 7 days.

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	 	Rev. [*]
	Home Program

	 	[*]

	 	 	 

	 

	 	TRAINING
	 

	 	Medicare allows a maximum of 36 training sessions for Home Hemodialysis
and a maximum of 15 training treatments for CAPD and CCPD. If this
maximum is reached and training is not complete, re-evaluation of the
patient’s ability to perform self-dialysis is required.
	 

	 	[*] HEMODIALYSIS
FOR PERITONEAL PATIENTS ([*])
	 

	 	SITUATION 1: [*] Hemodialysis and Peritoneal Services Provided at the [*]
	 

	 	

Though the service must be entered into [*], Medicare does not allow
a separate charge for [*] hemodialysis. The daily home peritoneal
treatment count is billed for the time period that a patient obtains
[*] hemodialysis. [*] hemodialysis is
considered [*] when the patient is unable to perform home dialysis and must receive
temporary in-center dialysis. A peritoneal patient may continue
receiving [*] hemodialysis for up to [*] days. After [*] days, the
patient must convert to an in-center modality and the in-center
dialysis treatments are no longer considered [*] (the daily peritoneal
count is also [*]).

	 

	 	
Medicare does allow a separate charge for [*] hemodialysis.
[*] hemodialysis is considered [*] in the [*] case that a [*]
prescribes that a patient perform both daily home peritoneal
dialysis, as well as in-center hemodialysis in order to achieve
satisfactory dialysis results. Both the [*] hemodialysis and the
daily home treatment counts are entered into [*] and both services
are billed in [*]. Upon each episode of a patient obtaining
[*] hemodialysis, the facility must enter a [*] code (defined by
the nephrologist ordering the [*] service) into the [*] screen in
[*]. This code will assist the billing group with identifying the
service as “[*]” and also allow them to attach the [*] to the
[*] hemodialysis services entered into [*]. In addition to the
[*] code, orders and [*] must be maintained at the facility as the
payer may require further medical justification in the form of
medical records.

	 

	 	
IMPORTANT. Billing groups must have all [*] hemodialysis procedure
codes [*] through [*] in [*]. The billing group must view the [*]
screen in [*] upon the appearance of a [*] hemodialysis treatment on
the [*] in order to determine whether it is [*]
or [*] hemodialysis.
Billing group staff should contact the [*] if the [*] status is
unclear.[*] hemodialysis must not be entered into [*]. Any
medications provided on the same day as the
[*] hemodialysis
service must be moved to the home dialysis ailment.
[*] hemodialysis services may be entered

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	 	Rev. [*]
	Home Program

	 	[*]

	 	 	 

	 

	 	
(along with any medications) once the [*] code is obtained from the
[*] screen in [*].

	 

	 	SITUATION 2:
[*] Hemodialysis and Peritoneal Services Provided at [*]
	 

	 	
If [*], the patient should be placed on a temporary absence in the
peritoneal facility and added a transient patient in the facility
where hemodialysis services will be provided. In this case, normal
hemodialysis services are billed out of the [*] and
[*] peritoneal
services are entered into [*] or M/M in the home facility.

	 

	 	
If [*], both the peritoneal services provided in the home facility
and the hemodialysis services provided in the [*] should be billed.

	 

	 	NOCTURNAL HOME HEMODIALYSIS
	Medicare allows a maximum of 13 treatments within a 30-day month and 14 treatments within a
31-day month. All treatments performed should be billed, with any nocturnal treatments [*] for
Medicare primary patients (commercial primary carriers
[*]). [*] Medicare [*].
	 

	 	MEDICARE CASE MIX ADJUSTMENT
	 

	 	As of April 2005, Medicare began applying a “Case Mix” adjustment factor
to each facility’s composite rate based on individual patient attributes.
Medicare calculates the adjustment based on the patient’s height, age and
weight as of the end of the service period billed. The patient’s weight
and height are communicated to Medicare in the value code section of the
monthly claim form. The patient’s weight in kilograms is reported with an
[*] value code and the height in centimeters is reported with an [*].
These value codes, as well as the patient’s weight and height, are listed
on the [*] and [*] Report. Billing group staff must manually enter these
value codes and their associated amounts as of the [*] date of service on
the patient’s ailment.
	 

	 	In addition to the value codes, an MMA Case Mix adjustment factor will
also appear on the [*] Report, as well as the [*] if a training occurs with
an associated exchange/treatment. This factor only applies to Medicare
primary patients and should be disregarded for patients with any other
primary insurance. Instructions regarding how to apply the MMA Case Mix
Factor to the Medicare composite rate is documented under Billing Group
Responsibilities.

FACILITY RESPONSIBILITIES

PATIENT ADMISSION

	 	 	 

	New Patient

	 	See [*] in Financial Procedure Manual — Facility/Billing Group [*] for guidelines.

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	 	Rev. [*]
	Home Program

	 	[*]

	 	 	 

	In-Center Patient
Converting to Home

	 	Complete all additional forms as required for a home patient per the [*].
	 

	 	•    ESRD Beneficiary Selection form (CMS-382).
**See Method Selection below**

	 

	 	•    FMC [*]

	 

	 	•    [*]

	 

	 	•    [*]

	 

	 	•    Revised ESRD Medical Evidence Form (if the
conversion to the home program is within the first 3 months
of beginning dialysis for chronic dialysis failure). The
home training section should be completed and the revised
form submitted to the local Social Security office to obtain
corrected eligibility dates.

	 

	 	Maintained at facility, not sent to the billing group:
	 

	 	•    [*]

	 

	 	•    [*]

	 

	 	•    [*]

	 

	 	The ESRD Network should be informed upon the event of a change in
modality.
	Method Selection

	 	All patients entering a home
training program are required to complete an (CMS-382 form) ESRD Method Selection Form (CMS-382). The patient uses the
form to decide whether they want to obtain home equipment and supplies
from the facility (Method 1) or from an outside vendor (Method 2).
The form is required on all patients regardless of insurance
coverage, but the chosen method only applies when Medicare is the
primary carrier. [*] commercial [*] Medicare
[*] primary [*].
	 

	 	It is up to the patient to choose which method they prefer; however FMS
only provides Method 1 services. Upon referral, the patient should be
notified that FMS is exclusively a Method 1 provider. If the patient
wishes to receive services from FMS, the patient must select a Method 1
option. Patients who choose a Method 2 billing option cannot be treated
at an FMS facility.
	 

	 	Method 1
	 

	 	The dialysis facility provides all equipment, supplies and home support
necessary to perform home dialysis. The terminology “Method 1” refers
specifically to a Medicare primary patient; however, patients with other
primary insurance coverage are [*] Medicare Method 1 patient. Medicare
requires one bill for the entire month, whereas FMS [*] primary commercial
carriers [*]. The billing interval is established by local A/R management and can occur [*].
	 

	 	The number of days billed on a Method 1 patient is not based on the actual
exchanges or “treatments” performed; it is based on providing the patient
a continuous care support system. Therefore, Method 1 treatments are
billed for every day of the calendar month 
EXCLUDING the specific day(s) when

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	Home Program

	 	[*]

	 	 	 

	 

	 	a training treatment occurs, the days following the death or discharge of
a patient and hospital stays. However, with regard to hospital stays,
the admission and discharge dates are both billable days and should not be
deducted from the monthly count.
	 

	 	Method 2
	 

	 	The dialysis facility provides nurse, dietitian and social work support;
an independent DME supplier provides supplies and equipment.
	 

	 	Currently, FMS only accepts the following Method 2 patients:
	 

	 	•    4 4

	 

	 	•    Patients in [*] facilities where the owner wishes to continue
providing Method 2 support. Supplies are obtained through an
independent DME supplier.

	 

	 	•    Method 2 patients admitted to FMS as a result of an
acquisition, and who do not qualify for a Medicare mid-year
exception, may remain Method 2 and receive support services from
FMS with an understanding that the patient will convert to Method
1 by December 31st of the year in which they are
admitted.

	 

	 	•    [*] patients that are currently Method 2 who are approved for a
mid-year method selection exception by the local Medicare Fiscal
Intermediary (FI). The mid-year exception must be approved prior
to the admission of the patient.

	 

	 	Mid-Year Method Selection Exception
	 

	 	[*] patient, who has previously selected Method 2, may be admitted to an
FMS facility is if the local Medicare Fiscal Intermediary approves an
exception to the normal method change guidelines. This will allow the
patient to change to Method 1 before the end of the calendar year. In
such cases, the facility should notify the billing group [*] that a Method
2 patient requests admission and is willing to request a mid-year
exception. The [*] should work with the [*] and facility to determine
whether the patient meets the guidelines that will allow him or her to
qualify for the mid-year exception. If the patient qualifies, the [*] or
[*] will work with the facility and the local Fiscal Intermediary to
obtain the exception. The patient cannot be admitted until the local Fiscal
Intermediary approves the request.
	 

	 	Fiscal Intermediaries are allowed by regulation to grant exceptions to the
general rule that method conversions are only effective at the beginning
of the next calendar year. These mid-year conversions are to be allowed
by Fiscal Intermediaries at their general discretion, but the regulations also list
the following examples as situations that would apparently be potentially
appropriate for the granting of such an exception:
	 

	 	 •    Failure of a kidney transplant within the past 6 months.

	 

	 	 •     Patient is confined to a nursing home or hospice.

	 

	 	 •    A home patient switches to
in-center for any reason and then elects to go on home
dialysis again after at least six full months in-center.

	 

	 	 •     Patient changes place of
residence and his/her new facility does not recognize their
present method of payment and another facility is not
available.

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	Home Program

	 	[*]

	 	 	 

	 

	 	 •     Patient is in a
life-threatening situation

	 

	 	If the exception is denied, the patient will have to obtain Method 2
services from another facility. The patient may request admission the
following year if a selection change to Method 1 is completed by December
31st of the current year.
	 

	 	If a new Method 2 patient is admitted [*], the [*] should notify the
facility’s [*]. If the patient does not qualify for a mid-year
exception, the facility should assist the patient with obtaining Method
2 support services from another facility. FMS would then discharge the
patient to this non-FMS facility.
	[*] ENTRY
	 	 
	 
	 	 
	Entry of Items and
Services Rendered

	 	All services provided to a patient on a given day should be entered into
[*]. This includes telephone contact, office visits, home visits, medications administered,
medications the patient picks up that have been dispensed from FMS [*], labs drawn, access device
management, consultations with physicians and any other service provided to the patient (i.e.
dietitian, social worker). All medications administered in the clinic or sent home for administration
at home should be entered into the [*] screen in [*]. Due to the Medicare Modernization Act, it is
also important that the patient’s weight is obtained and entered into [*].
	 

	 	Listed below are certain services where special attention is required.
	 

	 	TRAINING
	 

	 	In order to be considered an actual training treatment, the
patient must be [*] for each training session AND must complete a
therapeutic exchange or treatment either performed by his or herself or by
a caregiver. If these conditions are not met, the service should be
considered home support services rather than a training treatment. [*] is
considered home support services and not an actual training event.
Training should be entered as CAPD, CCPD or HOME HEMO TRAINING in the
[*] screen. [*] will ask whether an actual treatment/exchange occurred
during
the training, the answer should be yes only if both of the previously
stated conditions are met. No other dialysis treatment service may be
performed on the same day as a training treatment without medical
justification.
	 

	 	Medicare allows a maximum of 36 training sessions for Home Hemodialysis
and a maximum of 15 training treatments for CAPD and CCPD.
	 

	 	RE-TRAINING
	 

	 	Re-training is valid only in cases where the patient changes modality,
equipment, caregivers or if there is a change in the patient’s medical
condition. No other dialysis treatment service may be performed on the
same day as a re-training without medical justification. As in initial
training sessions, the patient

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	Home Program

	 	[*]

	 	 	 

	 

	 	must be [*] and an exchange/treatment must be completed. [*] and
providing [*] are considered support services, not re-training.
	 

	 	EPOGEN — Administered In-Center
	 

	 	EPOGEN administered In-Center to a home patient is not considered “Home
EPOGEN”. The medication should be entered into the [*] screen in [*], as
EPOGEN and the dosage should be equal to the amount administered.
	 

	 	EPOGEN — Self-Administered in the Home
	 

	 	EPOGEN provided for self-administration in the home is considered HOME
EPOGEN. The medication should be entered into the [*] screen in [*] as
HOME EPOGEN. The dosage is equal to the size of the vial sent home with
the patient. The vials are [*]vials. The
dosage should never be in increments other than the previously stated vial
sizes. The number of [*] is equal to the number of vials sent home.
	 

	 	To obtain Home Epogen, the patient must have an [*] in their medical
record.
	 

	 	ARANESP — Administered In-Center and Self-Administered in the Home
	 

	 	ARANESP administered In-Center should be entered into [*] with a dose
equal to that administered, the [*] field equal to [*] and a supply by
code that represents in-center administration.
	 

	 	ARANESP provided for self-administration in the home should be entered
into [*] with a dose equal to the size of the vial(s) distributed, the
[*] field equal to the number of vials distributed and a supply by code
that represents home administration.
	 

	 	OTHER MEDICATIONS
	 

	 	All medications are to be entered into the [*] screen in [*]. This
includes medications administered in-center to the home patient during a
support visit (i.e. vaccines, antibiotics, iron therapy or vitamin D
therapy), as well as the dispensed supply of injectable medications that
the patient self-administers in the home. The “Supply By” code is an
important field as it denotes from where a dispensed medication was
obtained and where it was administered.
	 

	 	Supply By Codes:
	 

	 	   1. [*] In-Center [*] In-Center Administration
	 

	 	   2. [*] FMS [*] In-Center Administration
	 

	 	   3. [*] In-Center Administration
	 

	 	   4. [*] FMSC [*] Home Administration***
	 

	 	   5. [*] In-Center [*] Home Administration***
	 

	 	   6. [*] Home Administration***

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	Home Program

	 	[*]

	 	 	 

	 

	 	   7. [*]
	 

	 	   8. [*]
	 

	 	   9.
[*] In-Center Administration
	 

	 	   10.
[*] Home Administration
	 

	 	                                        
	 

	 	
 ***  Excluding Home EPOGEN, ARANESP, and antibiotics provided to treat [*],
medications ordered for use in the home must have [*] insurance
verification clearance of prescription drug benefits. The facility
must ensure that the billing group verifies prescription drug coverage
through either the primary 
commercial OR 
secondary commercial plan [*] ordering the
medication (Medicare does not cover this service). An FMS [*] order form should be sent to
the billing group to request prescription coverage insurance
verification. The billing group will complete the form, noting
whether or not coverage exists, and return the form to the facility by
the [*] day.

	Monthly Treatment
Counts

	 	If a patient performed multiple types of HOME dialysis within the same month,
the treatments should be entered separately by modality. Enter the date span and number of treatments that
relate to each modality performed.
	 

	 	IMPORTANT. When determining the monthly treatment count, the patient must
be contacted in order to capture [*]. It is also vital that the death of
any patient is accounted for and that the days following the death are
reduced from the monthly treatment count. If this information is obtained
after treatment counts are reported, a new [*] report must be sent to a
designated billing group printer along with a [*] form e-mailed or faxed
to the [*] at the billing group.
	Treatment Count
Calculations/

	 	For CAPD, CCPD and Home IPD, the daily treatment count per patient is
based on the calendar month, LESS:
	Deductions
	 	 
	 

	 	
•    Each [*] period that the patient was hospitalized. The
admission and discharge dates are not included when calculating the reduction.

	 

	 	•    Each day the patient received an actual CAPD, CCPD or Home
Hemodialysis training or re-training treatment.

	 

	 	•    All days following the patient’s discharge from a facility
(including days following the death of a patient).

	 

	 	For Home Hemodialysis (Traditional, Staff-Assist and Nocturnal), the
treatment count is based on the actual days the patient performed dialysis
in the home. This information is obtained directly from the patient and
entered into [*].
	[*]
Hemodialysis

	 	
There should be
[*]
 in the monthly home treatment count for
either [*] hemodialysis treatments.

If the patient is receiving [*] 
hemodialysis, ensure a [*] code justifying the
event has been entered into the [*] screen in [*] ([*] to be
assigned by the nephrologist ordering the additional dialysis
service).
In addition to the [*] code, orders and [*] must
be maintained at the

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	Home Program

	 	[*]

	 	 	 

	 

	 	facility as the payer may require further medical
justification in the form of medical records.
	 
	 

	 	The [*] is not required
on a patient obtaining [*] hemodialysis, as
the services are entered into [*] but not [*] by the billing group.
	Temporary Absence/Hospital
Spans

	 	All home patients must be contacted to ensure that all hospital spans have
been accounted for. If the patient was discharged from the
hospital, ensure that the temporary absence has been closed. Each
[*] period that the patient was hospitalized is reduced from the monthly
CAPD/CCPD/Home IPD treatment count. Do NOT include admission and
discharge dates when calculating the reduction.
	 

	 	EXAMPLE 1
	 

	 	•    Patient admitted to the hospital on 12/03/02 and
discharged on 12/10/02

	 

	 	•    Monthly count would be 25; as there are 31 days in the
month and 6 full days were spent hospitalized (12/4, 12/5,
12/6, 12/7, 12/8 and 12/9).

	 

	 	EXAMPLE 2
	 

	 	•    Patient admitted to the hospital on 12/02/02 and
discharged on 12/03/02

	 

	 	•    Monthly count would be 31; as there are 31 days in the
month and the admission/discharge dates are not included
when calculating the reduction.

	Traveling/Seasonal
Patients

	 	Patient Traveling Away from Home Facility [*] Days With [*]
	 

	 	[*] temporary absence is entered in [*] and the home facility enters treatment services for the [*] that the
patient is traveling.
	 

	 	Patient Traveling Away from Home Facility [*] Days WITH [*]
	 

	 	The [*] admits the
patient as a transient and enters treatment counts for [*] the dates of service [*] was
provided to the patient. The home facility enters a temporary absence for the time that the [*] provided
service and enters treatment counts for the [*].
	 

	 	Patient Traveling Away From
the Home Facility [*] Days With [*]
	 

	 	The home facility enters a Temporary Absence for the [*] that the patient will be traveling. The [*] admits
the patient as a transient and enters treatment counts for the [*].
	Reporting Schedule

	 	[*] and [*] Report
	 

	 	Both reports should be reviewed for accuracy and printed to a designated
billing group printer at intervals decided by local AR management
(generally [*]). The [*] Report should be reviewed for missing height or weight information. Any patient
with a missing height or weight 

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	Home Program

	 	[*]

	 	 	 

	 

	 	should be corrected immediately. At
month-end, the reports must be complete, reviewed for accuracy and printed
to the billing group printer no later than the deadline of [*] on the [*]
of every month.
	Corrections to Items
And Services Rendered

	 	IMPORTANT. As corrections in [*] for home program services do not
[*], changes are not [*] to the billing group. All
changes to treatments and other items and services rendered that
are identified by the facility must be [*] and documented on the [*]
form. This includes changes to treatment counts due to information
obtained that was not previously known, such as hospitalization dates
and the death of a patient. The [*] form should be completed upon
discovery of the change and immediately e-mailed or faxed to the [*] at
the billing group. In addition, a new [*] or [*] report must be sent to
a designated billing group printer.
	 

	 	A [*] form is [*] if the billing group identifies and reports to the
facility a problem requiring correction in [*]. However, the facility
must still print a new [*] or [*] report to a designated billing group
printer before the billing group can update [*].
	 
	 	 
	BILLING GROUP RESPONSIBILITIES
	 
	 	 
	PATIENT ADMISSION
	 
	 	 
	New Patient

	 	See [*] in Financial Procedure Manual- Facility/Billing Group
[*] for guidelines.
	In-Center Patient
Converting to Home

	 	Ensure all additional forms, as required for a home patient per the [*], are obtained from the facility for
addition to the original [*].
	 

	 	•    ESRD Beneficiary Selection (CMS-382)

	 

	 	•    [*]

	 

	 	
•    Revised ESRD Medical Evidence Form (if the conversion to
the home program is within the first 3 months of beginning
dialysis for chronic dialysis failure). The home training
section should be completed by the facility.

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	Home Program

	 	[*]

	 	 	 

	Medicare Eligibility

	 	A home patient’s Medicare ESRD entitlement waiting period is waived when a
patient begins training for home dialysis within the first three months of chronic dialysis.
If this occurs, the 30-month coordination period will be based on the first month of dialysis
for EGHP primary patients. Ensure that any patient that changes from in-center to a home
program within the first three months of dialysis has the coordination period figured
correctly. Also ensure that the facility social worker has submitted a revised ESRD Medical
Evidence form
(CMS-2728) to the local Social Security office with the training section
completed.
	Method Selection

	 	For detailed information regarding this topic, see the Method Selection section
under Facility Responsibilities.
	 

	 	If the patient is Medicare primary, enter the selected method per the ESRD
Beneficiary Selection (CMS-382) in the [*] field under the [*] insurance
screen in [*]. The CMS-382 should either be entered into an online
Medicare system or mailed to the Intermediary.
	[*] CHARGE ENTRY
	Reports Utilized

	 	Two reports are utilized to perform charge entry:
	 

	 	•    Entry of daily items and services per the [*] Report.

	 

	 	•    Entry of monthly treatment counts using the [*] Report.

	 

	 	The [*] is expected to review all reports for accuracy and then send the
reports to a designated billing office printer.
	[*] Report

	 	At intervals designated by local management, billing group staff should receive a [*]
Report sent to a billing group printer by the facility [*].
	 

	 	The billing group reviews the report for billable items and services,
coding it with the applicable [*] procedure codes. A
[*] price list with
all applicable pricing profiles should be provided to billing staff for
coding purposes.
	 

	 	Following is a list of the most
frequently used home program [*] codes.

	 	 	 
	DESCRIPTION	 	PROCEDURE CODE
	CAPD Training

	 	[*]
	CCPD Training

	 	[*]
	Home Hemo Training

	 	[*]
	CAPD (Daily Charge)

	 	[*]
	CCPD (Daily Charge)

	 	[*]
	Home Hemodialysis

	 	[*]
	ARANESP 1 MCG

	 	[*]

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	Home Program

	 	[*]

	 	 	 
	DESCRIPTION	 	PROCEDURE CODE
	EPOGEN <10,000 (admin. In-Center)

	 	[*]
	EPOGEN >10,000 (admin. In-Center)

	 	[*]

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	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

HOME EPOGEN (administered in the home)

	 	 	 	 	 

	[*] vial
	 	 	[*]	 
	[*] vial
	 	 	[*]	 
	[*] vial
	 	 	[*]	 
	[*] vial
	 	 	[*]	 
	[*] vial
	 	 	[*]	 

	 	 	 

	 

	 	The [*] Report prints patient names first in the order of the insurance
type and method (if applicable) and then secondly in alphabetic order.
	 

	 	The report may, but will not
always, contain the following method categories:

	 	•	 	Method 1
	 
	 	 	 	All patients in this category are Medicare primary and will follow
the Medicare billing rules (below).
	 
	 	•	 	Method 2
	 
	 	 	 	FMS does not normally support Method 2 billing. For detailed
clarification regarding which Method 2 patients are acceptable, see
the Method Selection section under Facility Responsibilities.
	 
	 	 	 	If a patient appears on the [*] as Method 2, and they are not a
[*], the entry should first be evaluated for a [*] error. The
billing group should review the Method Selection form (CMS-382) to
determine the accuracy of the entry. If the form is not on file,
the billing group should obtain the form from the facility’s [*].
If it is determined to be a [*]error, the [*] field in [*]
insurance screen should be updated to the chosen method selection.
If it is not a [*] error, see the Method Selection/Mid-Year Method
Selection Exception section under Facility Responsibilities for
instructions.
	 
	 	•	 	[*]
	 
	 	 	 	[*]. The appearance of this code means that a Medicare primary
patient did not have their chosen method entered in the [*] field
of the [*] insurance screen in [*]. Obtain the ESRD Beneficiary
Selection form (CMS-382) from the facility and enter the chosen
method into [*]. If patient is Method 2, see section immediately
above for direction.
	 
	 	•	 	Other Insurance
	 
	 	 	 	This section combines commercial primary along with Medicaid
primary patients in alphabetic order.
	 
	 	 	 	Commercial plans will follow the commercial billing rules (below).
Local management should provide specific billing rules for
contracted carriers.
	 
	 	 	 	Medicaid plans generally follow the Medicare billing guidelines.
However, some may have other rules or limitations. Again, local
management must provide specific rules.

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	 	Rev. [*]
	Home Program
	 	[*]

	 	 	 

	Billable Services

	 	MEDICARE
	 

	 	IMPORTANT. MOST MEDICAID PLANS FOLLOW THESE RULES, BUT OTHERS
MAY HAVE OTHER RULES OR LIMITATIONS. LOCAL MANAGEMENT MUST DEFINE LOCAL
RULES.

	 	•	 	Method 1:

	 	•	 	Daily charge for CAPD, CCPD and Home IPD
	 
	 	•	 	Per treatment charge for Home
Hemodialysis (including Nocturnal and Staff Assisted)
	 
	 	 	 	Note: Separate charge for
staff assistance time is unbillable to Medicare, but may
be billable directly to the secondary carrier or patient.
	 
	 	•	 	Billing Group staff must apply the Medicare Case Mix
Factor listed on the Home Treatment Count to the composite
rate charged to Medicare primary patients.
	 
	 	•	 	Other services listed below.

	 	•	 	Method 2:

	 	•	 	Support Services provided by the [*] nurse, dietitian
and/or social worker. Services are billed by [*].
	 
	 	•	 	Other services listed below.

	 	 	 

	 

	 	OTHER ITEMS:

	 	•	 	Training for CAPD, CCPD and Home Hemodialysis (including
Nocturnal and Staff-Assist) when the patient is present and a
treatment or an exchange is performed. The [*] report notes
directly underneath the training service whether a treatment/
exchange was performed. If a treatment or exchange was not
performed, the charge cannot be considered a valid training
treatment and is unbillable [*] to a Medicare Method 2 patient.
Billing Group staff must apply the Medicare Case Mix Factor listed
on the [*] Report to the composite rate charged for training
treatments to Medicare primary patients.
	 
	 	•	 	EPOGEN administered in-center
	 
	 	•	 	ALL Medications administered in-center (including antibiotics),
	 
	 	•	 	HOME EPOGEN vials sent home for self-administration.
	 
	 	•	 	ARANESP administered in-center and sent home for
self-administration. which will have a “Supply By” code of
[*].
	 
	 	•	 	Administration Supply Fees (fees do not appear on the [*]
report). Billing group staff manually adds the procedure code as
a billable item. It is added exclusively for medications
(including EPOGEN) administered in-center (“Supply By” code of
[*]). The procedure code used is dependent upon the [*]. The
“[*]” appears on the [*].
	 
	 	•	 	Professional charge for the administration of vaccines. Again,
this fee does not appear on the [*] report and billing group staff
must manually add the procedure code as a billable item upon the
administration of a vaccine.

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	 	Rev. [*]
	Home Program
	 	[*]

	 	•	 	Limited other ancillaries (EKG). These are procedure codes starting
with a [*]. Refer to local Medicare Pricing report for billable
status.
	 
	 	•	 	SPECIAL NOTE: Excluding Home EPOGEN, ARANESP and antibiotics
given to treat [*], medications with “Supply By”
codes of [*] may
be billable to the secondary carrier of a Medicare primary
patient. This is in specific cases where the facility has
faxed an FMS [*] order form to the billing group and it has been
verified that the patient has prescription drug benefits through
their secondary commercial carrier. This order form must be
approved and on file at the billing group before medications of
this type can be billed to the secondary carrier. These items
would be billed directly to the secondary carrier on a separate
ailment.

	 	 	 

	 

	 	COMMERCIAL
	 

	 	IMPORTANT. CONTRACTED CARRIERS MAY HAVE OTHER RULES OR LIMITATIONS.
LOCAL MANAGEMENT MUST DEFINE RULES FOR CONTRACTED CARRIERS.

	 	•	 	Daily charge for CAPD, CCPD and Home IPD. Case Mix Factors DO
NOT APPLY to commercial patients and should be ignored by Billing
Group staff.
	 
	 	•	 	Per treatment charge for Home Hemodialysis (including Nocturnal
and Staff Assisted). Case Mix Factors DO NOT APPLY to commercial
patients and should be ignored by Billing Group staff.
	 
	 	•	 	Separate charge for staff assistance time on staff-assisted
Home Hemodialysis
	 
	 	•	 	Training for CAPD, CCPD and Home Hemodialysis (including
Nocturnal and Staff-Assist) when the patient is present and a
treatment or an exchange is performed. The [*] notes directly
underneath the training service whether a treatment or exchange
was performed. If a treatment or exchange was not performed, the
charge cannot be considered a valid training treatment and is
unbillable. Case Mix Factors DO NOT APPLY to commercial patients
and should be ignored by Billing Group staff.
	 
	 	•	 	Home EPO Training
	 
	 	•	 	EPOGEN administered in-center
	 
	 	•	 	HOME EPOGEN vials sent home for self-administration.
	 
	 	•	 	Medications with “Supply By” codes of [*]. Medications
provided with codes of [*] must have previous billing
group verification of prescription drug benefits. This
requirement does not apply to Home EPOGEN and antibiotics, which
are billable and do not require prior prescription drug
verification.
	 
	 	•	 	ARANESP administered in-center or sent home for
self-administration.
	 
	 	•	 	Administration Supply Fees (fees do not appear on the
[*] report). Billing group staff manually adds the procedure code
as a billable item. It is added exclusively for medications
(including EPOGEN) administered in-center (“Supply By” code of
[*]). The procedure code used is dependent upon the [*]. The
“[*]” appears on the [*].

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	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

	 	•	 	Professional charge for the administration of vaccines. Again,
this fee does not appear on the [*] report and billing group staff
must manually add the procedure code as a billable item upon the
administration of a vaccine.
	 
	 	•	 	[*] Services (procedure codes starting with [*])
	 
	 	•	 	Other Ancillaries (procedure codes starting with [*])
	 
	 	•	 	Catheter inspections, peritonitis exams, tubing changes,
peritoneal catheter flushes

	 	 	 

	[*] Home Validation 

Fields

	 	MEDICARE CASE MIX ADJUSTMENT
FACTOR FOR TRAINING TREATMENTS
	 

	 	As of April 2005, Medicare began applying a “Case Mix” adjustment
factor to each facility’s composite rate based on individual patient
attributes. Medicare calculates the adjustment based on the patient’s
height age and weight as of the end of the service period billed The
patient’s weight and height are communicated to Medicare in the value
code section of the monthly claim form. The patient’s weight in
kilograms is reported with an [*] value code and the height in
centimeters is reported with an [*]. These value codes, as well as the
patient’s weight and height, are listed on the [*] Report whenever a
training treatment with an associated exchange/treatment is set to [*].
Billing group staff must manually enter these value codes and their
associated amounts on the patient’s ailment as of the last training
service.
	 

	 	In addition to the value codes, the MMA Case Mix adjustment factor will
appear on the [*] Report if a training treatment occurs with an
associated exchange/treatment. This Case Mix factor only applies to
Medicare primary patients and should be disregarded for patients with
any other primary insurance. To obtain the adjusted composite rate for
billing for Medicare primary patients, billing group staff must
MANUALLY multiply the factor appearing on the reports by the training
composite rate that appears during procedure entry. This adjusted
composite rate must then be MANUALLY entered in M/M as the total
charge.
	 

	 	For example, if the Medicare training composite rate equals $125.00 and
the case mix factor is 1.2831, the user would multiply $125.00 by
1.2831 to obtain an adjusted composite rate of $160.39. The $160.39 is
manually entered in M/M as the total charge for the training treatment.
	 

	 	[*]
	 

	 	Value entered on the ailment when EPOGEN is provided. Value may [*]
and the ailment should be updated to the [*] value during each interval
of charge entry.

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	 	Rev. [*]
	Home Program
	 	[*]

	 	 	 

	 

	 	PROCEDURE CODE
	 

	 	Code applicable to the item or service provided that will be used for
procedure entry in [*]. Pharmacy codes (codes starting with [*])
listed are [*] codes and the billing group must determine the correct
procedure code to use based on the dosage and the available active
procedure codes per a current [*] price list.
	 

	 	DOSE (Medications only)
	 

	 	This is the amount either administered to the patient in-center or the
amount of medication per vial that is sent home for
self-administration.
	 

	 	NOTE: The dose for Home EPOGEN and ARANESP sent home for
self-administration should reflect the actual vial size, not the [*]
that the patient is supposed to administer at home.
	 

	 	[*] (Medications Only)
	 

	 	This is the [*] that a medication was [*]. Depending on insurance
coverage the billing group is allowed to add a pharmacy administration
supply fee for medications that are administered in-center
(“Supply By” code of [*]. Vaccines (Pneumococcal, Hepatitis,
Influenza) have their own specialized pharmacy administration supply
codes, as well as specialized professional fee codes.
	 

	 	The secondary diagnosis code
attached to the [*] medication administered
should also be used on its applicable administration supply or
professional fee.
	 

	 	Pharmacy administration supply codes are as follows:
	 

	 	Administration Supply Fee Procedure Codes

	 	 	 	 	 

	[*]
	 	 	[*]	 
	[*]
	 	 	[*]	 

	 	 	 

	 

	 	Vaccine Administration Supply and Professional Fee Procedure
Codes

	 	 	 	 	 

	Pneumococcal Admin. Supply
	 	 	[*]	 
	Pneumococcal Prof. Fee
	 	 	[*]	 
	Hepatitis B (Engerix B)/Recombivax Admin. Supply
	 	 	[*]	 
	Hepatitis B (Engerix B)/Recombivax Prof. Fee
	 	 	[*]	 
	Influenza Admin. Supply
	 	 	[*]	 
	Influenza Prof. Fee
	 	 	[*]	 

	 	 	 

	 

	 	[*]
	 

	 	[*] apply [*] to Medicare Method 2 support services. They are not
billed for any other type of service. [*] appear on training
treatments, but are not applicable to billing the training treatment.
	 

	 	Each occurrence of a training treatment should be [*], not [*].
	 

	 	SPECIAL NOTE: If a training treatment did not have an actual treatment
or exchange performed, it cannot be considered a valid

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	 	Rev. [*]
	Home Program
	 	[*]

	 	 	 

	 

	 	training treatment. The [*] report notes directly underneath the
training service whether a treatment or exchange was performed. If a
treatment or exchange was not performed, the charge
	 

	 	cannot be considered a valid training treatment and is considered
unbillable [*] Medicare Method 2 patient.
	 

	 	[*]
	 

	 	[*] codes are required for EPOGEN, ARANESP, ancillaries, lab work,
medications and pharmacy administration supply/professional fee codes.
If a [*] is [*] for one of these procedures, and the procedure is
billable to the insurance carrier involved, contact the facility to
request that [*] is updated. A new [*] report will have to be printed
by the facility to a designated billing group printer once the update
is made.
	 

	 	SUPPLY BY (Medications Only)
	 

	 	The supply by code denotes where a dispensed medication was obtained
from and where it was administered. The [*] report will print an [*]
to all supply by codes that denote [*] medications (which require
billing group evaluation based on insurance coverage). Supply by
codes that do not have [*] on the [*] report represent medications that
are [*] to any carrier.
	 

	 	The following supply by codes are:

	 	•	 	Billable to all insurance carriers (within
contractual limits):

	 	1.	 	[*] In-Center Administration
	 
	 	2.	 	[*] FMC [*] In-Center Administration
	 
	 	3.	 	[*] In-Center [*] In-Center Administration

	 	 	 

	 

	 	The following supply by codes are:

	 	•	 	Excluding EPOGEN or ARANESP, the codes are
unbillable to Medicare and possibly other government
programs (obtain other government billing rules from local
management).
	 
	 	•	 	Billable (including antibiotics) to primary
commercial carriers (within contractual limits).
	 
	 	•	 	Billable (excluding antibiotics) directly to
carriers secondary to Medicare where prescription drug
benefits have been previously verified***

	 	4.	 	[*] FMC [*]/Home Administration***
	 
	 	5.	 	[*] In-Center [*]/Home Administration***
	 
	 	6.	 	[*] /Home Administration***

 

			
	***	 	Excluding Home EPOGEN, ARANESP and antibiotics provided to treat
[*], medications ordered for use in the home must have
[*] insurance verification clearance of prescription drug
benefits through the primary or secondary commercial carrier
(services are not billable to

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	Home Program
	 	[*]

 

			
	 	 	Medicare).The benefits should have already been verified, and an FMS
[*] Order form already approved and on file, before a medication
appears on the [*] report with an [*] supply by code (excluding
EPOGEN, ARANESP and antibiotics). The billing group must verify
that the FMS [*] Order form is approved and on file prior to
entering a charge in [*]. If this [*] process was not
performed, the FMS Order form used to order the medication
should be requested from the facility [*] and the patient’s
commercial insurance contacted to verify the existence of
prescription drug benefits. If coverage does not exist, the
medication (except EPOGEN and ARANESP) is not billable. If
the coverage is through a secondary carrier, the secondary
carrier should be billed directly on a separate ailment from the
primary carrier.

	 	 	 

	 

	 	The following supply by codes are:

	 	•	 	Unbillable to all insurance carriers

	 	7.	 	[*]
	 
	 	8.	 	[*]
	 
	 	9.	 	[*] In-Center Administration
	 
	 	10.	 	[*] Home Administration

	 	 	 

	 

	 	METHOD
	 

	 	For billing purposes, the method column is used for Medicare Method 2
patients exclusively. It defines the method of contact between a
patient and the facility dietitian, social worker and nurse (i.e., by
phone or in person). Local Fiscal Intermediaries define what methods
of contact are reimbursable. Some Fiscal Intermediaries reimburse
telephone contact, while others reimburse “in-person” contact only.
Coverage for the different contact methods should be defined by local
management with the local Fiscal Intermediary.
	 
	 	 
	In-Center Hemo-
Dialysis and Training
Performed on the
Same Day

	 	An in-center hemodialysis treatment provided on the same day as a CAPD,
CCPD or Home Hemodialysis (re-)training treatment/exchange is unbillable to
Medicare and Medicaid programs. The training [*] in-center
treatment [*]. The in-center treatment should be voided.
	 
	 	 
	AILMENT CODING
	 	 
	 
	 	 
	Value Codes

	 	EPOGEN/HOME EPOGEN/ARANESP
	 

	 	All EPOGEN and ARANESP services require value codes to be placed on the
ailment. The code used is always [*] with an associated value that is equal
to the [*]). The value appears on the [*] Report. If EPOGEN was given, and
the [*]value

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	Home Program
	 	[*]

	 	 	 

	 

	 	does not appear on the [*], contact the facility to request that they add
the value to [*]. The billing group must obtain a new copy of the [*]
Report from the [*] showing the [*] prior to entering the value in [*].
Since the billing group identified the change and a new [*] is obtained, a
[*] form is not required.
	 

	 	HEIGHT AND WEIGHT
	 

	 	The [*] Report and the [*] Report (when a training treatment occurs) will
list the patient’s weight in kilograms and height in centimeters. The Value
Codes associated with this information is [*] for weight and [*] for height.
Billing Group staff must enter this information on the patient’s ailment in
the next available value code available after the EPOGEN value code for the
[*]. The values entered in M/M should reflect the last values reported as
of the [*] date of service for the [*].
	Condition Codes

	 	Each change of modality (CAPD, CAPD Training, CCPD, CCPD Training, etc.) requires
the creation of a separate ailment. The [*] report documents all modality changes and the
date on which it occurred. A new
ailment should be created upon each occurrence of a modality change, unless
the patient already performed services under that modality within the same
month. For instance, a patient starting out as CAPD in the beginning of the
month, switching to CCPD Training and then returning to CAPD for the rest of
the month would have a total of 2 ailments: one for CAPD reflecting the
charges for the beginning and the end of the month and another for CCPD
Training.
	 

	 	All billable charges should be attached to the ailment that corresponds to
the modality that the patient was when the service was performed. The
ailment should reflect the specific condition codes that apply to the
different modalities. Following is a list of the modalities that require a
separation in ailment, along with its corresponding condition code:

	 	 	 	 	 
	Modality	 	Condition Code	 
	In-Center Hemodialysis
	 	 	[*]	 
	[*]Hemodialysis
	 	 	[*]	 
	CAPD
	 	 	[*]	 
	CCPD
	 	 	[*]	 
	Home IPD
	 	 	[*]	 
	Home Hemodialysis (including Nocturnal
And Staff-Assist)
	 	 	[*]	 
	CAPD Training
	 	 	[*]	 
	CCPD Training
	 	 	[*]	 
	Home Hemodialysis Training (including
Nocturnal and Staff-Assist)
	 	 	[*]	 
	Home EPOGEN*
	 	 	[*]	*
	Patient Residing in a Nursing Home
	 	 	[*]	**

 

			
	*	 	HOME EPOGEN can either be billed on a separate ailment where the condition
code of [*] is entered in place of the [*]primary condition code of [*]. It
can also be billed in conjunction with the home dialysis ailment that
corresponds to the date the Home EPOGEN was given. In this case, the
condition code of [*]would be placed in the [*]condition code field (under
the [*] or [*], etc).

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	Home Program
	 	[*]

 

			
	**	 	This Condition Code will be reported on the [*] and [*] Report whenever
the patient is found to reside in a nursing home. This condition code
should be entered in the [*]condition code field after the [*] (whichever
are applicable).

EXAMPLE: Services Performed:

	 	•	 	CAPD Training [*]
	 
	 	•	 	EPOGEN administered in-center on [*]
	 
	 	•	 	CAPD on [*]
	 
	 	•	 	Engerix B administered in-center [*]
	 
	 	•	 	CCPD Training on [*]
	 
	 	•	 	Home EPOGEN on [*]
	 
	 	•	 	CCPD on [*]

There would be a total of 4 separate ailments, separated as follows:

	 	 	 	 	 	 	 
	 	 	Ailments/Services	 	 	 	Ailment Coding
	 
	 	 	 	 	 	 
	Ailment 1:

	 	CAPD Training

	 	[*]

	 	[*], with the [*]EPO value code and [*]

	 

	 	CAPD Training

In-Center EPO
	 	[*]

[*]	 	 
	 
	 	 	 	 	 	 
	Ailment 2:

	 	CAPD

Engerix B

Pharmacy Supply Fee

	 	[*]

[*]

[*]

	 	[*], with [*] in condition code [*]
to reflect the vaccine (under
the [*])

	 

	 	Vaccine Prof. Fee
	 	[*]	 	 
	 
	 	 	 	 	 	 
	Ailment 3:

	 	CCPD Training
	 	[*]
	 	[*]
	 

	 	CCPD Training
	 	[*]	 	 
	 
	 	 	 	 	 	 
	Ailment 4:

	 	CCPD

Home EPOGEN

	 	[*]

[*]
	 	[*]primary condition/[*]
secondary condition. Also
with the [*]EPO value code
and [*]

	 	 	 

	Comment/Reference Coding

	 	The comment/reference line of each ailment should reflect:

	 	1.	 	[*]
	 
	 	2.	 	[*]
	 
	 	3.	 	[*]
	 
	 	4.	 	[*] of the modality [*] [*]
	 
	 	5.	 	Primary condition code

	 	 	 
	Comment Examples	 	Definition
	[*]

	 	March 2003, CAPD
	[*]

	 	March 2003, CAPD Training
	[*]

	 	March 2003, Home Hemodialysis

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	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

	 	 	 

	 

	 	This format is used in order to easily identify [*] on Medicare [*] reports.
Normally, Medicare allows [*]modality changes.
	Influenza/Pneumococcal 

Vaccines

	 	An [*] should be placed on the ailment [*]primary condition code ([*],
[*], etc.) whenever a vaccine is billed.
	Patients Residing 

in a Nursing Home

	 	A condition code of [*] will appear on the [*] Report
whenever a patient resides in a nursing home. This condition code should be
entered on the patient’s ailment in the [*]condition code field.
	Hospital Spans -

Ailment Entry

	 	A [*]spans may be entered on the ailment. If additional hospital
stays occur; the span should be placed in the [*].
	 
	 	 
	[*] REPORT REVIEW/CODING
	 
	 	 
	Reporting Schedule

	 	At intervals designated by local management, billing group staff should receive a
[*] Report. It is printed by the facility [*] to a designated billing group printer. The month-end
deadline for the facility is [*] on the [*] of every month.
	Treatment Count 

Review

	 	Billing group staff should review the [*] report for any
apparent abnormalities with treatment count calculations. For instance, the treatment count for each
patient should normally reflect every day of the month with only the following items reduced from the
count:
	 
	 	 
	 

	 	  For CAPD/CCPD/IPD:

	 	•	 	Each [*] period that the patient was hospitalized
(excluding admission and discharge dates). Admission and
discharge dates are billable.
	 
	 	•	 	Each day the patient received CAPD/CCPD or Home
Hemodialysis training or re-training.
	 
	 	•	 	All days following the patient’s discharge from a
facility (including days following the death of a patient).

	 	 	 

	 

	 	NOTE: There should be [*] in the monthly home treatment
count for either [*]hemodialysis treatments. In the rare occurrence
that a patient received [*]hemodialysis, the in-center services
should have already been entered into [*] through the charge [*] process and
a [*] code already attached (obtained from the [*] screen in [*]). The
monthly treatment count entered by the facility should not have contained
any deductions for the [*]hemodialysis service and should be billed
on a separate ailment.
	 
	 	 
	 

	 	[*]hemodialysis [*]. There also [*] have been any [*]home
peritoneal treatment count

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	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

	 	 	 

	 

	 	for the time the patient obtained [*]hemodialysis. Any billable
medications received during the [*]hemodialysis treatment that posted to [*]
through the charge [*] should be moved to the home dialysis claim.
	 
	 	 
	 

	 	Any discrepancies should be reported to the facility’s [*] and [*] must be
updated prior to making changes to what will be entered into [*]. If any
changes are required, the facility must print a new [*] or [*] report to a
designated billing group printer. Since the billing group identified the
correction, a [*] form is not required.

	 	 	 

	Treatment Count 

Coding

	 	Once treatment counts are verified, the report must be coded for patient modality
and then treatment procedure code. In addition, it should be verified that all
patients performing home dialysis have treatment counts appearing on the report. The
[*] in [*] provides both modality information and is also used to verify that all
patients have been accounted for.
	 
	 	 
	 

	 	The [*] can be accessed in [*], using the following menus:

	 	 	 	From [*] Main Menu:

	 	•	 	[*]
	 
	 	•	 	[*]
	 
	 	•	 	[*]
	 
	 	•	 	[*]Method 2

	 	 	 

	 

	 	On the [*] report, the patient’s modality is documented next to their name
so that the correct treatment procedure code can be determined. In
addition, each patient on the [*] should have
treatment counts on the [*] Report unless there is an open temporary absence
or the patient is on [*]hemodialysis. If a patient is found to not have
treatment counts appearing on the report, first determine if the patient has
obtained other home services by verifying that the patient appears on the
[*] report. If the patient appears on the [*], contact the facility to
determine if counts should be entered for the patient. If the
patient is not appearing on the [*], verify whether there is an open
temporary absence or if the patient is obtaining [*]hemodialysis. If so,
the patient likely [*]. The facility should still be contacted to
[*]. If any changes are required in [*], the [*] must print a new [*]
or [*] report to the billing office printer. Since the billing group
identified the error, a [*] form is not required.
	 
	 	 
	Medicare Method 1, 

Medicaid and

	 	Once modalities are identified, the Medicare Method 1, Medicaid and commercial
patients are then coded using one of the following procedure codes:
	Commercial
	 	 

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	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

	 	 	 	 	 
	Description	 	Procedure Code
	CAPD
	 	 	[*]	 
	CCPD
	 	 	[*]	 
	Home Hemodialysis
	 	 	[*]	 
	Intermittent Peritoneal Dialysis (IPD)
	 	 	[*]	 

	 	 	 

	 

	 	Normally, the treatments are added into [*] using the date span that is
listed on the [*] report. Some commercial carriers may require [*]. In
these cases, each billable day must be entered [*].
	 
	 	 
	 

	 	The MMA Case Mix adjustment factor will be provided for every patient on the
[*] Report; however, this factor only applies to Medicare primary patients
and should be disregarded for patients with any other primary insurance.
Billing group staff must use this factor to obtain the adjusted daily
composite rate for billing Medicare primary patients. To obtain the
adjusted daily composite rate, billing group staff must MANUALLY multiply
the factor appearing on the report by the daily composite rate that appears
during procedure entry. This adjusted composite rate must then be MANUALLY
multiplied by the number of billable days. The user then MANUALLY inputs
the [*] AND the total charge.
	 
	 	 
	 

	 	For example, if the daily composite rate equals $54.70 and the case mix
factor is 1.2831, the user would multiply $54.70 by 1.2831 to obtain an
adjusted composite rate of $70.19.
	 
	 	 
	 

	 	The $70.19 is then manually multiplied by the number of billable days. If
the number of billable days is 30, then the total charge is equal to
$2,105.70 ($70.19 x 30). This amount must be manually entered in the total
charge field of procedure entry.
	 
	 	 
	 

	 	See Ailment section above for ailment coding based on modality and services
provided
	 
	 	 
	Medicare Method 2

	 	FMS does not normally support this billing method. For detailed information
regarding which Method 2 patients may be admitted to an FMS facility, see the Method
Selection section under Facility Responsibilities.
	 
	 	 
	 

	 	For Method 2 patients, Medicare is billed for support service [*] provided
by the nurse, social worker and/or dietitian. Although some Fiscal
Intermediaries allow support to be billed at a [*] rate, FMS billing
groups [*]. In addition, the reimbursable forms of support service
contact vary by Fiscal Intermediary [*]. Local AR management should contact
their Fiscal Intermediary in order to define rules regarding what forms of
contact are reimbursable.
	 
	 	 
	 

	 	Support Services [*]
	 
	 	 
	 

	 	The [*] Report is used to bill Method 2 support services by the [*].
Although [*] must be charged, Medicare caps the total charge at $121.15.
Charges over this cap rate will not be reimbursed and require [*]. The
amount over the cap rate should [*].

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	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

	 	 	 

	 

	 	The procedure codes used to bill support service [*] appear on the [*]
Report, along with the person providing support and the form of contact.
Where Fiscal Intermediaries allow, all forms of support service contact
should be billed.
	 
	 	 
	 

	 	Although training treatments include [*], the [*] are ignored and the
training treatment is billed as [*]. Training treatments are not considered
support service. If support services are provided on the same day as a
training treatment (which includes a treatment/exchange), the training
treatment would be billed [*]support service. However, if the [*] report
documents that a treatment or exchange [*], it cannot be considered
a valid training treatment. In this case, the training treatment may be
billed [*]as support services to a Medicare Method 2 patient. Training
services and support services require separate ailments.
	 
	 	 
	 

	 	In addition to dietitian, social worker and nursing support [*], a
separately billable lab support fee is billable [*] if any lab services
appear on the [*] report. This is a [*] charge [*]lab service.
Procedure codes used to bill the lab support fee are as follows:

	 	 	 	 	 
	Description	 	Procedure Code	 
	CAPD Lab Support
	 	 	[*]	 
	CCPD Lab Support
	 	 	[*]	 
	Home Hemodialysis Lab Support
	 	 	[*]	 

	 	 	 

	Multiple Treatment 

Modalities

	 	Occasionally patients may perform multiple forms of home dialysis within the
same month. This occurs when a patient is performing one
modality and completes training for a new modality. Each change in modality
that affects treatment counts should appear as a separation in counts on the
[*] report. The [*] report documents all changes in modality and can be
used to determine which modality should be billed [*]. If it is not
separated appropriately, or if it is not clear, the facility [*] should be
contacted to clarify.
	 
	 	 
	Corrections to
Monthly Treatment
Counts

	 	The facility may need to make changes to the monthly treatment count due to
hospitalization dates not previously known or due to a death of a patient. The
facility is expected to immediately e-mail or fax a [*]form to the
billing group [*], as well as print a new [*] Report to a designated billing
group printer. A [*] form is [*] if the billing group identifies
and reports to the facility a problem requiring correction in [*]. However,
the facility must still print a new [*] report to a designated billing group
printer before the billing group can update [*].
	 
	 	 
	BALANCING AND REPORT FILING

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	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

	 	 	 

	Balancing [*]
[*] to [*]

	 	The billing group must balance home treatment counts, training treatments
and EPOGEN entered into [*] with [*] prior to [*] or performing the month-end process. This function is performed by generating
a [*] report and comparing the totals to other reports generated in both [*]
and in [*].
	 
	 	 
	 

	 	INITIAL STEPS
	 
	 	 
	 

	 	A [*] has to occur prior to beginning the balancing process (whether
performed manually or [*]).
	 
	 	 
	 

	 	A [*] report (M/M [*]) should be generated and it is the primary
document with which all other reports will be compared.
	 
	 	 
	 

	 	BALANCING MONTHLY HOME TREATMENT COUNTS
	 
	 	 
	 

	 	The [*] report and the [*] report reflecting the date span of services
entered into [*] are required for this process.

	 	1.	 	On the [*] report, add the CAPD, CCPD, Home IPD
and Home Hemodialysis treatments together (do not include training).
This total is compared to the total count listed on the last page of
the [*] Report.*

	 	*	NOTE:	The total listed on the last page of the [*] report may be used as
long as there are no
Method 2 patients in the facility. In
the rare instance that valid Method 2 patients exist, add all the
Method 2 treatments on the [*] report together and subtract from the
total on the last page. This total is then compared to the one
obtained per the [*] report.

	 	•	 	IF TREATMENTS ARE IN BALANCE:
	 
	 	 	 	The next group of services should be balanced (Training Treatments
and EPOGEN-see below).
	 
	 	•	 	IF TREATMENTS ARE OUT OF BALANCE:
	 
	 	 	 	A [*] report (M/M [*]) should be generated to determine if
the variance is due to [*] void [*]. Home services appearing on the
[*] Report that are not a [*] (voided items
[*] items) will cause the
current month treatment count to be out of balance.

	 	v	 	IF THE [*] REPORT SHOWS A VARIANCE:

	 	•	 	If the void [*] variance
is [*] error, notate the variance with an
explanation on the [*] report and move on to balancing the
next group of services (Training Treatments and EPOGEN —
see below).
	 
	 	•	 	If the void [*] variance
[*] error, correct the entry in [*] and move on to
balancing the next group of services (Training and EPOGEN —
see below).

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	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

	 	v	 	IF THE [*] REPORT DOES NOT SHOW A VARIANCE:

	 	•	 	A [*] report for
procedure group [*] (M/M [*]) should be generated. Compare
each patient’s treatment count on the [*] to each patient’s
count listed on the [*] report to identify the variance(s).
Enter all corrections into [*] and proceed to balancing the
next group of services (Training Treatments and EPOGEN).

	 	 	 	BALANCING TRAINING TREATMENTS AND EPOGEN (BOTH IN-CENTER
ADMINISTRATION AND HOME EPO)
	 
	 		 	IMPORTANT. It is crucial that all parties are up to
date with charge [*] and home patient data entry for this balancing method to work. This
means that the [*]date pulled for in-center services by charge [*] should
match the [*] date of services entered in [*] for the home program.
	 
	 	 	 	Initially, the [*] Report and the [*] reports are used to perform this
process.

	 	1.	 	The [*] should be generated for the date span
which corresponds to the dates of service entered into [*] and should
include [*] In-Center and Home Patients ([*]). Both in-center and home
patients are included because the [*] Report includes both without the
option to exclude.
	 
	 	2.	 	The training treatment totals from the first
page and the In-Center EPOGEN/Home EPOGEN totals from the last page of
the [*] are compared to the [*] report totals.

	 	•	 	IF BOTH TRAINING AND EPOGEN BALANCE:
	 
	 	 	 	Proceed to the Final Step below.
	 
	 	•	 	IF TRAINING TREATMENTS OR EPOGEN DO NOT BALANCE:
	 
	 	 	 	The [*] report (M/M [*]) may identify the error(s) if the error
occurred on entries made to [*] previous to the current day. The
report compares [*] treatment and EPOGEN entries to [*], but it
[*] errors on services entered [*].

	 
	 	v	 	IF ALL VARIANCES ARE IDENTIFIED:
	 
	 	 	 	Correct entries and proceed to the Final Step below.
	 
	 	v	 	IF ALL VARIANCES ARE NOT IDENTIFIED:
	 
	 	 	 	It must be determined whether the variance is [*] charges or due
to [*] void [*].

	 	•	 	DETERMINING [*] VS [*]
VARIANCES

	 	 	 	A [*] report ([*]) should first be generated in [*] for the
date span reflecting the

30

 

			
	 	 	 
	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

dates of
service [*] entered into [*]. The training
treatments and EPOGEN totals on this report are then compared
to the [*] report generated at Step 1 under balancing
Training Treatments and EPOGEN.

	§	 	IF THE TOTALS MATCH FOR EITHER TRAINING OR
EPOGEN PER THE TWO REPORTS:
	 
	 	 	The variance is due to [*]. A [*] (M/M [*]) should be
generated to identify the entries causing the variance.

	 	o	 	IF THE VARIANCE IS NOT A [*]
ERROR:
	 
	 	 	 	The variance should be [*] on the [*] report. If all
variances are accounted for, proceed to the Final
Step below.
	 
	 	o	 	IF THE VARIANCE IS A [*] ERROR:
	 
	 	 	 	All errors should be corrected in [*]. Once all
variances are corrected and accounted for, proceed to
the Final Step below.

	§	 	IF THE TOTALS DO NOT MATCH FOR EITHER
TRAINING OR EPOGEN PER THE TWO REPORTS:
	 
	 	 	The variance is [*] and the following functions should be
performed for the particular service out of balance.

	 	o	 	TRAINING VARIANCE
	 
	 	 	 	A [*] Report (M/M [*]) should be generated for the
specific training procedure code reflecting
the training modality out of balance. This report is
then compared to the [*] Report that reflects the
same date span of services. Once the variance is
identified, all corrections should be entered into
[*].

	 	Ø	 	IF EPOGEN IS ALREADY IN BALANCE:
	 	 	 	Proceed to the Final Step below.
	 
	 	Ø	 	IF EPOGEN IS NOT IN BALANCE:
	 	 	 	Complete EPOGEN/HOME EPOGEN VARIANCE procedure
(next).

	 	o	 	EPOGEN/HOME EPOGEN VARIANCE
	 
	 	 	 	A [*] report ([*]) and the [*] report previously
generated to determine whether the variance was prior
[*] is used in this process.
	 
	 	 	 	The [*] report is generated in
[*] date of service
[*]. Each date of service is then compared to the
[*]

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	FMCNA Financial Procedures Manual — Facility/Billing Group
	 	Rev. [*]
	Home Program
	 	[*]

	 	 	 	[*] report until the date(s) out of balance are
identified. Once the date(s) are identified, both
the [*] report and the [*] report are generated again
in [*] for only those dates of service out of
balance. The reports are then compared to
identify the individual patient(s) out of balance.
	 
	 	 	 	Once all corrections are made to [*], proceed to the
Final Step below.

	 	 	 

	 

	 	FINAL STEP
	 
	 	 
	 

	 	If any corrections were made to
[*], a [*] must be performed and a new
[*] report generated to verify treatments are now in balance. Once services
are in balance, [*] or the normal month-end process may proceed. Keep all
reports used to complete the balancing process and file along with the other
[*] reports.
	 
	 	 
	Report Filing

	 	All reports generated during the charge entry or balancing process should be kept in
a binder dedicated to Home Program Services. Each facility should have its own binder and the
reports should be neatly filed and in date order (oldest on bottom to most recent on top).
This is required as the reports are the only [*] of how and why services were entered into
[*].

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	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

Preparing and Processing Write-Offs and Recoveries

	 	 	 

	Overview
	 	 
	 
	 	 
	Introduction

	 	This financial procedure outlines Fresenius Medical Care’s policy regarding the approval
of write-offs. It also outlines the procedure steps to be followed for preparation and
processing of write-offs. In addition it outlines the policy for proper processing of
recoveries against amounts that have been previously written off.
	Policy

	 	All eligible write-offs should be processed on a [*] basis.
	 

	 	The [*] Worksheet is the report used for determining what patient or indigent waiver balances
are eligible for write-off in any [*]. All balances appearing on the [*] Worksheet should be
submitted for approval in the [*] they appear on the worksheet, along with the [*]. All
balances meeting the established documentation requirements below should be approved and
returned to the billing group in time to be processed in the [*] that they appeared on the [*]
Worksheet. Any balances that the billing group is not submitting for approval should have a
note written on the [*] Worksheet regarding the reason for the delay in the write-off. Any
balances where approval is denied should have a comment on the [*] explaining the reason for
denial.
	 

	 	An insurance balance may need to be written off for reasons such as, Medicaid [*] programs that
do not pay the [*] Medicare, [*] not met or [*] filings by insurance carriers. These claims do
not appear on the [*] Worksheet. Use the [*] for the pertinent insurance company and highlight
the claim (s) for which you are requesting write-off approval. It is also important that these
write-offs are prepared, approved and processed in a timely manner.
	Proper 

Classification

	 	It is important that write-offs are properly classified as Medicare or Non-Medicare. The
criteria for each classification are listed below.

	 	 	 

	•

	 	Medicare Write-Offs

			

	•

	 	Medicare must be the primary insurance.
	•

	 	Balance must be co-insurance and or deductible, for Medicare [*], after Medicare has paid.
	•

	 	Balance must be patient responsibility or covered by an approved waiver.

			

	•

	 	Exception — Balances where Medicaid [*] secondary pays less than Medicare [*] should
be classified as a Medicare Write-Off.

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	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

	 	 	 

	•

	 	For patient balances not covered by an approved waiver, account must be at least [*] days old
from the first patient statement and reasonable collection efforts to obtain payment were
completed and documented. Refer to [*] procedure ([*]) for instructions.

			

	•

	 	Note: A claim should only be written off once all payments are received and all
collection efforts have been exhausted. There should not be [*]-[*] as this causes problems
with the bad debt schedule. Refer to M/M [*] [*] for instructions on how to edit Bad Debt
Schedule in the event this situation should occur.

	 	 	 

	•

	 	Non-Medicare Write-Offs

	 	 	 

	•

	 	Patient balances where Medicare is not the primary insurance or where the patient has no
primary insurance. An approved waiver may cover these.
	 
	•

	 	[*] write-offs.
	 
	•

	 	Balances that cannot qualify for Medicare bad debt due to lack of supporting documentation.

	 	 	 

	Documentation 

Requirements

	 	The required documentation must be attached to each write-off before the balance can be
approved for processing. Documentation requirements are listed below:

	 	 	 

	•

	 	Medicare Write-Off Documentation

			

	•

	 	[*] Worksheet
	•

	 	Medicare [*] copy
	•

	 	Copies of any secondary payments received, patient or insurance. Please note that copies of
denials or other [*] should also be included.
	•

	 	Waiver, front and back, that covers dates of service being requested for write-off. ([*]
approval date [*].) Please note that if your FI requires the supporting back up for the
waiver, it should be included as part of the write-off package.
	•

	 	If no waiver, copies of patient statements. Make sure statement date is legible on the
photocopy.
	•

	 	[*] or other supporting documentation i.e., [*].

	 	 	 

	•

	 	Non-Medicare Write-Off Documentation

			

	•

	 	Copy of [*] indicating balance is patient responsibility.
	•

	 	Waiver, front and back, that covers dates of service being requested for write-off.
([*] approval date [*].)

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	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

	 	 	 

	•

	 	If no waiver, copies of patient statements.
	•

	 	[*] or any other supporting documentation.
	•

	 	If an [*] write-off, denial indicating such along with a hard copy of the [*] screen which
reflects any [*] plus any correspondence for appeals.

	 	 	 

	Approval 

Requirements

	 	Appropriate approval must be received before write-offs can be processed. Approval levels
are as follows:

	 	 	 

	•

	 	[*] and Indigent Waiver balances that appear on the [*] Worksheet require [*] and A/R
Manager approval. Copies of the [*] will be provided to the [*] and [*] at the end of each [*]

	 	 	 

	•

	 	Note- Balances where Medicaid [*] do not pay the [*] will not appear on the [*]
Worksheet. These only require A/R Manager approval. At the discretion of the A/R Manager,
these write-offs may be processed at the time of payment posting, with the approval taking
place after the processing of the write-off. If any write-off is not approved, the A/R Manager
will request that it be [*].

	 	 	 

	•

	 	Insurance balances, with the exception of Medicaid and State Renal secondary claims as
noted above, which will not appear on the [*] Worksheet, require the following approvals:

	 	 	 

	•

	 	Batch totals < $ [*]- requires [*] and A/R Manager approval.
	•

	 	Batch totals > $ [*]- requires [*], A/R Manager and [*] approval.

			

	•

	 	Copies of the [*] will be provided to [*] and [*].
	•

	 	Note- Insurance balance write-offs, with the exception of Medicaid [*], should be batched by patient.

	 	 	 

	Medicare Bad 

Debt Schedule

	 	Medicare Bad Debt Schedules must be updated and balanced [*]. At the end of the cost
report year, normally [*] of each year, a full Medicare Bad Debt Schedule must be run and the
total balanced to the [*](Medicare Bad Debt). The [*] will sign the last page of each
facility’s Bad Debt Schedule. The [*], or other personnel as designated by the [*], will
complete a Schedule [*] for each facility and submit to the A/R Manager or designee for review
and signature according to the established deadline.

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	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

	 	 	 

	Recovery of
Bad Debt

	Recoveries, just like write-offs, must be classified correctly between Medicare and
Non-Medicare. If the original write-off was a Medicare Write-Off, the recovery would be a
Recovery of Medicare Bad Debt. If the original write-off was Non-Medicare, the recovery would
be a Non-Medicare Recovery of bad debt. Regardless of whether the recovery is Medicare or
Non-Medicare, the money should only be posted as a recovery when the write-off took place in a
prior cost reporting period. If the write-off was processed during the current cost reporting
period, the write-off must be [*] and, if the write-off was a Medicare write-off, the Medicare
Bad Debt Schedule must be edited.
	 
	 	 
	 

	Note: In most cases the cost report year is equal to the company’s [*] but this could differ
for [*] or [*] facilities.
	 
	 	 
	 

	All Medicare recoveries
must be entered onto the appropriate Medicare [*]. 

At year-end, the Medicare [*] must be totaled and balanced
to the [*] (Medicare Recoveries). The
Medicare [*]  are submitted, along with the [*] and the Medicare Bad Debt Schedule, to the
A/R Manager or designee for review according to the established deadline.
	 
	 	 
	Objectives

	This procedure outlines the write-off process for balances deemed uncollectible. It
establishes the criteria, documentation and approval requirements so that, where possible,
Medicare [*] can be obtained in accordance with company and Medicare guidelines.

	 	 	 

	Procedure Steps

	 	The primary steps in this procedure are:

	 	 	 

	 

	 	1. Preparing Write-Offs for Approval
	 
	 	 
	 

	 	2. Approval of Write-Offs
	 
	 	 
	 

	 	3. Posting Approved Write-Offs
	 
	 	 
	 

	 	4. Processing Recoveries

	 	 	 

	In this
Procedure

	This procedure contains the following topics.

	 	 	 	 	 
	Topic	 	See Page
	Preparing Write-Offs for Approval
	 	 	5	 
	Write-Off Approval
	 	 	8	 
	Posting Approved Write-Offs
	 	 	10	 
	Processing Recoveries
	 	 	12	 

4

 

			
	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

1.  Preparing Write-Offs For Approval

	 	 	 

	Purpose

	In order to recognize bad debt in a timely and accurate
manner, the billing group must prepare write-offs for
approval on a [*] basis.
	Responsibility

	The billing group staff will prepare write-off packages [*]
and include back up documentation in accordance with
policy. The [*] will review and approve as appropriate and
forward to the A/R Manager for the next level approval (s)
as required by policy.
	Procedure

	Follow the steps below in preparation of write-off packages.

	 	 	 	 	 
	Step	 	Who	 	Action
	1

	 	[*]
	 	Each [*], run the [*] Worksheet for both [*] Indigent and
[*] Patient responsibility to determine which balances are
eligible for write-off.

Refer to the [*] for instructions.
	 
	 	 	 	 
	2

	 	[*]
	 	Review each item on the worksheet. Where there are no
discrepancies, the write-off amount will carry over to the
APPROVED column for Medicare (M/C) write-offs. For
Non-Medicare (NON M/C) write-offs, the amt will have to be
carried over into the APPROVED (NON M/C) column. For
Medicare Write-Offs, where the amount does not carry over to
the approved column, you must explain why, if you are
requesting approval for this item. Some acceptable reasons
for this would be:

	 	 	 

	•

	 	Patient deductible- (Medicare [*] must reflect the
same amount applied to the deductible that appears in the
M/C [*] column).
	 
	 	 
	•

	 	Minor adjustment needed due to discrepancy with
pharmacy rates.
	 
	 	 
	•

	 	There may also be [*] amounts which would be due to
the fact that Medicare reimburses [*] for certain services; [*].

					

	 

	 	 	 	Once you have explained the amount in the M/C [*] column, you must then write the amount you are requesting
for write-off in the APPROVED (M/C) column.
	 

	 	 	 	Note: The amount being requested
for write-off must match the coinsurance amount on the [*] (or coinsurance

5

 

			
	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

	 	 	 	 	 
	Step	 	Who	 	Action
	 

	 	 	 	+ deductible amount).

	 	 	 	 	 

	3

	 	[*]
	 	If the [*] Worksheet indicates a primary insurance, there
must be a PRIMARY PAYMENT reflected. If not there must be
an explanation.
	 

	 	 	 	For Medicare Write-Offs where the worksheet reflects a
secondary insurance and there is no OTHER PAYMENT reflected,
this must be investigated and explained.
	 

	 	 	 	Note: The insurance coverage on the worksheet reflects the
current insurance information in [*]. Therefore, it is
possible that the coverage for the dates of service being
submitted for write-off was different than the current
coverage. If this is the case, cross out the incorrect
coverage and write in the correct information for the dates
of service in question.
	4

	 	[*]
	 	Attach the back up documentation as required, in accordance
with the policy, depending on whether the write-off is
Medicare or Non-Medicare.

For ease in review and approval, the documentation should be
in the same order as the items on the [*] Worksheet.
	5

	 	[*]
	 	For any items not being submitted for approval, indicate a
reason why on the worksheet. Some valid reasons might be:

	 	 	 

	•

	 	Waiver expired — (balance should be transferred to patient)
	 
	 	 
	•

	 	Medicare [*] (balance should be transferred back to Medicare)

					

	6

	 	[*]
	 	Run the [*] by Insurance for any insurance balances you are
requesting for write-off. Highlight the items for which you
are requesting write-off approval.
	7

	 	[*]
	 	Attach the back up in accordance with policy. The
documentation should be in the same order as the items on
the [*].
	8

	 	[*]
	 	Complete a [*] recording the [*] totals according to
Medicare and or Non-Medicare. Write-Offs should be
segregated according to the necessary approval levels, with
separate [*]

6

 

			
	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

	 	 	 	 	 
	Step	 	Who	 	Action
	 

	 	 	 	[*] for each batch.
	9

	 	[*]
	 	Give completed write-off batches to [*] for review and
approval.

7

 

			
	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

2.  Write-Off Approval

	 	 	 

	Purpose

	 	In order to recognize bad debt in a timely and accurate manner, the
A/R Manager, along with all other required authorizers, should
review and approve write-offs on a [*] basis.
	Responsibility

	 	The [*] and A/R Manager are responsible for the review and approval,
or denial, of all write-offs. They are responsible to ensure that
the reason for write-off and back up documentation are all in
accordance with policy. Any write-offs where the reason for
write-off or the documentation [*]. Any write-offs requiring [*]
approval, per policy, will be forwarded to the [*]. Write-offs
should be reviewed and approved, in accordance with policy, by all
[*] and returned to the billing group within the [*] so there are no
delays in processing.
	Procedure

	 	Follow the steps below in reviewing and approving write-off packages.

	 	 	 	 	 
	Step	 	Who	 	Action
	1

	 	[*]
	 	The [*] will review all items submitted for
write-off, ensuring that the required documentation
is attached. If a [*] is denied, it should be noted
on the [*].
	 

	 	 	 	The [*] will sign [*] of the [*] Worksheet or
the [*] along with signing the [*], ensuring that
totals are revised to reflect any changes based on
[*].
	2

	 	[*]
	 	Submit approved write-offs to A/R Manager for review
and approval.
	3

	 	A/R Manager
	 	The A/R Manager will review and approve, or deny,
all write-off packages, ensuring the reason for
write-off and back up documentation are all in
accordance with policy. Any approved write-offs
requiring additional approval, per policy, will be
forwarded to the [*] for review and approval. Any
approved write-offs not requiring additional
approval, will be returned to the billing group [*].
	4

	 	[*]
	 	The [*] is responsible for reviewing and approving /denying
any insurance write-off batches totaling
[*]. This review and approval /

8

 

			
	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

	 	 	 	 	 
	Step	 	Who	 	Action
	 

	 	 	 	denial should take
place [*].

9

 

			
	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

3.  Posting Approved Write-Offs

	 	 	 

	Purpose

	 	In order to recognize bad debt in a timely and accurate manner,
the billing group should process all approved write-offs in the
[*] they are approved.
	Responsibility

	 	The billing group will receive approved write-off packages from
the A/R Manager or [*].

	Procedure

	 	Follow the steps below in processing approved write-off packages.

	 	 	 	 	 
	Step	 	Who	 	Action
	1

	 	[*]
	 	Receive approved write-offs from the A/R Manager or [*].
	2

	 	[*]
	 	Enter the approved write-offs into M/M.

Be sure to enter one of the following write-off [*] codes:

	 	 	 
	Code	 	Description
	[*]
	 	Medicare Write-Off

	[*]
	 	Non-Medicare Write-Off

	[*]
	 	Medicare Write-Off — Indigent Waiver

	[*]
	 	Non-Medicare Write-Off — Indigent Waiver

	[*]
	 	Medicare Write-Off — [*]

	[*]
	 	Non-Medicare Write-Off — [*]

	[*]
	 	Non-Medicare Write-Off — [*]

	[*]
	 	Non-Medicare Write-Off — [*]

	[*]
	 	Medicare Write-Off — Medicaid [*]

	[*]
	 	Medicare Write-Off — [*]

	[*]
	 	Non-Medicare Write-Off — [*]

	 	 	Refer to the M/M [*] for instructions.

	 	 	 	 	 

	3

	 	[*]
	 	Run the [*]. Compare the totals on this report to the
approved totals on the [*]. Verify that the
Write-Offs were entered correctly as Medicare or
Non-Medicare. This report must be run and approved by the
[*].

10

 

			
	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

	 	 	 	 	 
	Step	 	Who	 	Action
	 

	 	 	 	Note: [*] appear under [*].
	 

	 	 	 	Refer to the M/M [*], for instructions.
	4

	 	[*]
	 	Prior to the [*], compare the [*] to the approved totals
on the [*] to ensure that only approved write-offs were
entered.

Sign and date the report once all data has been reviewed
and approved.
	5

	 	[*]
	 	At the [*], after all approved write-offs have been
processed, run the [*], either [*] copy or [*] version,
and forward to the [*] and [*].

11

 

			
	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

4. Processing Recoveries

	 	 	 

	Purpose

	 	When balances that were written off in a previous cost
reporting period are later paid, this money must be
processed as a recovery of bad debt. The recovery must be
processed accurately as Medicare or Non-Medicare.
	Responsibility

	 	The billing group must investigate all [*] to determine
whether they are recoveries, [*] or non a/r cash. If the
payment is identified as a recovery it must be posted,
through [*], to the correct [*].
	Procedure

	 	Follow the steps below in processing recoveries of bad debt.

	 	 	 	 	 
	Step	 	Who	 	Action
	1

	 	[*]
	 	Investigate all [*] to determine whether they are a recovery
of bad debt, an [*] or non a/r cash.
	2

	 	[*]
	 	If the payment is determined to be a recovery of bad debt,
determine whether the write-off was processed in a [*].
If it was, then the recovery will be posted through [*]
using the appropriate [*] so the money posts to the correct
[*] (Medicare Recovery) [*] (Non-Medicare Recovery). If the
write-off was processed during the [*], [*] the
write-off and, if the write-off was a Medicare Write-Off,
update the Medicare Bad Debt Schedule by [*] the
corresponding entry.
	3

	 	[*]
	 	For recoveries of Medicare Bad Debt, complete the Medicare
[*]. Make copies of the [*] and attach to the [*].

Subsequent recoveries for the [*] cost report year can be
recorded on the same [*].
	4

	 	[*]
	 	At year- end, total the Medicare [*], balance the total to
the [*], record the information on the [*] and attach to the
Medicare Bad Debt Schedule for submission to the A/R
Manager.

12

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Credit and Collection

Overview

	 	 	 

	Purpose

	 	This financial procedure provides instructions for
follow-up and documenting reasonable collection efforts
throughout the billing and collections process.
	 
	 	 
	Table of
Contents

	 	The table below lists the topics in this document.

	 	 	 	 	 
	Topic	 	See Page	 
	Overview
	 	 	1	 
	Commercial Insurance Billing and Follow-Up
	 	 	2	 
	Patient Payment Obligations
	 	 	7	 
	Medicare Collections
	 	 	13	 
	Medicaid Collections
	 	 	21	 
	Collections Documentation
	 	 	24	 

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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    Financial Manual — Billing group
	
 
	
 
	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Commercial Insurance Billing and Follow-Up

	 	 	 

	[*] Claim Follow-up

	 	The following actions should be taken for [*] Claim Follow-up:

	 	 	 
	Step	 	Action
	1

	 	If the claim is [*], try to determine which services were [*] before
making a call. Be aware of [*].
	2

	 	If the carrier is a contracted carrier, analyze claim against
contract. Know your contracts! If there seems to be a contract
issue versus an individual claim processing issue, see section below
regarding contract issues.
If balance is due to [*], advise billing group management [*] to
ensure that system is updated to prevent further claim payment
issues.
	3

	 	Call payer.
	4

	 	If this insurance is still active in the billing system, verify that
the payer still shows the coverage as active.
	5

	 	If balance is due from payer, request that claim be [*].  Verify
and document turn-around time on [*] processing.

	 	 	 

	Contract

	 	The following actions should be taken for Contract Issues:
	Issues Follow-up
	 	 

	 	 	 
	Step	 	Action
	1

	 	Before making a call, review contract and [*] to verify billing
requirements. Do your best to research the issue and understand the
problem in advance of making a call.
	 

	 	• If a copy of the contract is not available in the billing
group, notify billing group management who should contact [*] for a
copy.
	2

	 	Work with [*] and/or [*] as necessary to resolve contractual payment
issues.

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	Step	 	Action
	3

	 	Ensure payer system is updated to prevent [*] with claims
adjudication.
	4

	 	Do not adjust [*] balances due to contract issues, i.e., incorrect
payments as per the contract terms or [*] coverage questions. [*]
should be made aware of all contract related payment issues.

	 	 	 

	Denied Claims Follow-up

	 	The [*] reasons for the denial
of claims are listed below. Billing
Group collections personnel will
promptly address these problems
directly with the patient. [*], [*]
and/or [*]  may provide
assistance in resolving the
problems; however, the Billing Group
has primary responsibility in this
area. Always follow these steps for
each type of denial.

	 	 	 
	Denial Type	 	Action
	Insurance [*]

	 	1.   Contact payer and request the following information:

	 

	 	   •   Reason for and date of [*].
	 

	 	   •   If plan is an Employer Group Health Plan (EGHP),
request the date that the EGHP notified the carrier of
the [*].
	 

	 	   •   In addition, request the date that the carrier
updated their system with this information.
	 

	 	   •   Verify that
patient’s policy [*]  or [*].
	 

	 	2.   Call [*] or [*] to ask if the patient has provided an
update of insurance information.

	 

	 	3.   If the [*] or [*] has no updated information, call the
patient immediately to obtain updated coverage
information.

	 

	 	   •   If new coverage exists, verify new policy, obtain
authorization if required and update the applicable
system and bill the payer. If applicable, process void
and [*], once approved.
	 

	 	   •   If EGHP was primary and no new EGHP coverage [*],
determine whether patient has Medicare. If

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	Denial Type	 	Action
	 

	 	yes, follow
steps outlined above. If no, set patient up as [*]
primary and void and [*] all applicable claims, once
approved.
	 

	 	4.   Contact [*] or [*] and request assistance as necessary
based on the outcome of the steps above. If [*]
coverage, notify the [*].

	 

	 	5.   When a patients’ insurance has been [*], [*] must be
completed, or the patient must produce documentation
supporting that [*] has been approved and is in process,
within  [*]. If the [*] has not taken place within
[*] and documentation is not able to be produced, the
patient must be [*].

	No Authorization /

Referral

	 	1.   Verify in the billing system if an
authorization/referral number exists and is valid for the
date of service.

	 

	 	2.   Verify that the number is in the correct [*] in the
billing system so that it transmits on the claim.

	 

	 	3.   If authorization / referral number found, contact
payer and verify the following:

	 

	 	   •   [*]?
	 

	 	   •   If yes, request [*] the system. If [*] locates
authorization / referral, request that claim be [*] as a
[*] as this was a payer [*].
	 

	 	   •   If no, immediately request an updated
authorization / referral and work to obtain a [*]
authorization for the necessary period of time to cover
the outstanding claims.
	 

	 	4.   If there is [*] authorization / referral number,
immediately obtain a [*] authorization / referral and
work to obtain a [*] authorization / referral for the
necessary period of time to cover the outstanding claims.

	 

	 	5.   If unable to obtain [*] referral / authorization,
request a review of the case. Notify the patient of the

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	Denial Type	 	Action
	 

	 	problem and request his/her assistance as necessary. [*]
authorization / referral [*].

	 
	 	 
	 

	 	Note: There are circumstances where the [*]
authorizations. In these instances, it is not necessary
to [*].
	 

	 	6.   If the patient is unable to obtain a [*]
authorization, an appeal should be initiated. Reference
the carrier’s [*] to determine whether the patient must
initiate the appeal or if the provider is able to file
appeals.

	[*] Filing

	 	1.   Check system for [*] date [*] date(s) and [*] reports
(if applicable), before making call.

	 

	 	2.   Review [*] documentation gathered above and [*] claims
address with the [*].

	 

	 	   •   If the claims address is correct and
documentation  supports [*] filing, request fax number
to fax documentation. Request [*] review for [*]
processing.
	 

	 	   •   If the claims address is incorrect, but
documentation supports [*] filing, still request fax
number to fax documentation. Make sure to include copy
of [*] indicating address was previously verified. Do
not forget to have the applicable system updated with
correct address for future claims.
	 

	 	   •   If the [*] is unable to accept a fax, send a
written request for review and include all supporting
documentation. The request should be sent [*] for proof
of receipt.
	 

	 	   •   In any of the above cases, follow-up in [*].
	 

	 	3.   If documentation does support proof of [*] filing or
if request for review (above) is denied, file an appeal.
Reference the payer [*].

	Coordination of
Benefits

	 	1.   Review the Billing Group [*] Worksheet and ensure we
are billing the correct 

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	Denial Type	 	Action
	 

	 	primary payer. Once you have
confirmed that the carrier is primary, request phone
number from [*] where the member can have information
updated.

	 

	 	2.   Call the patient and request that they call the payer
to update the Coordination of Benefit (COB) file on their
next visit to the facility. Explain the necessity of
having this information updated to prevent the patient
from becoming responsible for the balance.

	 

	 	   •   Notify the [*] or [*] to have the patient call
the payer on his/her next visit and remind him / her to
document who they spoke with and when.
	 

	 	   •   On the day after the patient calls, call the [*]
to verify that COB information has been updated and
request all claims be [*].
	 

	 	3.   If the patient fails to call the payer on his/her next
visit, notify the [*] to have the patient call the
carrier on their next visit and to document who they
spoke to and when.

	 

	 	   •   On the day after the patient calls, call [*] to
verify that COB information has been updated and request
all claims be [*].
	 

	 	4.   If the patient still fails to call, send a letter to
the patient, with a copy to the [*], requesting that
they call their payer to have the file updated. Explain
that if this information is not updated within [*] all
outstanding claims will become their responsibility.

	 

	 	5.   If the
patient does [*], the [*] should call the
patient.  [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Patient Payment Obligations

	 	 	 

	Patients with a [*] Balance

	 	The following applies to all
payment amounts due from the patient
regardless of whether those amounts
are [*] or are payments of
deductibles, co-payments or
coinsurance obligations associated
with insured coverage.

	 	 	 
	Step	 	Action
	1

	 	Reasonable collection efforts will be made to collect all balances
due. The efforts may include a combination of all or some of the
following collection activities:
	 

	 	•   patient statements,
	 

	 	•   [*],
	 

	 	•   [*],
	 

	 	•   telephone calls to patients,
	 

	 	•   meetings or phone calls with [*],  [*] or [*],
	 

	 	•   assessment of patient’s financial resources,
	 

	 	•   use of professional collection agencies or legal counsel for
cases where insured patients, regardless of payer, receive checks but
do not forward funds per instructions
	2

	 	If the patient indicates they are [*] balance [*], notify the [*] or
[*] and [*] via email so they can begin the Indigent Waiver process.

The execution of a [*] should be considered as an alternative for
patients who have past due balances and are [*] for Indigent Waiver.
Refer to approved [*] Form and Guidelines.
	3

	 	FMCNA reserves the right to discharge patients for the following
reasons:
	 

	 	•   those who [*] insurance for which they may be eligible

•   those who [*] an Indigent Waiver.
	4

	 	All collection activity, except the mailing of the monthly statement,
must be documented in the [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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    Financial Manual — Billing group
	
 
	
 
	
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    ©2007,

    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	Step	 	Action
	5

	 	All calls from patients who have questions about their statements
must be [*] and any [*] as necessary. Billing Groups should always
accept [*].
	6

	 	If a statement is [*] to the Billing Group due to an incorrect [*]
address:
	 

	 	1.   Enter a [*] into the billing system.

	 

	 	2.   Utilize [*] available to locate the correct address. [*]

	 

	 	3.   Address corrections for, active patients, should be confirmed with
the patient or facility prior to changing in the system.

	 

	 	4.   Address corrections for inactive patients should be updated in the
system.

	7

	 	If a [*] is received from the patient statement [*].
	 

	 	•   Active Patients — Contact the facility and verify the
correct address. Request for the appropriate system to be updated
prior to the [*].
	 

	 	•   Inactive patients — Billing group should update the
appropriate system prior to the [*].
	8

	 	If a [*] is received from the patient  statement [*]:
	 

	 	•   Any patient statement that has an invalid address will not be
sent.
	 

	 	•   Each billing group will receive a report that lists any
patients for which [*].
	 

	 	•   The billing group must obtain a correct valid address and
ensure that it is entered into the appropriate system in order for
[*].
	9

	 	For [*] patients, the statement address should [*] unless written
notification is received from the  [*] or the [*]. In such
cases, [*] should be updated in the patient’s address file in the
billing system.
	 

	 	Note: Patient name should [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 

	[*] Patients

	 	The following guidelines should be followed for [*] patients:
	 

	 	1.   [*] patients will be billed monthly as part of the patient
statement process.

	 

	 	2.   Patient should be contacted on a [*] regarding [*] balances.

	 

	 	3.   Status of [*] patients should be reviewed with the [*]
and/or [*] if the patient is [*] with payment, has not completed a
[*] or has not applied for an insurance for which they are
eligible.

	 

	 	4.   Failure by a patient to [*] is grounds for [*].

	 	 	 

	Patients Being Billed for 

Amounts That Are Patient’s 

Responsibility

	 	The following actions should be
taken for Patients being billed for
amounts that are patient
responsibility:

	 	 	 
	Step	 	Action
	1

	 	•   Once all payments have been received from all insurance [*]
balance on the account must be [*] transferred to patient
responsibility.
	 

	 	•   A patient statement will automatically be generated and
mailed to the patient when the next monthly statement cycle is run
and each month thereafter until the balance is resolved.
	 

	 	•   Patients must be called routinely, and [*], until the
balance is resolved.
	2

	 	If full payment is not received, a [*] statement will automatically
be generated. 

Note: Patient statements are generated as part of month-end
processing.
	3

	 	If full payment is still not received, a [*] statement will
automatically be generated, along with a  [*].
	4

	 	If full payment is still not received, a [*] statement will
automatically be generated.
	5

	 	If full payment is still not received, a [*] statement will
automatically be generated along with a  [*].
	6

	 	•   Finally, if [*], the account may be reviewed for [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	Step	 	Action
	 

	 	•   Refer to [*].
	 

	 	•   [*] will continue to automatically be generated until the
balance is resolved.
	 

	 	IMPORTANT: The only instance where a patient balance can be [*] is
for [*] where written notification is received from the  [*].

Summary of
Collections
Timetable

	 	 	 
	Summary of Collections Timetable
	[*] days

	 	[*] statement sent, [*] collection call made
	[*] days

	 	[*] statement sent
	[*] days

	 	[*] statement sent along with a  [*]
	[*] days

	 	[*] statement sent
	[*] days

	 	[*] statement sent along with a [*]
	[*] days

	 	Statements and [*] will continue to
automatically be generated until the balance
is resolved.

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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    Financial Manual — Billing group
	
 
	
 
	
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    10 Of 24

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ©2007,

    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 

	Patients Who Receive Insurance 

Checks

	 	The following actions should be
taken for patients who receive
insurance checks directly:

	 	 	 
	Step	 	Action
	1

	 	If during insurance verification, the payer indicates that they do
not accept [*]:
	 

	 	   1.   The [*] Letter should be prepared and sent to the patient, making
them aware that the checks will be sent directly to them.

	 

	 	   2.   Copies of the letter should be sent to the [*] and/or [*] and [*].

	 

	 	   3.   The expectation is that the [*] or [*] will meet with the patient
to review the letter and the process for handling insurance payments.

	2

	 	Once the Billing Group is informed by the payer that a check has been
mailed to the patient, the following steps should be performed:
	 

	 	   1.   The [*] Letter should be prepared and sent to the patient to
notify them to expect the insurance payment and provide instructions
on how to handle the check upon receipt.

	 

	 	   2.   Copies of the letter should be sent to the [*] and/or [*] and [*].

	 

	 	   3.   The applicable balance should be transferred to patient
responsibility so that the patient will receive a statement during
the next monthly patient statement run.

	 

	 	   4.   The Billing Group should make collection calls to the patient and
follow up with the [*] or [*] on a [*] basis whenever the patient is
expected to receive insurance checks.

	 

	 	   5.   If after [*] days from the date the patient receives the insurance
check, the patient has still not [*], the [*] Letter should be
prepared and sent to the patient, notifying them that the balance
will be turned over to collections if not paid within [*] days from
the date of [*] the letter.

	 

	 	   6.   Copies of the letter should be sent to the [*] and/or [*] and [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 

	Collection Agency Placement

	 	•   Any balance where the patient
refuses to remit payments received directly
from their insurance must be placed with a
collection agency for collection.

	 

	 	•   [*] collection agency [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Credit and Collection Procedure

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    12 Of 24

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ©2007,

    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

Medicare Collections

	 	 	 

	[*] Batch [*]

	 	The following steps should be performed [*] Medicare:

	 	 	 
	Step	 	Action
	1

	 	Log online to Medicare and print the Provider Batch List Report for
each facility. This report contains the following information for
each facility:
	 

	 	•   Date and time received
	 

	 	•   Total # claims in batch
	2

	 	Forward completed package to Management for review.
	 

	 	Note: Management [*] facility batches [*].
	3

	 	Investigate [*] batches to confirm reason for failure and resubmit
batches as needed.
	4

	 	Repeat steps 1-2 above for resubmitted batches.

	 	 	 

	[*] (RTP)

	 	Follow the guidelines below for Medicare claims that go into [*] (RTP) [*].
	 

	 	•   Claims normally start showing up in the RTP [*] of claims by Medicare.
	 

	 	•   RTP [*] should be checked and claims should be worked [*].
	 

	 	•   Any [*] because of [*] RTP claims should be [*] for Management.
	 

	 	List below are the [*] reasons that claims will go into the RTP [*] and actions
necessary to correct the claims.

	 	 	 
	RTP Reason	 	Action
	Patient / Insured 

Health 

Identification 

Number And Name Do 

Not Match

	 	•   The patient’s name on the claims must match the Social
Security Card exactly. If there are discrepancies, contact the [*] or
[*] for assistance with clarification and so that they can correct the patient’s name in the appropriate system.

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	RTP Reason	 	Action
	 

	 	•   Patient may need to update their name with the Social Security
office.
	[*]

	 	1.   On the [*] the RTP is received, fax an [*] letter to the facility
[*], requesting a diagnosis code for support of [*]. Letter
should include a [*].

	 

	 	2.   If after [*] is received:

	 

	 	   •   [*] requesting status of the outstanding request.
	 

	 	   •   If after [*] there is still no response, [*] the [*] and copy the
[*].
	 

	 	3.   Upon receipt of an updated [*] code:

	 

	 	   •   Verify that the [*] code has been changed in the applicable [*]
system
	 

	 	   •   Update the [*] code in the applicable billing system
	 

	 	   •   Enter the corrected code into [*]
	 

	 	4.   If the claim RTPs again, based on the [*] received  from the
facility, move the [*] to [*]. This will allow the [*].

	 

	 	   •   If [*] code is verified as correct and there is no additional [*],
contact the  [*] to determine whether this should be adjusted or
whether we would proceed with an appeal when the service is denied.
	 

	 	   •   If a new code is provided, update the appropriate system and [*].
If [*] is still denied, contact the [*] following procedures for
appeals.
	Method Selection
Issues

	 	•   Verify that the Method Selection Form on file matches the
Method set up in the billing system.
	 

	 	   •   If there is no form on file, contact the  [*] for a copy.
	 

	 	   •   The [*] allows providers with [*] the ability to view and/or
enter the [*] Selection information.

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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    Financial Manual — Billing group
	
 
	
 
	
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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	RTP Reason	 	Action
	[*]

	 	The billing group cannot [*] claims that hit a [*].

•   [*] will show up in the [*].
	 

	 	   •   [*] must be printed from the on-line system and forwarded to the
facility [*] with the [*].
	 

	 	   •   Reference [*] and [*] billing group responsibilities with respect to
[*].
	 

	 	•   With the exception of [*], any claims that remain in [*] for
longer than [*] days should be addressed with [*] at the [*].
	Denied Claims

	 	Listed below are the [*] reasons that claims will be denied and
actions required:
	 

	 	•   [*] coverage or  [*] coverage [*].
	 

	 	   •   Verify coverage via the [*] system.
	 

	 	   •   Verify billing with the correct [*]. Coverage may be through the
[*], in which case, the patient’s coverage may be under the [*]
Social Security Number.
	 

	 	   •   If not eligible, determine whether premiums are paid by [*].
	 

	 	•   If yes, contact [*].
	 

	 	•   If no, contact patient [*].
	 

	 	•   Was patient aware of [*]?
	 

	 	•   Inform patient that they must see the [*] or [*] on their next
visit so they can contact the local Social Security Office to
determine why Medicare was [*] and to request [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	RTP Reason	 	Action
	 

	 	   •   Contact the  [*] or [*] and [*] and notify them regarding
the [*] to ensure follow-up with the patient on their next visit.
	 

	 	   •   Send letter to patient and copy [*] and [*] confirming the Medicare
[*] and outlining expectations.
	 

	 	   •   If there is no [*] of [*] in process within [*], the patient should
be set up as [*] primary. Claims for service dates after the Medicare
[*] date should be Void and [*].
	 

	 	   •   [*] coverage.

•   An open ESRD / EGHP, [*] or  [*] record exists at  [*].
	 

	 	   •   Print all [*] records from the [*] system to determine what EGHP
Medicare believes the patient has. Pay particular attention to the
[*] record(s) [*] date. [*] record(s) [*].
	 

	 	   •   Does EGHP information match the billing system?
	 

	 	   •   If no, contact patient [*]. If new insurance information is
accurate, [*] insurance and complete a new Billing Group [*]
worksheet. If [*] Worksheet agrees with Medicare’s determination,
update the applicable system and complete void and [*] once approved.
If Medicare’s  insurance information is inaccurate, contact [*]
department for resolution.

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Credit and Collection Procedure

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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	RTP Reason	 	Action
	 

	 	   •   If yes, review original Billing Group [*] Worksheet to
determine why we are billing Medicare primary. Review all the facts
surrounding that determination
	 

	 	      •   i.e., [*] COB [*] dates, [*] and [*] employment status for those
with Medicare [*] ESRD.
	 

	 	   •   If discrepancies are found with original information, complete
a new Billing Group [*] worksheet with revised information.
	 

	 	   •   If the new [*] Worksheet agrees with Medicare’s determination,
update the appropriate system and complete void and [*] once approved.
	 

	 	   •   If Medicare’s insurance information is inaccurate, contact [*]
department for resolution.
	 

	 	   •   If [*] file is to be updated, check [*] and contact [*] office
as necessary until file updated. [*] office and Billing Group
management as necessary. Involve patient in resolution as necessary.
	 

	 	   •   If patient [*], send letter to patient and copy [*] and
[*] Explain that if [*] department is  [*] that all outstanding
claims will be transferred to patient.

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	RTP Reason	 	Action
	 

	 	•   An [*] exists at [*].
	 

	 	   •   Once we are certain that the ESRD diagnosis is not related to the
[*], re-enter claim into [*] with an [*] code [*] with the [*] date
of service [*]. Also, enter the comment, “ESRD treatment not related
to [*] ”.
	 

	 	   •   Set up a [*] so that the [*] code [*] along with [*] date of service
[*] and the comment can be added to the [*] screen [*] before billing
is completed to avoid unnecessary denials.
	 

	 	•   Charges are covered under a Medicare Advantage Plan
	 

	 	   •   Call Medicare [*] to inquire about the specific Medicare Advantage
Plan that is primary as the [*] system only references a [*] code.
	 

	 	   •   Contact the Medicare Advantage Plan to verify eligibility and obtain
authorization if needed.
	 

	 	   •   If patient is not eligible according to the Medicare Advantage Plan,
contact patient immediately to confirm correct information.
	 

	 	   •   Complete voids and [*], once approved, as necessary.
	 

	 	•   Patient enrolled in Hospice
	 

	 	   •   Re-enter claim into [*] with a condition code [*] in the [*]
condition code field, (after the [*]).
	 

	 	   •   Set up a [*] so that the condition code [*] can be added to the [*]
screen [*]  before billing is completed to avoid unnecessary
denials.
	 

	 	•   [*] Filing 

Re-enter claim into [*] system adding a [*] code and explanation on
[*] of claim.

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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    ©2007,

    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	RTP Reason	 	Action
	[*]

	 	If a claim is [*]:
	 

	 	•   Identify reason for [*] by reviewing the details of the
charges online.
	 

	 	•   Verify that total [*] and covered [*] match.
	 

	 	Note: Use the [*] to scroll down by service to compare total [*] to
covered [*].
	 

	 	   •   Review [*] for  [*]. Note: [*] will allow the screen to move
[*] in order to view the reason [*].
	 

	 	   •   If [*] due to [*] code, complete and fax the [*] to facility
attention [*] requesting [*] turnaround. If response not received,
refer to RTP section [*] for steps to follow.
	 

	 	•   Check charges in the billing system and compare to charges in
[*] system. Note: [*] should be investigated and Management notified.

	 	 	 

	Medicare

	 	The following actions should be taken for Medicare Follow-up:
	Follow-up
	 	 

	 	 	 
	Step	 	Action
	1

	 	Medicare [*] should be run each [*] right after [*], excluding
[*].
	2

	 	Follow-up on all [*]. Collections activity must be documented in
the billing system.
	3

	 	Request information from the facility as necessary. Always establish
a [*] and follow-up with [*] or [*] if information is not received.
	5

	 	If it is determined that a claim is not on file in the Medicare
system, investigate why.

Note: [*] RTP [*].

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Credit and Collection Procedure

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    ©2007,

    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	
	 	Procedure
	 	 	 
	Fresenius Medical Services	 	 

	 	 	 
	Step	 	Action
	6

	 	[*] the claim in the billing system and resubmit electronically.
	7

	 	Once the [*] Medicare payments are posted, Medicare [*] should be
[*], including [*]. This will identify any [*] Medicare claims.

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Credit and Collection Procedure

    Financial Manual — Billing group
	
 
	
 
	
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    ©2007,

    Fresenius Medical Care Holdings, Inc. All Rights Reserved.
    

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

			
	 	 	 
	
	 	Procedure

Fresenius Medical Services

Medicaid Collections

	 	 	 

	Medicaid

	 	The following actions should be taken for Medicaid follow-up:
	Follow-up
	 	 

	 	 	 	 	 
	Step	 	Action
	1	 	Depending on the state, there are different methodologies in place
for Medicaid eligibility verification and follow-up [*] , state
Medicaid on-line systems or via telephone.
	2	 	Medicaid regulations often dictate [*]  . [*] filing denials!
	3

	 	•
	 	For most states an electronic batch is automatically sent for
verification via [*] (approximately the [*]  and the [*] ) and
responses posted to the billing groups’ [*] .
	 

	 	•
	 	If your state does not have verification available via [*]
then one of the other means listed above should be used.
	4	 	Claim collection follow-up must be initiated no later than [*] days
from date of submission and [*] .
	5	 	Medicaid secondary claims may crossover from Medicare. Medicaid
collections staff should know how their Medicaid secondary claims are
billed.

	 	 	 

	Medicaid

	 	The following actions should be taken for Medicaid follow-up:
	Follow-up
	 	 

	 	 	 	 	 	 	 
	Step	 	Action
	[*]	 	Using the technology available [*], check claim status.
	 	 	•	 	Claim paid
	 

	 	 	 	o
	 	Verify date [*] and determine if [*] has been [*]. If necessary, call to verify whether
payment is being [*]
by a [*].

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
	 	Credit
and Collection Procedure

Financial Manual — Billing group

	 	 	 	 	 	PAGE
	 	 	21 Of 24	 
	 	©2007, Fresenius Medical Care Holdings, Inc. All Rights Reserved.
	 
	 

 

 

			
	 	 	 
	
	 	Procedure

Fresenius Medical Services

	 	 	 	 	 	 	 	 	 	 	 	 	 
	Step	 	Action
	 

	 	 	 	 	 	•
	 	[*]	 	 	 	 
	 	 	 	 	 	 	 	 	o	 	Verify Medicaid eligibility for entire date span.
	 	 	 	 	 	 	 	 	o	 	If still eligible for entire date span, [*] claim and [*]
or resubmit electronically as applicable.
	 

	 	 	 	 	 	 	 	 	 	•
	 	Submit [*] claim if this is your only alternative.
	 

	 	 	 	 	 	 	 	 	 	•
	 	[*] claims with [*] may be
required for secondary claims.
	[*] Medicaid [*]	 	 	1.	 	 	Verify eligibility with [*].
	 	 	 	 	 	 	•	 	Immediately obtain a [*] authorization / referral and work to
obtain a [*] authorization / referral as necessary.
	 	 	 	 	 	 	•	 	If unable to obtain [*] referral / authorization, notify the
patient of the problem and request assistance as necessary.
	 	 	 	 	 	 	•	 	If still unable to obtain [*] authorization, request an
appeal. Refer to [*].
	 	 	 	2.	 	 	If eligible, update the billing system then void and [*] at
correct [*] once void approved.
	 	 	 	3.	 	 	If not eligible, verify Medicaid eligibility again to see if
Medicaid has updated their file.
	 	 	 	4.	 	 	If still no eligibility, call Medicaid [*] regarding
discrepancy.
	[*] Medicare	 	 	1.	 	 	Verify Medicare eligibility on [*]
	 	 	 	2.	 	 	If eligible, update billing system and perform void and [*] at
Medicare [*]
	[*] date of
service	 	 	1.	 	 	Check eligibility.
	 	 	 	2.	 	 	If patient has [*] eligibility, check to see date patient
became eligible. [*] to cover eligible dates of service and
resubmit claim.
	 	 	 	3.	 	 	If patient has no eligibility, transfer to patient responsibility
or IW as applicable.

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
	 	Credit and Collection Procedure

Financial Manual — Billing group

	 	 	 	 	 	PAGE
	 	 	22 Of 24	 
	 	©2007, Fresenius Medical Care Holdings, Inc. All Rights Reserved.
	 
	 

 

 

			
	 	 	 
	
	 	Procedure

Fresenius Medical Services

	 	 	 	 	 

	Medicaid [*]

	 	•
	 	Medicaid collections staff must know the [*] for their state.
	 

	 	•
	 	FMCNA has a responsibility to ensure that any FMCNA charges used to
satisfy a [*] are not billed to the state Medicaid program. Refer to Medicaid
[*] and [*] .

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
	 	Credit and Collection Procedure

Financial Manual — Billing group

	 	 	 	 	 	PAGE
	 	 	23 Of 24	 
	 	©2007, Fresenius Medical Care Holdings, Inc. All Rights Reserved.
	 
	 

 

 

			
	 	 	 
	
	 	Procedure

Fresenius Medical Services

Collections Documentation

	 	 	 	 	 

	Collections
Documentation

	 	•
	 	Billing Group personnel are responsible for documenting all
collection activities involved in obtaining reimbursement.
	 

	 	•
	 	Problems, actions, dates and names should be clearly
documented.
	 

	 	•
	 	Telephone calls to patients associated with collection efforts
must be documented. Refer to [*] for additional guidance.
	 

	 	•
	 	Use of [*] is recommended.
	 

	 	•
	 	Additional documentation such as a correspondence or e-mail
from the [*] , [*] , [*] or [*] should be sent to [*] using the
appropriate Document Type.
	 

	 	•
	 	When contacting third party payers [*] the [*] or last [*] .
Note: Often a [*] will only provide a [*] ; however, it is
recommended that you [*] .
	 

	 	•
	 	It is also important to document the [*] , if applicable

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
	 	Credit and Collection Procedure

Financial Manual — Billing group

	 	 	 	 	 	PAGE
	 	 	24 Of 24	 
	 	©2007, Fresenius Medical Care Holdings, Inc. All Rights Reserved.
	 
	 

 

 

			
	
	 	Policy

Fresenius Medical Services

Credit and Collections

	 	 	 

	Overview

	 	The purpose of the Credit and Collections Policy is to
establish processes that govern third party claim
submissions and follow-up, handling of denials, patient
collections, record keeping, and use of collection agencies.
Consistent with Medicare regulations this Credit and
Collections Policy will be followed for all patients,
regardless of payer source. This includes consistent
documented reasonable collection efforts.
	Insurance
Billing and
Follow-Up

	 	Following is a listing of Insurance Billing and Follow-up guidelines.
Guidelines must be followed as applicable to each payer.

	 	•	 	All claims must be filed [*] and in accordance with payer
guidelines and/or contracts that determine the claims submission cycle.
	 
	 	•	 	Where not otherwise specified, claims should be submitted [*].
	 
	 	•	 	Claims follow-up should be initiated [*] date of submission or
sooner based upon [*].
	 
	 	•	 	Whenever possible, claims should be filed electronically and no
less frequently than [*]. All available on-line systems should be
utilized for claim status, [*] and eligibility verifications.
	 
	 	•	 	Follow-up requirements will vary based on payer contracts, payer
[*], and whether submission was electronic or paper. The expectation is
for all insurers to [*] based on the contract terms or the state’s [*]
standards.
	 
	 	•	 	Initial follow-up on a claim should occur [*] submission date.
Note: Follow-up on [*] submissions for [*] should be performed [*].
Subsequent follow-up should be performed as appropriate.
	 
	 	•	 	Staff responsible for following up on claims with contract payers
should have a full understanding of the contract terms. [*].
	 
	 	•	 	Always remember, many payers, both contracted and non-contracted,
have [*] submission [*]

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
	 	Credit and Collection Policy

Financial Manual — Facility/Billing group

	 	 	 	 	 	PAGE
	 	 	1 Of 4	 
	 	©2007, Fresenius Medical Care Holdings, Inc. All Rights Reserved.
	 
	 

 

 

			
	
	 	Policy

Fresenius Medical Services

	 	•	 	[*] eligibility, for active patients, should be
re-verified each time a call is made to a payer.
	 
	 	•	 	When any information is faxed, always call to verify receipt of
fax. Scan into [*] using the [*] document type.
	 
	 	•	 	Always request the items below from [*] and document this
information in the billing system:

	 	•	 	[*],
	 
	 	•	 	[*](whichever the payer is using [*] in their system)

	 	•	 	Always
remember that the patient/policyholder is the insurance company’s
customer.

	 	•	 	Do not hesitate to utilize the patient/policyholder as a resource in
problem resolution as they have more leverage than the provider.
	 
	 	•	 	Do not hesitate to [*] sent to the carrier if you believe that their
involvement will help. They are ultimately responsible for seeing that
their claims are paid.

	 	•	 	When calling third party payers  [*]. Note: Attempts should
always be made to obtain the [*].
	 
	 	•	 	It is also important to document the [*] 
	 
	 	•	 	If the patient is expected to receive insurance checks directly,
the billing group must notify the patient and facility that checks are
forthcoming. [*] check [*] FMS.

	 	 	 

	Payment Problems

	 	Prompt action must be taken to resolve:
	 and
Denials

	 	•    all claims denials,

•    coverage issues,

•    insurance [*],

•    coordination of benefits issues,

•    contract issues,

•    incorrect [*].

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
	 	Credit and Collection Policy

Financial Manual — Facility/Billing group

	 	 	 	 	 	PAGE
	 	 	2 Of 4	 
	 	©2007, Fresenius Medical Care Holdings, Inc. All Rights Reserved.
	 
	 

 

 

			
	
	 	Policy

Fresenius Medical Services

	 	 	 

	 

	 	A comprehensive detailed description of the problem and
actions to resolve the problem must be documented in the
billing system.
	 

	 

	 	Note: Any [*] due to [*] or RTP must be [*] for Management.
	 
	 	 
	Patient
Payment Obligations

	 	Reasonable collection efforts must be made to collect
 all balances due the provider. Efforts may include a
combination of all or some of the following collection
activities:

	 	•	 	patient statements,
	 
	 	•	 	[*],
	 
	 	•	 	[*],
	 
	 	•	 	telephone calls,
	 
	 	•	 	meetings with [*],
	 
	 	•	 	assessment of patient’s financial resources,
	 
	 	•	 	use of professional collection agencies or legal
counsel for cases where insured patients, regardless of
payer, receive checks but do not forward funds per
instructions

	 	 	 

	 

	 	[*] not covered by an Indigent Waiver will be billed
monthly as part of the patient statement process. [*]
should be contacted a [*] and the status of [*] patients
should be reviewed with the [*] and/or [*] if the
patient is [*], has not completed a [*] or has not applied
for an insurance for which they are eligible. Failure by a
patient to [*] is grounds for [*].
	 
	 

	 	Patient deductibles, co-payments and [*] balances after
insurance must be transferred to patient liability [*]
following posting of the insurance payment when there is no
secondary coverage with other insurance or Medicare.
	 
	 

	 	[*] where [*] has been filed must be removed and the file
with the [*] if the service dates are prior to the
[*] date
or the patient has [*]. All collection efforts [*]  for
all service dates prior to the [*] date. The [*]  will
file all [*] the billing groups behalf. Refer to [*] for
details regarding handles of balances.

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
	 	Credit and Collection Policy

Financial Manual — Facility/Billing group

	 	 	 	 	 	PAGE
	 	 	3 Of 4	 
	 	©2007, Fresenius Medical Care Holdings, Inc. All Rights Reserved.
	 
	 

 

 

			
	
	 	Policy

Fresenius Medical Services

	 	 	 

	 

	 	Guidelines below should be followed
for [*] patient balances:

	 	•	 	Patient name should [*]
	 
	 	•	 	Statement address should [*] unless written
notification is received from the [*] or the [*]. In such
cases, [*] should be updated in the patient’s address file
in the billing system.

	 	 	 

	Collections Documentation

	 	All collection activities must
be documented in the billing system.
In addition, to establish an [*],
additional backup documentation
should be sent to [*] using the
appropriate Document Type.. [*] Refer
to retention policy for retention
guidelines.

END OF DOCUMENT

	 	 	 	 	 	 	 	 	 	 	 	 

	 	DOCUMENT

	 	 	DOCUMENT REVISION
	 	 	ISSUE DATE:
	 	 	EFFECTIVE DATE	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
	 	Credit and Collection Policy

Financial Manual — Facility/Billing group

	 	 	 	 	 	PAGE
	 	 	4 Of 4	 
	 	©2007, Fresenius Medical Care Holdings, Inc. All Rights Reserved.
	 
	 

 

 

    Exhibit C

 

 

    EXHIBIT C

    to

    FOURTH AMENDED AND RESTATED

    TRANSFER AND ADMINISTRATION AGREEMENT

 

    List
    of Special Account Banks, Designated Account Agents and
    Concentration Bank

 

    SRM
    (LABS)

    Fleet Bank

    Spectra East, Inc.

    Lockbox [ * ]

    [ * ]

 

    Fleet Bank

    Spectra Labs, Inc.

    Lockbox [ * ]

    [ * ]

 

    DPD (Products)

 

    Fleet Bank

    Fresenius USA Manufacturing, Inc.

    Lockbox [ * ]

    [ * ]

 

    Fleet Bank

    Fresenius USA Home Dialysis, Inc.

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    Fresenius USA Marketing Inc

    Lockbox [ * ]

    [ * ]

 

    DSD (Services)

    Wachovia Bank

    Bio Medical Applications Management Co.

    Lockbox [ * ]

    [ * ]

    NBU

    Mid Atlantic, Ohio Valley, Eastern PA and Erie Regions

 

    Bank of America

    Bio Medical Applications Management Co.

    Lockbox [ * ]

    [ * ]

    NBU

    North and South New England Regions

 

    Bank One

    BMA of Michigan

    Lockbox [ * ]

    [ * ]

    CBU

    Michigan Region

 

    LaSalle Bank NA

    Everest Healthcare Holdings

    Lockbox [ * ]

    [ * ]

    NBU

    Everest Facilities

 

    Wachovia Bank

    Bio Medical Applications Georgia

    Lockbox [ * ]

    [ * ]

    EBU

    NC, SC, GA, AL, TN

 

    M&T Bank

    Bio Medical Applications Co., Inc.

    Lockbox [ * ]

    [ * ]

    EBU

    VA, W VA, KY, IN, MD, DC

 

    Bank One

    Bio Medical Applications Management Co.

    Lockbox [ * ]

    [ * ]

    SBU

    LA, OK, AR, TN, MS

 

    LaSalle Bank NA

    Everest Healthcare Holdings

    Lockbox [ * ]

    [ * ]

    CBU

    Transitioning all CBU facilities except Michigan to this account

 

    Bank of America

    Bio Medical Applications Management Co.

    Lockbox [ * ]

    [ * ]

    SBU

    Florida

 

    Bank One

    Bio Medical Applications Puerto Rico

    [ * ]

    Lockbox [ * ]

    SBU

    Puerto Rico

 

    Bank One

    Bio Medical Applications Texas

    [ * ]

    Lockbox [ * ]

    SBU

    Texas

 

    Bank of America

    Bio Medical Applications of Arizona

    [ * ]

    Lockbox [ * ]

    WBU

    All WBU except Hawaii payments remitted from Hawaii

 

    First Hawaiian Bank

    Bio Medical Applications of California

    [ * ]

    Mail Code 61123

    PO Box 1300

    Honolulu, HI
    96807-1300

 

    Wachovia Bank

    Fresenius Medical Care Holdings, Inc. — North BU

    

    2

 

    Lockbox [ * ]

    [ * ]

 

    Wachovia Bank

    Fresenius Medical Care Holdings, Inc. — Central BU

    Lockbox [ * ]

    [ * ]

 

    Wachovia Bank

    Fresenius Medical Care Holdings, Inc. — South BU

    Lockbox [ * ]

    [ * ]

 

    Wachovia Bank

    Fresenius Medical Care Holdings, Inc. — East BU

    Lockbox [ * ]

    [ * ]

 

    Wachovia Bank

    Fresenius Medical Care Holdings, Inc. — West BU

    Lockbox [ * ]

    [ * ]

 

    Wachovia Bank

    Fresenius Medical Care Holdings, Inc. — Southwest BU

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    Apheresis Care Group

    [ * ]

 

    Bank of America

    RCG Indiana LLC

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    Dialysis Centers of America d/b/a RCG- Central Illinois

    [ * ]

 

    National City

    Michigan Home Dialysis Center Inc.

    Lockbox [ * ]

    [ * ]

 

    National City

    RCG Indiana LLC

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    RCG East, Inc,

    Lockbox [ * ]

    [ * ]

 

    Harris Bank

    Dialysis Centers of America Illinois, Inc.

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    Renal Care Group of the Southeast, Inc.

    Lockbox [ * ]

    [ * ]

    

    3

 

    AmSouth

    Naples Dialysis Center, LLC

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    Renal Care Group of the Southeast d/b/a NNA of the MidSouth

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Brevard County Dialysis

    [ * ]

 

    Wachovia

    West Palm Beach Dialysis

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Clermont Dialysis Center

    Lockbox [ * ]

    [ * ]

 

    Intrust Bank

    Renal Care Group of the Midwest, Inc.

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    RCG Louisville

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    RCG University

    Lockbox [ * ]

    [ * ]

 

    Wells Fargo

    Renal Care Group Alaska, Inc.

    Lockbox [ * ]

    [ * ]

 

    Wells Fargo

    Renal Care Group Northwest, Inc.

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    Renal Partners, Inc.

    [ * ]

 

    AmSouth

    Northeast Alabama Kidney Clinic

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    Northeast Alabama Kidney Clinic

    Lockbox [ * ]

    [ * ]

    

    4

 

    Bank of America

    RCG of the South

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Clayton County Dialysis

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Norcross Dialysis Center

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Henry Dialysis Center

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Cobb County Dialysis

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Holton Dialysis Center

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Douglas County Dialysis

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Cartersville Dialysis

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Stone Mountain Dialysis

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Covington Dialysis Center

    Lockbox [ * ]

    [ * ]

 

    Wachovia

    Smyrna Dialysis Center

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    RCG Texas, Inc.

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    Renal Care Group Southwest Holdings, Inc.

    [ * ]

    

    5

 

    AmSouth

    RCG Mississippi Inc. d/b/a Kidney Care

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    RCG Mississippi Inc. d/b/a RCG Ferriday/RCG Helena

    [ * ]

 

    Bank of America

    RCG Supply Co.

    [ * ]

 

    AmSouth

    RCG Mississippi Inc. d/b/a NNA of Mississippi

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    RCG Memphis, LLC

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    RCG Memphis East, LLC

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    RCG Martin, LLC

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    RCG Memphis South, LLC

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    RCG Whitehaven, LLC

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    RCG Marion, LLC

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    NNA of Florida, LLC d/b/a RCG of Florida, LLC

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    RCG Mississippi Inc. d/b/a NNA of Louisiana

    MSC [ * ]

    [ * ]

 

    AmSouth

    Renal Care Group Central Memphis, LLC

    Lockbox [ * ]

    [ * ]

    

    6

 

    AmSouth

    Renal Care Group of the Midwest, Inc.

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    RCG Texas, Inc.

    [ * ]

 

    Bank of America

    Dialysis Management Corp.

    [ * ]

 

    Bank of America

    Stat Dialysis Corp.

    [ * ]

 

    Bank of America

    RCG Arkansas

    [ * ]

 

    Bank of America

    NNA Operating Account

    [ * ]

 

    Bank of America

    National Nephrology Associates, Inc.

    [ * ]

 

    Bank of America

    RCG Saint Luke’s LLC

    [ * ]

 

    Bank of America

    Kentucky Renal Care Group LLC

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    Satellite Kidney Disease Centers, Inc.

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    RCG of the Ozarks, LLC

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    RCG East Texas LLP

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    NNA Harrison, LLC

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    NNA East Orange, LLC

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    NNA of Paducah, LLC

    [ * ]

    

    7

 

    Bank of America

    RCG Irving LP

    Lockbox [ * ]

    [ * ]

 

    Bank of America

    Dialysis Centers of America

    Lockbox [ * ]

    [ * ]

 

    First National Bank

    Physicians Dialysis Co. Inc.

    [ * ]

 

    Greenfield Banking Company

    RCG Greenfield

    [ * ]

 

    Harris Bank

    Arlington Heights

    Lockbox [ * ]

    [ * ]

 

    Ironstone

    Naples Dialysis Center, LLC

    [ * ]

 

    National City Bank

    RCG Westlake

    Lockbox [ * ]

    [ * ]

 

    National City Bank

    RCG Westlake

    Lockbox [ * ]

    [ * ]

 

    National City Bank

    Three Rivers Dialysis Services LLC

    Lockbox [ * ]

    [ * ]

 

    National City Bank

    Maumee Dialysis Services, LLC

    Lockbox [ * ]

    [ * ]

 

    National City Bank

    RCG Bloomington, LLC

    Lockbox [ * ]

    [ * ]

 

    National City Bank

    Columbus Area Renal Alliance

    [ * ]

 

    National City Bank

    Southwest Michigan

    [ * ]

 

    National City Bank

    RCG Toledo

    [ * ]

    

    8

 

    Wachovia

    Renal Care Group East, Inc.

    Lockbox [ * ]

    [ * ]

 

    Wells Fargo

    RCG South New Mexico

    Lockbox [ * ]

    [ * ]

 

    Wells Fargo

    RCG Southwest LP

    Lockbox [ * ]

    [ * ]

 

    Wells Fargo

    BMA of Nevada

    Lockbox [ * ]

    [ * ]

 

    KeyBank

    Physicians Dialysis Co. Inc.

    [ * ]

 

    KeyBank

    Physicians Dialysis Co. Inc.

    Lockbox [ * ]

    [ * ]

 

    KeyBank

    Physicians Dialysis Co. Inc.

    Lockbox [ * ]

    [ * ]

 

    KeyBank

    Physicians Dialysis Co. Inc.

    Lockbox [ * ]

    [ * ]

 

    KeyBank

    Physicians Dialysis Co. Inc.

    Lockbox [ * ]

    [ * ]

 

    AmSouth

    NMC Funding Corporation

    [ * ]

 

    Bank of America

    NMC Funding Corporation

    [ * ]

 

    National City

    NMC Funding Corporation

    [ * ]

 

    Wachovia

    NMC Funding Corporation

    [ * ]

 

    Wells Fargo

    NMC Funding Corporation

    [ * ]

 

    JP Morgan

    NMC Funding Corporation

    [ * ]

    

    9

 

    Exhibit 10.3

 

    Exhibit D

 

    EXHIBIT D-1

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORM OF
    SPECIAL ACCOUNT LETTER

 

    EXHIBIT D-1

    

 

    FORM OF
    SPECIAL ACCOUNT BANK LETTER

 

    [DATE]
    

 

    [Name and Address of

         Special Account Bank]

 

    [Name of
    Originating Entity]
    

 

    Ladies and Gentlemen:

 

    Reference is made to our depositary account[s]
    number[s]          
    maintained in the name of the undersigned (the “Originating
    Entity”) with you (the “Account[s]”).

 

    Unless otherwise directed by the Originating Entity, you are
    hereby instructed to transfer funds on deposit in the Account[s]
    solely to the following account by [ACH transfer or, if so
    directed by the Originating Entity, by wire transfer] [intrabank
    transfer]:

 

    [Name, number and designation of (i) the Concentration
    Account and Concentration Account Bank or (ii) the
    Intermediate Concentration Account, as applicable].

 

    Each such transfer shall be made at the end of each banking day
    on which the amount on deposit in the Account[s] exceeds
    $20,000, with the amount of the transfer being equal to the
    total amount of such funds in excess of $5,000; provided that
    that Originating Entity may, at its option, deliver a standing
    instruction to you to effect such transfer at the end of each
    banking day regardless of the amount on deposit in the
    Account[s], with the amount of the transfer being equal to the
    total amount of funds in the Account[s].

 

    Please agree to the terms of, and acknowledge receipt of, this
    letter by signing in the space provided below on two copies
    hereof sent herewith and send the signed copies to NMC the
    Originating Entity at its address at 920 Winter Street, Waltham,
    MA 02451, Attention: Mark Fawcett.

 

    Very truly yours,

 

    [NAME OF ORIGINATING ENTITY]

 

			
	 	    By: 
	
        

    Title

 

    Agreed and acknowledged:

 

    [NAME OF SPECIAL ACCOUNT BANK]

 

			
	    By: 
	
        

	 

    Title:

 

    EXHIBIT D-2

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORM OF
    CONCENTRATION ACCOUNT AGREEMENT

 

    EXHIBIT D-2

 

    FORM OF
    CONCENTRATION ACCOUNT AGREEMENT

    (the “Agreement”)

 

    October 16, 2008

 

    JPMorgan Chase Bank

    270 Park Avenue

    New York, NY
    10017-2070

 

    Re:  Account #323-0-76823

 

    Ladies and Gentlemen:

 

    You are hereby notified, in connection with certain transactions
    involving its accounts receivable, that NMC FUNDING CORPORATION
    (the “Transferor”) has transferred certain rights in
    Account #323-0-76823
    (the “Account”), as more particularly described below,
    to WestLB AG, New York Branch (“WestLB”), as Agent
    (the “Agent”) under the Fourth Amended and Restated
    Transfer and Administration Agreement dated October 16,
    2008 by and among the Transferor, as transferor, National
    Medical Care, Inc., as Collection Agent, the entities from time
    to time parties thereto as “Conduit Investors,”
    “Bank Investors,” “Administrative Agents”
    and WestLB as Agent, as the same may be amended, restated,
    supplemented or otherwise modified from time to time. The
    Agreement amends, restates and supersedes the letter agreement
    dated October 23, 2003 among the Transferor, the Agent and
    you.

 

    (a) Transfer to the Agent.  The
    Transferor has transferred exclusive ownership and dominion over
    the Account, including with respect to all monies, checks,
    instruments, collections, remittances and other payment items
    received in the Account (the “Payment Items”), to the
    Agent and, effective as of the Effective Time (as defined
    below), will transfer exclusive control of the Account to the
    Agent.

 

    (b) Prior to Notice of
    Effectiveness.  You are hereby instructed:
    (i) until the Effective Time to make such transfers from
    the Account at such times and in such manner as the Transferor
    shall from time to time instruct to the extent such instructions
    are not inconsistent with the instructions set forth herein, and
    (ii) to permit the Transferor and the Agent to obtain upon
    request any information relating to the Account, including,
    without limitation, any information regarding the balance or
    activity of the Account.

 

    (c) Following Notice of
    Effectiveness.  The Transferor and the Agent
    hereby instruct you, beginning on the opening of business on the
    business day next succeeding the business day on which a notice
    purporting to be signed by the Agent in substantially the form
    attached hereto as “Annex I” with a copy of this
    Agreement attached thereto (a “Notice of
    Effectiveness”) is received by facsimile or otherwise by
    Frances A. Ruke or Jeanne A. Muino at the address or facsimile
    number set forth below (or at such other address or facsimile
    number as you may from time to time notify the Agent and the
    Transferor in writing) (or if such Notice of Effectiveness is so
    received after 12:00 noon, New York City time, on any such
    business day, on the opening of business on the second business
    day next succeeding the business day on which such receipt
    occurs) (either such time, the “Effective Time”),
    (i) to transfer all funds deposited and collected in the
    Account pursuant to instructions given to you by the Agent from
    time to time, (ii) that notwithstanding anything herein or
    elsewhere to the contrary, the Agent, and not Transferor, shall
    be irrevocably entitled to exercise any and all applicable
    rights in respect of or in connection with the Payment Items,
    including, without limitation, the right to specify when
    payments in respect of the Payment Items are to be made out of
    or in connection with the Account and (iii) you shall not
    take instruction from the Transferor with respect to any amounts
    in the Account. You are hereby advised by the Agent and the
    Transferor that the Transferor has under a separate agreement
    granted to the Agent certain ownership and security interests in
    all Payment Items and their proceeds and all monies and earning,
    if any, therefrom the Account, and by your signature below you
    acknowledge being so advised. A “business day” is any
    day other than a Saturday, Sunday or other day on which you are
    or are authorized or required by law to be closed. Anything to
    the contrary herein notwithstanding, (i) all transactions
    relating to the Account or any Payment Items therein duly
    commenced by you or your affiliates in accordance with customary
    procedures prior to the Effective Time and so consummated or
    processed thereafter shall be deemed not to constitute a
    violation of this Agreement,; and (ii) you,
    and/or any
    affiliate may (at your discretion and without any obligation to
    do so) (x) cease honoring the Transferor’s
    instructions
    and/or
    commence honoring solely the Agent’s instructions
    concerning the Account or the Payment Items at any time or from
    time to time after you become aware that the Agent has sent a
    Notice of Effectiveness to you but prior to the Effective Time
    therefor (including without limitation halting, reversing or
    redirecting any transaction referred to in clause (i)
    above), or (y) deem a Notice of Effectiveness to be
    received by you for purposes of the foregoing prior to the
    specified individual’s actual receipt if otherwise actually
    received by you (or if such Notice of Effectiveness contains
    minor mistakes or other

 

    irregularities but otherwise substantially complies with the
    form attached hereto as “Annex I” or does not
    attach an appropriate copy of this Agreement) with no liability
    whatsoever to the Transferor or any other party for doing so and
    provided further that this Agreement evidences the
    Agent’s control over the Account and notwithstanding
    anything to the contrary in any other agreement governing the
    Account, on and after the Effective Time you shall comply with
    instructions originated by the Agent that are permitted under
    the Account Documentation directing the disposition of funds
    without further consent of the Transferor or any other person.

 

    (d) General Terms.  The monies,
    checks, instruments and other items of payment mailed to, and
    funds deposited to, the Account will not be subject to
    deduction, setoff, banker’s lien, or any other right in
    favor of any person other than the Agent and the Transferor
    (except that you may set off (i) all amounts due to you in
    respect of your customary fees and expenses for the routine
    maintenance and operation of the Account, (ii) the face
    amount of any Payment Items which have been credited to the
    Account but are subsequently returned unpaid or charged back or,
    as to Payment Items consisting of payment orders or other
    electronic funds transfers, reversed, cancelled or otherwise
    corrected or adjusted, and (iii) to cover overdrafts in the
    Account).

 

    This Agreement supplements, rather than replaces, your deposit
    account agreement, terms and conditions and other standard
    documentation in effect from time to time with respect to the
    Account or services provided in connection with the Account (the
    “Account Documentation”), which Account Documentation
    will continue to apply to the Account and such services, and the
    respective rights, powers, duties, obligations, liabilities and
    responsibilities of the parties thereto and hereto, to the
    extent not expressly conflicting with the provisions of this
    Agreement (however, in the event of any such conflict, the
    provisions of this Agreement shall control). Without limiting
    the generality of the foregoing, it is understood and agreed
    that the only instructions the Transferor or the Agent are
    entitled to give with respect to the Account are those which are
    permitted under the Account Documentation and the Agent may
    request you to provide other services (such as automatic daily
    transfers) with respect to the Account on or after the Effective
    Time; however, if such services are not authorized or otherwise
    covered under the Account Documentation, your decision to
    provide any such services shall be made in your sole discretion
    (including without limitation being subject to the Transferor
    and/or the
    Agent executing such Account Documentation or other
    documentation as you may require in connection therewith). Prior
    to issuing any instructions which it is entitled to issue under
    this Agreement (for the avoidance of doubt, other than a Notice
    of Effectiveness), the Agent shall provide you with a
    Certificate of Incumbency substantially in the form of
    Annex II hereto.

 

    Anything to the contrary in this Agreement notwithstanding,
    (i) you shall have only the duties and responsibilities
    with respect to matters set forth herein as are expressly set
    forth in writing herein and shall not be deemed to be a
    fiduciary for any party hereto, (ii) you shall be fully
    protected in acting or refraining from acting in good faith on
    any written notice (including a Notice of Effectiveness),
    instruction, or request purportedly furnished to you by the
    Agent in accordance with the terms hereof, in which case the
    parties hereto agree that you have no duty to make any further
    inquiry whatsoever (without limiting the generality of the
    foregoing, it is hereby acknowledged and agreed that you have no
    knowledge of (and are not required to know) the terms and
    provisions of the separate agreement referred to in
    clause (c) above or any other related documentation to
    which you are not a party or whether any actions by the Agent
    (including without limitation the sending of a Notice of
    Effectiveness), the Transferor or any other person or entity are
    permitted or a breach thereunder or consistent or inconsistent
    therewith), (iii) you shall not be liable to any party
    hereto or any other person for any action or failure to act
    under or in connection with this Agreement except for your own
    willful misconduct or gross negligence (and, to the maximum
    extent permitted by law, shall under no circumstances be liable
    for indirect, special, punitive or consequential damages);
    further, you shall not be liable for losses or delays caused by
    force majeure, interruption or malfunction of computer,
    transmission or communications facilities, labor difficulties,
    court order or decree, the commencement of bankruptcy or other
    similar proceedings or other matters beyond your reasonable
    control; (iv) the Transferor hereby indemnifies you for,
    and holds you harmless against, any loss, cost, liability or
    expense (including reasonable inside or outside counsel fees and
    disbursements) incurred or suffered by you arising out of or in
    connection with this Agreement or the Account, except as may
    result from your willful misconduct or gross negligence, or any
    interpleader proceeding related thereto or incurred or suffered
    by you at the Transferor’s direction or instruction; and
    (v) upon and after the Effective Time, the Agent agrees to
    reimburse you for the item(s) referred to in clause (ii) of
    subparagraph (d) above (to the extent that the Agent has
    already received the benefits of such item(s)), in the event
    that there are insufficient funds in the Account therefor and
    you have not received reimbursement from the Transferor within
    10 days after your written request therefor.

 

    You may terminate this Agreement upon the sending of at least
    thirty (30) business days advance written notice to the
    other parties hereto. The Agent may terminate this Agreement
    upon the sending of at least five (5) business days advance
    written notice to the other parties hereto. The Transferor may
    not terminate this Agreement except upon the sending of at least
    ten (10) business days advance written notice to you
    accompanied by the Agent’s written

    

    2

 

    consent to such termination. Neither this Agreement nor any
    provision hereof may be changed, amended, modified or waived
    orally but only by an instrument in writing signed by you, the
    Agent and the Transferor.

 

    You shall not assign or transfer your rights or obligations
    hereunder (other than to the Agent) without the prior written
    consent of the Agent and the Transferor provided,
    however that you may transfer any such rights or
    obligations to an affiliate upon 30 days advance written
    notice to the Agent and the Transferor. Subject to the preceding
    sentence, this Agreement shall be binding upon each of the
    parties hereto and their respective successors and assigns, and
    shall inure to the benefit of, and be enforceable by, the Agent,
    each of the parties hereto and their respective successors and
    assigns.

 

    You hereby represent that the person signing this Agreement on
    your behalf is duly authorized by you to sign.

 

    You agree to give the Agent, at its address specified below,
    copies of each periodic statement relating to activity in the
    Account which you provide to the Transferor, together with such
    additional information relating to the Account as the Agent may
    from time to time reasonably request. You further agree to give
    the Agent and the Transferor prompt notice if the Account become
    subject to any writ, garnishment, judgement, warrant or
    attachment, execution or similar process.

 

    Any notice, demand or other communication required or permitted
    to be given hereunder shall be in writing and may be personally
    served or sent by facsimile or by courier service or by United
    States mail and except as provided above with respect to a
    Notice of Effectiveness shall be deemed to have been delivered
    when delivered in person or by courier service or by facsimile
    or three (3) business days after deposit in the United
    States mail (registered or certified, with postage prepaid and
    properly addressed). For the purposes hereof, (i) the
    addresses of the parties hereto shall be as set forth below each
    party’s name below, or, as to each party, at such other
    address as may be designated by such party in a written notice
    to the other party and the Agent and (ii) the address of
    the Agent shall be WestLB AG, New York Branch, 1211 Avenue of
    the Americas, New York, New York 10036, attention: Asset
    Securitization Group, fax:
    212-597-1423
    or at such other address as may be designated by the Agent in a
    written notice to each of the parties hereto.

 

    This Agreement may be signed in any number or counterparts, each
    of which shall be an original, with the same effect as if the
    signatures thereto and hereto were upon the same instrument,
    (ii) shall become effective when counterparts hereof have
    been signed by the parties hereto and (iii) shall be
    governed by and construed in accordance with the laws of the
    State of New York. All parties hereby waive all rights to a
    trial by jury in any action or proceeding relating to the
    Account or this Agreement.

 

    Please agree to the terms of, and acknowledge receipt of this
    notice by signing in the space provided below.

 

    Very truly yours,

 

    NMC FUNDING CORPORATION,

 

			
	    By: 
	
    

	 

			
	    Title: 
	
    

	 

 

    920 Winter Street

    Waltham, Massachusetts 02451

    Facsimile No:
    (781) 699-9756

    

    3

 

    ACKNOWLEDGED AND AGREED:

 

    JPMORGAN CHASE BANK

 

			
	    By: 
	
    

	 

			
	    Title: 
	
    

	 
	    Date: 
	
    

	 

 

		
	    Attention: 	
    [                    ]

    JPMorgan Chase Bank

    2 Chase Manhattan Plaza,
    22nd Floor

    New York, NY 10081

 

    Facsimile
    No: [                    ]

 

    WESTLB AG, NEW YORK BRANCH, as Agent

 

			
	    By: 
	
    

	 

			
	    Name: 
	
    

	 

			
	    Title: 
	
    

	 

 

			
	    By: 
	
    

	 

			
	    Name: 
	
    

	 

			
	    Title: 
	
    

	 

    

    4

 

    ANNEX 1

    

 

    TO
    CONCENTRATION ACCOUNT LETTER

    

 

    (FORM OF
    NOTICE OF EFFECTIVENESS)

 

    DATED:                     ,
    200  
    

 

		
	    TO:  	
    JP Morgan Chase Bank

    2 Chase Manhattan Plaza,
    22nd Floor

    New York, N.Y. 10081

 

    ATTN: [                    ]
    or
    [                    ]

 

    Re: Concentration Account Bank
    No. 323-0-76823

 

    Ladies and Gentlemen:

 

    We hereby give you a “Notice of Effectiveness” with
    respect to the above referenced Account, as and to the extent
    described in our letter agreement with you dated
    October 16, 2008, a copy of which is attached hereto. You
    are hereby instructed to comply with the instructions of the
    undersigned as set forth in that letter.

 

    Very truly yours,

 

    WESTLB AG, NEW YORK BRANCH, as Agent

 

			
	 	    By: 
	
    

			
	 	    Title: 
	
    

    

    5

 

    ANNEX II

 

    TO CONCENTRATION ACCOUNT LETTER

 

    (FORM OF INCUMBENCY CERTIFICATE)

 

    CERTIFICATE OF AN OFFICER OF

 

    WESTLB AG, NEW YORK BRANCH, AS AGENT

 

    The undersigned
    [          ]
    being an [Assistant Secretary] [Vice President] of WestLB AG,
    New York Branch (the “Company”) hereby executes and
    delivers this certificate to JPMorgan Chase Bank
    (“JPMCB”) on behalf of the Company pursuant to the
    Concentration Account Letter dated as of October 16, 2008
    among the Company, NMC Funding Corporation, Bank of America
    N.A., and JPMCB (as amended, restated, supplemented or otherwise
    modified from time to time, the “Concentration Account
    Letter”). Capitalized terms used herein and not
    otherwise defined herein shall have the respective meanings
    assigned thereto in the Concentration Account Letter.

 

    The undersigned hereby certifies, as of the date hereof, that
    the following named persons are duly appointed officers of the
    Company, holding the office or offices set forth opposite their
    respective names, and each is authorized to execute and deliver,
    on behalf of the Company, instructions pursuant to the terms of
    the Concentration Account Letter, and the signatures appearing
    opposite the names of such individuals are authentic and genuine
    and are, in fact, the signatures of such individuals:

 

	 	 	 	 	 
	
    Name
	
 
	
    Title
	
 
	
    Signature

	 

	

    [               ]

	
 
	
    [               ]
	
 
	
    [               ]

	

    [               ]

	
 
	
    [               ]
	
 
	
    [               ]

	

    [               ]

	
 
	
    [               ]
	
 
	
    [               ]

 

    IN WITNESS WHEREOF, I have hereunto set my hand this  
    day
    of          ,
    2008.

 

			
	 	    By: 
	
        

    [Name]

    [Assistant Secretary] [Vice President]

    

    6

 

    EXHIBIT D-3

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORM OF
    INTERMEDIATE CONCENTRATION ACCOUNT AGREEMENT

 

    EXHIBIT D-3

 

    FORM OF
    INTERMEDIATE CONCENTRATION ACCOUNT AGREEMENT

    (the “Agreement”)

    [DATE]

 

    [Name and Address of Intermediate Concentration Account Bank]

 

    Re:     Account
    #[               ]

 

    Ladies and Gentlemen:

 

    You are hereby notified, in connection with certain transactions
    involving its accounts receivable, that NMC FUNDING CORPORATION
    (the “Transferor”) has transferred certain rights in
    Account
    #[          ]
    (the “Account”), as more particularly described below,
    to WestLB AG, New York Branch (“WestLB”), as Agent
    (the “Agent”) under the Fourth Amended and Restated
    Ttransfer and Administration Agreement dated October 16,
    2008 by and among the Transferor, as transferor, National
    Medical Care, Inc., as Collection Agent, the entities from time
    to time parties thereto as “Conduit Investors,”
    “Bank Investors,” “Administrative Agents”
    and WestLB as Agent (as the same has been or may hereafter be
    amended, restated, supplemented or otherwise modified from time
    to time, the “TAA”).

 

    (a) Transfer to the Agent.  The
    Transferor has transferred exclusive ownership and dominion over
    the Account, including with respect to all monies, checks,
    instruments, collections, remittances and other payment items
    received in the Account (the “Payment Items”), to the
    Agent and, effective as of the Effective Time (as defined
    below), will transfer exclusive control of the Account to the
    Agent.

 

    (b) Prior to Notice of
    Effectiveness.  You are hereby instructed
    until the Effective Time to transfer at the end of each banking
    day all funds on deposit in the Account to the account listed in
    Annex I by ACH transfer or, if so directed by the
    Originating Entity, by wire transfer.

 

    You are hereby further instructed to permit the Transferor and
    the Agent to obtain upon request any information relating to the
    Account, including, without limitation, any information
    regarding the balance or activity of the Account.

 

    (c) Following Notice of
    Effectiveness.  The Transferor and the Agent
    hereby instruct you, beginning on the opening of business on the
    business day next succeeding the business day on which a notice
    purporting to be signed by the Agent in substantially the form
    attached hereto as “Annex II” with a copy of this
    Agreement attached thereto (a “Notice of
    Effectiveness”) is received by facsimile or otherwise by
    you at the address or facsimile number set forth below (or at
    such other address or facsimile number as you may from time to
    time notify the Agent and the Transferor in writing) (or if such
    Notice of Effectiveness is so received after 12:00 noon, New
    York City time, on any such business day, on the opening of
    business on the second business day next succeeding the business
    day on which such receipt occurs) (either such time, the
    “Effective Time”), (i) to transfer all funds
    deposited and collected in the Account pursuant to instructions
    given to you by the Agent from time to time, (ii) that
    notwithstanding anything herein or elsewhere to the contrary,
    the Agent, and not Transferor, shall be irrevocably entitled to
    exercise any and all applicable rights in respect of or in
    connection with the Payment Items, including, without
    limitation, the right to specify when payments in respect of the
    Payment Items are to be made out of or in connection with the
    Account and (iii) you shall not take instruction from the
    Transferor with respect to any amounts in the Account. You are
    hereby advised by the Agent and the Transferor that the
    Transferor has under a separate agreement granted to the Agent
    certain ownership and security interests in all Payment Items
    and their proceeds and all monies and earning, if any, therefrom
    the Account, and by your signature below you acknowledge being
    so advised. A “business day” is any day other than a
    Saturday, Sunday or other day on which you are or are authorized
    or required by law to be closed. Anything to the contrary herein
    notwithstanding, (i) all transactions relating to the
    Account or any Payment Items therein duly commenced by you or
    your affiliates in accordance with customary procedures prior to
    the Effective Time and so consummated or processed thereafter
    shall be deemed not to constitute a violation of this
    Agreement,; and (ii) you,
    and/or any
    affiliate may (at your discretion and without any obligation to
    do so) (x) cease honoring the Transferor’s
    instructions
    and/or
    commence honoring solely the Agent’s instructions
    concerning the Account or the Payment Items at any time or from
    time to time after you become aware that the Agent has sent a
    Notice of Effectiveness to you but prior to the Effective Time
    therefor (including without limitation halting, reversing or
    redirecting any transaction referred to in clause (i)
    above), or (y) deem a Notice of Effectiveness to be
    received by you for purposes of the foregoing prior to the
    specified individual’s actual receipt if otherwise actually
    received by you (or if such Notice of Effectiveness contains
    minor mistakes or other irregularities but otherwise
    substantially complies with the form attached hereto as
    “Annex II” or does not attach an appropriate copy
    of this Agreement) with no liability whatsoever to the
    Transferor or any other party for doing so and provided
    further that

 

    this Agreement evidences the Agent’s control over the
    Account and notwithstanding anything to the contrary in any
    other agreement governing the Account, on and after the
    Effective Time you shall comply with instructions originated by
    the Agent that are permitted under the Account Documentation
    directing the disposition of funds without further consent of
    the Transferor or any other person.

 

    (d) General Terms.  The monies,
    checks, instruments and other items of payment mailed to, and
    funds deposited to, the Account will not be subject to
    deduction, setoff, banker’s lien, or any other right in
    favor of any person other than the Agent and the Transferor
    (except that you may set off (i) all amounts due to you in
    respect of your customary fees and expenses for the routine
    maintenance and operation of the Account, (ii) the face
    amount of any Payment Items which have been credited to the
    Account but are subsequently returned unpaid or charged back or,
    as to Payment Items consisting of payment orders or other
    electronic funds transfers, reversed, cancelled or otherwise
    corrected or adjusted, and (iii) to cover overdrafts in the
    Account). This Agreement supplements, rather than replaces, your
    deposit account agreement, terms and conditions and other
    standard documentation in effect from time to time with respect
    to the Account or services provided in connection with the
    Account (the “Account Documentation”), which Account
    Documentation will continue to apply to the Account and such
    services, and the respective rights, powers, duties,
    obligations, liabilities and responsibilities of the parties
    thereto and hereto, to the extent not expressly conflicting with
    the provisions of this Agreement (however, in the event of any
    such conflict, the provisions of this Agreement shall control).
    Without limiting the generality of the foregoing, it is
    understood and agreed that the only instructions the Transferor
    or the Agent are entitled to give with respect to the Account
    are those which are permitted under the Account Documentation
    and the Agent may request you to provide other services (such as
    automatic daily transfers) with respect to the Account on or
    after the Effective Time; however, if such services are not
    authorized or otherwise covered under the Account Documentation,
    your decision to provide any such services shall be made in your
    sole discretion (including without limitation being subject to
    the Transferor
    and/or the
    Agent executing such Account Documentation or other
    documentation as you may require in connection therewith). Prior
    to issuing any instructions which it is entitled to issue under
    this Agreement (for the avoidance of doubt, other than a Notice
    of Effectiveness), the Agent shall provide you with a
    Certificate of Incumbency substantially in the form of
    Annex III hereto.

 

    Anything to the contrary in this Agreement notwithstanding,
    (i) you shall have only the duties and responsibilities
    with respect to matters set forth herein as are expressly set
    forth in writing herein and shall not be deemed to be a
    fiduciary for any party hereto, (ii) you shall be fully
    protected in acting or refraining from acting in good faith on
    any written notice (including a Notice of Effectiveness),
    instruction, or request purportedly furnished to you by the
    Agent in accordance with the terms hereof, in which case the
    parties hereto agree that you have no duty to make any further
    inquiry whatsoever (without limiting the generality of the
    foregoing, it is hereby acknowledged and agreed that you have no
    knowledge of (and are not required to know) the terms and
    provisions of the TAA referred to above or any other related
    documentation to which you are not a party or whether any
    actions by the Agent (including without limitation the sending
    of a Notice of Effectiveness), the Transferor or any other
    person or entity are permitted or a breach thereunder or
    consistent or inconsistent therewith), (iii) you shall not
    be liable to any party hereto or any other person for any action
    or failure to act under or in connection with this Agreement
    except for your own willful misconduct or gross negligence (and,
    to the maximum extent permitted by law, shall under no
    circumstances be liable for indirect, special, punitive or
    consequential damages); further, you shall not be liable for
    losses or delays caused by force majeure, interruption or
    malfunction of computer, transmission or communications
    facilities, labor difficulties, court order or decree, the
    commencement of bankruptcy or other similar proceedings or other
    matters beyond your reasonable control; (iv) the Transferor
    hereby indemnifies you for, and holds you harmless against, any
    loss, cost, liability or expense (including reasonable inside or
    outside counsel fees and disbursements) incurred or suffered by
    you arising out of or in connection with this Agreement or the
    Account, except as may result from your willful misconduct or
    gross negligence, or any interpleader proceeding related thereto
    or incurred or suffered by you at the Transferor’s
    direction or instruction; and (v) upon and after the
    Effective Time, the Agent agrees to reimburse you for the
    item(s) referred to in clause (ii) of subparagraph
    (d) above (to the extent that the Agent has already
    received the benefits of such item(s)), in the event that there
    are insufficient funds in the Account therefor and you have not
    received reimbursement from the Transferor within 10 days
    after your written request therefor.

 

    You may terminate this Agreement upon the sending of at least
    thirty (30) business days advance written notice to the
    other parties hereto. The Agent may terminate this Agreement
    upon the sending of at least five (5) business days advance
    written notice to the other parties hereto. The Transferor may
    not terminate this Agreement except upon the sending of at least
    ten (10) business days advance written notice to you
    accompanied by the Agent’s written consent to such
    termination. Neither this Agreement nor any provision hereof may
    be changed, amended, modified or waived orally but only by an
    instrument in writing signed by you, the Agent and the
    Transferor.

    

    2

 

 

    You shall not assign or transfer your rights or obligations
    hereunder (other than to the Agent) without the prior written
    consent of the Agent and the Transferor provided,
    however that you may transfer any such rights or
    obligations to an affiliate upon 30 days advance written
    notice to the Agent and the Transferor. Subject to the preceding
    sentence, this Agreement shall be binding upon each of the
    parties hereto and their respective successors and assigns, and
    shall inure to the benefit of, and be enforceable by, the Agent,
    each of the parties hereto and their respective successors and
    assigns.

 

    You hereby represent that the person signing this Agreement on
    your behalf is duly authorized by you to sign.

 

    You agree to give the Agent, at its address specified below,
    copies of each periodic statement relating to activity in the
    Account which you provide to the Transferor, together with such
    additional information relating to the Account as the Agent may
    from time to time reasonably request. You further agree to give
    the Agent and the Transferor prompt notice if the Account become
    subject to any writ, garnishment, judgment, warrant or
    attachment, execution or similar process.

 

    Any notice, demand or other communication required or permitted
    to be given hereunder shall be in writing and may be personally
    served or sent by facsimile or by courier service or by United
    States mail and except as provided above with respect to a
    Notice of Effectiveness shall be deemed to have been delivered
    when delivered in person or by courier service or by facsimile
    or three (3) business days after deposit in the United
    States mail (registered or certified, with postage prepaid and
    properly addressed). For the purposes hereof, (i) the
    addresses of the parties hereto shall be as set forth below each
    party’s name below, or, as to each party, at such other
    address as may be designated by such party in a written notice
    to the other party and the Agent and (ii) the address of
    the Agent shall be WestLB AG, New York Branch, 1211 Avenue of
    the Americas, New York, New York 10036, attention: Matt Tallo or
    at such other address as may be designated by the Agent in a
    written notice to each of the parties hereto.

 

    This Agreement may be signed in any number of counterparts, each
    of which shall be an original, with the same effect as if the
    signatures thereto and hereto were upon the same instrument,
    (ii) shall become effective when counterparts hereof have
    been signed by the parties hereto and (iii) shall be
    governed by and construed in accordance with the laws of the
    State of New York. All parties hereby waive all rights to a
    trial by jury in any action or proceeding relating to the
    Account or this Agreement.

    

    3

 

    Please agree to the terms of, and acknowledge receipt of this
    notice by signing in the space provided below.

 

    Very truly yours,

 

    NMC FUNDING CORPORATION,

 

			
	    By: 
	
    

	 

			
	    Title: 
	
    

	 

 

    920 Winter Street

    Waltham, MA 02451

    Facsimile No:
    (781) 699-9756

 

    ACKNOWLEDGED AND AGREED:

 

    [NAME OF BANK]

 

			
	    By: 
	
    

	 

			
	    Title: 
	
    

	 
	    Date: 
	
    

	 

 

    [Name, Address and Facsimile No.]

 

    WESTLB AG, NEW YORK BRANCH, as Agent

 

			
	    By: 
	
    

	 

			
	    Name: 
	
    

	 

			
	    Title: 
	
    

	 

 

			
	    By: 
	
    

	 

			
	    Name: 
	
    

	 

			
	    Title: 
	
    

	 

    

    4

 

    ANNEX I

 

    TO INTERMEDIATE CONCENTRATION ACCOUNT AGREEMENT

 

    [Insert
    wire instructions for Concentration Account]

    

    5

 

    ANNEX II

 

    TO INTERMEDIATE CONCENTRATION ACCOUNT AGREEMENT

 

    (FORM OF NOTICE OF EFFECTIVENESS)

 

    DATED:                ,
    200  
    

    TO:     [Name and Address of Bank]

 

    ATTN:
    [          ]
    or [          ]

 

    Re: Account No.
    [               ]

 

    Ladies and Gentlemen:

 

 

    We hereby give you a “Notice of Effectiveness” with
    respect to the above referenced Account, as and to the extent
    described in our letter agreement with you dated [DATE], a copy
    of which is attached hereto. You are hereby instructed to comply
    with the instructions of the undersigned as set forth in that
    letter.

 

    Very truly yours,

 

    WESTLB AG, NEW YORK BRANCH, as Agent

 

			
	 	    By: 
	
    

			
	 	    Title: 
	
    

 

			
	 	    By: 
	
    

			
	 	    Title: 
	
    

    

    6

 

    ANNEX III

 

    TO CONCENTRATION ACCOUNT AGREEMENT

 

    (FORM OF INCUMBENCY CERTIFICATE)

 

    CERTIFICATE
    OF AN OFFICER OF

    

 

    WESTLB
    AG, NEW YORK BRANCH, AS AGENT

 

    The undersigned
    [          ]
    being an [Assistant Secretary] [Vice President] of WestLB AG,
    New York Branch (the “Company”) hereby executes and
    delivers this certificate to
    [          ]
    (the “Bank”) on behalf of the Company pursuant to the
    Intermediate Concentration Account Letter dated as of [DATE]
    among the Company, NMC Funding Corporation and the Bank (as
    amended, restated, supplemented or otherwise modified from time
    to time, the ‘‘Concentration Account
    Letter”). Capitalized terms used herein and not
    otherwise defined herein shall have the respective meanings
    assigned thereto in the Concentration Account Letter.

 

    The undersigned hereby certifies, as of the date hereof, that
    the following named persons are duly appointed officers of the
    Company, holding the office or offices set forth opposite their
    respective names, and each is authorized to execute and deliver,
    on behalf of the Company, instructions pursuant to the terms of
    the Concentration Account Letter, and the signatures appearing
    opposite the names of such individuals are authentic and genuine
    and are, in fact, the signatures of such individuals:

 

	 	 	 	 	 
	
    Name
	
 
	
    Title
	
 
	
    Signature

	 

	

    [               ]

	
 
	
    [               ]
	
 
	
    [               ]

	

    [               ]

	
 
	
    [               ]
	
 
	
    [               ]

	

    [               ]

	
 
	
    [               ]
	
 
	
    [               ]

 

    IN WITNESS WHEREOF, I have hereunto set my hand
    this  day
    of          ,
    2003.

 

			
	 	    By: 
	
        

    [Name]

    [Assistant Secretary] [Vice President]

    

    7

 

    EXHIBIT E

    to

    FOURTH AMENDED AND RESTATED

    TRANSFER AND ADMINISTRATION AGREEMENT

    FORM OF INVESTOR REPORT

 

   

 

    NMC
    Funding Corporation

    Investor Report as of

    August 31, 2008

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
    (a)

    
	
 
	
    (b)

    
	
 
	
    (c)

    
	
 
	
    (d)

    
	
 
	
 

	
 
	
 
	
    PORTFOLIO INFORMATION
	
 
	
    Dialysis (DSD+ RCG)
	
 
	
    Products (DPD)
	
 
	
    Spectra (Lab)
	
 
	
    Total
	
 
	
 

	 

	

    (1)

	
 
	
    Outstanding Balance
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (2)

	
 
	
    Receivables as a percent of Total
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (3)

	
 
	
    Total Estimated Maturity Period From Schedule I
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (4)

	
 
	
    Collection Delay Factor
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
    CALCULATION OF NET RECEIVABLE BALANCE 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    (5)

	
 
	
    Outstanding Balance
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
    Less Ineligibles:
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    (6)

	
 
	
    A/R on Excluded Systems
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (7)

	
 
	
      IDPN (Homecare)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (8)

	
 
	

      SRM Net Receivables in excess of 7.5% Net Investment

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (9)

	
 
	

      Self-Pays on eligible systems in excess of 5% of Net
    Receivable

	
 
	
 
	
    [ * ]
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (10)

	
 
	
      Receivables from Affiliates
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (11)

	
 
	

      Delinquent Receivables (At Initial Purchase Only)
    (not included in above)

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (12)

	
 
	
      Receivables from
    non-U.S.
    resident Obligors
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (13)

	
 
	

      Unrealized Contractual Adjustments (excluding
    pre-arranged c

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (14)

	
 
	

      Receivables from Obligors who are not Designated
    Obligors

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (15)

	
 
	
      Defaulted Receivables
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (16)

	
 
	

      Receivables in excess of Concentration Limit per
    Schedule II

	
 
	
 
	
    [ * ]
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (17)

	
 
	

      Government A/R excluding Medicare, Medicaid,
    CHAMPUS, & CHAMPUS/VA

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (18)

	
 
	

      Disputed Receivables (Refer to TAA proviso clause ix)

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (19)

	
 
	
      Receivables accrued but not yet billed
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 

	

    (19)b

	
 
	
      Other Ineligible Receivables
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (20)

	
 
	
    Total Inedible Receivables
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (21)

	
 
	
    Net Receivables Balance (Eligible)
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
    NET INVESTMENT SUMMARY
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    (22)

	
 
	
    Net Investment
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (23)

	
 
	
    Is line 22 <= $637,000,000
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (24)

	
 
	
    Percentage Factor based on Net investment above
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (25)

	
 
	
    Is Percentage Factor <= 98%?
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
    SELF-PAY SUMMARY 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    (26)

	
 
	
    Total Self-Pay Receivables
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (27)

	
 
	
    Defaulted Self-Pay Receivables
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (28)

	
 
	
    Other Ineligible Self-Pay Receivables
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (29)

	
 
	
    Eligible Self-Pay Receivables
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (30)

	
 
	
    5% of Eligible Receivables
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (31)

	
 
	
    Portion of “Self-Pay Receivables over 5% Limit
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

 

 

			
	
    (i) 		
    The net Receivables balance before the Self-Pays on eligible
    systems in excess of 5% of Net Receivables” (Line
    9) and “Sec, in excess of Concentration Limit”
    (Line 16) we [ * ] 5% of this amount is
    [ * ] line 3D). Since DSD account for 98% of the total
    self-Pay Receivables (Line 26) the entire amount has been
    included in DS
	 
	
    (ii) 		
    The entire amount of the Receivables in excess of
    Concentration limits  has been included in DSD, since this
    division accounts for 98% of then

    

    1

 

    NMC
    Funding Corporation

    Investor Report as of

    [ * ]

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
    (a)

    
	
 
	
    (b)

    
	
 
	
    (c)

    
	
 
	
    (d)

    
	
 
	
 

	
 
	
 
	
 
	
 
	
    DSD
	
 
	
    Products
	
 
	
    Lab
	
 
	
    Total
	
 
	
 

	 

	
 
	
 
	
 
	
 
	
    MONTHLY ACTIVITY
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
    (32
	
    )
	
 
	
      Sales
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (33
	
    )  
	
 
	
      Contractual Adjustments (excluding pre-arranged
    contractual adj
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (34
	
    )
	
 
	
      Returns & Allowances
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (35
	
    )
	
 
	
      Write-offs
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (36
	
    )
	
 
	
      Cash collections
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (37
	
    )
	
 
	
      Other Negative Billing Adjustments
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (38
	
    )
	
 
	
      Net Change in Receivables
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (39
	
    )
	
 
	
      Change in Total Receivables Current Month versus
    Prior Month
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (40
	
    )
	
 
	
      Does Line 38 = Line 39?
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
    RATIO CALCULATIONS
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
    I. Loss-to-Liquidation Ratio:
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
    (41
	
    )
	
 
	
      Monthly Defaulted Receivables(*)
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (42
	
    )
	
 
	
      Cash Collections
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (43
	
    )
	
 
	
      Loss-to-Liquidation
    Ratio
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (44
	
    )
	
 
	
      [Reserved]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (45
	
    )
	
 
	
      Is Ratio <= 8% (Trigger)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

 

 

			
	
    (*) 		
    Monthly Defaulted Receivables =AR Balance that became defaulted
    during the month

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
    II. Dilution Ratio (Limit p«r definition):
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	

      =Returns & Allowances, and Contractual
    Adjustments contractual adjustments) Divided By Aggregate
    Receivable Balance from the Preceding Month

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    (46)a

	
 
	
      contractual adjustments excluding pre-arranged
    contractual adju
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (46)b

	
 
	

      less contractual adjustments related to Ineligible
    receivables

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 

	

    (46)

	
 
	

      = Contractual Adjustments (excluding pre-arranged
    contractual a

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 

	

    (47)

	
 
	
      Returns & Allowances
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (48)

	
 
	
      Other Negative Adjustments
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    ([ * ]
	
    )

	

    (49)

	
 
	

      Aggregate Receivables Balance Which Arose in the
    Preceding

    Month
    (Schedule IV-Dilution
    Reserve)

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (50)

	
 
	
      Dilution Ratio= (Sum of 46, 474 48 / 49)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (51)

	
 
	
      Is Ratio <=10% (Trigger)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
    III. Default Ratio

         (Aggregated Monthly Defaulted
    Receivables)/Sales From The Prior Nine Months
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    (52)

	
 
	
      Monthly Defaulted Receivables(*)
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (53)

	
 
	
      Disputed Receivables
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (54)

	
 
	
      Sales From The Ninth Preceding Month
    (Schedule V-Loss
    Reserve)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (55)

	
 
	
      Default Ratio = (Sum of 52 & 53)/54)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (56)

	
 
	
      Is Ratio <= 9% (Trigger)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

 

 

			
	
    (*) 		
    Monthly Default Receivable =AR Balance that become defaulted
    during the month

    

    2

 

    NMC
    Funding Corporation

    Investor Report as of

    [ * ]

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
    RESERVE CALCULATIONS
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
    I. Dilution Reserve:
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
      =Dilution Reserve Percentage (from
    Schedule IV) Times Net Receivables Balance
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
    (57
	
    )
	
 
	
      Dilution Reserve Percentage (from Schedule IV)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (58
	
    )
	
 
	
      Net Receivables Balance
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (59
	
    )
	
 
	
      Dilution Reserve (57*58)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
    II. Discount Reserve:
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	

      =Total unpaid Discount as of the report date (from
    Schedule III) Plus Liquidation Yiek Liquidation Yield:

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	

      =(Rate Variance Factor * Base Rate * Net Investment)
    * (Est. Maturity + Collection Delay)/360

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
    (60
	
    )
	
 
	
      Rate Variance Factor
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (61
	
    )
	
 
	
      Base Rate applicable to liquidation period of Net
    Investment
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (62
	
    )
	
 
	
      Estimated Maturity Period
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (63
	
    )
	
 
	
      Collection Delay Factor
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (64
	
    )
	
 
	
    Liquidation Yield= ((60 X 61 X 22) X ((62 + 63)/ 360);
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (65
	
    )
	
 
	
    Total Unpaid Discount as of the report date (from
    Schedule III;
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (66
	
    )
	
 
	
    Discount Reserve= (64 + 65)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
    III. Servicing Fee Reserve:
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
      =Aggregate Outstanding Balance * Servicing Fee% * +
    Collection Delay Period)/360)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
    (67
	
    )
	
 
	
      Servicing Fee Percentage (provided by Agent)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (68
	
    )
	
 
	
      Servicing Fee Reserve (1 * 67*( 62 + 63)/ 360)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
    IV. Loss Reserve:
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	

      =Loss Res.% * (Net Investment + Dilution Reserve +
    Discount Reserve + Servicing Fee Reserve)

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
    (69
	
    )
	
 
	
      Loss Horizon% (From Schedule V)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (70
	
    )
	
 
	
      Loss Reserve Percentage (higher of: 20% or 2.0 times
    (69))
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (71
	
    )
	
 
	
      Loss Reserve 70*(Sum of 22 + 59 + 66 + 68)
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
    V. Percentage Factor (Limit per definition of Maximum
    Percentage Factor):
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	

      =(Net Investment + Dilution Reserve + Discount +
    Loss Reserve/Net Receivable Balance)

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
    (72
	
    )
	
 
	
     Percentage Factor ((Sum of 22 + 59+ 66 + 68 + 71)/ 21;
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (73
	
    )
	
 
	
    Is the Percentage Factor <= 98%
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

    

    3

 

    NMC
    Funding Corporation

    Investor Report as of

    [ * ]

 

    PERCENTAGE
    FACTOR SUMMARY

 

	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
    (74
	
    )
	
 
	
    Net Investment
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (75
	
    )
	
 
	
    Dilution Reserve
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (76
	
    )
	
 
	
    Discount Reserve
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (77
	
    )
	
 
	
    Servicing Fee Reserve
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (78
	
    )
	
 
	
    Loss Reserve
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (79
	
    )
	
 
	
    Net investment plus Reserves
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (80
	
    )
	
 
	
    Net Receivables Balance (Eligible)
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (81
	
    )
	
 
	
    Percentage Factor
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (82
	
    )
	
 
	
    Increase/ (Decrease) to Net investment
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (83
	
    )
	
 
	
    Adjusted Net Investment plus Reserves
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
    (84
	
    )
	
 
	
    Adjusted Percentage Factor
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

 

    Schedules:

 

    I. Aging Schedule

 

    II. Concentrations

 

    III. Total Discount for Tranche Periods

 

    IV. Dilution Ratio Output Tracking

 

    V. Loss Ratio Tracking Output

 

    VI. UCC Filings

 

    The undersigned, a duly authorized representative of NMC Funding
    Corporation, as Transferor pursuant to the Amended and restated
    Transfer and Administration Agreement dated as of
    September 27, 1999 “TAA”) between NMC Funding
    Corporation, as Transferor, National Medical Care, Inc. as
    Collection Agent. Enterprise Funding Corporation and Compass USA
    as Conduit Investors, does hereby certify

 

	 	 	 	 	 
	
 
	
    (1
	
    )
	
 
	
    References used herein to certain sections and subsections are
    references to their respective sections and subsections in the
    TAA

	
 
	
    (2
	
    )
	
 
	
    This certificate is being delivered pursuant to 2.11

	
 
	
    (3
	
    )
	
 
	
    The undersigned is an authorized officer of NMC Funding
    Corporation

	
 
	
    (4
	
    )
	
 
	
    No termination Event or Potential Termination Event has occurred
    under the TAA

	
 
	
    (5
	
    )
	
 
	
    The following information is true and correct in all material
    respects as of: [ * ]

 

    IN WITNESS WHEREOF, the undersigned has duly executed and
    delivered this Settlement Statement the [ * ]

 

    National Medical Care. Inc. as Collection Agent

 

		
	    By: 	
        

    Name: [ * ]

    

    4

 

 

    NMC
    Funding Corporation

    Investor Report as of

    [ * ]

 

    Schedule I — Aging Schedule

 

	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
    (a)

    
	
 
	
    (b)

    
	
 
	
    (c)

    
	
 
	
    (d)

    

	
 
	
 
	
    AGING SCHEDULE (Gross Receivables)
	
 
	
    DSD
	
 
	
    Products
	
 
	
    Lab
	
 
	
    Total

	 

	

    (1)

	
 
	
    0-3 Months
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (2)

	
 
	
    4-6 Months
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (3)

	
 
	
    7-9 Months
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (4)

	
 
	
    10-12 Months
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (5)

	
 
	
    >1 Year
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (6)

	
 
	
    Total Pool
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

 

	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
    Total Agings
	
 
	
    % of Total
	
 
	
    Days Factor
	
 
	
    Average Maturity

	 

	

    (7)

	
 
	
    0-3 Months
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (8)

	
 
	
    4-6 Months
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (9)

	
 
	
    7-9 Months
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (10)

	
 
	
    10-12 Months
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (11)

	
 
	
    >1 Year
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
    [ * ]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    (12)

	
 
	
    Total
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
    [ * ]

	

    (13)

	
 
	
    0-9 Months
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

    Schedule II —
    Concentrations

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
    Moody’s

    
	
 
	
    S&P

    
	
 
	
    Fitch

    
	
 
	
 
	
 
	
    Maximum

    

	
    A.
	
 
	
    CONCENTRATION LIMITS
	
 
	
    Rating
	
 
	
    Rating
	
 
	
    Rating
	
 
	
    % Limit
	
 
	
    Amount

	 

	

    (1)

	
 
	
    Net Receivables Balance (Eligible) Concentration Limits for
    Obligor Designated as Commercial or Hospitals:
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 

	

    (2)

	
 
	
    Aetna Inc. 
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 

	

    (3)

	
 
	
    Cigna Inc. 
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 

	

    (4)

	
 
	
    United Healthcare  Corp. 
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 

	

    (5)

	
 
	
    All Other Obligors
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 

	

    (6)

	
 
	
    Wellpoint Inc. 
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 

	

    (7)

	
 
	
    Concentration Limit for Obligors Designated as a US Government
    Obligors
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
    [ * ]
	
 

 

	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
    (a)

    
	
 
	
    (b)

    
	
 
	
    (c)

    
	
 
	
    (d)

    

	
    B.
	
 
	
    Concentration by Primary Obligor
	
 
	
    DSD
	
 
	
    Products
	
 
	
    Lab
	
 
	
    Total

	 

	

    (8)

	
 
	
    Medicare
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (9)

	
 
	
    Medicaid
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (10)

	
 
	
    Commercial
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (11)

	
 
	
    Hospitals
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]

	

    (12)

	
 
	
    CHAMPUS
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]

	

    (13)

	
 
	
    CHAMPUS/VA
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]

	

    (14)

	
 
	
    Other
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (15)

	
 
	
    Total Pool
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

 

	 	 	 	 	 	 	 	 	 	 	 
	
    C.
	
 
	
    Large Obligor Concentration
	
 
	
    Aetna
	
 
	
    Cigna
	
 
	
    United Healthcare
	
 
	
    Wellpoint Inc

	 

	

    (16)

	
 
	
    0-3 Months
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (17)

	
 
	
    4-6 Months
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (18)

	
 
	
    7-9 Months
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (19)

	
 
	
    Eligible Receivables
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (20)

	
 
	
    Concentration Limit
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

	

    (21)

	
 
	
    Excess Over Concentration Limit
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]
	
 
	
    [ * ]

    

    5

 

    Schedule III — Discount

    List all Tranches which were outstanding as of the date hereof:

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
    (a)

    
	
 
	
 
	
    (b)

    
	
 
	
 
	
 
	
 
	
 
	
    (d)

    
	
 
	
 
	
    (e)

    
	
 
	
 
	
    (f)

    
	
 

	
 
	
 
	
 
	
 
	
 
	
    input

    
	
 
	
 
	
    input

    
	
 
	
 
	
    (c)

    
	
 
	
 
	
    input

    
	
 
	
 
	
    input

    
	
 
	
 
	
    (d x e x [c/360])

    
	
 

	
 
	
 
	
    Net

    
	
 
	
 
	
    Issue

    
	
 
	
 
	
    Maturity

    
	
 
	
 
	
    input

    
	
 
	
 
	
    Face

    
	
 
	
 
	
    CP Interest/

    
	
 
	
 
	
    Unpaid Discount

    
	
 

	
    Bank
	
 
	
    Investment
	
 
	
 
	
    Date
	
 
	
 
	
    Date
	
 
	
 
	
    # days
	
 
	
 
	
    Amount
	
 
	
 
	
    Disc. Rate
	
 
	
 
	
    Amount
	
 

	 

	

    [ * ]

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 

	

    [ * ]

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
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    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
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    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
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    [ * ]
	
 
	
 
	
 
	
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    [ * ]
	
 
	
 
	
 
	
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    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 

	

    [ * ]

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
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    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 

 

    Schedule III — Commercial P

    

    1

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
    Net

    
	
 
	
 
	
    Issue

    
	
 
	
 
	
    Maturity

    
	
 
	
 
	
 
	
 
	
 
	
    Face

    
	
 
	
 
	
    CP Interest/

    
	
 
	
 
	
    Unpaid Discount

    
	
 

	
    Bank
	
 
	
    Investment
	
 
	
 
	
    Date
	
 
	
 
	
    Date
	
 
	
 
	
    # days
	
 
	
 
	
    Amount
	
 
	
 
	
    Disc. Rate
	
 
	
 
	
    Amount
	
 

	 

	

    AMN AMRO

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
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    [ * ]
	
 
	
 
	
 
	
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    [ * ]
	
 
	
 
	
 
	
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    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 

	
 

	
 

	

    TOTAL

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [ * ]
	
 

	
 

	
 

 

    New Net
    Investment Based on this Report

 

	 	 	 	 	 
	

    Total as of     [ * ]

	
 
	
 
	
    [ * ]
	
 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
    Future

    
	
 
	
 
	
    Current

    
	
 
	
 
	
    Change from

    
	
 

	
 
	
 
	
    pro-rata
	
 
	
 
	
    Net Investment
	
 
	
 
	
    Net Investment
	
 
	
 
	
    Current
	
 

	 

	

    WestLB

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    BLB

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    Scotia

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

	

    ABN AMRO

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
 
	
 

	

    TOTAL

	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 
	
 
	
 
	
    [ * ]
	
 

 

    Schedule III —
    Commercial P
    

    

    2

 

 

    Schedule IV — Ratio Output Tracking

 

    Dilution Reserve Calculation

 

    [*]

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    D1

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    H = higher of..

    
	
 
	
 
	
 
	
 
	
 
	
    J

    
	
 
	
 
	
 
	
 
	
 
	
    L=

    
	
 

	
 
	
 
	
    C

    
	
 
	
 
	
    C1

    
	
 
	
 
	
    D

    
	
 
	
 
	
    Contractuals Adj.

    
	
 
	
 
	
    E=C+D-D1

    
	
 
	
 
	
    F

    
	
 
	
 
	
    G

    
	
 
	
 
	
    E/F(1 month prior), or

    
	
 
	
 
	
    I

    
	
 
	
 
	
    12-Month

    
	
 
	
 
	
    K=F(1 month prior)/G

    
	
 
	
 
	
    ((1.5*J)+(I-J)*(I/J))

    
	
 

	
 
	
 
	
    Contractual (1)

    
	
 
	
 
	
    Pre-arranged

    
	
 
	
 
	
    Other

    
	
 
	
 
	
    related to

    
	
 
	
 
	
    Total

    
	
 
	
 
	
    Credit

    
	
 
	
 
	
    Net Receivables

    
	
 
	
 
	
    6.00%

    
	
 
	
 
	
    12 Month

    
	
 
	
 
	
    Average

    
	
 
	
 
	
    Dilution

    
	
 
	
 
	
    Dilution Reserve

    
	
 

	
    Report Date
	
 
	
    Adjustments
	
 
	
 
	
    Contractuals(2)
	
 
	
 
	
    Dilution
	
 
	
 
	
    ineligible AR
	
 
	
 
	
    Dilution
	
 
	
 
	
    Sales
	
 
	
 
	
    Balance
	
 
	
 
	
    Dilution Ratio(3)
	
 
	
 
	
    Dilution Spike
	
 
	
 
	
    Dilution Ratio
	
 
	
 
	
    Horizon
	
 
	
 
	
    Percentage
	
 

	 

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    [*]
	
 
	
 
	
 
	
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    (1) 		
    [*]
	 
	
    (2) 		
    [*]
	 
	
    (3) 		
    [*]

 

    Schedule IV —
    Dilution Reserve
    

    

    3

 

 

    Schedule V — Ratio Output Tracking

 

    Loss Reserve Calculation

 

    [*]

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    I

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    0/S Balance of

    
	
 
	
 
	
 
	
 
	
 
	
    (Higher of Stress

    
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    D

    
	
 
	
 
	
 
	
 
	
 
	
    F

    
	
 
	
 
	
    G=

    
	
 
	
 
	
    H

    
	
 
	
 
	
    Receivables

    
	
 
	
 
	
    J=

    
	
 
	
 
	
    Factor* Loss Horizon

    
	
 
	
 
	
 
	
 

	
 
	
 
	
    A

    
	
 
	
 
	
    B

    
	
 
	
 
	
    C

    
	
 
	
 
	
    Sales For Ninth

    
	
 
	
 
	
    E=C/D

    
	
 
	
 
	
    Average 3 Month

    
	
 
	
 
	
    (Max (F) last 12 Mths)

    
	
 
	
 
	
    Sales for TWO

    
	
 
	
 
	
    Less Receivables

    
	
 
	
 
	
    G*(H/I)

    
	
 
	
 
	
    Ratio or 20%)

    
	
 
	
 
	
 
	
 

	
 
	
 
	
    Monthly defaultec

    
	
 
	
 
	
    Disputed

    
	
 
	
 
	
    Monthly defaults

    
	
 
	
 
	
    Preceding

    
	
 
	
 
	
    Default

    
	
 
	
 
	
    Loss

    
	
 
	
 
	
    Default

    
	
 
	
 
	
    Preceding

    
	
 
	
 
	
    >270 days past

    
	
 
	
 
	
    Loss Horizon

    
	
 
	
 
	
    Loss

    
	
 
	
 
	
 
	
 

	
    Report Date
	
 
	
    Rec. + W/O(i)
	
 
	
 
	
    Receivables
	
 
	
 
	
    + Write-offs(i)
	
 
	
 
	
    Month
	
 
	
 
	
    Ratio
	
 
	
 
	
    Ratio
	
 
	
 
	
    Spike
	
 
	
 
	
    Months
	
 
	
 
	
    due
	
 
	
 
	
    Ratio
	
 
	
 
	
    Reserve%
	
 
	
 
	
 
	
 

	 

	

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    (i) 		
    [*]

 

    Schedule V —
    Loss Reserve
    

 

    

    4

 

    NMC
    FUNDING CORPORATION

    Amended and Restated Transfer and Administration Agreement

    UCC Financing Statements

 

	 	 	 	 	 	 	 
	
    Name of Entity
	
 
	
    Filing
	
 
	
    Filing Date
	
 
	
    Filing #

	 

	

    (1) Bio-Medical Applications Home Dialysis Services, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185177

	

    (2) Bio-Medical Applications Management Company, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20188270

	

    (3) Bio-Medical Applications of Alabama, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20201248

	

    (4) Bio-Medical Applications of Anacostia, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20201040

	

    (5) Bio-Medical Applications of Aquadilla, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20201362

	

    (6) Bio-Medical Applications of Arecibo, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20201446

	

    (7) Bio-Medical Applications of Arizona, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20207518

	

    (8) Bio-Medical Applications of Arkansas, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20207492

	

    (9) Bio-Medical Applications of Bayamon, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20207500

	

    (10) Bio-Medical Applications of Blue Springs, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185151

	

    (11) Bio-Medical Applications of Caguas, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20207484

	

    (12) Bio-Medical Applications of California, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20207468

	

    (13) Bio-Medical Applications of Camarillo, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20207476

	

    (14) Bio-Medical Applications of Capitol Hill, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20207682

	

    (15) Bio-Medical Applications of Carolina, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20196109

	

    (16) Bio-Medical Applications of Carson, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20196067

	

    (17) Bio-Medical Applications of Clinton, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185128

	

    (18) Bio-Medical Applications of Columbia Heights, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205660

	

    (19) Bio-Medical Applications of Connecticut, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205645

	

    (20) Bio-Medical Applications of Delaware, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205611

	

    (21) Bio-Medical Applications of Dover, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185110

	

    (22) Bio-Medical Applications of East Orange, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205629

	

    (23) Bio-Medical Applications of Essex, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20187488

	

    (24) Bio-Medical Applications of Eureka, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205603

 

    Schedule VI —
    UCC Filings
    

    

    1

 

    NMC
    FUNDING CORPORATION

    Amended and Restated Transfer and Administration Agreement

    UCC Financing Statements

 

	 	 	 	 	 	 	 
	
    Name of Entity
	
 
	
    Filing
	
 
	
    Filing Date
	
 
	
    Filing #

	 

	

    (25) Bio-Medical Applications of Fayetteville, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20201701

	

    (26) Bio-Medical Applications of Florida, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205587

	

    (27) Bio-Medical Applications of Fremont, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205579

	

    (28) Bio-Medical Applications of Fresno, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205553

	

    (29) Bio-Medical Applications of Georgia, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205546

	

    (30) Bio-Medical Applications of Glendora, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205538

	

    (31) Bio-Medical Applications of Guayama, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205496

	

    (32) Bio-Medical Applications of Hillside, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205256

	

    (33) Bio-Medical Applications of Hoboken, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20187389

	

    (34) Bio-Medical Applications of Humacao, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205231

	

    (35) Bio-Medical Applications of Illinois, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206932

	

    (36) Bio-Medical Applications of Indiana, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206908

	

    (37) Bio-Medical Applications of Irvington, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206916

	

    (38) Bio-Medical Applications of Jersey City, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206890

	

    (39) Bio-Medical Applications of Kansas, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206882

	

    (40) Bio-Medical Applications of Kentucky, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206866

	

    (41) Bio-Medical Applications of Las Americas, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206858

	

    (42) Bio-Medical Applications of Long Beach, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206833

	

    (43) Bio-Medical Applications of Los Gatos, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206841

	

    (44) Bio-Medical Applications of Louisiana, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206874

	

    (45) Bio-Medical Applications of Maine, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20206825

	

    (46) Bio-Medical Applications of Manchester, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20187165

	

    (47) Bio-Medical Applications of Maryland, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205686

	

    (48) Bio-Medical Applications of Massachusetts, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20205694

 

    Schedule VI —
    UCC Filings
    

    

    2

 

    NMC
    FUNDING CORPORATION

    Amended and Restated Transfer and Administration Agreement

    UCC Financing Statements

 

	 	 	 	 	 	 	 
	
    Name of Entity
	
 
	
    Filing
	
 
	
    Filing Date
	
 
	
    Filing #

	 

	

    (49) Bio-Medical Applications of Mayaguez, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20191555

	

    (50) Bio-Medical Applications of Michigan, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20191498

	

    (51) Bio-Medical Applications of Minnesota, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20191373

	

    (52) Bio-Medical Applications of Mission Hills, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20191332

	

    (53) Bio-Medical Applications of Mississippi, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20191027

	

    (54) Bio-Medical Applications of Missouri, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20189518

	

    (55) Bio-Medical Applications of MLK, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20189443

	

    (56) Bio-Medical Applications of Nevada, Inc. 

	
 
	
    Nevada
	
 
	
    12/26/2001
	
 
	
    20010146901

	

    (57) Bio-Medical Applications of New Hampshire, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20189468

	

    (58) Bio-Medical Applications of New Jersey, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20203095

	

    (59) Bio-Medical Applications of New Mexico, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20187793

	

    (60) Bio-Medical Applications of New York, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20187314

	

    (61) Bio-Medical Applications of North Carolina, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20189351

	

    (62) Bio-Medical Applications of Northeast, D.C., Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20188668

	

    (63) Bio-Medical Applications of Oakland, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20188619

	

    (64) Bio-Medical Applications of Ohio, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20188478

	

    (65) Bio-Medical Applications of Oklahoma, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20188114

	

    (66) Bio-Medical Applications of Pennsylvania, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20188056

	

    (67) Bio-Medical Applications of Pine Brook, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20187900

	

    (68) Bio-Medical Applications of Ponce, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20187827

	

    (69) Bio-Medical Applications of Puerto Rico, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20187694

	

    (70) Bio-Medical Applications of Rhode Island, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20187629

	

    (71) Bio-Medical Applications of Rio Piedras, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185862

	

    (72) Bio-Medical Applications of San Antonio, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20186456

 

    Schedule VI —
    UCC Filings
    

    

    3

 

    NMC
    FUNDING CORPORATION

    Amended and Restated Transfer and Administration Agreement

    UCC Financing Statements

 

	 	 	 	 	 	 	 
	
    Name of Entity
	
 
	
    Filing
	
 
	
    Filing Date
	
 
	
    Filing #

	 

	

    (73) Bio-Medical Applications of San German, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20186305

	

    (74) Bio-Medical Applications of San Juan, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185938

	

    (75) Bio-Medical Applications of South Carolina, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185912

	

    (76) Bio-Medical Applications of South Queens, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20186373

	

    (77) Bio-Medical Applications of Southeast Washington, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185854

	

    (78) Bio-Medical Applications of Tennessee, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20186084

	

    (79) Bio-Medical Applications of Texas, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20186282

	

    (80) Bio-Medical Applications of The District of Columbia,
    Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20186134

	

    (81) Bio-Medical Applications of Trenton, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185631

	

    (82) Bio-Medical Applications of Ukiah, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185573

	

    (83) Bio-Medical Applications of Virginia, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185425

	

    (84) Bio-Medical Applications of West Virginia, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185383

	

    (85) Bio-Medical Applications of Wisconsin, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185292

	

    (86) Bio-Medical Applications of Woonsocket, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185268

	

    (87) Dialysis America Alabama, LLC

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185474

	

    (88) Dialysis America Georgia, LLC

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185920

	

    (89) Dialysis Associates of Northern New Jersey, LLC

	
 
	
    New Jersey
	
 
	
    12/26/2001
	
 
	
    2079480

	

    (90) Everest Healthcare Holdings, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182554

	

    (91) Everest Healthcare Indiana, Inc. 

	
 
	
    Indiana
	
 
	
    12/26/2001
	
 
	
    200100009985327

	

    (92) Everest Healthcare Rhode Island, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182430

	

    (93) Everest Healthcare Texas Holding Corp

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182422

	

    (94) Everest Healthcare Texas, LP

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182372

	

    (95) Everest Management, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182323

	

    (96) FMC Dialysis Services Colorado, LLC (f/k/a Bio-Medical
    Applications Of Colorado,

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182299

 

    Schedule VI —
    UCC Filings
    

    

    4

 

    NMC
    FUNDING CORPORATION

    Amended and Restated Transfer and Administration Agreement

    UCC Financing Statements

 

	 	 	 	 	 	 	 
	
    Name of Entity
	
 
	
    Filing
	
 
	
    Filing Date
	
 
	
    Filing #

	 

	

    (97) FMC Dialysis Services-Oregon, LLC

	
 
	
    Oregon
	
 
	
    12/26/2001
	
 
	
    573701

	

    (98) FMC Dialysis Services-Oregon, LLC (f/k/a Willamette Valley
    Kidney Center, LLC)

	
 
	
    Oregon
	
 
	
    12/26/2001
	
 
	
    573699

	

    (99) Fresenius Management Services, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182265

	

    (100) Fresenius USA Home Dialysis, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182273

	

    (101) Fresenius USA Marketing, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182232

	

    (102) Fresenius USA of Puerto Rico, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20182042

	

    (103) Fresenius USA, Inc. 

	
 
	
    Massachusetts
	
 
	
    12/26/2001
	
 
	
    200107918400

	

    (104) Gulf Region Mobile Dialysis, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    11791206

	

    (105) Home Dialysis of America, Inc. 

	
 
	
    Arizona
	
 
	
    12/26/2001
	
 
	
    200111999672

	

    (106) Home Dialysis of Muhlenberg County, Inc. 

	
 
	
    Kentucky
	
 
	
    12/26/2001
	
 
	
    2001-1743498-99

	

    (107) Home Intensive Care, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185235

	

    (108) Mercy Dialysis Center, Inc. 

	
 
	
    Wisconsin
	
 
	
    12/26/2001
	
 
	
    10010579325

	

    (109) National Medical Care, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185219

	

    (110) National Medical Care, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185185

	

    (111) Neomedica, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185201

	

    (112) North Buckner Dialysis Center, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20183628

	

    (113) Northern New Jersey Dialysis, L.L.C. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20183651

	

    (114) Qualicenters, Inc. 

	
 
	
    Colorado
	
 
	
    12/26/2001
	
 
	
    20012119190

	

    (115) Renal Scientific Services, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20183578

	

    (116) San Diego Dialysis Services, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185748

	

    (117) Spectra East, Inc. 

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20185680

	

    (118) Spectra Laboratories, Inc. 

	
 
	
    Nevada
	
 
	
    12/26/2001
	
 
	
    2001014691-3

	

    (119) Terrell Dialysis Center, L.L C

	
 
	
    Delaware
	
 
	
    12/26/2001
	
 
	
    20183164

	

    (120) Conejo Valley Dialysis, Inc. 

	
 
	
    California
	
 
	
    12/27/2001
	
 
	
    136260218

 

    Schedule VI —
    UCC Filings
    

    

    5

 

    NMC
    FUNDING CORPORATION

    Amended and Restated Transfer and Administration Agreement

    UCC Financing Statements

 

	 	 	 	 	 	 	 
	
    Name of Entity
	
 
	
    Filing
	
 
	
    Filing Date
	
 
	
    Filing #

	 

	

    (121) Dialysis Services of Cincinnati, Inc. 

	
 
	
    Ohio
	
 
	
    12/27/2001
	
 
	
    OH00043224499

	

    (122) Dialysis Services, Inc. 

	
 
	
    Texas
	
 
	
    12/27/2001
	
 
	
    02-0013486387

	

    (123) Dialysis Specialists of Topeka, Inc. 

	
 
	
    Kansas
	
 
	
    12/27/2001
	
 
	
    5101266

	

    (124) Dialysis Specialists of Tulsa, Inc. 

	
 
	
    Oklahoma
	
 
	
    12/27/2001
	
 
	
    2001011361217

	

    (125) Everest Healthcare Ohio, Inc. 

	
 
	
    Ohio
	
 
	
    12/27/2001
	
 
	
    OH00043224277

	

    (126) Fresenius USA Sales, Inc. 

	
 
	
    Massachusetts
	
 
	
    12/27/2001
	
 
	
    200107918220

	

    (127) Haemo-Stat, nc., Acute Hemodialysis Nursing Service

	
 
	
    California
	
 
	
    12/27/2001
	
 
	
    136260283

	

    (128) Prime Medical, Inc. 

	
 
	
    Delaware
	
 
	
    12/27/2001
	
 
	
    200107918040

	

    (129) Santa Barbara Community Dialysis Center

	
 
	
    California
	
 
	
    12/27/2001
	
 
	
    136260308

	

    (130) Con-Med Supply Company, Inc. 

	
 
	
    Illinois
	
 
	
    1/9/2002
	
 
	
    4569733

	

    (131) WSKC Dialysis Services, Inc. 

	
 
	
    Illinois
	
 
	
    1/9/2002
	
 
	
    4569717

	

    (132) Du Page Dialysis Ltd. 

	
 
	
    Illinois
	
 
	
    1/10/2002
	
 
	
    4569725

 

    Schedule VI —
    UCC Filings
    

    

    6

 

    EXHIBIT F

    

    to

    

    FOURTH AMENDED AND RESTATED

    TRANSFER AND ADMINISTRATION AGREEMENT

    

    FORM OF TRANSFER CERTIFICATE

 

    EXECUTION
    COPY

 

 

    SECOND
    AMENDED AND RESTATED TRANSFER CERTIFICATE

 

 

    Reference is made to the Fourth Amended and Restated Transfer
    and Administration Agreement dated as of October 16, 2008,
    (such agreement as amended, modified or supplemented from time
    to time, the “Agreement”) among NMC Funding
    Corporation, as transferor (in such capacity, the
    “Transferor”), National Medical Care, Inc., as
    collection agent (in such capacity, the “Collection
    Agent”), Paradigm Funding LLC, as a Conduit Investor, Giro
    Balanced Funding Corporation as a Conduit Investor, Liberty
    Street Funding LLC as a Conduit Investor, the financial
    institutions from time to time a party thereto as Bank
    Investors, Bayerische Landesbank, New York Branch, as an
    Administrative Agent, The Bank of Nova Scotia as an
    Administrative Agent and WestLB, New York Branch
    (“WestLB”) as an Administrative Agent and as Agent.
    Terms defined in the Agreement are used herein as therein
    defined.

 

    The Transferor hereby conveys, transfers and assigns to the
    Agent, on behalf of the Conduit Investors and the Bank
    Investors, as applicable, an undivided ownership interest in the
    Affected Assets. Each Incremental Transfer by the Transferor to
    the Agent and each reduction or increase in the Net Investment
    in respect of each Incremental Transfer evidenced hereby shall
    be indicated by the Agent on the grid attached hereto which is
    part of this Transfer Certificate.

 

    This Transfer Certificate is made without recourse except as
    otherwise provided in the Agreement.

 

    This Transfer Certificate shall be governed by, and construed in
    accordance with, the laws of the State of New York.

 

    This Transfer Certificate amends and restates in its entirety
    that certain Transfer Certificate dated as of October 23,
    2003 issued to WestLB, New York Branch.

 

    [The
    remainder of this page intentionally left blank]

    

    1

 

    IN WITNESS WHEREOF, the undersigned has caused this Transfer
    Certificate to be duly executed and delivered by its duly
    authorized officer as of the date first above written.

 

    NMC FUNDING CORPORATION,

 

			
	 	    By: 
	
        

    Name:     

    Title:

 

    Dated as of October 16, 2008

    

    2

 

    Transfer
    Certificate

    (Grid)

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Increase (or

    
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
    Decrease in Net

    
	
 
	
 
	
    Notation

    
	
 

	
    Date
	
 
	
 
	
    Event(1)
	
 
	
 
	
    Investment
	
 
	
 
	
    Made By
	
 

	 

 

 

			
	
    (1) 		
    Specify whether Incremental Transfer or Reduction in Net
    Investment.

    

    3

 

    EXHIBIT G

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORM OF
    ASSIGNMENT AND ASSUMPTION AGREEMENT

 

    Exhibit G

    

 

    to

    

 

    Fourth
    Amended and Restated Transfer and Administration Agreement

    

 

    FORM OF
    ASSIGNMENT AND ASSUMPTION

    

    Dated          ,
    20  

 

    Reference is made to the Fourth Amended and Restated Transfer
    and Administration Agreement dated as of October 16, 2008
    (as the same may be amended, restated, supplemented, or
    otherwise modified from time to time, the “TAA”) by
    and among NMC Funding Corporation, as transferor (the
    “Transferor”), National Medical Care, Inc., as the
    initial collection agent (the “Collection Agent”),
    those entities from time to time parties thereto as
    “Conduit Investors”, those financial institutions from
    time to time parties thereto as “Bank Investors”,
    those entities from time to time parties thereto as
    “Administrative Agents”, and WestLB AG, New York
    Branch, as “Agent”. Unless otherwise defined herein,
    capitalized terms used herein and not otherwise defined herein
    shall have the respective meanings ascribed thereto in the TAA.

 

              (the
    “Assignor”)
    and          
    (the “Assignee”) agree as follows:

 

    1. The Assignor hereby assigns to the Assignee, without
    recourse, a percentage of the Transferred Interest (such
    percentage as set forth on Schedule I hereto, to be
    determined based on the relation that the amount of the Sales
    Price (as hereinafter defined) allocated to Net Investment bears
    to the aggregate Net Investment held by the Assignor immediately
    prior to the assignment contemplated hereby) owned by the
    Assignor under the TAA as of the Assignment Date (as hereinafter
    defined). In consideration thereof, the Assignee has paid to the
    Assignor an amount (the “Sales Price”) equal to
    $     
    1,

    receipt of which payment is hereby acknowledged. In addition, in
    consideration of the payment of the Sales Price, the Assignor
    hereby sells and assigns to the Assignee, without recourse and
    the Assignee hereby accepts and assumes from the Assignor, [all]
    [such percentage] of the Assignor’s rights, obligations and
    duties under the TAA as a Bank Investor [(it being understood
    that the Assignee shall (a) be obligated to effect
    Incremental Transfers in accordance with the TAA,
    notwithstanding that the Assignor was not so obligated and
    (b) not have the right to elect the commencement of the
    amortization of the Net Investment pursuant to the definition of
    Reinvestment Termination Date, notwithstanding that the Assignor
    had such right)
    and]2

    [all] [such percentage] of the Assignor’s related rights
    and obligations as the owner of such Transferred Interest under
    the TAA and the other Transaction Documents [,in each
    case,]2

    as of the Assignment Date.

 

    2. The Assignor (i) represents and warrants that it is
    the legal and beneficial owner of the Transferred Interest being
    assigned by it hereunder and that such interest is free and
    clear of any Adverse Claim created by the Assignor;
    (ii) makes no representation and warranty and assumes no
    responsibility with respect to any statements, warranties, or
    representations made in or in connection with the TAA, the other
    Transaction Documents or any other instrument or document
    furnished pursuant thereto or the execution, legality, validity,
    enforceability, genuineness, sufficiency or value of the TAA,
    the other Transaction Documents, or any other instrument or
    document related to the foregoing; and (iii) makes no
    representation or warranty and assumes no responsibility with
    respect to the financial condition of the Transferor, any of the
    Originating Entities, any other Parent Group Member or the
    Collection Agent, or the performance or observance by the
    Transferor, any of the Originating Entities, any other Parent
    Group Member or the Collection Agent of any of their respective
    obligations under the TAA, the Receivables Purchase Agreement,
    the other Transaction Documents, or any other instrument or
    document furnished pursuant thereto.

 

    3. The Assignee (i) confirms that it has received a
    copy of the TAA, the Receivables Purchase Agreement and such
    other instruments, documents and information as it has deemed
    appropriate to make its own credit analysis and decision to
    enter into this Assignment and Assumption Agreement and to
    purchase such interest;

 

 

    1 This

    amount shall be an amount determined, calculated, allocated and
    otherwise mutually agreed to by the Assignor and Assignee in
    their sole discretion.

    2 To

    be included only where the Assignor is a Conduit Investor under
    the TAA and is assigning all of its rights as such to its
    related Bank Investors in accordance with
    Section 9.7 of the TAA.

    

    1

 

    (ii) agrees that it will, independently and without
    reliance upon the Agent, any Investor, any Administrative Agent
    or any of the foregoing’s respective Affiliates, or the
    Assignor and based on such documents and information as it shall
    deem appropriate at the time, continue to make its own credit
    decisions in taking or not taking action under the TAA and the
    other Transaction Documents; (iii) appoints and authorizes
    the Agent to take such action as agent on its behalf and to
    exercise such powers under the TAA, the other Transaction
    Documents and any other instrument or document furnished
    pursuant thereto as are delegated to the Agent by the terms
    thereof, together with such powers as are reasonably incidental
    thereto and to enforce its respective rights and interests under
    the TAA, the other Transaction Documents, the Receivables, the
    Contracts and the Related Security; (iv) appoints and
    authorizes its Administrative Agent to take such action as agent
    on its behalf and to exercise such powers under the TAA, the
    other Transaction Documents and any other instrument or document
    furnished pursuant thereto as are delegated to such
    Administrative Agent by the terms thereof, together with such
    powers as are reasonably incidental thereto, (v) agrees
    that it will perform in accordance with their terms all of the
    obligations which by the terms of the TAA and the other
    Transaction Documents are required to be performed by it as the
    Assignee of the Assignor; (vi) agrees that it will not
    institute against any Conduit Investor any proceeding of the
    type referred to in Section 10.9 of the TAA at any time
    prior to the date which is one year and one day after the
    payment in full of all Commercial Paper issued by such Conduit
    Investor; and (vii) specifies as its address for notices
    the address set forth in Section 2 of
    Schedule 1 hereto.

 

    4. This Assignment and Acceptance shall be effective as of
    the date specified in Section 2 of
    Schedule 1 hereto as of the “Assignment
    Date” but only after [the Administrative Agent of the
    Assignor’s Related Group has given its written approval
    and]3 a

    fully executed copy of this Assignment and Assumption has been
    delivered to such Administrative Agent and the Agent.

 

    5. Upon delivery of this Assignment and Assumption to the
    Agent, as of the Assignment Date, (i) the Assignee shall
    have all of the rights and obligations of the Assignor under the
    TAA and under the other Transaction Documents to which such
    Assignor is or, immediately prior to this Assignment and
    Assumption, was a party with respect to such assigned interest
    for all purposes of the TAA and under the other Transaction
    Documents to which such assignor is, or immediately prior to
    this Assignment and Assumption, was a party and (ii) the
    Assignor shall, to the extent provided in this Assignment and
    Assumption and the TAA, relinquish its rights with respect to
    such assigned interest for all purposes of the TAA and under the
    other Transaction Documents to which the Assignor is or,
    immediately prior to this Assignment and Assumption was a party.

 

    6. From and after [the later of] the Assignment Date [and
    the date of approval of this Assignment and Assumption by the
    Administrative Agent for the Assignor’s Related Group],
    such Administrative Agent and the Agent shall make all payments
    under the TAA and the other applicable Transaction Documents in
    respect of the interest assigned hereby (including, without
    limitation, all payments on account of the Receivables with
    respect thereto) to the Assignee. The Assignor and Assignee
    shall make directly between themselves all appropriate
    adjustments in payments under the TAA and such other applicable
    Transaction Documents for periods, if any, prior to the later of
    the dates specified in the preceding sentence.

 

    7. This Assignment and Assumption shall be governed by, and
    construed in accordance with, the laws of the State of New York.

 

    8. This Assignment and Assumption may be executed in any
    number of counterparts and by different parties hereto in
    separate counterparts, each of which when so executed shall be
    deemed to be an original, and all of which when taken together
    shall constitute one and the same instrument.

 

 

    3 To

    be included only where the Assignor is a Bank Investor under the
    TAA.

    

    2

 

    IN WITNESS WHEREOF, the parties hereto have caused this
    Assignment and Acceptance to be executed by their respective
    officers thereunto duly authorized, as of the date first above
    written.

 

    [ASSIGNOR]

 

			
	 	    By: 
	
        

 

    [ASSIGNEE]

 

			
	 	    By: 
	
        

 

    [Approved this   day

    of          ,
    20  

 

    [ADMINISTRATIVE AGENT]

 

			
	 	    By: 
	
        

    Title:]

 

    Accepted and recorded this  day

    of          ,
    20  

 

    WESTLB AG, NEW YORK BRANCH, as Agent

 

			
	 	    By: 
	
        

    Title:

 

			
	 	    By: 
	
        

    Title:

    

    3

 

    Schedule 1

    

 

    to

    

 

    Assignment
    and Acceptance

    

 

    Dated          ,
    20  

 

    Section 1.

 

	 	 	 	 	 
	

    Percentage of Assignor’s Transferred Interest assigned
    hereunder (without giving effect to any assignments thereof
    which have not yet become effective):

	
 
	
    $
	
              
	
 

	
 
	
 
	
 
	
 
	
 

	

    Assignor’s Net Investment immediately prior to this
    assignment

	
 
	
    $
	

	
 

	
 
	
 
	
 
	
 
	
 

	

    Amount of Net Investment assigned to Assignee

	
 
	
 
	
              
	
    %

	
 
	
 
	
 
	
 
	
 

	

    Amount of Assignee’s remaining Net Investment

	
 
	
 
	
 
	
    %

	
 
	
 
	
 
	
 
	
 

	

    [Assignee’s Commitment (after giving effect
    hereto):]4

	
 
	
    $
	

	
 

	
 
	
 
	
 
	
 
	
 

	

    [Assignor’s remaining Commitment (after giving effect
    hereto)]

	
 
	
    $
	

	
 

	
 
	
 
	
 
	
 
	
 

 

    Section 2.

 

    Assignment
    Date:          ,
    20  

 

    Address for Notices:

 

    [Name of Assignor]

    [Address]

    [Facsimile Number/Confirmation Number]

 

    [Name of Assignee]

    [Address]

    [Facsimile Number/Confirmation Number]

 

 

    4 To

    be included only where the Assignor is a Bank Investo under the
    TAA.

    

    4

 

    EXHIBIT H

    

 

    To

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    LIST OF
    ACTIONS AND SUITS

    

 

    SECTIONS 3.1(g),
    3.1(k) and 3.3(e)

 

    3.1(g)(i) Transferor:  None

 

    3.1(g)(ii) Affiliates:  The following is an
    excerpt from the
    Form 6-K
    filing of Fresenius Medical Care G & Co. KGaA (the
    “Company”) with the Securities and Exchange Commission
    for the period ending June 30, 2008:

 

    Legal
    Proceedings (in thousands)

 

    Commercial
    Litigation

 

    The Company was originally formed as a result of a series of
    transactions it completed pursuant to the Agreement and Plan of
    Reorganization dated as of February 4, 1996, by and between
    W.R. Grace & Co. and Fresenius SE (the
    “Merger”). At the time of the Merger, a W.R.
    Grace & Co. subsidiary known as W.R. Grace &
    Co.-Conn. had, and continues to have, significant liabilities
    arising out of product-liability related litigation (including
    asbestos-related actions), pre-Merger tax claims and other
    claims unrelated to National Medical Care, Inc.
    (“NMC”), which was W.R. Grace & Co.’s
    dialysis business prior to the Merger. In connection with the
    Merger, W.R. Grace & Co.-Conn. agreed to indemnify the
    Company, FMCH, and NMC against all liabilities of W.R.
    Grace & Co., whether relating to events occurring
    before or after the Merger, other than liabilities arising from
    or relating to NMC’s operations. W.R. Grace & Co.
    and certain of its subsidiaries filed for reorganization under
    Chapter 11 of the U.S. Bankruptcy Code (the
    “Grace Chapter 11 Proceedings”) on April 2,
    2001.

 

    Prior to and after the commencement of the Grace Chapter 11
    Proceedings, class action complaints were filed against W.R.
    Grace & Co. and FMCH by plaintiffs claiming to be
    creditors of W.R. Grace & Co.-Conn., and by the
    asbestos creditors’ committees on behalf of the W.R.
    Grace & Co. bankruptcy estate in the Grace
    Chapter 11 Proceedings, alleging among other things that
    the Merger was a fraudulent conveyance, violated the uniform
    fraudulent transfer act and constituted a conspiracy. All such
    cases have been stayed and transferred to or are pending before
    the U.S. District Court as part of the Grace
    Chapter 11 Proceedings.

 

    In 2003, the Company reached agreement with the asbestos
    creditors’ committees on behalf of the W.R.
    Grace & Co. bankruptcy estate and W.R.
    Grace & Co. in the matters pending in the Grace
    Chapter 11 Proceedings for the settlement of all fraudulent
    conveyance and tax claims against it and other claims related to
    the Company that arise out of the bankruptcy of W.R.
    Grace & Co. Under the terms of the settlement
    agreement as amended (the “Settlement Agreement”),
    fraudulent conveyance and other claims raised on behalf of
    asbestos claimants will be dismissed with prejudice and the
    Company will receive protection against existing and potential
    future W.R. Grace & Co. related claims, including
    fraudulent conveyance and asbestos claims, and indemnification
    against income tax claims related to the non-NMC members of the
    W.R. Grace & Co. consolidated tax group upon
    confirmation of a W.R. Grace & Co. bankruptcy
    reorganization plan that contains such provisions. Under the
    Settlement Agreement, the Company will pay a total of $115,000
    without interest to the W.R. Grace & Co. bankruptcy
    estate, or as otherwise directed by the Court, upon plan
    confirmation. No admission of liability has been or will be
    made. The Settlement Agreement has been approved by the
    U.S. District Court. Subsequent to the Merger, W.R.
    Grace & Co. was involved in a multi-step transaction
    involving Sealed Air Corporation (“Sealed Air,”
    formerly known as Grace Holding, Inc.). The Company is engaged
    in litigation with Sealed Air to confirm its entitlement to
    indemnification from Sealed Air for all losses and expenses
    incurred by the Company relating to pre-Merger tax liabilities
    and Merger-related claims. Under the Settlement Agreement, upon
    confirmation of a plan that satisfies the conditions of the
    Company’s payment obligation, this litigation will be
    dismissed with prejudice.

 

    In April 2008, W.R. Grace & Co. announced an agreement
    in principle with the asbestos creditors’ and equity
    security holders’ committees in the Grace Chapter 11
    Proceedings to settle all present and future asbestos-related

    

    1

 

    personal injury claims. The agreement in principle and W.R.
    Grace & Co.’s related bankruptcy reorganization
    plan are subject to conditions including resolution of claims of
    other creditors and Bankruptcy Court and District Court
    approvals.

 

    On April 4, 2003, FMCH filed a suit in the
    U.S. District Court for the Northern District of
    California, styled Fresenius USA, Inc., et al., v. Baxter
    International Inc., et al., Case No. C
    03-1431,
    seeking a declaratory judgment that FMCH does not infringe on
    patents held by Baxter International Inc. and its subsidiaries
    and affiliates (“Baxter”), that the patents are
    invalid, and that Baxter is without right or authority to
    threaten or maintain suit against FMCH for alleged infringement
    of Baxter’s patents. In general, the alleged patents
    concern the use of touch screen interfaces for hemodialysis
    machines. Baxter filed counterclaims against FMCH seeking more
    than $140,000 in monetary damages and injunctive relief, and
    alleging that FMCH willfully infringed on Baxter’s patents.
    On July 17, 2006, a jury verdict was entered in favor of
    FMCH finding that all the asserted claims of the Baxter patents
    are invalid as obvious
    and/or
    anticipated in light of prior art. On February 13, 2007,
    the court granted Baxter’s motion to set aside the
    jury’s verdict in favor of FMCH and reinstated the patents
    and entered judgment of infringement. Following a retrial on
    damages, the court entered judgment on November 6, 2007 in
    favor of Baxter on a jury award of $14,300. On April 4,
    2008, the court denied Baxter’s motion for a new trial,
    established a royalty payable to Baxter of 10% of the sales
    price for continuing sales of FMCH’s 2008K hemodialysis
    machines and 7% of the sales price of related disposables, parts
    and service beginning November 7, 2007, and enjoined sales
    of the 2008K machine effective January 1, 2009. We have
    appealed the court’s rulings to the Court of Appeals for
    the Federal Circuit. We are confident that we will prevail on
    appeal and have made no provision in our financial statements
    for any potential liability in this matter. If we are
    unsuccessful on all appeals, including any appeal of the
    royalty, the royalties payable to Baxter on the machines and
    disposable supplies that are subject to the court’s order
    are estimated to be in the range of $2 million to
    $4 million per month. In the interim period until our
    appeal is decided, we are funding a court-approved escrow
    account at the rate noted above. If we win the appeal, the
    escrowed funds will be returned to us with interest. We are
    pursuing design modifications to the 2008K machine that we
    expect will limit the scope of royalty payment exposure and
    permit the continued sale of the modified 2008K machine after
    the January 1, 2009 injunction effective date, irrespective
    of the outcome of our appeal.

 

    Gambro Pty Limited and Gambro Lundia AB (“Gambro AB”
    and, together with Gambro Pty Limited, “the Gambro
    Group”) commenced litigation against FMC AG & Co.
    KGaA’s Australian subsidiary, Fresenius Medical Care
    Australia Pty Limited (“Fresenius Medical Care
    Australia”) regarding infringement and damages with respect
    to a Gambro AB patent protecting intellectual property in
    relation to a system for preparation of dialysis or replacement
    fluid, the Gambro Bicart device in Australia (the “Gambro
    Patent”). As a result of the commercialization of a system
    for the preparation of dialysis fluid based on the Fresenius
    Medical Care Bibag device in Australia, the Australian courts
    concluded that Fresenius Medical Care Australia infringed the
    Gambro Patent. In May 2008, the Gambro Group and Fresenius
    Medical Care Australia and FMC AG & Co. KGaA entered
    into a Deed of Settlement and Release pursuant to which
    Fresenius Medical Care made certain cash payments to the Gambro
    Group and pursuant to which the proceedings and all claims under
    the Gambro Patent, including any claims for relief for losses
    alleged to have been incurred after the expiry of the Gambro
    Patent, were resolved.

 

    Two patent infringement actions have been pending in Germany
    between Gambro Industries (“Gambro”) on the one side
    and D-GmbH and FMC AG & Co. KGaA on the other side
    (hereinafter collectively “Fresenius Medical Care”).
    Gambro herein alleged patent infringements concerning a patent
    on a device for the preparation of medical solutions by
    Fresenius Medical Care. The first case was dismissed as being
    unfounded. Such decision has already become final. In the second
    case, the District Court of Mannheim rendered a judgement on
    June 27, 2008 deciding in favor of Gambro and declaring
    that Fresenius Medical Care has infringed a patent claim.
    Accordingly, the court ordered Fresenius Medical Care to pay
    compensation (to be determined in a separate court proceeding)
    for alleged infringement and to stop offering the alleged patent
    infringing technology in its current form in Germany. Such
    verdict could be enforced provisionally by way of security to be
    deposited by Gambro, however the Company has received no notice
    that Gambro has applied for provisional enforceability, as yet.
    D-GmbH brought an invalidity action in the Federal German Patent
    Court (“BPatG”) against Gambro’s patent. This
    case is currently pending with the Federal Court of Justice as
    the court of appeal. Fresenius Medical Care has also filed an
    appeal against the District Court’s verdict. Irrespective
    of the outcome of the appeal, Fresenius Medical Care pursues to
    develop design modifications to the concerned devices that
    Fresenius Medical Care expects will enable it to provide an

    

    2

 

    alternative technical solution. In view of the pending appeal
    against BPatG’s verdict and Fresenius Medical Care’s
    appeal against the District Court’s verdict, Fresenius
    Medical Care continues to believe that the alleged patent
    infringing technology does not infringe any valid patent claims
    of Gambro. Therefore, the Company has made no provision in the
    financial statements for any potential liability in this matter.

 

    Other
    Litigation and Potential Exposures

 

    Renal Care Group (“RCG”) was named as a nominal
    defendant in a second amended complaint filed September 13,
    2006 in the Chancery Court for the State of Tennessee Twentieth
    Judicial District at Nashville against former officers and
    directors of RCG which purports to constitute a class action and
    derivative action relating to alleged unlawful actions and
    breaches of fiduciary duty in connection with the Company’s
    acquisition of RCG (the “RCG Acquisition”) and in
    connection with alleged improper backdating
    and/or
    timing of stock option grants. The amended complaint was styled
    Indiana State District Council of Laborers and Hod Carriers
    Pension Fund, on behalf of itself and all others similarly
    situated and derivatively on behalf of RCG, Plaintiff, vs. RCG,
    Gary Brukardt, William P. Johnston, Harry R. Jacobson, Joseph C.
    Hutts, William V. Lapham, Thomas A. Lowery, Stephen D. McMurray,
    Peter J. Grua, C. Thomas Smith, Ronald Hinds, Raymond Hakim and
    R. Dirk Allison, Defendants. The complaint sought damages
    against former officers and directors and did not state a claim
    for money damages directly against RCG. On August 30, 2007,
    this suit was dismissed by the trial court without leave to
    amend. Plaintiff subsequently appealed and the matter remains
    pending in the appellate court of Tennessee.

 

    In October 2004, FMCH and its subsidiaries, including RCG (prior
    to the RCG Acquisition), received subpoenas from the
    U.S. Department of Justice, Eastern District of New York in
    connection with a civil and criminal investigation, which
    requires production of a broad range of documents relating to
    FMCH’s and RCG’s operations, with specific attention
    to documents relating to laboratory testing for parathyroid
    hormone (“PTH”) levels and vitamin D therapies. The
    Company is cooperating with the government’s requests for
    information. The Company believes that it has fulfilled all
    requests for information made by government investigators in
    this matter, and that it has complied with applicable laws
    relating to PTH testing and use of vitamin D therapies.

 

    FMCH and its subsidiaries, including RCG (prior to the RCG
    Acquisition), received a subpoena from the U.S. Department
    of Justice, Eastern District of Missouri, in connection with a
    joint civil and criminal investigation. FMCH received its
    subpoena in April 2005. RCG received its subpoena in August
    2005. The subpoenas require production of a broad range of
    documents relating to FMCH’s and RCG’s operations,
    with specific attention to documents related to clinical quality
    programs, business development activities, medical director
    compensation and physician relationships, joint ventures, and
    anemia management programs, RCG’s supply company,
    pharmaceutical and other services that RCG provides to patients,
    RCG’s relationships to pharmaceutical companies, and
    RCG’s purchase of dialysis equipment from FMCH. The Office
    of the Inspector General of the U.S. Department of Health
    and Human Services and the U.S. Attorney’s office for
    the Eastern District of Texas have also confirmed that they are
    participating in the review of the anemia management program
    issues raised by the U.S. Attorney’s office for the
    Eastern District of Missouri. On July 17, 2007, the
    U.S. Attorney’s office filed a civil complaint against
    RCG and FMCH in its capacity as RCG’s current corporate
    parent in United States District Court, Eastern District of
    Missouri. The complaint seeks monetary damages and penalties
    with respect to issues arising out of the operation of
    RCG’s Method II supply company through 2005, prior to
    the date of FMCH’s acquisition of RCG. The complaint is
    styled United States of America ex rel. Julie Williams et al.
    vs. Renal Care Group, Renal Care Group Supply Company and FMCH.
    The Company believes that RCG’s operation of its
    Method II supply company was in compliance with applicable
    law and will defend this litigation vigorously. We will continue
    to cooperate in the ongoing investigation.

 

    In May 2006, RCG received a subpoena from the
    U.S. Department of Justice, Southern District of New York
    in connection with an investigation into RCG’s
    administration of its stock option programs and practices,
    including the procedure under which the exercise price was
    established for certain of the option grants. The subpoena
    required production of a broad range of documents relating to
    the RCG stock option program prior to the RCG Acquisition. The
    Company believes that is has fulfilled all requests for
    information made by government investigators in this matter, and
    that RCG complied with applicable laws relating to the issuance
    of stock options.

    

    3

 

    In August 2007, the Sheet Metal Workers National Pension Fund
    filed a complaint in the United States District Court for the
    Central District of California, Western Division (Los Angeles),
    alleging that Amgen, Inc., the Company and DaVita Inc., marketed
    Amgen’s products,
    Epogen®

    and
    Aranesp®,

    to hemodialysis patients for uses not approved by the FDA and
    thereby caused a putative class of commercial insurers to pay
    for unnecessary prescriptions of these products. Although the
    court dismissed the original allegations against the Company, it
    granted plaintiff leave to amend and this litigation was
    subsequently consolidated with other cases against
    Epogen®

    and
    Aranesp®

    Off-Label Marketing and Sales Practices Multidistrict Litigation
    and assigned to the Central District of California. On
    July 2, 2008, a consolidated complaint was filed in the
    Multidistrict Litigation that renews allegations against the
    Company and DaVita, in addition to those against Amgen.

 

    On November 27, 2007, the United States District Court for
    the Western District of Texas (El Paso) unsealed and
    permitted service of two complaints previously filed under seal
    by a qui tam relator, a former FMCH local clinic employee (Qui
    tarn is a legal provision under the United States False Claims
    Act, which allows for private individuals to bring suit on
    behalf of the U.S. federal government, as far as such
    individuals believe to have knowledge of presumable fraud
    committed by third parties). The first complaint alleges that a
    nephrologist unlawfully employed in his practice an assistant to
    perform patient care tasks that the assistant was not licensed
    to perform and that Medicare billings by the nephrologist and
    FMCH therefore violated the False Claims Act. The second
    complaint alleges that FMCH unlawfully retaliated against the
    relator by discharging her from employment constructively. The
    United States Attorney for the Western District of Texas has
    declined to intervene and to prosecute on behalf of the United
    States. Counsel for the nephrologist has asserted that a
    criminal investigation of the relator’s allegations is
    continuing and has moved the Court to stay all activity in the
    qui tam until the alleged criminal investigation has
    concluded. FMCH has received no other notice of the pendency of
    any criminal investigation related to this matter.

 

    From time to time, the Company is a party to or may be
    threatened with other litigation or arbitration, claims or
    assessments arising in the ordinary course of its business.
    Management regularly analyzes current information including, as
    applicable, the Company’s defenses and insurance coverage
    and, as necessary, provides accruals for probable liabilities
    for the eventual disposition of these matters.

 

    The Company, like other health care providers, conducts its
    operations under intense government regulation and scrutiny. It
    must comply with regulations which relate to or govern the
    safety and efficacy of medical products and supplies, the
    operation of manufacturing facilities, laboratories and dialysis
    clinics, and environmental and occupational health and safety.
    The Company must also comply with the Anti-Kickback Statute, the
    False Claims Act, the Stark Statute, and other federal and state
    fraud and abuse laws. Applicable laws or regulations may be
    amended, or enforcement agencies or courts may make
    interpretations that differ from the Company’s
    interpretations or the manner in which it conducts its business.
    Enforcement has become a high priority for the federal
    government and some states. In addition, the provisions of the
    False Claims Act authorizing payment of a portion of any
    recovery to the party bringing the suit encourage private
    plaintiffs to commence “whistle blower” actions. By
    virtue of this regulatory environment, as well as the
    Company’s corporate integrity agreement with the
    U.S. federal government, the Company’s business
    activities and practices are subject to extensive review by
    regulatory authorities and private parties, and continuing
    audits, investigative demands, subpoenas, other inquiries,
    claims and litigation relating to the Company’s compliance
    with applicable laws and regulations. The Company may not always
    be aware that an inquiry or action has begun, particularly in
    the case of “whistle blower” actions, which are
    initially filed under court seal.

 

    The Company operates many facilities throughout the United
    States. In such a decentralized system, it is often difficult to
    maintain the desired level of oversight and control over the
    thousands of individuals employed by many affiliated companies.
    The Company relies upon its management structure, regulatory and
    legal resources, and the effective operation of its compliance
    program to direct, manage and monitor the activities of these
    employees. On occasion, the Company may identify instances where
    employees, deliberately or inadvertently, have submitted
    inadequate or false billings. The actions of such persons may
    subject the Company and its subsidiaries to liability under the
    Anti-Kickback Statute, the Stark Statute and the False Claims
    Act, among other laws.

 

    Physicians, hospitals and other participants in the health care
    industry are also subject to a large number of lawsuits alleging
    professional negligence, malpractice, product liability,
    worker’s compensation or related claims,

    

    4

 

    many of which involve large claims and significant defense
    costs. The Company has been and is currently subject to these
    suits due to the nature of its business and expects that those
    types of lawsuits may continue. Although the Company maintains
    insurance at a level which it believes to be prudent, it cannot
    assure that the coverage limits will be adequate or that
    insurance will cover all asserted claims. A successful claim
    against the Company or any of its subsidiaries in excess of
    insurance coverage could have a material adverse effect upon it
    and the results of its operations. Any claims, regardless of
    their merit or eventual outcome, could have a material adverse
    effect on the Company’s reputation and business.

 

    The Company has also had claims asserted against it and has had
    lawsuits filed against it relating to alleged patent
    infringements or businesses that it has acquired or divested.
    These claims and suits relate both to operation of the
    businesses and to the acquisition and divestiture transactions.
    The Company has, when appropriate, asserted its own claims, and
    claims for indemnification. A successful claim against the
    Company or any of its subsidiaries could have a material adverse
    effect upon its business, financial condition, and the results
    of its operations. Any claims, regardless of their merit or
    eventual outcome, could have a material adverse effect on the
    Company’s reputation and business.

 

    Accrued
    Special Charge for Legal Matters

 

    At December 31, 2001, the Company recorded a pre-tax
    special charge of $258,159 to reflect anticipated expenses
    associated with the defense and resolution of pre-Merger tax
    claims, Merger-related claims, and commercial insurer claims.
    The costs associated with the Settlement Agreement and
    settlements with insurers have been charged against this
    accrual. With the exception of the proposed $115,000 payment
    under the Settlement Agreement, all other matters included in
    the special charge have been resolved. While the Company
    believes that its remaining accrual reasonably estimates its
    currently anticipated costs related to the continued defense and
    resolution of this matter, no assurances can be given that its
    actual costs incurred will not exceed the amount of this accrual.

 

	 	 	 	 	 
	

    3.1(k)

	
 
	
    Tradenames:
	
 
	
    Renal Care Group

    National Nephrology Associates

	
 
	
 
	
    Mergers:
	
 
	

On April 2, 2004, Renal Care Group, Inc. completed its acquisition of National Nephrology Associates, Inc.

On March 31, 2006, FMCH completed the acquisition of Renal Care Group, Inc.

	

    3.3(e)

	
 
	
    Collection Agent:
	
 
	
    None

	
 
	
 
	
    Affiliates:
	
 
	
    See disclosure for Section 3.1(g)(ii) above.

    

    5

 

    EXHIBIT I

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    LOCATION
    OF RECORDS

 

    FMS

 

    Bio-Medical Applications of
    Aguadilla, Inc.

    Bio-Medical Applications of
    Aguadilla, Inc., PUERTO RICO BILLING GROUP, ANTILLAS
    WAREHOUSE & OFFICE PARK, 

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    Alabama, Inc.

    Bio-Medical Applications of
    Alabama, Inc., MOBILE BILLING GROUP, 6420 HILLCREST PARK CT,
    SUITE 210, MOBILE, AL, 36608
    

 

    Bio-Medical Applications of
    Anacostia, Inc.

    Bio-Medical Applications of
    Anacostia, Inc., STEEL CITY BILLING GROUP, 

    BMA PITTSBURGH, 190 BILMAR DR., SUITE 375, PITTSBURGH, PA,
    15205
    

 

    Bio-Medical Applications of
    Arecibo, Inc.

    Bio-Medical Applications of
    Arecibo, Inc., PUERTO RICO BILLING GROUP, ANTILLAS
    WAREHOUSE & OFFICE PARK, 

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    Arkansas, Inc.

    Bio-Medical Applications of
    Arkansas, Inc., MOBILE BILLING GROUP, 6420 HILLCREST PARK CT,
    SUITE 210, MOBILE, AL, 36608
    

 

    Bio-Medical Applications of
    Bayamon, Inc.

    Bio-Medical Applications of
    Aguadilla, Inc., PUERTO RICO BILLING GROUP, ANTILLAS
    WAREHOUSE & OFFICE PARK, 

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of Blue
    Springs, Inc.

    Bio-Medical Applications of
    Aguadilla, Inc., PUERTO RICO BILLING GROUP, ANTILLAS
    WAREHOUSE & OFFICE PARK, 

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    Caguas, Inc.

    Bio-Medical Applications of Caguas,
    Inc., PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE &
    OFFICE PARK, 461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    Texas, Inc.

    Bio-Medical Applications of Texas,
    Inc., ALBUQUERQUE BILLING GROUP, 909 VIRGINIA NE,
    SUITE 112, ALBUQUERQUE, NM, 87108
    

 

    Bio-Medical Applications of Texas,
    Inc., LUBBOCK BILLING GROUP, 4747 SOUTH LOOP 289.,
    SUITE 120., LUBBOCK, TX, 79424
    

 

    Bio-Medical Applications of Texas,
    Inc., 

    NORTH TEXAS BILLING GROUP, 1485 RICHARDSON DRIVE #100, ,
    RICHARDSON, TX, 75080
    

 

    Bio-Medical Applications of Texas,
    Inc., SAN ANTONIO BILLING GROUP, 6100 BANDERA ROAD,
    SUITE 601, SAN ANTONIO, TX, 78238
    

    Bio-Medical Applications of Texas,
    Inc., TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100,
    TYLER, TX, 75701
    

    Bio-Medical Applications of Texas,
    Inc., WACO BILLING GROUP, UPTOWN PLAZA, 1110 RICHLAND
    DR., #3, WACO, TX, 76710
    

 

    Bio-Medical Applications of the
    District of Columbia, Inc.

    Bio-Medical Applications of the
    District of Columbia, Inc., STEEL CITY BILLING GROUP, BMA
    PITTSBURGH, 190 BILMAR DR., SUITE 375, PITTSBURGH, PA, 15205
    

 

    Bio-Medical Applications of
    Ukiah, Inc.

    Bio-Medical Applications of Ukiah,
    Inc., PACIFIC NW BILLING GROUP, 

    4560 S. COACH DRIVE, SUITE 100, TUCSON, AZ, 85714
    

 

    Bio-Medical Applications of
    Virginia, Inc.

    Bio-Medical Applications of
    Virginia, Inc., 

    ROANOKE BILLING GROUP, 

    2830 KEAGY ROAD, SALEM, VA, 24153
    

 

    Bio-Medical Applications of West
    Virginia, Inc.,

    ROANOKE BILLING GROUP, 

    2830 KEAGY ROAD, . SALEM, VA, 24153
    

 

    Bio-Medical Applications of West
    Virginia, Inc., 

    KENTUCKY BILLING GROUP,

    6100 DUTCHMANS LANE, 12TH FLOOR, LOUISVILLE, KY, 40205
    

 

    Bio-Medical Applications of
    Wisconsin, Inc.

 

    NNA of Louisiana, LLC

    NNA of Louisiana, LLC, INDIANAPOLIS
    BILLING, 10585 NORTH MERIDIAN STREET, SUITE 160,
    INDIANAPOLIS, IN, 46290
    

 

    NNA of Oklahoma,
    L.L.C.

    NNA of Oklahoma, L.L.C., TYLER
    BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
    

 

    NNA of Rhode Island,
    Inc.

    NNA of Rhode Island, Inc.,
    CLEVELAND BILLING, 25050 COUNTRY CLUB BOULEVARD, SUITE 250,
    NORTH OLMSTED, OH, 44070
    

 

    NNA of Toledo, Inc.

    NNA of Toledo, Inc., INDIANAPOLIS
    BILLING, 10585 NORTH MERIDIAN STREET, SUITE 160,
    INDIANAPOLIS, IN, 46290
    

 

    NNA-Saint Barnabas,
    L.L.C.

    NNA-Saint Barnabas, L.L.C.,
    CLEVELAND BILLING, 25050 COUNTRY CLUB BOULEVARD, SUITE 250,
    NORTH OLMSTED, OH, 44070
    

 

    NNA-Saint Barnabas-Livingston,
    L.L.C.

    NNA-Saint Barnabas-Livingston,
    L.L.C., CLEVELAND BILLING, 25050 COUNTRY CLUB BOULEVARD,
    SUITE 250, 

    NORTH OLMSTED, OH, 44070
    

 

    Norcross Dialysis Center,
    LLC

    Norcross Dialysis Center, LLC,
    INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

    NORMAN NEPHROLOGY,
    P.L.L.C.

    NORMAN NEPHROLOGY, P.L.L.C., 

    LUBBOCK BILLING GROUP, 

    4747 SOUTH LOOP 289, SUITE 120, LUBBOCK, TX, 79424
    

 

    Bio-Medical Applications of
    California, Inc.

    Bio-Medical Applications of
    California, Inc., PACIFIC NW BILLING GROUP, 

    4560 S. COACH DRIVE, SUITE 100, TUCSON, AZ, 85714
    

 

    Bio-Medical Applications of
    California, Inc., PACIFIC NW BILLING GROUP, 

    4560 S. COACH DRIVE, SUITE 100, TUCSON, AZ,
    85714, SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND
    OAKS BLVD, SUITE 216, THOUSAND OAKS, CA, 91362
    

 

    Bio-Medical Applications of
    California, Inc., PACIFIC NW BILLING GROUP, 

    4560 S. COACH DRIVE, SUITE 100, TUCSON, AZ,
    85714, SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND
    OAKS BLVD, SUITE 216, THOUSAND OAKS, CA, 91362, SAN DIEGO
    BILLING GROUP, 2917 S. DOBSON, SUITE 101, MESA,
    AZ, 85202
    

 

    Bio-Medical Applications of
    Camarillo, Inc.

    Bio-Medical Applications of
    Camarillo, Inc., 

    SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND OAKS BLVD,
    SUITE 216, THOUSAND OAKS, CA, 91362
    

 

    Bio-Medical Applications of
    Capitol Hill, Inc.

    Bio-Medical Applications of Capitol
    Hill, Inc., 

    STEEL CITY BILLING GROUP, BMA PITTSBURGH, 190 BILMAR DR., SUITE
    375, PITTSBURGH, PA, 15205
    

 

    Bio-Medical Applications of
    Carolina, Inc.

    Bio-Medical Applications of
    Carolina, Inc., PUERTO RICO BILLING GROUP, ANTILLAS
    WAREHOUSE & OFFICE PARK, 

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    Carson, Inc.

    Bio-Medical Applications of Carson,
    Inc., SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND OAKS
    BLVD, SUITE 216, THOUSAND OAKS, CA, 91362
    

 

    Bio-Medical Applications of
    Clinton, Inc.

    Bio-Medical Applications of
    Clinton, Inc., FAYETTEVILLE BILLING GROUP, 

    4200 MORGANTON ROAD, SUITE 300, FAYETTEVILLE, NC, 28314
    

 

    Bio-Medical Applications of
    Columbia Heights, Inc.

    Bio-Medical Applications of
    Columbia Heights, Inc., STEEL CITY BILLING GROUP, BMA
    PITTSBURGH, 190 BILMAR DR., SUITE 375, PITTSBURGH, PA, 15205
    

 

    Bio-Medical Applications of
    Connecticut, Inc.

    Bio-Medical Applications of
    Connecticut, Inc., NEW BEDFORD BILLING GROUP, 

    700 PLEASANT STREET, , NEW BEDFORD, MA, 2740
    

    

    1

 

    Bio-Medical Applications of
    Delaware, Inc.

    Bio-Medical Applications of
    Delaware, Inc., 

    ALLENTOWN BILLING GROUP, 

    861 MARCON BLVD SUITE 2, , ALLENTOWN, PA, 18109
    

 

    Bio-Medical Applications of
    Dover, Inc.

    Bio-Medical Applications of Dover,
    Inc., NEW BEDFORD BILLING GROUP, 

    700 PLEASANT STREET,, NEW BEDFORD, MA, 2740
    

 

    Bio-Medical Applications of
    Eureka, Inc.

    Bio-Medical Applications of
    Wisconsin, Inc., 

    UPPER MIDWEST BILLING GROUP, 

    9120 SPRINGBROOK DRIVE, , COON RAPIDS, MN, 55433
    

 

    Bio-Medical Applications of
    Wisconsin, Inc., MICHIGAN BILLING GROUP, 

    3500 MASSILLON ROAD SUITE 230, , UNIONTOWN, OH, 44685
    

 

    Brazoria Kidney Center,
    Inc.

    Brazoria Kidney Center, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    Brevard County Dialysis,
    LLC

    Brevard County Dialysis, LLC,
    INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

 

    Clayton County Dialysis,
    LLC

    Clayton County Dialysis, LLC,
    INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

 

    Clermont Dialysis Center,
    LLC

    Clermont Dialysis Center, LLC,
    INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

 

    Columbus Area Renal Alliance,
    LLC

    Columbus Area Renal Alliance, LLC,
    CLEVELAND BILLING,
    

    25050 COUNTRY CLUB BOULEVARD,
    SUITE 250, NORTH OLMSTED, OH, 44070
    

 

    Conejo Valley Dialysis,
    Inc.

    Conejo Valley Dialysis, Inc., 

    SOUTHERN CALIFORNIA BILLING GROUP, 

    1337 EAST THOUSAND OAKS BLVD, SUITE 216, THOUSAND OAKS, CA,
    91362
    

 

    Dialysis America Georgia,
    LLC

    Dialysis America Georgia, LLC,
    KNOXVILLE BILLING GROUP, BILLING GROUP, 

    1512 COLEMAN ROAD, SUITE 308,
    

    KNOXVILLE, TN, 37919
    

 

    Dialysis Associates of Northern
    New Jersey, L.L.C.

    Dialysis Associates of Northern New
    Jersey, L.L.C., ALLENTOWN BILLING GROUP, 

    861 MARCON BLVD SUITE 2, ALLENTOWN, PA, 18109
    

 

    Dialysis Associates,
    LLC

    Dialysis Associates, LLC,
    INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

    Dialysis Centers of
    America — Illinois, Inc.

    Dialysis Centers of
    America — Illinois, Inc., CHICAGO BILLING GROUP, 

    ONE WESTBROOK DRIVE, TOWER 1, SUITE 1000, WESTCHESTER, IL,
    

    60154 Dialysis Centers of America — Illinois, Inc.,
    CLEVELAND BILLING,
    

    25050 COUNTRY CLUB BOULEVARD,
    SUITE 250, NORTH OLMSTED, OH, 44070
    

 

    Northeast Alabama Kidney Clinic,
    Inc.

    Northeast Alabama Kidney Clinic,
    Inc., INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

 

    Northern New Jersey Dialysis,
    LLC

    Northern New Jersey Dialysis, LLC,
    ALLENTOWN BILLING GROUP, 

    861 MARCON BLVD SUITE 2, ALLENTOWN, PA, 18109
    

 

    Physicians Dialysis Company,
    Inc.

    Physicians Dialysis Company, Inc.,
    CLEVELAND BILLING, 

    25050 COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED,
    

    OH, 44070
    

 

    RCG Bloomington, LLC

    RCG Bloomington, LLC, INDIANAPOLIS
    BILLING, 10585 NORTH MERIDIAN STREET, SUITE 160,
    INDIANAPOLIS, IN, 46290
    

 

    RCG East Texas, LLP

    RCG East Texas, LLP, TYLER BILLING,
    

    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
    

 

    RCG Indiana, L.L.C.

    RCG Indiana, L.L.C., INDIANAPOLIS
    BILLING, 10585 NORTH MERIDIAN STREET, SUITE 160.
    INDIANAPOLIS, IN, 46290
    

 

    RCG Irving, LLP

    RCG Irving, LLP, TYLER BILLING, 

    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
    

 

    RCG Martin, LLC

    RCG Martin, LLC, INDIANAPOLIS
    BILLING, 10585 NORTH MERIDIAN STREET, SUITE 160,
    INDIANAPOLIS, IN, 46290
    

 

    RCG Memphis East, LLC

    RCG Memphis East, LLC, 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

 

    RCG Mississippi, Inc.

    RCG Mississippi, Inc., 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

    RCG Mississippi, Inc., TYLER
    BILLING, 

    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
    

    RCG Mississippi, Inc., MESA
    BILLING, 

    1750 SOUTH MESA DRIVE, SUITE 110, MESA, AZ, 85210
    

    Bio-Medical Applications of Eureka,
    Inc., PACIFIC NW BILLING GROUP, 

    4560 S. COACH DRIVE, SUITE 100, TUCSON, AZ, 85714
    

 

    Bio-Medical Applications of
    Fayetteville, Inc.

    Bio-Medical Applications of
    Fayetteville, Inc., FAYETTEVILLE BILLING GROUP, 

    4200 MORGANTON ROAD, SUITE 300,
    

    FAYETTEVILLE, NC, 28314
    

 

    Bio-Medical Applications of
    Florida, Inc.

    Bio-Medical Applications of
    Florida, Inc., 

    ORLANDO BILLING GROUP, 

    BMA ORLANDO, INC., 

    1155 W STATE ROAD 434,
    

    SUITE 125, LONGWOOD, FL,
    32750, 

    TAMPA BILLING GROUP, BMA TAMPA INC., 5625 WEST WATERS AVENUE,
    SUITE A, TAMPA, FL, 33634
    

 

    Bio-Medical Applications of
    Glendora, Inc.

    Bio-Medical Applications of
    Glendora, Inc., 

    SOUTHERN CALIFORNIA BILLING GROUP, 

    1337 EAST THOUSAND OAKS BLVD, SUITE 216, THOUSAND OAKS, CA,
    91362
    

 

    Bio-Medical Applications of
    Guayama, Inc.

    Bio-Medical Applications of
    Guayama, Inc., 

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK,
    

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    Humacao, Inc.

    Bio-Medical Applications of
    Humacao, Inc., 

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK,
    

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    Illinois, Inc.

    Bio-Medical Applications of
    Illinois, Inc., 

    CHICAGO BILLING GROUP, 

    ONE WESTBROOK DRIVE, TOWER 1, SUITE 1000, WESTCHESTER, IL,
    60154
    

 

    Bio-Medical Applications of
    Indiana, Inc.

    Bio-Medical Applications of
    Indiana, Inc., 

    MICHIGAN BILLING GROUP, 

    3500 MASSILLON ROAD, SUITE 230, UNIONTOWN, OH, 44685
    

 

    Bio-Medical Applications of
    Maine, Inc.

    Bio-Medical Applications of Maine,
    Inc., 

    NEW BEDFORD BILLING GROUP, 

    700 PLEASANT STREET, , NEW BEDFORD,
    

    MA, 2740
    

 

    Bio-Medical Applications of
    Manchester, Inc.

    Dialysis Centers of
    America — Illinois, Inc., INDIANAPOLIS BILLING, 10585
    NORTH MERIDIAN STREET, SUITE 160,
    

    INDIANAPOLIS, IN, 46290
    

 

    Dialysis Management
    Corporation

    Dialysis Management Corporation,
    

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    Dialysis Services of Cincinnati,
    Inc.

    Dialysis Services of Cincinnati,
    Inc., 

    NORTHERN OHIO BILLING GROUP, 

    3500 MASSILLON ROAD, SUITE 280, UNIONTOWN, OH, 44685
    

    

    2

 

    Dialysis Specialists of Topeka,
    Inc.

    Dialysis Specialists of Topeka,
    Inc., 

    ARIZONA BILLING GROUP, 

    2917 S. DOBSON, SUITE 101, MESA, 

    AZ, 85202
    

 

    Dialysis Specialists of Tulsa,
    Inc.

    Dialysis Specialists of Tulsa,
    Inc., 

    LUBBOCK BILLING GROUP,
    

    4747 SOUTH LOOP 289,,
    SUITE 120,, LUBBOCK, TX, 79424
    

 

    Douglas County Dialysis,
    LLC

    Douglas County Dialysis, LLC, 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

 

    Du Page Dialysis,
    Ltd.

    Du Page Dialysis, Ltd., 

    CHICAGO BILLING GROUP, 

    ONE WESTBROOK DRIVE, TOWER 1, SUITE 1000, WESTCHESTER, IL,
    60154
    

 

    Everest Healthcare Indiana,
    Inc.

    Everest Healthcare Indiana, Inc.,
    

    KENTUCKY BILLING GROUP,
    

    6100 DUTCHMANS LANE, 12TH FLOOR,
    LOUISVILLE, KY, 40205
    

 

    Everest Healthcare Indiana, Inc.,
    

    NORTHERN OHIO BILLING GROUP, 

    3500 MASSILLON ROAD, SUITE 280,

    UNIONTOWN, OH, 44685
    

 

    Everest Healthcare Indiana, Inc.,
    

    MICHIGAN BILLING GROUP,
    

    3500 MASSILLON ROAD SUITE 230,
    UNIONTOWN, OH, 44685
    

 

    Everest Healthcare Ohio,
    Inc.

    Everest Healthcare Ohio, Inc., 

    NORTHERN OHIO BILLING GROUP, 

    3500 MASSILLON ROAD, SUITE 280, 

    UNIONTOWN, OH, 44685
    

 

    RCG University Division,
    Inc.

    RCG University Division, Inc., 

    CLEVELAND BILLING, 

    25050 COUNTRY CLUB BOULEVARD, 

    SUITE 250, NORTH OLMSTED, OH, 44070
    

 

    Renal Care Group Alaska,
    Inc.

    Renal Care Group Alaska, Inc., 

    MESA BILLING, 

    1750 SOUTH MESA DRIVE, SUITE 110,

    MESA, AZ, 85210
    

 

    Renal Care Group East,
    Inc.

    Renal Care Group East, Inc., 

    CLEVELAND BILLING, 

    25050 COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH,
    44070
    

 

    Renal Care Group Northwest,
    Inc.

    Renal Care Group Northwest, Inc.,
    

    MESA BILLING, 1750 SOUTH MESA DRIVE, SUITE 110, MESA, AZ,
    85210
    

 

    Renal Care Group of the Midwest,
    Inc.

    Renal Care Group of the Midwest,
    Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

    Renal Care Group of the Ozarks,
    LLC

    Renal Care Group of the Ozarks,
    LLC, 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    Renal Care Group of the South,
    Inc.

    Renal Care Group of the South,
    Inc., 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

 

    Renal Care Group of the
    Southeast, Inc.

    Renal Care Group of the Southeast,
    Inc., 

    INDIANAPOLIS BILLING,
    

    10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

 

    Renal Care Group South New
    Mexico, LLC

    Renal Care Group South New Mexico,
    LLC, TYLER BILLING, 

    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
    

 

    Renal Care Group Southwest,
    L.P.

    Bio-Medical Applications of
    Manchester, Inc., 

    NEW BEDFORD BILLING GROUP, 

    700 PLEASANT STREET, NEW BEDFORD,
    

    MA, 2740
    

 

    Bio-Medical Applications of
    Maryland, Inc.

    Bio-Medical Applications of
    Maryland, Inc., 

    STEEL CITY BILLING GROUP, 

    BMA PITTSBURGH, 190 BILMAR DR., SUITE 375, PITTSBURGH, PA,
    15205
    

 

    Bio-Medical Applications of
    Massachusetts, Inc.

    Bio-Medical Applications of
    Massachusetts, Inc., 

    NEW BEDFORD BILLING GROUP, 

    700 PLEASANT STREET, NEW BEDFORD, MA, 2740
    

 

    Bio-Medical Applications of
    Mayaguez, Inc.

    Bio-Medical Applications of
    Mayaguez, Inc., 

    PUERTO RICO BILLING GROUP, 

    ANTILLAS WAREHOUSE & OFFICE PARK,
    

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    Michigan, Inc.

    Bio-Medical Applications of
    Michigan, Inc., 

    MICHIGAN BILLING GROUP, 

    3500 MASSILLON ROAD SUITE 230, UNIONTOWN, OH, 44685
    

 

    Bio-Medical Applications of
    Minnesota, Inc.

    Bio-Medical Applications of
    Minnesota, Inc., 

    UPPER MIDWEST BILLING GROUP, 

    9120 SPRINGBROOK DRIVE,, COON
    

    RAPIDS, MN, 55433
    

 

    Bio-Medical Applications of
    Mission Hills, Inc.

    Bio-Medical Applications of Mission
    Hills, Inc., 

    SOUTHERN CALIFORNIA BILLING GROUP, 

    1337 EAST THOUSAND OAKS BLVD, SUITE 216, THOUSAND OAKS, CA,
    91362
    

 

    Bio-Medical Applications of
    Mississippi, Inc.

    Bio-Medical Applications of
    Mississippi, Inc., 

    CRESCENT CITY BILLING GROUP, 

    3850 N. CAUSEWAY BLVD, SUITE 700,
    

    METAIRIE, LA, 70002
    

    Bio-Medical Applications of
    Missouri, Inc.

    Bio-Medical Applications of
    Missouri, Inc., 

    ARIZONA BILLING GROUP, 2917 S. DOBSON, SUITE 101,
    MESA, AZ, 85202
    

 

    Bio-Medical Applications of MLK,
    Inc.

    Bio-Medical Applications of MLK,
    Inc., 

    STEEL CITY BILLING GROUP, 

    BMA PITTSBURGH, 190 BILMAR DR., SUITE 375, PITTSBURGH, PA,
    15205
    

 

    Bio-Medical Applications of
    Nevada, Inc.

 

    Everest Healthcare Rhode Island,
    Inc.

    Everest Healthcare Rhode Island,
    Inc., 

    NEW BEDFORD BILLING GROUP, 

    700 PLEASANT STREET, NEW BEDFORD,
    

    MA, 2740
    

 

    Everest Healthcare Texas,
    L.P.

    Everest Healthcare Texas, L.P., 

    WACO BILLING GROUP, UPTOWN PLAZA, 1110 RICHLAND DR., #3, WACO,
    TX, 76710
    

 

    Fondren Dialysis Clinic,
    Inc.

    Fondren Dialysis Clinic, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    Fort Scott Regional
    Dialysis Center, Inc.

    Fort Scott Regional Dialysis
    Center, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    Four State Regional Dialysis
    Center, Inc.

    Four State Regional Dialysis
    Center, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    Fresenius Medical Care Dialysis
    Services — Oregon, LLC

    Fresenius Medical Care Dialysis
    Services — Oregon, LLC, PACIFIC NW BILLING GROUP, 

    4560 S. COACH DRIVE, SUITE 100, TUCSON, AZ, 85714
    

 

    Fresenius Medical Care Dialysis
    Services Colorado LLC

    Fresenius Medical Care Dialysis
    Services Colorado LLC,
    

    ALBUQUERQUE BILLING GROUP, 

    909 VIRGINIA NE, SUITE 112, ALBUQUERQUE, NM, 87108
    

 

    Gulf Region Mobile Dialysis,
    Inc.

    Gulf Region Mobile Dialysis, Inc.,
    

    SAN ANTONIO BILLING GROUP, 

    6100 BANDERA ROAD, SUITE 601, 

    SAN ANTONIO, TX, 78238
    

 

    Haemo-Stat, Inc.

    Haemo-Stat, Inc., 

    SOUTHERN CALIFORNIA BILLING GROUP,
    

    1337 EAST THOUSAND OAKS BLVD,
    SUITE 216, THOUSAND OAKS, CA, 91362
    

 

    Henry Dialysis Center,
    LLC

    Henry Dialysis Center, LLC, 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS,
    IN, 46290
    

 

    Renal Care Group Southwest, L.P.,
    

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER,
    TX, 75701
    

    

    3

 

    Renal Care Group Texas,
    Inc.

    Renal Care Group Texas, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    Renal Care Group Westlake,
    LLC

    Renal Care Group Westlake, LLC, 

    CLEVELAND BILLING, 25050 COUNTRY CLUB BOULEVARD, SUITE 250,
    

    NORTH OLMSTED, OH, 44070
    

 

    Renal Care Group, Inc.

    Renal Care Group, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    Renex Dialysis Clinic of
    Bridgeton, Inc.

    Renex Dialysis Clinic of Bridgeton,
    Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER,
    TX, 75701
    

 

    Renex Dialysis Clinic of Creve
    Coeur, Inc.

    Renex Dialysis Clinic of Creve
    Coeur, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER,
    TX, 75701
    

 

    Renex Dialysis Clinic of
    Doylestown, Inc.

    Renex Dialysis Clinic of
    Doylestown, Inc., 

    CLEVELAND BILLING,

    25050 COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH,
    44070
    

 

    Renex Dialysis Clinic of
    Maplewood, Inc.

    Renex Dialysis Clinic of Maplewood,
    Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, 

    SUITE 100, TYLER, TX, 75701
    

 

    Renex Dialysis Clinic of Orange,
    Inc.

    Renex Dialysis Clinic of Orange,
    Inc., 

    CLEVELAND BILLING,
    

    25050 COUNTRY CLUB BOULEVARD,
    SUITE 250, NORTH OLMSTED, OH, 44070
    

 

    Renex Dialysis Clinic of Penn
    Hills, Inc.

    Renex Dialysis Clinic of Penn
    Hills, Inc., 

    CLEVELAND BILLING,
    

    25050 COUNTRY CLUB BOULEVARD,
    SUITE 250, NORTH OLMSTED, OH, 44070
    

 

    Renex Dialysis Clinic of
    Philadelphia, Inc.

    Bio-Medical Applications of Nevada,
    Inc., 

    MESA BILLING, 1750 SOUTH MESA DRIVE, SUITE 110, MESA, AZ,
    85210
    

 

    Bio-Medical Applications of New
    Hampshire, Inc.

    Bio-Medical Applications of New
    Hampshire, Inc., NEW BEDFORD

    BILLING GROUP, 700 PLEASANT STREET,

    NEW BEDFORD, MA, 2740
    

 

    Bio-Medical Applications of New
    Jersey, Inc.

    Bio-Medical Applications of New
    Jersey, Inc., 

    ALLENTOWN BILLING GROUP, 

    861 MARCON BLVD SUITE 2, ALLENTOWN, PA, 18109
    

 

    Bio-Medical Applications of New
    Mexico, Inc.

    Bio-Medical Applications of New
    Mexico, Inc.,

    ALBUQUERQUE BILLING GROUP, 

    909 VIRGINIA NE, SUITE 112,
    

    ALBUQUERQUE, NM, 87108
    

    Bio-Medical Applications of
    North Carolina, Inc.

    Bio-Medical Applications of North
    Carolina, Inc., 

    FAYETTEVILLE BILLING GROUP, 

    4200 MORGANTON ROAD, SUITE 300,
    

    FAYETTEVILLE, NC, 28314
    

 

    Bio-Medical Applications of
    Northeast D.C., Inc.

    Bio-Medical Applications of
    Northeast D.C., Inc., 

    STEEL CITY BILLING GROUP, 

    BMA PITTSBURGH, 190 BILMAR DR., SUITE 375, PITTSBURGH, PA,
    15205
    

 

    Bio-Medical Applications of
    Oakland, Inc.

    Bio-Medical Applications of
    Oakland, Inc., 

    PACIFIC NW

    BILLING GROUP, 4560 S. COACH DRIVE, SUITE 100,
    TUCSON, AZ, 85714
    

 

    Bio-Medical Applications of
    Ohio, Inc.

    Bio-Medical Applications of Ohio,
    Inc., 

    KENTUCKY BILLING GROUP, 

    6100 DUTCHMANS LANE, 12TH FLOOR,
    

    LOUISVILLE, KY, 40205
    

 

    Bio-Medical Applications of
    Oklahoma, Inc.

    Bio-Medical Applications of
    Oklahoma, Inc., 

    LUBBOCK BILLING GROUP, 

    4747 SOUTH LOOP 289,, SUITE 120,, LUBBOCK, TX, 79424
    

 

    Bio-Medical Applications of
    Pennsylvania, Inc.

    Bio-Medical Applications of
    Pennsylvania, Inc., 

    ALLENTOWN BILLING GROUP, 

    861 MARCON BLVD. SUITE 2,
    

    ALLENTOWN, PA, 18109
    

 

    Bio-Medical Applications of
    Pennsylvania, Inc., 

    ALLENTOWN BILLING GROUP, 

    861 MARCON BLVD. SUITE 2,
    

    ALLENTOWN, PA, 18109, STEEL CITY
    BILLING GROUP, BMA PITTSBURGH, 

    190 BILMAR DR., SUITE 375, PITTSBURGH, PA, 15205
    

 

    Holton Dialysis Clinic,
    LLC

    Holton Dialysis Clinic, LLC, 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS,
    IN, 46290
    

 

    Home Dialysis of Muhlenburg
    County, Inc.

    Home Dialysis of Muhlenburg County,
    Inc., KENTUCKY

    BILLING GROUP, 6100 DUTCHMANS LANE,

    12TH FLOOR, LOUISVILLE, KY, 40205
    

 

    Jefferson County Dialysis,
    Inc.

    Jefferson County Dialysis, Inc.,
    

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER,
    TX, 75701
    

 

    KDCO, Inc.

    KDCO, Inc., TYLER BILLING, 

    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
    

 

    Kentucky Renal Care Group,
    LLC

    Kentucky Renal Care Group, LLC, 

    INDIANAPOLIS BILLING,
    

    10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

    Lawton Dialysis, Inc.

    Lawton Dialysis, Inc., 

    TYLER BILLING, 3910 BROOKSIDE
    

    DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    Little Rock Dialysis,
    Inc.

    Little Rock Dialysis, Inc., TYLER
    BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
    

 

    Maumee Dialysis Services,
    LLC

    Maumee Dialysis Services, LLC, 

    INDIANAPOLIS BILLING,
    

    10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

 

    Miami Regional Dialysis Center,
    Inc.

    Miami Regional Dialysis Center,
    Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER,
    TX, 75701
    

 

    Michigan Home Dialysis Center,
    Inc.

    Michigan Home Dialysis Center,
    Inc., 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS,
    IN, 46290
    

 

    Renex Dialysis Clinic of
    Philadelphia, Inc., CLEVELAND BILLING,
    

    25050 COUNTRY CLUB BOULEVARD,
    SUITE 250, NORTH OLMSTED, OH, 44070
    

 

    Renex Dialysis Clinic of
    Pittsburgh, Inc.

    Renex Dialysis Clinic of
    Pittsburgh, Inc., CLEVELAND BILLING,
    

    25050 COUNTRY CLUB BOULEVARD,
    SUITE 250, NORTH OLMSTED, OH, 44070
    

 

    Renex Dialysis Clinic of Shaler,
    Inc.

    Renex Dialysis Clinic of Shaler,
    Inc., CLEVELAND BILLING, 

    25050 COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED,
    

    OH, 44070
    

 

    Renex Dialysis Clinic of South
    Georgia, Inc.

    Renex Dialysis Clinic of South
    Georgia, Inc., 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

 

    Renex Dialysis Clinic of
    St. Louis, Inc.

    Renex Dialysis Clinic of
    St. Louis, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, 

    SUITE 100, TYLER, TX, 75701
    

 

    Renex Dialysis Clinic of Union,
    Inc.

    Renex Dialysis Clinic of Union,
    Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, 

    SUITE 100, TYLER, TX, 75701
    

 

    Renex Dialysis Clinic of
    University City, Inc.

    Renex Dialysis Clinic of University
    City, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, 

    SUITE 100, TYLER, TX, 75701
    

 

    Renex Dialysis Clinic of
    Woodbury, Inc.

    Renex Dialysis Clinic of Woodbury,
    Inc., 

    CLEVELAND BILLING, 

    25050 COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH,
    44070
    

 

    Renex Dialysis Facilities, Inc.,
    

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

    

    4

 

    Renex Dialysis Facilities, Inc.,
    MESA BILLING, 1750 SOUTH MESA DRIVE, SUITE 110, MESA, AZ,
    85210
    

 

    San Diego Dialysis
    Services, Inc.

    San Diego Dialysis Services,
    Inc., SAN DIEGO BILLING GROUP, 2917 S. DOBSON,
    SUITE 101, MESA, AZ, 85202
    

 

    Santa Barbara Community
    Dialysis Center, Inc.

    Bio-Medical Applications of Ponce,
    Inc., 

    PUERTO RICO BILLING GROUP, 

    ANTILLAS WAREHOUSE & OFFICE PARK, 461 FRANCIA
    ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    Puerto Rico, Inc.

    Bio-Medical Applications of Puerto
    Rico, Inc., 

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK,
    

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of Rio
    Piedras, Inc.

    Bio-Medical Applications of Rio
    Piedras, Inc., 

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK, 

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    San Antonio, Inc.

    Bio-Medical Applications of
    San Antonio, Inc., 

    

    SAN ANTONIO BILLING GROUP, 

    6100 BANDERA ROAD, SUITE 601, SAN ANTONIO, TX, 78238
    

 

    Bio-Medical Applications of
    San German, Inc.

    Bio-Medical Applications of
    San German, Inc., 

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK,
    

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    San Juan, Inc.

    Bio-Medical Applications of
    San Juan, Inc., 

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK,
    

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917
    

 

    Bio-Medical Applications of
    South Carolina, Inc.

    Bio-Medical Applications of South
    Carolina, Inc., 

    FAYETTEVILLE BILLING GROUP, 

    4200 MORGANTON ROAD, SUITE 300,
    

    FAYETTEVILLE, NC, 28314
    

 

    Bio-Medical Applications of South
    Carolina, Inc., 

    FLORENCE BILLING GROUP, 218 N. DOZIER BLVD., ,
    FLORENCE, SC, 29501
    

 

    Bio-Medical Applications of South
    Carolina, Inc., 

    MACON BILLING GROUP, 1515 BASS ROAD, SUITE B, MACON,
    GA, 31210
    

 

    Bio-Medical Applications of
    Tennessee, Inc.

    Bio-Medical Applications of
    Tennessee, Inc., 

    KNOXVILLE BILLING GROUP, BILLING GROUP, 1512 COLEMAN ROAD,
    

    SUITE 308, KNOXVILLE, TN, 37919
    

    Bio-Medical Applications of
    Tennessee, Inc., 

    OCALA BILLING GROUP, BMA OCALA, INC., 1308 SE 25TH LOOP,
    SUITE 102,
    

    OCALA, FL, 34471
    

 

    National Medical Care,
    Inc.

    National Medical Care, Inc., 

    CHICAGO BILLING GROUP, 

    ONE WESTBROOK DRIVE, TOWER 1, SUITE 1000, WESTCHESTER, IL,
    60154
    

 

    National Medical Care, Inc., 

    MICHIGAN BILLING GROUP, 3500 MASSILLON ROAD,
    SUITE 230, UNIONTOWN, OH, 44685
    

 

    National Medical Care, Inc., 

    KNOXVILLE BILLING GROUP, BILLING GROUP, 1512 COLEMAN ROAD,
    SUITE 308,
    

    KNOXVILLE, TN, 37919
    

 

    National Medical Care, Inc., 

    OCALA BILLING GROUP, BMA OCALA, INC., 1308 SE 25TH LOOP,
    SUITE 102, OCALA, FL, 34471
    

 

    National Medical Care, Inc., 

    ORLANDO BILLING GROUP, 

    BMA ORLANDO, INC., 

    1155 W STATE ROAD 434, SUITE 125, LONGWOOD, FL, 32750
    

 

    National Medical Care, Inc., 

    ALLENTOWN BILLING GROUP,
    

    861 MARCON BLVD SUITE 2,
    ALLENTOWN, PA, 18109
    

 

    National Medical Care, Inc., 

    TAMPA BILLING GROUP, BMA TAMPA INC., 

    5625 WEST WATERS AVENUE, SUITE A,
    

    TAMPA, FL, 33634
    

 

    National Nephrology Associates
    of Texas, L.P.

    National Nephrology Associates of
    Texas, L.P., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    NNA of Alabama, Inc.

    NNA of Alabama, Inc., 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

 

    NNA of East Orange,
    L.L.C.

    NNA of East Orange, L.L.C., 

    CLEVELAND BILLING, 

    25050 COUNTRY CLUB BOULEVARD, SUITE 250, NORTH
    OLMSTED, OH, 44070
    

 

    NNA of Florida, LLC

    NNA of Florida, LLC, 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

 

    NNA of Georgia, Inc.

    NNA of Georgia, Inc., 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

    Santa Barbara Community
    Dialysis Center, Inc., 

    SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND OAKS BLVD,
    SUITE 216, THOUSAND OAKS, CA, 91362
    

    Smyrna Dialysis Center,
    LLC

    Smyrna Dialysis Center, LLC, 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS,
    IN, 46290
    

 

    SSKG, Inc.

    SSKG, Inc., INDIANAPOLIS BILLING,
    

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

 

    STAT Dialysis
    Corporation

    STAT Dialysis Corporation, TYLER
    BILLING, 

    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
    

 

    Stone Mountain Dialysis Center,
    LLC

    Stone Mountain Dialysis Center,
    LLC, 

    INDIANAPOLIS BILLING,
    

    10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

 

    Stuttgart Dialysis,
    LLC

    Stuttgart Dialysis, LLC, 

    TYLER BILLING, 

    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
    

 

    Terrell Dialysis Center,
    LLC

    Terrell Dialysis Center, LLC, 

    WACO BILLING GROUP, UPTOWN PLAZA, 

    1110 RICHLAND DR., #3, WACO, TX, 76710
    

 

    Three Rivers Dialysis Services,
    LLC

    Three Rivers Dialysis Services,
    LLC, 

    INDIANAPOLIS BILLING,
    

    10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
    

 

    West Palm Dialysis,
    LLC

    West Palm Dialysis, LLC, 

    INDIANAPOLIS BILLING, 

    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290
    

 

    Wharton Dialysis, Inc.

    Bio-Medical Applications of
    Tennessee, Inc., 

    ORLANDO BILLING GROUP, 

    BMA ORLANDO, INC., 

    1155 W STATE ROAD  434, SUITE 125, LONGWOOD, FL, 32750
    

 

    NNA of Harrison,
    L.L.C.

    NNA of Harrison, L.L.C., CLEVELAND
    BILLING, 25050 COUNTRY CLUB BOULEVARD, SUITE 250, 

    NORTH OLMSTED, OH, 44070
    

 

    Wharton Dialysis, Inc., 

    TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX,
    75701
    

 

    WSKC Dialysis Services,
    Inc.

    WSKC Dialysis Services, Inc., 

    CHICAGO BILLING GROUP, 

    ONE WESTBROOK DRIVE, TOWER 1, SUITE 1000, WESTCHESTER,
    IL, 60154
    

 

    

    5

 

    RTG

 

    Fresenius USA, Inc

    2637 Shadelands Drive
    

    Walnut Creek, CA 94590
    

    920 Winter Street
    

    Waltham, MA 02451
    

 

    Fresenius USA Home Dialysis,
    Inc

    920 Winter Street
    

    Waltham, MA 02451
    

 

    Fresenius USA Marketing,
    Inc

    920 Winter Street
    

    Waltham, MA 02451
    

 

    Fresenius USA of Puerto Rico,
    Inc

    PO Box 191690
    

    San Juan, PR 00919
    

 

    Life Assist Medical Products,
    Inc

    PO Box 191690
    

    San Juan, PR 00919
    

    Spectra East

    8 King Road
    

    Rockleigh, NJ 07647
    

    920 Winter Street
    

    Waltham, MA 02451
    

 

    Spectra Renal Research,
    LLC

    920 Winter Street
    

    Waltham, MA 02451
    

 

    Fresenius USA
    Manufacturing

    920 Winter Street
    

    Waltham, MA 02451
    

 

    Fresenius Medical Care
    Canada

    45 Staples Suite 110
    

    Richmond Hill, ON
    

    L4B 4W6
    

    Distriduter D’Equipment
    Medicaux Haemotec, Inc

    383 Joseph Carrier
    

    Vaudreil-Dorion, QC
    

    J7V 5V5
    

    Erika de Reynosa S.A. de
    C.V.

    Brecha
    E-99 Sur
    Parque Ind. Reynosa
    

    Apartado Postal # 326
    

    Reynosa, Tamps.
    

    Mexico, CP 88780
    

 

    Pharr Warehouse

    1100 E. Military Hwy.
    Ste. C
    

    Pharr, TX 78577
    

 

    Renal Solutions, Inc —
    Fresenius Medical Care Holdings, Inc (legal entity)

    770 Commonwealth Drive
    

    Suite 101
    

    Warrendale, PA 15086
    

 

    Sorb Technologies (manufacturing
    site)

    3631 SW 54th Street
    

    Oklahoma City, OK 73119
    

    

    6

 

 

    Location
    of Records — Exhibit I — Fresenius
    Medical Services

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Bio-Medical Applications of Aguadilla, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Aguadilla, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ANTILLAS WAREHOUSE & OFFICE PARK,

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Alabama, Inc. 

	
 
	
    MOBILE BILLING GROUP
	
 
	
    6420 HILLCREST PARK CT
	
 
	
    SUITE 210
	
 
	
    MOBILE
	
 
	
    AL
	
 
	
 
	
    36608
	
 

	

    Bio-Medical Applications of Alabama, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    MOBILE BILLING GROUP, 6420

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    HILLCREST PARK CT, SUITE 210, MOBILE, AL, 36608

	
 
	
    KNOXVILLE BILLING GROUP
	
 
	
 
	
 
	
    1512 COLEMAN ROAD, SUITE 308
	
 
	
    KNOXVILLE
	
 
	
    TN
	
 
	
 
	
    37919
	
 

	

    Bio-Medical Applications of Anacostia, Inc. 

	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	

    Bio-Medical Applications of Anacostia, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    STEEL CITY BILLING GROUP, BMA PITTSBURGH, 190 BILMAR DR.,
    SUITE 375, PITTSBURGH, PA, 15205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Arecibo, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Arecibo, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK, 461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Arkansas, Inc. 

	
 
	
    MOBILE BILLING GROUP
	
 
	
    6420 HILLCREST PARK CT
	
 
	
    SUITE 210
	
 
	
    MOBILE
	
 
	
    AL
	
 
	
 
	
    36608
	
 

	

    Bio-Medical Applications of Arkansas, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    MOBILE BILLING GROUP, 6420 HILLCREST PARK CT, SUITE 210,
    MOBILE, AL, 36608

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Bayamon, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Aguadilla, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK, 461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Blue Springs, Inc. 

	
 
	
    ARIZONA BILLING GROUP
	
 
	
    2917 S. DOBSON
	
 
	
    SUITE 101
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85202
	
 

	

    Bio-Medical Applications of Aguadilla, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK, 461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Caguas, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Caguas, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE &
    OFFICE PARK, 461 FRANCIA ST.,
    SUITE 1-401,

    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of California, Inc. 

	
 
	
    PACIFIC NW BILLING GROUP
	
 
	
    4560 S. COACH DRIVE
	
 
	
    SUITE 100
	
 
	
    TUCSON
	
 
	
    AZ
	
 
	
 
	
    85714
	
 

	

    Bio-Medical Applications of California, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PACIFIC NW BILLING GROUP, 4560 S. COACH DRIVE,
    SUITE 100, TUCSON, AZ, 85714

	
 
	
    SOUTHERN CALIFORNIA BILLING GROUP
	
 
	
    1337 EAST THOUSAND OAKS BLVD
	
 
	
    SUITE 216
	
 
	
    THOUSAND OAKS
	
 
	
    CA
	
 
	
 
	
    91362
	
 

	

    Bio-Medical Applications of California, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PACIFIC NW BILLING GROUP, 4560 S. COACH DRIVE,
    SUITE 100, TUCSON, AZ, 85714, SOUTHERN CALIFORNIA BILLING
    GROUP, 1337 EAST THOUSAND OAKS BLVD, SUITE 216, THOUSAND
    OAKS, CA, 91362

	
 
	
    SAN DIEGO BILLING GROUP
	
 
	
    2917 S. DOBSON
	
 
	
    SUITE 101
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85202
	
 

    

    7

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Bio-Medical Applications of California, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PACIFIC NW BILLING GROUP, 4560 S. COACH DRIVE,
    SUITE 100, TUCSON, AZ, 85714, SOUTHERN CALIFORNIA BILLING
    GROUP, 1337 EAST THOUSAND OAKS BLVD, SUITE 216, THOUSAND
    OAKS, CA, 91362, SAN DIEGO BILLING GROUP,
    2917 S. DOBSON, SUITE 101, MESA,

    AZ, 85202

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Camarillo, Inc. 

	
 
	
    SOUTHERN CALIFORNIA BILLING GROUP
	
 
	
    1337 EAST THOUSAND OAKS BLVD
	
 
	
    SUITE 216
	
 
	
    THOUSAND OAKS
	
 
	
    CA
	
 
	
 
	
    91362
	
 

	

    Bio-Medical Applications of Camarillo, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND OAKS BLVD,
    SUITE 216, THOUSAND OAKS, CA, 91362

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Capitol Hill, Inc. 

	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	

    Bio-Medical Applications of Capitol Hill, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    STEEL CITY BILLING GROUP, BMA PITTSBURGH,

    190 BILMAR DR., SUITE 375, PITTSBURGH, PA, 15205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Carolina, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Carolina, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK, 461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Carson, Inc. 

	
 
	
    SOUTHERN CALIFORNIA BILLING GROUP
	
 
	
    1337 EAST THOUSAND OAKS BLVD
	
 
	
    SUITE 216
	
 
	
    THOUSAND OAKS
	
 
	
    CA
	
 
	
 
	
    91362
	
 

	

    Bio-Medical Applications of Carson, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND OAKS BLVD,
    SUITE 216, THOUSAND OAKS, CA, 91362

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Clinton, Inc. 

	
 
	
    FAYETTEVILLE BILLING GROUP
	
 
	
    4200 MORGANTON ROAD
	
 
	
    SUITE 300
	
 
	
    FAYETTEVILLE
	
 
	
    NC
	
 
	
 
	
    28314
	
 

	

    Bio-Medical Applications of Clinton, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    FAYETTEVILLE BILLING GROUP, 4200 MORGANTON ROAD, SUITE 300,
    FAYETTEVILLE, NC, 28314

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Columbia Heights, Inc. 

	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	

    Bio-Medical Applications of Columbia Heights, Inc., STEEL CITY
    BILLING GROUP, BMA PITTSBURGH, 190 BILMAR DR., SUITE 375,
    PITTSBURGH, PA, 15205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Connecticut, Inc. 

	
 
	
    NEW BEDFORD BILLING GROUP
	
 
	
    700 PLEASANT STREET
	
 
	
 
	
 
	
    NEW BEDFORD
	
 
	
    MA
	
 
	
 
	
    02740
	
 

	

    Bio-Medical Applications of Connecticut, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    NEW BEDFORD BILLING GROUP, 700 PLEASANT STREET, NEW BEDFORD, MA,
    2740

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Delaware, Inc. 

	
 
	
    ALLENTOWN BILLING GROUP
	
 
	
    861 MARCON BLVD SUITE 2
	
 
	
 
	
 
	
    ALLENTOWN
	
 
	
    PA
	
 
	
 
	
    18109
	
 

	

    Bio-Medical Applications of Delaware, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ALLENTOWN BILLING GROUP, 861 MARCON BLVD SUITE 2,,
    ALLENTOWN, PA, 18109

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Dover, Inc. 

	
 
	
    NEW BEDFORD BILLING GROUP
	
 
	
    700 PLEASANT STREET
	
 
	
 
	
 
	
    NEW BEDFORD
	
 
	
    MA
	
 
	
 
	
    02740
	
 

	

    Bio-Medical Applications of Dover, Inc., NEW BEDFORD BILLING
    GROUP, 700 PLEASANT STREET,

    NEW BEDFORD, MA, 2740

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Eureka, Inc. 

	
 
	
    PACIFIC NW BILLING GROUP
	
 
	
    4560 S. COACH DRIVE
	
 
	
    SUITE 100
	
 
	
    TUCSON
	
 
	
    AZ
	
 
	
 
	
    85714
	
 

	

    Bio-Medical Applications of Eureka, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PACIFIC NW BILLING GROUP, 4560 S. COACH DRIVE,
    SUITE 100, TUCSON, AZ, 85714

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

    

    8

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Bio-Medical Applications of Fayetteville, Inc. 

	
 
	
    FAYETTEVILLE BILLING GROUP
	
 
	
    4200 MORGANTON ROAD
	
 
	
    SUITE 300
	
 
	
    FAYETTEVILLE
	
 
	
    NC
	
 
	
 
	
    28314
	
 

	

    Bio-Medical Applications of Fayetteville, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    FAYETTEVILLE BILLING GROUP, 4200 MORGANTON ROAD, SUITE 300,
    FAYETTEVILLE, NC, 28314

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Florida, Inc. 

	
 
	
    ORLANDO BILLING GROUP
	
 
	
    BMA ORLANDO, INC.
	
 
	
    1155 W STATE ROAD 434, SUITE 125
	
 
	
    LONGWOOD
	
 
	
    FL
	
 
	
 
	
    32750
	
 

	

    Bio-Medical Applications of Florida, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ORLANDO BILLING GROUP, BMA ORLANDO, INC., 1155 W STATE ROAD 434,
    SUITE 125, LONGWOOD, FL, 32750

	
 
	
    OCALA BILLING GROUP
	
 
	
    BMA OCALA, INC.
	
 
	
    1308 SE 25TH LOOP, SUITE 102
	
 
	
    OCALA
	
 
	
    FL
	
 
	
 
	
    34471
	
 

	
 
	
 
	
    TAMPA BILLING GROUP
	
 
	
    BMA TAMPA INC.
	
 
	
    5625 WEST WATERS AVENUE, SUITE
	
 
	
    TAMPA
	
 
	
    FL
	
 
	
 
	
    33634
	
 

	

    TAMPA BILLING GROUP, BMA TAMPA INC., 5625 WEST WATERS AVENUE,
    SUITE A, TAMPA,

    FL, 33634

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Fremont, Inc. 

	
 
	
    PACIFIC NW BILLING GROUP
	
 
	
    4560 S. COACH DRIVE
	
 
	
    SUITE 100
	
 
	
    TUCSON
	
 
	
    AZ
	
 
	
 
	
    85714
	
 

	

    Bio-Medical Applications of Fremont, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PACIFIC NW BILLING GROUP, 4560 S. COACH DRIVE,
    SUITE 100, TUCSON, AZ, 85714

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Fresno, Inc. 

	
 
	
    PACIFIC NW BILLING GROUP
	
 
	
    4560 S. COACH DRIVE
	
 
	
    SUITE 100
	
 
	
    TUCSON
	
 
	
    AZ
	
 
	
 
	
    85714
	
 

	

    Bio-Medical Applications of Fresno, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PACIFIC NW BILLING GROUP, 4560 S. COACH DRIVE,
    SUITE 100, TUCSON, AZ, 85714

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Georgia, Inc. 

	
 
	
    KNOXVILLE BILLING GROUP
	
 
	
    BILLING GROUP
	
 
	
    1512 COLEMAN ROAD, SUITE 308
	
 
	
    KNOXVILLE
	
 
	
    TN
	
 
	
 
	
    37919
	
 

	
 
	
 
	
    MACON BILLING GROUP
	
 
	
    1515 BASS ROAD
	
 
	
    SUITE B
	
 
	
    MACON
	
 
	
    GA
	
 
	
 
	
    31210
	
 

	

    Bio-Medical Applications of Glendora, Inc. 

	
 
	
    SOUTHERN CALIFORNIA BILLING GROUP
	
 
	
    1337 EAST THOUSAND OAKS BLVD
	
 
	
    SUITE 216
	
 
	
    THOUSAND OAKS
	
 
	
    CA
	
 
	
 
	
    91362
	
 

	

    Bio-Medical Applications of Glendora, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND OAKS BLVD,
    SUITE 216, THOUSAND OAKS, CA, 91362

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Guayama, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Guayama, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK, 461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Humacao, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Humacao, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK, 461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Illinois, Inc. 

	
 
	
    CHICAGO BILLING GROUP
	
 
	
    ONE WESTBROOK DRIVE
	
 
	
    TOWER 1, SUITE 1000
	
 
	
    WESTCHESTER
	
 
	
    IL
	
 
	
 
	
    60154
	
 

	

    Bio-Medical Applications of Illinois, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    CHICAGO BILLING GROUP, ONE WESTBROOK DRIVE, TOWER 1,
    SUITE 1000, WESTCHESTER, IL, 60154

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Indiana, Inc. 

	
 
	
    MICHIGAN BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 230
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	

    Bio-Medical Applications of Indiana, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    MICHIGAN BILLING GROUP, 3500 MASSILLON ROAD, SUITE 230,
    UNIONTOWN, OH, 44685

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Maine, Inc. 

	
 
	
    NEW BEDFORD BILLING GROUP
	
 
	
    700 PLEASANT STREET
	
 
	
 
	
 
	
    NEW BEDFORD
	
 
	
    MA
	
 
	
 
	
    02740
	
 

	

    Bio-Medical Applications of Maine, Inc., NEW BEDFORD BILLING
    GROUP, 700 PLEASANT STREET,

    NEW BEDFORD, MA, 2740

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Manchester, Inc. 

	
 
	
    NEW BEDFORD BILLING GROUP
	
 
	
    700 PLEASANT STREET
	
 
	
 
	
 
	
    NEW BEDFORD
	
 
	
    MA
	
 
	
 
	
    02740
	
 

	

    Bio-Medical Applications of Manchester, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

    

    9

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    NEW BEDFORD BILLING GROUP, 700 PLEASANT STREET, NEW BEDFORD, MA,
    2740

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Maryland, Inc. 

	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	

    Bio-Medical Applications of Maryland, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    STEEL CITY BILLING GROUP, BMA PITTSBURGH,

    190 BILMAR DR., SUITE 375, PITTSBURGH, PA, 15205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Massachusetts, Inc. 

	
 
	
    NEW BEDFORD BILLING GROUP
	
 
	
    700 PLEASANT STREET
	
 
	
 
	
 
	
    NEW BEDFORD
	
 
	
    MA
	
 
	
 
	
    02740
	
 

	

    Bio-Medical Applications of Massachusetts, Inc., NEW BEDFORD
    BILLING GROUP, 700 PLEASANT STREET.,

    NEW BEDFORD, MA, 2740

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Mayaguez, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Mayaguez, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE 4 OFFICE PARK, 461
    FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Michigan, Inc. 

	
 
	
    MICHIGAN BILLING GROUP
	
 
	
    3500 MASSILLON ROAD SUITE 230
	
 
	
 
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	

    Bio-Medical Applications of Michigan, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    MICHIGAN BILLING GROUP, 3500 MASSILLON ROAD SUITE 230, ,
    UNIONTOWN, OH, 44685

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Minnesota, Inc. 

	
 
	
    UPPER MIDWEST BILLING GROUP
	
 
	
    9120 SPRINGBROOK DRIVE
	
 
	
 
	
 
	
    COON RAPIDS
	
 
	
    MN
	
 
	
 
	
    55433
	
 

	

    Bio-Medical Applications of Minnesota, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    UPPER MIDWEST BILLING GROUP, 9120 SPRINGBROOK DRIVE, , COON
    RAPIDS, MN, 55433

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Mission Hills, Inc. 

	
 
	
    SOUTHERN CALIFORNIA BILLING GROUP
	
 
	
    1337 EAST THOUSAND OAKS BLVD
	
 
	
    SUITE 216
	
 
	
    THOUSAND OAKS
	
 
	
    CA
	
 
	
 
	
    91362
	
 

	

    Bio-Medical Applications of Mission Hills, Inc., SOUTHERN
    CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND OAKS BLVD,
    SUITE 216, THOUSAND OAKS, CA, 91362

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Mississippi, Inc. 

	
 
	
    CRESCENT CITY BILLING GROUP
	
 
	
    3850 N. CAUSEWAY BLVD
	
 
	
    SUITE 700
	
 
	
    METAIRIE
	
 
	
    LA
	
 
	
 
	
    70002
	
 

	

    Bio-Medical Applications of Mississippi, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    CRESCENT CITY BILLING GROUP, 3850 N. CAUSEWAY BLVD,
    SUITE 700, METAIRIE, LA, 70002

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Missouri, Inc. 

	
 
	
    ARIZONA BILLING GROUP
	
 
	
    2917 S. DOBSON
	
 
	
    SUITE 101
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85202
	
 

	

    Bio-Medical Applications of Missouri, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ARIZONA BILLING GROUP, 2917 S, DOBSON, SUITE 101, MESA, AZ,
    65202

	
 
	
    SAN ANTONIO BILLING GROUP
	
 
	
    6100 BANDERA ROAD
	
 
	
    SUITE 601
	
 
	
    SAN ANTONIO
	
 
	
    TX
	
 
	
 
	
    78238
	
 

	

    Bio-Medical Applications of MLK, Inc. 

	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	

    Bio-Medical Applications of MLK, Inc., STEEL CITY BILLING GROUP,
    BMA PITTSBURGH, 190 BILMAR DR., SUITE 375, PITTSBURGH, PA,
    15205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Nevada, Inc. 

	
 
	
    MESA BILLING
	
 
	
    1750 SOUTH MESA DRIVE
	
 
	
    SUITE 110
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85210
	
 

	

    Bio-Medical Applications of Nevada, Inc., MESA BILLING,

    1750 SOUTH MESA DRIVE, SUITE 110, MESA, AZ, 85210

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of New Hampshire, Inc. 

	
 
	
    NEW BEDFORD BILLING GROUP
	
 
	
    700 PLEASANT STREET
	
 
	
 
	
 
	
    NEW BEDFORD
	
 
	
    MA
	
 
	
 
	
    02740
	
 

	

    Bio-Medical Applications of New Hampshire, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    NEW BEDFORD BILLING GROUP, 700 PLEASANT STREET, NEW BEDFORD, MA,
    2740

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of New Jersey, Inc. 

	
 
	
    ALLENTOWN BILLING GROUP
	
 
	
    861 MARCON BLVD SUITE 2
	
 
	
 
	
 
	
    ALLENTOWN
	
 
	
    PA
	
 
	
 
	
    18109
	
 

	

    Bio-Medical Applications of New Jersey, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ALLENTOWN BILLING GROUP, 861 MARCON BLVD SUITE 2, ,
    ALLENTOWN, PA, 18109

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of New Mexico, Inc. 

	
 
	
    ALBUQUERQUE BILLING GROUP
	
 
	
    909 VIRGINIA NE
	
 
	
    SUITE 112
	
 
	
    ALBUQUERQUE
	
 
	
    NM
	
 
	
 
	
    87108
	
 

	

    Bio-Medical Applications of New Mexico, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

    

    10

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    ALBUQUERQUE BILLING GROUP, 909 VIRGINIA NE, SUITE 112,
    ALBUQUERQUE, NM, 87108

	
 
	
    LUBBOCK BILLING GROUP
	
 
	
    4747 SOUTH LOOP 289,
	
 
	
    SUITE 120.
	
 
	
    LUBBOCK
	
 
	
    TX
	
 
	
 
	
    79424
	
 

	

    Bio-Medical Applications of North Carolina, Inc. 

	
 
	
    FAYETTEVILLE BILLING GROUP
	
 
	
    4200 MORGANTON ROAD
	
 
	
    SUITE 300
	
 
	
    FAYETTEVILLE
	
 
	
    NC
	
 
	
 
	
    28314
	
 

	

    Bio-Medical Applications of North Carolina, Inc., FAYETTEVILLE
    BILLING GROUP, 4200 MORGANTON ROAD, SUITE 300,
    FAYETTEVILLE, NC, 28314

	
 
	
    FLORENCE BILLING GROUP
	
 
	
    216 N. DOZIER BLVD.
	
 
	
 
	
 
	
    FLORENCE
	
 
	
    SC
	
 
	
 
	
    29501
	
 

	

    Bio-Medical Applications of Northeast D.C., Inc. 

	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	

    Bio-Medical Applications of Northeast D.C., Inc., STEEL CITY
    BILLING GROUP, BMA PITTSBURGH, 190 BILMAR DR., SUITE 375,
    PITTSBURGH, PA, 15205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Oakland, Inc. 

	
 
	
    PACIFIC NW BILLING GROUP
	
 
	
    4560 S. COACH DRIVE
	
 
	
    SUITE 100
	
 
	
    TUCSON
	
 
	
    AZ
	
 
	
 
	
    85714
	
 

	

    Bio-Medical Applications of Oakland, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PACIFIC NW BILLING GROUP, 4560 S. COACH DRIVE,
    SUITE 100, TUCSON, AZ, 85714

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Ohio, Inc. 

	
 
	
    KENTUCKY BILLING GROUP
	
 
	
    6100 DUTCHMANS LANE
	
 
	
    12TH FLOOR
	
 
	
    LOUISVILLE
	
 
	
    KY
	
 
	
 
	
    40205
	
 

	

    Bio-Medical Applications of Ohio, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    KENTUCKY BILLING GROUP, 6100 DUTCHMANS LANE,

    12TH FLOOR, LOUISVILLE, KY, 40205

	
 
	
    NORTHERN OHIO BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 280
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	

    Bio-Medical Applications of Oklahoma, Inc. 

	
 
	
    LUBBOCK BILLING GROUP
	
 
	
    4747 SOUTH LOOP 289,
	
 
	
    SUITE 120,
	
 
	
    LUBBOCK
	
 
	
    TX
	
 
	
 
	
    79424
	
 

	

    Bio-Medical Applications of Oklahoma, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    LUBBOCK BILLING GROUP, 4747 SOUTH LOOP 289., SUITE 120.,
    LUBBOCK, TX, 79424

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Pennsylvania, Inc. 

	
 
	
    ALLENTOWN BILLING GROUP
	
 
	
    861 MARCON BLVD. SUITE 2
	
 
	
 
	
 
	
    ALLENTOWN
	
 
	
    PA
	
 
	
 
	
    18109
	
 

	

    Bio-Medical Applications of Pennsylvania, Inc., ALLENTOWN
    BILLING GROUP, 861 MARCON BLVD, SUITE 2, ALLENTOWN, PA,
    18109

	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	

    Bio-Medical Applications of Pennsylvania, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ALLENTOWN BILLING GROUP, 861 MARCON BLVD, SUITE 2, ,
    ALLENTOWN, PA, 18109, STEEL CITY BILLING GROUP, BMA PITTSBURGH,
    190 BILMAR DR., SUITE 375, PITTSBURGH,

    PA, 15205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Ponce, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Ponce, Inc., PUERTO RICO BILLING
    GROUP, ANTILLAS WAREHOUSE & OFFICE PARK,

    461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Puerto Rica, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Puerto Rico, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE 4 OFFICE PARK, 461
    FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Rio Piedras, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of Rio Piedras, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE
    PARK, 461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of San Antonio, Inc. 

	
 
	
    SAN ANTONIO BILLING GROUP
	
 
	
    6100 BANDERA ROAD
	
 
	
    SUITE 601
	
 
	
    SAN ANTONIO
	
 
	
    TX
	
 
	
 
	
    78238
	
 

	

    Bio-Medical Applications of San Antonio, Inc., SAN ANTONIO
    BILLING GROUP, 6100 BANDERA ROAD, SUITE 601, SAN
    ANTONIO,

    TX, 78236

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of San German, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of San German, Inc.,

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    PUERTO RICO BILLING GROUP, ANTILLAS WAREHOUSE &
    OFFICE PARK, 461 FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

    

    11

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Bio-Medical Applications of San Juan, Inc. 

	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE & OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	

    Bio-Medical Applications of San Juan, Inc., PUERTO RICO
    BILLING GROUP, ANTILLAS WAREHOUSE & OFFICE PARK, 461
    FRANCIA ST.,
    SUITE 1-401,
    SAN JUAN, PR, 917

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of South Carolina, Inc. 

	
 
	
    FAYETTEVILLE BILLING GROUP
	
 
	
    4200 MORGANTON ROAD
	
 
	
    SUITE 300
	
 
	
    FAYETTEVILLE
	
 
	
    NC
	
 
	
 
	
    28314
	
 

	

    Bio-Medical Applications of South Carolina, Inc., FAYETTEVILLE
    BILLING GROUP, 4200 MORGANTON ROAD, SUITE 300,
    FAYETTEVILLE, NC, 28314

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of South Carolina, Inc. 

	
 
	
    FLORENCE BILLING GROUP
	
 
	
    218 N. DOZIER BLVD.
	
 
	
 
	
 
	
    FLORENCE
	
 
	
    SC
	
 
	
 
	
    29501
	
 

	

    Bio-Medical Applications of South Carolina, Inc., FLORENCE
    BILLING GROUP, 218 N. DOZIER BLVD., , FLORENCE,

    SC, 29501

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of South Carolina, Inc. 

	
 
	
    MACON BILLING GROUP
	
 
	
    1515 BASS ROAD
	
 
	
    SUITE B
	
 
	
    MACON
	
 
	
    GA
	
 
	
 
	
    31210
	
 

	

    Bio-Medical Applications of South Carolina, Inc., MACON BILLING
    GROUP, 1515 BASS ROAD, SUITE B, MACON, GA, 31210

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Southeast Washington, Inc. 

	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	

    Bio-Medical Applications of Southeast Washington, Inc., STEEL
    CITY BILLING GROUP, BMA PITTSBURGH, 190 BILMAR DR.,
    SUITE 375, PITTSBURGH, PA, 15205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Tennessee, Inc. 

	
 
	
    KNOXVILLE BILLING GROUP
	
 
	
    BILLING GROUP
	
 
	
    1512 COLEMAN ROAD, SUITE 308
	
 
	
    KNOXVILLE
	
 
	
    TN
	
 
	
 
	
    37919
	
 

	

    Bio-Medical Applications of Tennessee, Inc., KNOXVILLE BILLING
    GROUP, BILLING GROUP, 1512 COLEMAN ROAD, SUITE 308,
    KNOXVILLE, TN, 37919

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Tennessee, Inc. 

	
 
	
    OCALA BILLING GROUP
	
 
	
    BMA OCALA, INC.
	
 
	
    1308 SE 25TH LOOP, SUITE 102
	
 
	
    OCALA
	
 
	
    FL
	
 
	
 
	
    34471
	
 

	

    Bio-Medical Applications of Tennessee, Inc., OCALA BILLING
    GROUP, BMA OCALA, INC., 1308 SE 25TH LOOP, SUITE 102,
    OCALA, FL, 34471

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Tennessee, Inc. 

	
 
	
    ORLANDO BILLING GROUP
	
 
	
    BMA ORLANDO, INC.
	
 
	
    1155 W STATE ROAD 434, SUITE 125
	
 
	
    LONGWOOD
	
 
	
    FL
	
 
	
 
	
    32750
	
 

	

    Bio-Medical Applications of Tennessee, Inc., ORLANDO BILLING
    GROUP, BMA ORLANDO, INC., 1155 W STATE ROAD 434, SUITE 125,
    LONGWOOD, FL, 32750

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	
    ALBUQUERQUE BILLING GROUP
	
 
	
    909 VIRGINIA NE
	
 
	
    SUITE 112
	
 
	
    ALBUQUERQUE
	
 
	
    NM
	
 
	
 
	
    87108
	
 

	

    Bio-Medical Applications of Texas, Inc., ALBUQUERQUE BILLING
    GROUP, 909 VIRGINIA NE, SUITE 112, ALBUQUERQUE,

    NM, 87108

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	
    LUBBOCK BILLING GROUP
	
 
	
    4747 SOUTH LOOP 289,
	
 
	
    SUITE 120,
	
 
	
    LUBBOCK
	
 
	
    TX
	
 
	
 
	
    79424
	
 

	

    Bio-Medical Applications of Texas, Inc., LUBBOCK BILLING GROUP,
    4747 SOUTH LOOP 289., SUITE 120., LUBBOCK,

    TX, 79424

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	
    NORTH TEXAS BILLING GROUP
	
 
	
    1485 RICHARDSON DRIVE #100
	
 
	
 
	
 
	
    RICHARDSON
	
 
	
    TX
	
 
	
 
	
    75080
	
 

	

    Bio-Medical Applications of Texas, Inc., NORTH TEXAS BILLING
    GROUP, 1485 RICHARDSON DRIVE #100., RICHARDSON,

    TX, 75080

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	
    SAN ANTONIO BILLING GROUP
	
 
	
    6100 BANDERA ROAD
	
 
	
    SUITE 601
	
 
	
    SAN ANTONIO
	
 
	
    TX
	
 
	
 
	
    78238
	
 

	

    Bio-Medical Applications of Texas, Inc., SAN ANTONIO BILLING
    GROUP, 6100 BANDERA ROAD, SUITE 601, SAN ANTONIO, TX, 78238

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Bio-Medical Applications of Texas, Inc., TYLER BILLING,

    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	
    WACO BILLING GROUP
	
 
	
    UPTOWN PLAZA
	
 
	
    1110 RICHLAND DR., #3
	
 
	
    WACO
	
 
	
    TX
	
 
	
 
	
    76710
	
 

	

    Bio-Medical Applications of Texas, Inc., WACO BILLING GROUP,
    UPTOWN PLAZA, 1110 RICHLAND DR., #3, WACO, TX, 76710

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

    

    12

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Bio-Medical Applications of the District of Columbia, Inc. 

	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	

    Bio-Medical Applications of the District of Columbia, Inc.,
    STEEL CITY BILLING GROUP, BMA PITTSBURGH, 190 BILMAR DR.,
    SUITE 375, PITTSBURGH, PA, 15205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Ukiah, Inc. 

	
 
	
    PACIFIC NW BILLING GROUP
	
 
	
    4560 S. COACH DRIVE
	
 
	
    SUITE 100
	
 
	
    TUCSON
	
 
	
    AZ
	
 
	
 
	
    85714
	
 

	

    Bio-Medical Applications of Ukiah, Inc., PACIFIC NW BILLING
    GROUP, 4560 S, COACH DRIVE, SUITE 100, TUCSON,

    AZ, 85714

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Virginia, Inc. 

	
 
	
    ROANOKE BILLING GROUP
	
 
	
    2830 KEAGY ROAD
	
 
	
 
	
 
	
    SALEM
	
 
	
    VA
	
 
	
 
	
    24153
	
 

	

    Bio-Medical Applications of Virginia, Inc., ROANOKE BILLING
    GROUP, 2830 KEAGY ROAD., SALEM, VA, 24153

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of West Virginia, Inc. 

	
 
	
    ROANOKE BILLING GROUP
	
 
	
    2830 KEAGY ROAD
	
 
	
 
	
 
	
    SALEM
	
 
	
    VA
	
 
	
 
	
    24153
	
 

	

    Bio-Medical Applications of West Virginia, Inc., ROANOKE BILLING
    GROUP, 2830 KEAGY ROAD., SALEM, VA, 24153

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of West Virginia, Inc. 

	
 
	
    KENTUCKY BILLING GROUP
	
 
	
    6100 DUTCHMANS LANE
	
 
	
    12TH FLOOR
	
 
	
    LOUISVILLE
	
 
	
    KY
	
 
	
 
	
    40205
	
 

	

    Bio-Medical Applications of West Virginia, Inc., KENTUCKY
    BILLING GROUP, 6100 DUTCHMANS LANE, 12TH FLOOR, LOUISVILLE, KY,
    40205

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Wisconsin, Inc. 

	
 
	
    UPPER MIDWEST BILLING GROUP
	
 
	
    9120 SPRINGBROOK DRIVE
	
 
	
 
	
 
	
    COON RAPIDS
	
 
	
    MN
	
 
	
 
	
    55433
	
 

	

    Bio-Medical Applications of Wisconsin, Inc., UPPER MIDWEST
    BILLING GROUP, 9120 SPRINGBROOK DRIVE., COON RAPIDS, MN, 55433

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Bio-Medical Applications of Wisconsin, Inc. 

	
 
	
    MICHIGAN BILLING GROUP
	
 
	
    3500 MASSILLON ROAD SUITE 230
	
 
	
 
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	

    Bio-Medical Applications of Wisconsin, Inc., MICHIGAN BILLING
    GROUP, 3500 MASSILLON ROAD SUITE 230, , UNIONTOWN, OH,
    44685 Brazoria Kidney Center, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Brazoria Kidney Center, Inc., TYLER BILLING, 3910 BROOKSIDE
    DRIVE, SUITE 100, TYLER, TX, 75701 Brevard County Dialysis,
    LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Brevard County Dialysis, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 Clayton
    County Dialysis, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Clayton County Dialysis, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290
    Clermont Dialysis Center, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Clermont Dialysis Center, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290
    Columbus Area Renal Alliance, LLC

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Columbus Area Renal Alliance, LLC, CLEVELAND BILLING, 25050
    COUNTRY CLUB BOULEVARD, SUITE 250,

    NORTH OLMSTED, OH, 44070 Conejo Valley Dialysis, Inc. 

	
 
	
    SOUTHERN CALIFORNIA BILLING GROUP
	
 
	
    1337 EAST THOUSAND OAKS BLVD
	
 
	
    SUITE 216
	
 
	
    THOUSAND OAKS
	
 
	
    CA
	
 
	
 
	
    91362
	
 

	

    Conejo Valley Dialysis, Inc., SOUTHERN CALIFORNIA BILLING GROUP,
    1337 EAST THOUSAND OAKS BLVD, SUITE 216, THOUSAND OAKS, CA,
    91362 Dialysis America Georgia, LLC

	
 
	
    KNOXVILLE BILLING GROUP
	
 
	
    BILLING GROUP
	
 
	
    1512 COLEMAN ROAD, SUITE 308
	
 
	
    KNOXVILLE
	
 
	
    TN
	
 
	
 
	
    37919
	
 

	

    Dialysis America Georgia, LLC, KNOXVILLE BILLING GROUP, BILLING
    GROUP, 1512 COLEMAN ROAD, SUITE 308, KNOXVILLE, TN, 37919
    Dialysis Associates of Northern

    New Jersey, L.L.C. 

	
 
	
    ALLENTOWN BILLING GROUP
	
 
	
    861 MARCON BLVD SUITE 2
	
 
	
 
	
 
	
    ALLENTOWN
	
 
	
    PA
	
 
	
 
	
    18109
	
 

    

    13

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Dialysis Associates of Northern New Jersey, L.L.C., ALLENTOWN
    BILLING GROUP, 861 MARCON BLVD SUITE 2, , ALLENTOWN, PA,

    18109 Dialysis Associates, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Dialysis Associates, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290
    Dialysis Centers of America — Illinois, Inc. 

	
 
	
    CHICAGO BILLING GROUP
	
 
	
    ONE WESTBROOK DRIVE
	
 
	
    TOWER 1, SUITE 1000
	
 
	
    WESTCHESTER
	
 
	
    IL
	
 
	
 
	
    60154
	
 

	

    Dialysis Centers of America — Illinois, Inc., CHICAGO
    BILLING GROUP, ONE WESTBROOK DRIVE, TOWER 1, SUITE 1000,
    WESTCHESTER, IL, 60154 Dialysis Centers of America —
    Illinois, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Dialysis Centers of America — Illinois, Inc.,
    CLEVELAND BILLING, 25050 COUNTRY CLUB BOULEVARD, SUITE 250,
    NORTH OLMSTED, OH,’ 44070 Dialysis Centers of
    America — Illinois, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Dialysis Centers of America — Illinois, Inc.,
    INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290 Dialysis Management
    Corporation

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Dialysis Management Corporation, TYLER BILLING, 3910 BROOKSIDE
    DRIVE, SUITE 100, TYLER, TX, 75701 Dialysis Services of
    Cincinnati, Inc. 

	
 
	
    NORTHERN OHIO BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 280
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	

    Dialysis Services of Cincinnati, Inc., NORTHERN OHIO BILLING
    GROUP, 3500 MASSILLON ROAD, SUITE 280, UNIONTOWN, OH, 44685
    Dialysis Specialists of Topeka, Inc. 

	
 
	
    ARIZONA BILLING GROUP
	
 
	
    2917 S. DOBSON
	
 
	
    SUITE 101
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85202
	
 

	

    Dialysis Specialists of Topeka, Inc., ARIZONA BILLING GROUP,
    2917 S, DOBSON, SUITE 101, MESA, AZ, 85202

	
 
	
    LUBBOCK BILLING GROUP
	
 
	
    4747 SOUTH LOOP 289,
	
 
	
    SUITE 120
	
 
	
    LUBBOCK
	
 
	
    TX
	
 
	
 
	
    79424
	
 

	

    Dialysis Specialists of Tulsa, Inc. Dialysis Specialists of
    Tulsa, Inc. LUBBOCK BILLING GROUP, 4747 SOUTH LOOP 289.,
    SUITE 120., LUBBOCK, TX, 79424 Douglas County Dialysis, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Douglas County Dialysis, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 Du
    Page Dialysis, Ltd. 

	
 
	
    CHICAGO BILLING GROUP
	
 
	
    ONE WESTBROOK DRIVE
	
 
	
    TOWER 1, SUITE 1000
	
 
	
    WESTCHESTER
	
 
	
    IL
	
 
	
 
	
    60154
	
 

	

    Du Page Dialysis, Ltd., CHICAGO BILLING GROUP, ONE
    WESTBROOK DRIVE, TOWER 1, SUITE 1000, WESTCHESTER, IL,
    60154 Everest Healthcare Indiana, Inc. 

	
 
	
    KENTUCKY BILLING GROUP
	
 
	
    6100 DUTCHMANS LANE
	
 
	
    12TH FLOOR
	
 
	
    LOUISVILLE
	
 
	
    KY
	
 
	
 
	
    40205
	
 

	

    Everest Healthcare Indiana, Inc., KENTUCKY BILLING GROUP, 6100
    DUTCHMANS LANE, 12TH FLOOR, LOUISVILLE, KY, 40205 Everest
    Healthcare Indiana, Inc. 

	
 
	
    NORTHERN OHIO BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 280
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	

    Everest Healthcare Indiana, Inc., NORTHERN OHIO BILLING GROUP,
    3500 MASSILLON ROAD, SUITE 280, UNIONTOWN, OH, 44685
    Everest Healthcare Indiana, Inc. 

	
 
	
    MICHIGAN BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 230
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	

    Everest Healthcare Indiana, Inc., MICHIGAN BILLING GROUP, 3500
    MASSILLON ROAD SUITE 230., UNIONTOWN, OH, 44685 Everest
    Healthcare Ohio, Inc. 

	
 
	
    NORTHERN OHIO BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 280
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	

    Everest Healthcare Ohio, Inc., NORTHERN OHIO BILLING GROUP, 3500
    MASSILLON ROAD, SUITE 280, UNIONTOWN, OH, 44685 Everest
    Healthcare Rhode Island, Inc. 

	
 
	
    NEW BEDFORD BILLING GROUP
	
 
	
    700 PLEASANT STREET
	
 
	
 
	
 
	
    NEW BEDFORD
	
 
	
    MA
	
 
	
 
	
    02740
	
 

	

    Everest Healthcare Rhode Island, Inc., NEW BEDFORD BILLING
    GROUP,

    700 PLEASANT STREET., NEW BEDFORD, MA, 2740 Everest Healthcare
    Texas, L.P. 

	
 
	
    WACO BILLING GROUP
	
 
	
    UPTOWN PLAZA
	
 
	
    1110 RICHLAND DR., #3
	
 
	
    WACO
	
 
	
    TX
	
 
	
 
	
    76710
	
 

	

    Everest Healthcare Texas, L.P., WACO BILLING GROUP, UPTOWN
    PLAZA, 1110 RICHLAND DR., #3, WACO, TX, 76710 Fondren Dialysis
    Clinic, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Fondren Dialysis Clinic, Inc., TYLER BILLING, 3910 BROOKSIDE
    DRIVE, SUITE 100, TYLER, TX, 75701 Fort Scott Regional
    Dialysis Center, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

    

    14

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Fort Scott Regional Dialysis Center, Inc., TYLER BILLING,
    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Four
    State Regional Dialysis Center, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Four State Regional Dialysis Center, Inc., TYLER BILLING, 3910
    BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Fresenius
    Medical Care Dialysis Services – Oregon, LLC

	
 
	
    PACIFIC NW BILLING GROUP
	
 
	
    4560 S. COACH DRIVE
	
 
	
    SUITE 100
	
 
	
    TUCSON
	
 
	
    AZ
	
 
	
 
	
    85714
	
 

	

    Fresenius Medical Care Dialysis Services — Oregon,
    LLC, PACIFIC NW BILLING GROUP, 4560 S. COACH DRIVE,
    SUITE 100, TUCSON, AZ, 85714 Fresenius Medical Care
    Dialysis Services Colorado LLC

	
 
	
    ALBUQUERQUE BILLING GROUP
	
 
	
    909 VIRGINIA NE
	
 
	
    SUITE 112
	
 
	
    ALBUQUERQUE
	
 
	
    NM
	
 
	
 
	
    87108
	
 

	

    Fresenius Medical Care Dialysis Services Colorado LLC,
    ALBUQUERQUE BILLING GROUP, 909 VIRGINIA NE, SUITE 112,
    ALBUQUERQUE, NM, 87108 Gulf Region Mobile Dialysis, Inc. 

	
 
	
    SAN ANTONIO BILLING GROUP
	
 
	
    6100 BANDERA ROAD
	
 
	
    SUITE 601
	
 
	
    SAN ANTONIO
	
 
	
    TX
	
 
	
 
	
    78238
	
 

	

    Gulf Region Mobile Dialysis, Inc., SAN ANTONIO BILLING GROUP,
    6100 BANDERA ROAD, SUITE 601, SAN ANTONIO, TX, 78238
    Haemo-Stat, Inc.

	
 
	
    SOUTHERN CALIFORNIA BILLING GROUP
	
 
	
    1337 EAST THOUSAND OAKS BLVD
	
 
	
    SUITE 216
	
 
	
    THOUSAND OAKS
	
 
	
    CA
	
 
	
 
	
    91362
	
 

	

    Haemo-Stat, Inc., SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST
    THOUSAND OAKS BLVD, SUITE 216, THOUSAND OAKS, CA, 91362
    Henry Dialysis Center, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Henry Dialysis Center, LLC. INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 Holton
    Dialysis Clinic, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Holton Dialysis Clinic, LLC. INDIANAPOLIS BILLING; 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 Home
    Dialysis of Muhlenburg County, Inc. 

	
 
	
    KENTUCKY BILLING GROUP
	
 
	
    6100 DUTCHMANS LANE
	
 
	
    12TH FLOOR
	
 
	
    LOUISVILLE
	
 
	
    KY
	
 
	
 
	
    40205
	
 

	

    Home Dialysis of Muhlenburg County, Inc., KENTUCKY BILLING
    GROUP, 6100 DUTCHMANS LANE, 12TH FLOOR, LOUISVILLE, KY, 40205
    Jefferson County Dialysis, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Jefferson County Dialysis, Inc., TYLER BILLING, 3910 BROOKSIDE
    DRIVE, SUITE 100, TYLER, TX, 75701 KDCO, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    KDCO, Inc., TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100,
    TYLER, TX, 75701 Kentucky Renal Care Group, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Kentucky Renal Care Group, LLC. INDIANAPOLIS BILLING, 10585
    NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290
    Lawton Dialysis, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Lawton Dialysis, Inc., TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 Little Rock Dialysis, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Little Rock Dialysis, Inc., TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 Maumee Dialysis Services, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Maumee Dialysis Services, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 Miami
    Regional Dialysis Center, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

    

    15

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Miami Regional Dialysis Center, Inc., TYLER BILLING, 3910
    BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Michigan Home
    Dialysis Center, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Michigan Home Dialysis Center, Inc., INDIANAPOLIS BILLING, 10585
    NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290
    National Medical Care, Inc. 

	
 
	
    CHICAGO BILLING GROUP
	
 
	
    ONE WESTBROOK DRIVE
	
 
	
    TOWER 1, SUITE 1000
	
 
	
    WESTCHESTER
	
 
	
    IL
	
 
	
 
	
    60154
	
 

	

    National Medical Care, Inc., CHICAGO BILLING GROUP, ONE
    WESTBROOK DRIVE, TOWER 1, SUITE 1000, WESTCHESTER, IL,
    60154 National Medical Care, Inc. 

	
 
	
    MICHIGAN BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 230
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	

    National Medical Care, Inc., MICHIGAN BILLING GROUP, 3500
    MASSILLON ROAD, SUITE 230, UNIONTOWN, OH, 44685 National
    Medical Care, Inc. 

	
 
	
    KNOXVILLE BILLING GROUP
	
 
	
    BILLING GROUP
	
 
	
    1512 COLEMAN ROAD, SUITE 308
	
 
	
    KNOXVILLE
	
 
	
    TN
	
 
	
 
	
    37919
	
 

	

    National Medical Care, Inc., KNOXVILLE BILLING GROUP, BILLING
    GROUP, 1512 COLEMAN ROAD, SUITE 308, KNOXVILLE, TN, 37919
    National Medical Care, Inc. 

	
 
	
    OCALA BILLING GROUP
	
 
	
    BMA OCALA, INC.
	
 
	
    1308 SE 25TH LOOP, SUITE 102
	
 
	
    OCALA
	
 
	
    FL
	
 
	
 
	
    34471
	
 

	

    National Medical Care, Inc., OCALA BILLING GROUP, BMA OCALA,
    INC., 1308 SE 25TH LOOP, SUITE 102, OCALA, FL, 34471
    National Medical Care, Inc. 

	
 
	
    ORLANDO BILLING GROUP
	
 
	
    BMA ORLANDO, INC.
	
 
	
    1155 W STATE ROAD 434, SUITE 125
	
 
	
    LONGWOOD
	
 
	
    FL
	
 
	
 
	
    32750
	
 

	

    National Medical Care, Inc., ORLANDO BILLING GROUP, BMA ORLANDO.
    INC., 1155 W STATE ROAD 434, SUITE 125, LONGWOOD, FL, 32750
    National Medical Care, Inc. 

	
 
	
    ALLENTOWN BILLING GROUP
	
 
	
    861 MARCON BLVD SUITE 2
	
 
	
 
	
 
	
    ALLENTOWN
	
 
	
    PA
	
 
	
 
	
    18109
	
 

	

    National Medical Care, Inc., ALLENTOWN BILLING GROUP, 861 MARCON
    BLVD SUITE 2., ALLENTOWN, PA, 18109 National Medical Care,
    Inc. 

	
 
	
    TAMPA BILLING GROUP
	
 
	
    BMA TAMPA INC.
	
 
	
    5625 WEST WATERS AVENUE, SUITE
	
 
	
    TAMPA
	
 
	
    FL
	
 
	
 
	
    33634
	
 

	

    National Medical Care, Inc., TAMPA BILLING GROUP, BMA TAMPA
    INC., 5625 WEST WATERS AVENUE, SUITE A, TAMPA, FL, 33634
    National Nephrology Associates of Texas, L.P. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    National Nephrology Associates of Texas, L.P., TYLER BILLING,
    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 NNA of
    Alabama, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    NNA of Alabama, Inc., INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN
    STREET, SUITE 160, INDIANAPOLIS, IN, 46290 NNA of East
    Orange, L.L.C. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    NNA of East Orange, L.L.C., CLEVELAND BILLING, 25050 COUNTRY
    CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070 NNA of
    Florida, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    NNA of Florida, LLC, INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN
    STREET, SUITE 160, INDIANAPOLIS, IN, 46290 NNA of Georgia,
    Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    NNA of Georgia, Inc., INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN
    STREET, SUITE 160, INDIANAPOLIS, IN, 46290 NNA of Harrison,
    L.L.C. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    NNA of Harrison, L.L.C., CLEVELAND BILLING, 25050 COUNTRY CLUB
    BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070 NNA of
    Louisiana, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    NNA of Louisiana, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 NNA of
    Oklahoma, L.L.C. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    NNA of Oklahoma, L.L.C., TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 NNA of Rhode Island, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    NNA of Rhode Island, Inc., CLEVELAND BILLING, 25050 COUNTRY CLUB
    BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070 NNA of
    Toledo, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    NNA of Toledo, Inc., INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN
    STREET, SUITE 160, INDIANAPOLIS, IN, 46290 NNA-Saint
    Bamabas, L.L.C. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

    

    16

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    NNA-Saint Bamabas, L.L.C., CLEVELAND BILLING, 25050 COUNTRY CLUB
    BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070 NNA-Saint
    Bamabas-Livingston, L.L.C. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    NNA-Saint Bamabas-Livingston, L.L.C.,CLEVELAND BILLING, 25050
    COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070
    Norcross Dialysis Center, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Norcross Dialysis Center, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 NORMAN
    NEPHROLOGY, P.L.L.C. 

	
 
	
    LUBBOCK BILLING GROUP
	
 
	
    4747 SOUTH LOOP 289
	
 
	
    SUITE 120,
	
 
	
    LUBBOCK
	
 
	
    TX
	
 
	
 
	
    79424
	
 

	

    NORMAN NEPHROLOGY, P.L.L.C., LUBBOCK BILLING GROUP, 4747 SOUTH
    LOOP 289, SUITE 120, LUBBOCK, TX, 79424 Northeast Alabama
    Kidney Clinic, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Northeast Alabama Kidney Clinic, Inc., INDIANAPOLIS BILLING,
    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290 Northern New Jersey Dialysis, LLC

	
 
	
    ALLENTOWN BILLING GROUP
	
 
	
    861 MARCON BLVD
	
 
	
    SUITE 2
	
 
	
    ALLENTOWN
	
 
	
    PA
	
 
	
 
	
    18109
	
 

	

    Northern New Jersey Dialysis, LLC, ALLENTOWN BILLING GROUP, 861
    MARCON BLVD SUITE 2, ALLENTOWN, PA, 18109 Physicians
    Dialysis Company, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Physicians Dialysis Company, Inc., CLEVELAND BILLING, 25050
    COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070
    RCG Bloomington, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    RCG Bloomington, LLC, INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN
    STREET, SUITE 160, INDIANAPOLIS, IN, 46290 RCG East Texas,
    LLP

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    RCG East Texas, LLP, TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 RCG Indiana, L.L.C. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    RCG Indiana, L.L.C., INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN
    STREET, SUITE 160, INDIANAPOLIS, IN, 46290 RCG Irving, LLP

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    RCG Irving, LLP, TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 RCG Martin, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    RCG Martin, LLC, INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN
    STREET, SUITE 160, INDIANAPOLIS, IN, 46290 RCG Memphis
    East, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    RCG Memphis East, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 RCG
    Mississippi, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    RCG Mississippi, Inc., INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 48290 RCG
    Mississippi, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    RCG Mississippi, Inc., TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 RCG Mississippi, Inc. 

	
 
	
    MESA BILLING
	
 
	
    1750 SOUTH MESA DRIVE
	
 
	
    SUITE 110
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85210
	
 

	

    RCG Mississippi. Inc., MESA BILLING, 1750 SOUTH MESA DRIVE,
    SUITE 110, MESA, AZ, 85210 RCG University Division,
    Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    RCG University Division, Inc., CLEVELAND BILLING, 25050 COUNTRY
    CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070 RCG
    University Division, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Renal Care Group Alaska, Inc. 

	
 
	
    MESA BILLING
	
 
	
    1750 SOUTH MESA DRIVE
	
 
	
    SUITE 110
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85210
	
 

	

    Renal Care Group Alaska, Inc., MESA BILLING, 1750 SOUTH MESA
    DRIVE, SUITE 110, MESA, AZ, 85210 Renal Care Group East,
    Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Renal Care Group East, Inc., CLEVELAND BILLING, 25050 COUNTRY
    CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070 Renal
    Care Group Northwest, Inc. 

	
 
	
    MESA BILLING
	
 
	
    1750 SOUTH MESA DRIVE
	
 
	
    SUITE 110
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85210
	
 

	

    Renal Care Group Northwest, Inc., MESA BILLING, 1750 SOUTH MESA
    DRIVE, SUITE 110, MESA, AZ, 85210 Renal Care Group of the
    Midwest, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renal Care Group of the Midwest, Inc., TYLER BILLING, 3910
    BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Renal Care
    Group of the Ozarks, LLC

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

    

    17

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Renal Care Group of the Ozarks, LLC, TYLER BILLING, 3910
    BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Renal Care Group of the South, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Renal Care Group of the South, Inc., INDIANAPOLIS BILLING, 10585
    NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290
    Renal Care Group of the Southeast, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Renal Care Group of the Southeast, Inc., INDIANAPOLIS BILLING,
    10585 NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290 Renal Care Group South New Mexico, LLC

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renal Care Group South New Mexico, LLC, TYLER BILLING, 3910
    BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Renal Care
    Group Southwest, L.P. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renal Care Group Southwest, L.P., TYLER BILLING, 3910 BROOKSIDE
    DRIVE, SUITE 100, TYLER, TX, 75701 Renal Care Group Texas,
    Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renal Care Group Texas, Inc., TYLER BILLING, 3910 BROOKSIDE
    DRIVE, SUITE 100, TYLER, TX, 75701 Renal Care Group
    Westlake, LLC

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Renal Care Group Westlake, LLC, CLEVELAND BILLING, 25050 COUNTRY
    CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070 Renal
    Care Group, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renal Care Group, Inc., TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 Renex Dialysis Clinic of
    Bridgeton, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renex Dialysis Clinic of Bridgeton, Inc., TYLER BILLING, 3910
    BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Renex Dialysis
    Clinic of Creve Coeur, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renex Dialysis Clinic of Creve Coeur, Inc., TYLER BILLING, 3910
    BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Renex Dialysis
    Clinic of Doylestown, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Renex Dialysis Clinic of Doylestown, Inc., CLEVELAND BILLING,
    25050 COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH,
    44070 Renex Dialysis Clinic of Maplewood, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renex Dialysis Clinic of Maplewood, Inc., TYLER BILLING, 3910
    BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Renex Dialysis
    Clinic of Orange, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Renex Dialysis Clinic of Orange, Inc., CLEVELAND BILLING, 25050
    COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070
    Renex Dialysis Clinic of Penn Hills, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Renex Dialysis Clinic of Penn Hills, Inc., CLEVELAND BILLING,
    25050 COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH,
    44070 Renex Dialysis Clinic of Philadelphia, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Renex Dialysis Clinic of Philadelphia, Inc., CLEVELAND BILLING,
    25050 COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH,
    44070 Renex Dialysis Clinic of Pittsburgh, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Renex Dialysis Clinic of Pittsburgh, Inc., CLEVELAND BILLING,
    25050 COUNTRY CLUB BOULEVARD. SUITE 250, NORTH OLMSTED, OH,
    44070 Renex Dialysis Clinic of Shaler, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Renex Dialysis Clinic of Shaler, Inc., CLEVELAND BILLING, 25050
    COUNTRY CLUB BOULEVARD, SUITE 250, NORTH OLMSTED, OH, 44070
    Renex Dialysis Clinic of South Georgia, Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Renex Dialysis Clinic of South Georgia, Inc., INDIANAPOLIS
    BILLING, 10585 NORTH MERIDIAN STREET, SUITE 160,
    INDIANAPOLIS, IN, 46290 Renex Dialysis Clinic of St, Louis,
    Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renex Dialysis Clinic of St. Louis, Inc., TYLER BILLING,
    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Renex
    Dialysis Clinic of Union, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renex Dialysis Clinic of Union, Inc., TYLER BILLING, 3910
    BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Renex Dialysis
    Clinic of University City, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

    

    18

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	

    Renex Dialysis Clinic of University City, Inc. TYLER BILLING,

    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701 Renex
    Dialysis Clinic of Woodbury, Inc. 

	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	

    Renex Dialysis Clinic of Woodbury, Inc., CLEVELAND BILLING,
    25050 COUNTRY CLUB BOULEVARD, SUITE 250,

    NORTH OLMSTED. OH, 44070 Renex Dialysis Facilities, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Renex Dialysis Facilities, Inc., TYLER BILLING, 3910 BROOKSIDE
    DRIVE. SUITE 100, TYLER, TX, 75701 Renex Dialysis
    Facilities, Inc. 

	
 
	
    MESA BILLING
	
 
	
    1750 SOUTH MESA DRIVE
	
 
	
    SUITE 110
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85210
	
 

	

    Renex Dialysis Facilities, Inc., MESA BILLING, 1750 SOUTH MESA
    DRIVE, SUITE 110, MESA, AZ, 85210 San Diego Dialysis
    Services, Inc. 

	
 
	
    SAN DIEGO BILLING GROUP
	
 
	
    2917 S. DOBSON
	
 
	
    SUITE 101
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85202
	
 

	

    San Diego Dialysis Services, Inc., SAN DIEGO BILLING GROUP,
    2917 S. DOBSON, SUITE 101, MESA, AZ, 85202

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Santa Barbara Community Dialysis Center, Inc. 

	
 
	
    SOUTHERN CALIFORNIA BILLING GROUP
	
 
	
    1337 EAST THOUSAND OAKS BLVD
	
 
	
    SUITE 216
	
 
	
    THOUSAND OAKS
	
 
	
    CA
	
 
	
 
	
    91362
	
 

	

    Santa Barbara Community Dialysis Center, Inc., SOUTHERN
    CALIFORNIA BILLING GROUP, 1337 EAST THOUSAND OAKS BLVD,
    SUITE 216, THOUSAND OAKS, CA, 91362 Smyrna Dialysis Center,
    LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Smyrna Dialysis Center, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 SSKG,
    Inc. 

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    SSKG, Inc.. INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290 STAT Dialysis Corporation

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    STAT Dialysis Corporation, TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 Stone Mountain Dialysis Center,
    LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Stone Mountain Dialysis Center, LLC, INDIANAPOLIS BILLING, 10585
    NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290
    Stuttgart Dialysis, LLC

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Stuttgart Dialysis, LLC, TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 Terrell Dialysis Center, LLC

	
 
	
    WACO BILLING GROUP
	
 
	
    UPTOWN PLAZA
	
 
	
    1110 RICHLAND DR., #3
	
 
	
    WACO
	
 
	
    TX
	
 
	
 
	
    76710
	
 

	

    Terrell Dialysis Center, LLC, WACO BILLING GROUP, UPTOWN PLAZA,
    1110 RICHLAND DR., #3, WACO, TX, 76710 Three Rivers Dialysis
    Services, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    Three Rivers Dialysis Services, LLC, INDIANAPOLIS BILLING, 10585
    NORTH MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN,
    46290 West Palm Dialysis, LLC

	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	

    West Palm Dialysis, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290 Wharton
    Dialysis, Inc. 

	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	

    Wharton Dialysis, Inc., TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701 WSKC Dialysis Services,
    Inc. 

	
 
	
    CHICAGO BILLING GROUP
	
 
	
    ONE WESTBROOK DRIVE
	
 
	
    TOWER 1, SUITE 1000
	
 
	
    WESTCHESTER
	
 
	
    IL
	
 
	
 
	
    60154
	
 

	

    WSKC Dialysis Services, Inc., CHICAGO BILLING GROUP, ONE
    WESTBROOK DRIVE, TOWER 1 , SUITE 1000,
    WESTCHESTER, IL, 60154

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

    

    19

 

    EXHIBIT J

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    [FORM OF
    BUSINESS ASSOCIATE AGREEMENT]

 

    

 

    Schedule
    [Insert Schedule Number or Letter Here]

    

 

    HIPAA
    Business Associate Terms and Conditions

 

    These HIPAA Business Associate Terms and Conditions are
    expressly made part of and incorporated into the [name of
    underlying agreement) (the “Agreement”). Fresenius
    Medical Care North America (“FMCNA”) and [NAME OF BA]
    (“Business Associate”) (each sometimes referred to
    individually as a “Party” and collectively as the
    “Parties”), hereby agree to the following terms and
    conditions:

 

    Recitals

 

    FMCNA is required to meet the requirements of the Health
    Insurance Portability and Accountability Act of 1996 (PL
    104 — 91) (“HIPAA”) and regulations enacted
    by the United States Department of Health and Human Services at
    45 C.F.R. Parts 160 — 164 (the “Privacy and
    Security Rules”).

 

    [NAME OF BA] (“Business Associate”) provides services
    to FMCNA that involve the access to individually identifiable
    health information (“Protected Health Information” or
    “PHI”) created, received, maintained or transmitted by
    or on behalf of FMCNA.

 

    As required by the Privacy and Security Rules, FMCNA and
    Business Associate agree to the Business Associate Terms and
    Conditions relating to the use, disclosure and protection of
    PHI. These Business Associate Terms and Conditions are required
    to allow Business Associate to provide its services to FMCNA.

 

    For purposes of these Business Associate Terms and Conditions,
    all capitalized terms shall have the meanings set forth herein;
    provided, however, that if a capitalized term is not defined
    herein, it shall have the meaning set forth in the Privacy and
    Security Rules.

 

    1. Responsibilities of Business Associate

 

    If, during the term of this Agreement, Business Associate is in
    receipt of PHI, Business Associate hereby agrees to do the
    following:

 

    a. Use
    and/or
    disclose the PHI only as permitted or required by the Agreement
    or as otherwise Required by Law.

 

    b. Report to the designated Privacy and Security Officer of
    FMCNA, in writing, any use
    and/or
    disclosure of the PHI that is not permitted or required by the
    Agreement of which Business Associate becomes aware within two
    (2) days of Business Associate’s discovery of such
    unauthorized use
    and/or
    disclosure.

 

    c. Establish procedures for mitigating, to the greatest
    extent possible, any deleterious effects from any improper use
    and/or
    disclosure of PHI that Business Associate reports to FMCNA.

 

    d. Use appropriate safeguards to prevent unauthorized use
    and/or
    disclosure of PHI.

 

    e. Implement Administrative, Physical, and Technical
    safeguards that reasonably and appropriately protect the
    Confidentiality, Integrity and Availability of the Electronic
    PHI that Business Associate creates, receives, maintains, or
    transmits on behalf of FMCNA.

 

    f. Require all of its subcontractors and agents that
    create, receive, maintain, transmit, use, or have access to, PHI
    governed by this Agreement to agree, in writing, to adhere to
    the same restrictions and conditions on the use, disclosure,
    and/or
    protection of PHI that apply to Business Associate pursuant
    hereto.

 

    g. Make available all records, books, agreements, policies,
    procedures, and internal practices relating to the use
    and/or
    disclosure of PHI to the United States Secretary of Health and
    Human Services for purposes of

    

    1

 

 

    

 

    determining FMCNA’s compliance with HIPAA, subject to
    attorney-client and other applicable legal privileges.

 

    h. Upon prior written request, make available to FMCNA
    during normal business hours at Business Associate’s
    offices all records, books, agreements, policies and procedures,
    and internal practices relating to the use
    and/or
    disclosure of PHI within three (3) days for purposes of
    enabling FMCNA to determine Business Associate’s compliance
    with the terms of this Agreement.

 

    i. Upon termination of the Agreement, where feasible,
    destroy or return to FMCNA within thirty (30) days all PHI
    received from, or created, received, maintained or transmitted
    by Business Associate on behalf of FMCNA. Where return or
    destruction is not feasible, the duties of Business Associate
    under this Agreement shall be extended to protect the PHI
    retained by Business Associate. Business Associate agrees to
    limit further uses and disclosures of the PHI retained to those
    purposes that made the return or destruction infeasible.

 

    j. Disclose to its subcontractors, agents or other third
    parties, and request from FMCNA, only the minimum PHI necessary
    to perform or fulfill a specific function required or permitted
    hereunder.

 

    k. Notify FMCNA within two (2) business days if an
    Individual (FMCNA patient or the patient’s legal
    representative) wishes to assert his or her right of access to
    obtain a copy of PHI as set forth in 45 C.F.R.
    § 164.524.

 

    l. At the request of FMCNA, and in the time and manner
    specified by FMCNA, provide access to PHI contained in a
    Designated Record Set to an Individual in accordance with the
    terms and provisions of 45 C.F.R. § 164.524.
    FMCNA’s determination of what constitutes PHI or a
    Designated Record Set shall be final and conclusive.

 

    m. Notify FMCNA within two (2) business days if an
    Individual (FMCNA patient or the patient’s legal
    representative) wishes to assert his or her right to amend PHI
    or amend a record in a Designated Record Set as set forth in
    45 C.F.R. § 164.526.

 

    n. Make any amendment(s) to an Individual’s PHI
    contained in a Designated Record Set that FMCNA directs or
    agrees to pursuant to 45 C.F.R. § 164.526 and in the
    time and manner directed by FMCNA. FMCNA’s determination of
    what PHI is subject to amendment pursuant to 45 C.F.R.
    § 164.526 shall be final and conclusive.

 

    o. Notify FMCNA within two (2) business days if an
    Individual (FMCNA patient or the patient’s legal
    representative) wishes to assert his or her right to receive an
    accounting of disclosures of PHI as set forth in 45 C.F.R.
    § 164.528.

 

    p. Document any disclosures of PHI that would be required
    for FMCNA to respond to a request by an Individual for an
    accounting of disclosures of PHI in accordance with
    45 C.F.R. § 164.528. Business Associate agrees to
    provide to FMCNA, in a time and manner designated by FMCNA, the
    information collected in accordance with this paragraph to
    permit FMCNA respond to a request by an Individual for an
    accounting of disclosures pursuant to 45 C.F.R. §
    164.528.

 

    q. Report in writing, within two (2) days, to FMCNA
    any Security Incident (as defined in 45 C.F.R.
    § 164.304) of which Business Associate becomes aware.
    However, the obligation to report a Security Incident shall not
    include immaterial incidents, such as unsuccessful attempts to
    penetrate Business Associate’s information system.

 

    2. 

    Termination.  Notwithstanding anything in the
    Agreement to the contrary, a breach of these Business Associate
    Terms and Conditions shall be considered a material breach of
    the Agreement entitling FMCNA to terminate the Agreement. FMCNA
    may, however, provide an opportunity for Business Associate to
    cure such

    

    2

 

 

    

 

    breach of these Business Associate terms and conditions within
    ten (10) calendar days of such breach. If neither
    termination nor cure is feasible, FMCNA shall report the
    violation to the Secretary.

 

    3. Representations of the Parties

 

    Each Party represents to the other Party:

 

    a. That it is duly authorized, validly existing, and in
    good standing under the laws of the jurisdiction(s) in which it
    is organized or licensed, it has the full power to enter into
    this Agreement and to perform its obligations described in this
    Agreement, that the performance by it of its obligations under
    this Agreement have been duly authorized by all necessary
    corporate or other actions, and that such performance will not
    violate any provision of any organizational charter or bylaws.
    b. That it will reasonably cooperate with the other Party in the
    performance of its obligations under this Agreement.

 

    4. Miscellaneous

 

    a. If the Privacy or Security Rules are modified in any way
    impacting the Agreement, FMCNA and Business Associate shall,
    prior to the compliance date for such modifications, amend the
    Business Associate Terms and Conditions, as appropriate, to
    ensure compliance with such modifications.

 

    b. A reference in these Business Associate Terms and
    Conditions to the Privacy or Security Rules means the section in
    effect or as amended.

 

    c. In the event of a conflict between these Business
    Associate Terms and Conditions and any other terms and
    conditions of the Agreement, the terms and conditions of these
    Business Associate Terms and Conditions shall control.

    

    3

 

    EXHIBIT K

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORMS OF
    OPINIONS OF COUNSEL

 

    

 

    October 16, 2008

    Giro Balanced Funding Corporation

    c/o Global
    Securitization Services

    114 West
    47th

    Street, Suite 1715

    New York, NY 10036

 

    Paradigm Funding LLC

    c/o WestLB
    AG, New York Branch

    1211 Avenue of the Americas

    New York, NY 10036

 

    Liberty Street Funding Corp.

    c/o Global
    Securitization Services, LLC

    114 West
    47th

    Street, Suite 1715

    New York, NY 10036

 

    WestLB AG, New York Branch, as Administrative Agent and as Agent

    1211 Avenue of the Americas

    New York, NY 10036

 

    Bayerische Landesbank, New York Branch, as Administrative Agent

    560 Lexington Avenue

    New York, New York 10022

 

    The Bank of Nova Scotia, as Administrative Agent

    One Liberty Plaza

    New York, NY 10006

 

    Each of the “Bank Investors”

    (as defined in the Fourth Amended and Restated Transfer and

    Administration Agreement described in this letter)

 

    Arent Fox PLLC

    1050 Connecticut Avenue, N.W.

    Washington, D.C.
    20036-5339

 

    RE:  Fresenius Medical Care Holdings, Inc., National
    Medical Care, Inc. and NMC Funding Corporation —
    Fourth Amended and Restated Transfer and Administration Agreement

 

    Ladies and Gentlemen

 

    I have acted as counsel to Fresenius Medical Care Holdings,
    Inc., a New York corporation (“FMCH”), and National
    Medical Care, Inc., a Delaware corporation (“NMC”), in
    connection with (a) the Amended and Restated Receivables
    Purchase Agreement dated as of October 16, 2008 between
    NMC, as seller, and NMC Funding Corporation (the
    “Transferor”), as purchaser (the “Amended
    Receivables Purchase Agreement”), (b) the Fourth
    Amended and Restated Transfer and Administration Agreement
    (“TAA”) dated as of October 16, 2008 among the
    Transferor, NMC as initial Collection Agent, Paradigm Funding
    LLC (“Paradigm”), Giro Balanced Funding Corporation
    (“GBFC”), Liberty Street Funding Corp. (“Liberty
    Street”), the Bank Investors listed in such agreement,
    Bayerische Landesbank, Cayman Islands Branch
    (“BayernLB”), The Bank of Nova Scotia
    (“Scotiabank”), and WestLB AG, New York Branch
    (“WestLB”), as Administrative Agent and as Agent (the
    “Agent”) for the benefit of the Investors,
    (c) the Amended and Restated Parent Agreement dated as of
    October 16, 2008 among FMCH and Fresenius Medical Care
    AG & Co. KGaA, a partnership limited by shares
    organized and existing under the laws of the Federal Republic of
    Germany (“FME KGaA”) in favor of the Transferor, and
    the Agent (the “Amended Parent Agreement”),
    (d) the Amended and Restated Transferring Affiliate Letter
    dated as of

 

 

	 	 	 	 	 	 	 
	
    Fresenius Medical Care North America

	
    Corporate Headquarters:
	
 
	
                920 Winter
    Street
	
 
	
    Waltham, MA 02451
	
 
	
    (781) 699-9000

    

    1

 

    October 16, 2008, executed by each of the Transferring
    Affiliates and acknowledged and accepted by NMC as Seller, the
    Transferor, as Purchaser, and the Agent (the “Amended
    Transferring Affiliate Letter”), and (e) the Fourth
    Amended and Restated Investor Fee Letter dated October 16,
    2008 among the Transferor, WestLB, BayernLB, and Scotiabank (the
    “Amended Investor Fee Letter”). I have also acted as
    counsel to (x) each of the corporations and other entities
    listed on Schedule I to this letter (each, a
    “Transferring Affiliate”, and collectively, the
    “Transferring Affiliates” and together with FMCH, NMC
    and the Transferor, the “Parent Group Members”) and
    (y) for the limited purpose of rendering the opinion set
    forth in Section 9(g) hereof, FME KGaA. The Amended
    Receivables Purchase Agreement, the TAA, the Amended Parent
    Agreement, the Amended Transferring Affiliate Letter, and the
    Amended Investor Fee Letter together with each of the other
    instruments and agreements listed on Schedule II
    hereto are collectively referred to herein as the
    “Transaction Documents.” I am a Deputy General
    Counsel, Vice President and the Assistant Secretary of FMCH.
    Capitalized terms not defined herein have the meanings assigned
    to them in the Transaction Documents, except as otherwise
    indicated herein.

 

    I have examined and relied upon such corporate records and
    certificates of officers of the Parent Group Members,
    certificates of public officials and the representations and
    warranties of the Parent Group Members in the relevant
    Transaction Documents, and have made such examination of law as
    I deemed relevant to the opinions set forth herein. Based upon
    the above, and subject to the qualifications set forth below, it
    is my opinion that:

 

    1. Organization, Existence and Good Standing.

 

    (a) FMCH is a corporation duly formed, validly existing and
    in good standing under the laws of the State of New York, and is
    duly qualified and in good standing in each other state in which
    the nature of the business it conducts or the assets it owns or
    leases requires such qualification and in which the failure to
    be so qualified would have a Material Adverse Effect on its
    business or operations.

 

    (b) NMC is a corporation duly formed, validly existing and
    in good standing under the laws of the State of Delaware, and is
    duly qualified and in good standing in each other state in which
    the nature of the business it conducts or the assets it owns or
    leases requires such qualification and in which the failure to
    be so qualified would have a Material Adverse Effect on its
    business or operations.

 

    (c) Each Transferring Affiliate is a corporation, limited
    liability company, limited partnership or limited liability
    partnership, as the case may be, duly formed, validly existing
    and in good standing under the laws of the state of its
    incorporation or organization, and is duly qualified and in good
    standing in each other state in which the nature of the business
    it conducts or the assets it owns or leases requires such
    qualification and in which the failure to be in good standing or
    so qualified would have a Material Adverse Effect on the
    business or operations of such Transferring Affiliate.

 

    2. Power and Authority.

 

    (a) FMCH has the requisite corporate power and authority to
    execute and deliver, and to perform its obligations under, each
    of the Transaction Documents to which it is a party.

 

    (b) NMC has the requisite corporate power and authority to
    execute and deliver, and to perform its obligations under, each
    of the Transaction Documents to which it is a party.

 

    (c) Each Transferring Affiliate has the requisite power and
    authority to execute and deliver, and to perform its obligations
    under, each of the Transaction Documents to which it is a party.

 

    3. Due Authorization.

 

    (a) The execution, delivery and performance of the
    Transaction Documents, to which it is a party, by NMC have been
    duly authorized by all necessary corporate action of NMC.

 

    (b) The execution, delivery and performance of the
    Transaction Documents, to which it is a party, by each
    Transferring Affiliate have been duly authorized by all
    necessary action of each Transferring Affiliate.

 

    4. No Violation of Organic Documents.

 

    (a) NMC’s execution and delivery of, and its
    performance of its obligations under, the Transaction Documents
    to which it is a party will not violate its charter or by-laws.

    

    2

 

    (b) Each Transferring Affiliate’s execution and
    delivery of, and its performance of its obligations under, the
    Transaction Documents to which it is a party will not violate
    its charter, by-laws or other organizational documents.

 

    5. Due Execution and Delivery; Validity; Binding Effect
    and General Enforceability

 

    (a) NMC has duly executed and delivered each of the
    Transaction Documents to which it is a party.

 

    (b) Each Transferring Affiliate has duly executed and
    delivered each of the Transaction Documents to which it is a
    party.

 

    (c) Assuming that the transactions contemplated by the
    Transaction Documents bear a reasonable relationship to the
    State of New York, in any action or proceeding arising out of or
    relating to any Transaction Document in any court of The
    Commonwealth of Massachusetts or in any federal court sitting in
    The Commonwealth of Massachusetts, such court should recognize
    and give effect to the provisions thereof wherein the parties
    agree that such Transaction Document shall be governed by, and
    construed in accordance with, the laws of the State of New York.
    However, in the event that any such court shall determine that
    any of the Transaction Documents are governed by the laws of The
    Commonwealth of Massachusetts, each of the Transaction Documents
    constitutes the legal and valid obligation of, and is binding on
    and enforceable against, each of the Parent Group Members
    parties thereto.

 

    6. General Qualifications.  The opinions
    set forth in Section 5 are subject to the following
    qualifications:

 

    (a) The enforceability of the Transaction Documents may be
    limited by bankruptcy, insolvency, fraudulent transfer,
    reorganization, moratorium and other laws or other equitable
    principles relating to or affecting the rights of creditors or
    other obligees generally.

 

    (b) The enforceability of the Transaction Documents may be
    limited by applicable principles of equity, whether such
    principles are applied by a court of equity or a court of law,
    and I express no opinion on whether a court would grant specific
    performance, injunctive relief or any other equitable remedy.

 

    (c) The provisions regarding the remedies available to the
    Agent on default as set forth in the Transaction Documents may
    be subject to certain procedural requirements that are not
    expressly stated in the Transaction Documents, but neither the
    existence of these procedural requirements nor the failure to
    specify them in the Transaction Documents make the remedies
    unenforceable.

 

    (d) A court could refuse to permit the Agent to foreclose
    any security interest in favor of the Agent or enforce the
    Agent’s remedies under the Transaction Documents by reason
    of (i) a waiver by the Agent, (ii) unconscionable
    conduct by the Agent, (iii) the exercise of remedies by the
    Agent without providing adequate notice to FMCH, NMC or any of
    the Transferring Affiliates, as applicable of the default and a
    reasonable opportunity to cure the default, (iv) the
    court’s determination that FMCH, NMC or any of the
    Transferring Affiliates, as applicable are entitled to an
    opportunity to be heard by the court before the Agent is
    entitled to exercise any remedies, (v) the court’s
    determination that a remedy is a penalty or is unconscionable,
    (vi) the court’s determination that the Agent is
    seeking to exercise remedies with respect to a breach that is
    immaterial or that does not adversely affect the Agent or the
    Agent’s security, (vii) defenses arising from the
    Agent’s failure to act in accordance with the terms and
    conditions of the Transaction Documents, (viii) defenses
    arising as a consequence of the passage of time (e.g., laches or
    statutes of limitation), (ix) defenses arising as a result
    of the Agent’s failure to act in a commercially reasonable
    manner or in good faith or (x) public policy considerations.

 

    (e) I express no opinion with respect to any of the
    following provisions if they are contained in any of the
    Transaction Documents: (i) self-help, non-judicial remedies
    or provisions purporting to grant a right of possession without
    resort to judicial action to the extent inconsistent with the
    Uniform Commercial Code or other applicable law; (ii) any
    provisions that entitle the Agent, as a matter of right, to the
    appointment of a receiver; (iii) any provisions imposing
    penalties, forfeitures, increased interest/discount rates
    and/or late
    payment charges upon delinquency in payment or the occurrence of
    a default; (iv) any provisions under which FMCH, NMC or any
    of the Transferring Affiliates, as applicable, waive any of its
    legal or equitable rights except to the extent the waived rights
    are expressly waivable pursuant to a statute or constitution
    provision; (v) any provisions entitling the Agent to obtain
    reimbursement for attorneys’ fees and other costs incurred
    by the Agent; (vi) any provision permitting the Agent to
    accelerate the Obligations or exercise any remedies in the

    

    3

 

    event of a transfer or encumbrancing of an immaterial portion of
    any collateral or immaterial changes in the beneficial ownership
    of FMCH, NMC or any of the Transferring Affiliates, as
    applicable; (vii) any provision exonerating or indemnifying
    the Agent (or any agent or employee of the Agent or any party
    acting on behalf of the Agent) from the consequences of its own
    acts or omissions; (viii) any severability provision;
    (ix) provisions relating to setoff rights; (x) any
    provision granting a power of attorney or similar right;
    (xi) any provision to the effect that rights or remedies
    are not exclusive, that every right or remedy is cumulative and
    may be exercised in addition to or with any other right or
    remedy or that the election of a particular remedy does not
    preclude recourse to one or more other remedies; (xii) any
    provision pursuant to which a party has granted to another party
    any power to execute documents, settle claims or appear in
    judicial proceedings on behalf of such party or to take any
    other action on behalf of such party; (xiii) any provision
    which purports to affect jurisdiction or venue of any specified
    court or which purports to establish evidentiary standards, or
    which waives trial by jury; (xiv) choice of law provision
    (except as discussed in Section 5 above); (xv) any
    provision by which any party agrees to take action if that
    party’s ability to take the action in question is subject
    to conditions another party to the Transaction Documents
    controls; or (xvi) any provision that purports to grant the
    Agent relief from any provisions of the Bankruptcy Code.

 

    7. No Violations of Other Contracts.

 

    (a) NMC’s execution, delivery and performance of the
    Transaction Documents to which it is a party will not breach any
    Other Contract.

 

    (b) Each Transferring Affiliate’s execution, delivery
    and performance of the Transaction Documents to which it is a
    party will not breach any Other Contract.

 

    (c) For purposes of this section, the term “Other
    Contract” means an indenture, mortgage, deed of trust, loan
    agreement, or other material agreement or instrument of which I
    have knowledge, to which, to the best of my knowledge, FMCH, NMC
    or any Transferring Affiliate is a party.

 

    8. No Violations of Applicable Laws.

 

    (a) To the best of my knowledge, NMC’s execution,
    delivery and performance of the Transaction Documents to which
    it is a party will not violate any Applicable Law.

 

    (b) To the best of my knowledge, the Transferor’s and
    each Transferring Affiliate’s execution, delivery and
    performance of the Transaction Documents to which it is a party
    will not violate any Applicable Law.

 

    (c) For purposes of this paragraph, the term Applicable Law
    means, subject to the following sentences, any provision of
    federal or Massachusetts law or regulation or Delaware General
    Corporation Law that is generally applicable to organizations
    such as FMCH, NMC or any Transferring Affiliate or that relates
    to transactions of this type. The term Applicable Law excludes
    federal and state securities and blue-sky laws, tax laws,
    healthcare laws and related rules and regulations.

 

    9. No Violations of Court Decrees or Orders and other
    Matters.

 

    (a) NMC’s execution, delivery and performance of the
    Transaction Documents to which it is a party will not violate
    any Court Decree or Order.

 

    (b) Each Transferring Affiliate’s execution, delivery
    and performance of the Transaction Documents to which it is a
    party will not violate any Court Decree or Order.

 

    (c) For purposes of this paragraph, the term Court Decree
    or Order means a decree, order or other official action of any
    court or other governmental body that is, to the best of my
    knowledge, specifically applicable to FMCH, NMC or any
    Transferring Affiliate as a named party.

 

    (d) The execution, delivery and performance by each Parent
    Group Member of the Transaction Documents to which it is named
    as a party (a) to the best of my knowledge, does not result
    in or require the creation of any lien, security interest or
    other charge or encumbrance upon or with respect to any of such
    Person’s properties (except as may be specifically
    contemplated in the Transaction Documents) and (b) does not
    require compliance with any bulk sales act or similar law.

    

    4

 

    (e) To the best of my knowledge, no authorization,
    approval, consent or other action by, and no notice to or filing
    with, any governmental authority or regulatory body is required
    for the due execution, delivery and performance by any Parent
    Group Member of any Transaction Document to which it is named as
    a party.

 

    (f) To the best of my knowledge, there are no actions,
    suits, orders, decrees, investigations, or other proceedings
    pending or threatened at law, in equity, in arbitration or
    before any governmental agency, commission or official against
    or affecting any Parent Group Member or FME KGaA which
    challenges or affects the legality, validity or enforceability
    of any Transaction Document or, except as otherwise disclosed in
    Exhibit A attached hereto, which would otherwise be
    reasonably likely to have a Material Adverse Effect.

 

    (g) To the best of my knowledge and belief there are no
    governmental authorization, approvals, orders, licenses,
    certificates, franchises or permits of and from any governmental
    regulatory officials and bodies, that are necessary in order for
    any Parent Group Member to own its respective properties and to
    conduct its respective businesses as now being conducted, which
    have not been obtained, except where the failure to have so
    obtained any such authorization, approvals, orders, licenses,
    certificates franchises or permits, individually or in the
    aggregate, would not have a Material Adverse Effect.

 

    10. Investment Company Act.  Neither FMCH,
    NMC, the Transferor nor any Transferring Affiliate is or is
    controlled by an “investment company” within the
    meaning of the Investment Company Act of 1940, as amended, and
    therefore none of them is subject to registration as an
    “investment company.”

 

    11. Public Utility Holding Company
    Act.  Neither FMCH, NMC, the Transferor nor any
    Transferring Affiliate is a “holding company” within
    the meaning of the Public Utility Holding Company Act of 1935,
    as amended.

 

    12. The execution, delivery and performance of the TAA and
    the Amended Transferring Affiliate Letter (collectively, the
    “Amendments”) would not cause me to modify any of the
    opinions or legal conclusions set forth in my opinion dated
    October 23, 2003 (the “Original Opinion”),
    a copy of which is attached hereto as
    Exhibit B.  Subject to all applicable
    assumptions, limitations and qualifications set forth in the
    Original Opinion and in this opinion, I hereby reaffirm such
    opinions and legal conclusions as of the date hereof, both
    before and after giving effect to the Amendments.

 

    The foregoing opinion is subject in its entirety to the
    following qualifications:

 

    The opinions expressed in this letter are solely for the use of
    the Agent, the Conduit Investors, the Administrative Agents, and
    the Bank Investors and their permitted assignees and
    participants, and their legal counsel. These opinions may not be
    relied on by any other persons, may not be quoted in whole or in
    part, and may not be filed with any governmental agency, in each
    case without my express prior written approval; provided that
    these opinions may be disclosed to, and relied upon by, any
    rating agency then rating obligations of Paradigm, GBFC, Liberty
    Street, the Related CP Issuer, any Credit Support Provider, any
    Liquidity Provider and Arent Fox PLLC.

 

    The opinions expressed in this letter are rendered as of the
    date hereof and I express no opinion as to circumstances or
    events that may occur in the future. The opinions expressed in
    this letter are limited to the matters set forth in this letter,
    and no other opinions should be inferred beyond the matters
    expressly stated.

 

    This opinion is based and relies upon the current status of the
    laws of The Commonwealth of Massachusetts and the United States,
    and the General Corporation Law of the State of Delaware and in
    all respects this opinion is subject to and may be limited by
    amendments or other changes in such laws, rules and regulations,
    and any future laws, rules and regulations, as well as by
    developing case law.

 

    [Signature page to follow]

    

    5

 

    I have relied without investigation on certificates and other
    communications from public officials as to matters of fact. I
    have executed and delivered this opinion in my capacity as an
    officer of Fresenius Medical Care Holdings, Inc.

 

    Very truly yours,

    

    Douglas G. Kott

    Vice President, Assistant Secretary and

    Deputy General Counsel

    

    6

 

    SCHEDULE I

    

 

    LIST
    OF TRANSFERRING AFFILIATES

 

	 	 	 
	

    Chief Executive Office for each

	
 
	
    920 Winter Street

	

    Transferring Affiliate:

	
 
	
    Waltham, Massachusetts 02451

 

	 	 	 	 	 
	
 
	
 
	
    State of

    
	
 
	
 

	
    Transferring Affiliates
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Angleton Dialysis, Inc. 

	
 
	
    Texas
	
 
	
    [*]

	

    Bio-Medical Applications Home Dialysis Services, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications Management Company, Inc

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Aguadilla, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Alabama, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Anacostia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Arecibo, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Arkansas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Bayamon, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Blue Springs, Inc

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Caguas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of California, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Camarillo, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Capitol Hill, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Carolina, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Carson, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Clinton, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Columbia Heights, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Connecticut, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Delaware, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Dover, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Eureka, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Fayetteville, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Florida, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Fremont, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Fresno, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Georgia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Glendora, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Guayama, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Hoboken, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Humacao, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Illinois, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Indiana, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Kansas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Kentucky, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Las Americas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Long Beach, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Los Gatos, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

    

    1

 

	 	 	 	 	 
	
 
	
 
	
    State of

    
	
 
	
 

	
    Transferring Affiliates
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Bio-Medical Applications of Louisiana, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Maine, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Manchester, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Maryland, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Massachusetts, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Mayaguez, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Michigan, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Minnesota, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Mission Hills, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Mississippi, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Missouri, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of MLK, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Nevada, Inc

	
 
	
    Nevada
	
 
	
    [*]

	

    Bio-Medical Applications of New Hampshire, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of New Jersey, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of New Mexico, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of North Carolina, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Northeast, D.C., Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Oakland, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Ohio, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Oklahoma, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Pennsylvania, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Ponce, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Puerto Rico, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Rhode Island, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Rio Piedras, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of San Antonio, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of San German, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of San Juan, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of South Carolina, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Southeast Washington, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Tennessee, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of The District of Columbia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Ukiah, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Virginia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of West Virginia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Wisconsin, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Woonsocket, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Brazoria Kidney Center, Inc. 

	
 
	
    Texas
	
 
	
    [*]

	

    Conejo Valley Dialysis, Inc. 

	
 
	
    California
	
 
	
    [*]

	

    Con-Med Supply Company, Inc. 

	
 
	
    Illinois
	
 
	
    [*]

	

    Diabetes Care Group, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

    2

 

	 	 	 	 	 
	
 
	
 
	
    State of

    
	
 
	
 

	
    Transferring Affiliates
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Dialysis America Alabama, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Dialysis America Georgia, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Dialysis Associates of Northern New Jersey, L.L.C. 

	
 
	
    New Jersey
	
 
	
    [*]

	

    Dialysis Centers of America — Illinois, Inc. 

	
 
	
    Illinois
	
 
	
    [*]

	

    Dialysis Licensing Corp. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Dialysis Management Corporation

	
 
	
    Texas
	
 
	
    [*]

	

    Dialysis Services of Atlanta, Inc. 

	
 
	
    Georgia
	
 
	
    [*]

	

    Dialysis Services of Cincinnati, Inc. 

	
 
	
    Ohio
	
 
	
    [*]

	

    Dialysis Services, Inc. 

	
 
	
    Texas
	
 
	
    [*]

	

    Dialysis Specialists of Topeka, Inc. 

	
 
	
    Kansas
	
 
	
    [*]

	

    Dialysis Specialists of Tulsa, Inc. 

	
 
	
    Oklahoma
	
 
	
    [*]

	

    Du Page Dialysis, Ltd. 

	
 
	
    Illinois
	
 
	
    [*]

	

    Everest Healthcare Holdings, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Everest Healthcare Indiana, Inc. 

	
 
	
    Indiana
	
 
	
    [*]

	

    Everest Healthcare Ohio, Inc. 

	
 
	
    Ohio
	
 
	
    [*]

	

    Everest Healthcare Rhode Island, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Everest Healthcare Texas Holding Corp

	
 
	
    Delaware
	
 
	
    [*]

	

    Everest Healthcare Texas, L.P. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Everest Management, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    FMS New York, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Fondren Dialysis Clinic, Inc. 

	
 
	
    Texas
	
 
	
    [*]

	

    Fort Scott Regional Dialysis Center, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Four State Regional Dialysis Center, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Fresenius Management Services, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius Medical Care Dialysis
    Services — Oregon, LLC

	
 
	
    Oregon
	
 
	
    [*]

	

    Fresenius Medical Care Dialysis Services Colorado LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius USA Home Dialysis, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius USA Marketing, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius USA Sales, Inc. 

	
 
	
    Massachusetts
	
 
	
    [*]

	

    Fresenius USA, Inc. 

	
 
	
    Massachusetts
	
 
	
    [*]

	

    Gulf Region Mobile Dialysis, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Haemo-Stat, Inc. 

	
 
	
    California
	
 
	
    [*]

	

    Henry Dialysis Center, LLC

	
 
	
    Georgia
	
 
	
    [*]

	

    Holton Dialysis Clinic, LLC

	
 
	
    Georgia
	
 
	
    [*]

	

    Home Dialysis of America, Inc. 

	
 
	
    Arizona
	
 
	
    [*]

	

    Home Dialysis of Muhlenberg County, Inc. 

	
 
	
    Kentucky
	
 
	
    [*]

	

    Home Intensive Care, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Jefferson County Dialysis, Inc. 

	
 
	
    Arkansas
	
 
	
    [*]

	

    KDCO, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Kentucky Renal Care Group, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Lawton Dialysis, Inc. 

	
 
	
    Arkansas
	
 
	
    [*]

	

    Little Rock Dialysis, Inc. 

	
 
	
    Arkansas
	
 
	
    [*]

	

    Maumee Dialysis Services, LLC

	
 
	
    Delaware
	
 
	
    [*]

    3

 

	 	 	 	 	 
	
 
	
 
	
    State of

    
	
 
	
 

	
    Transferring Affiliates
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Mercy Dialysis Center, Inc. 

	
 
	
    Wisconsin
	
 
	
    [*]

	

    Miami Regional Dialysis Center, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Michigan Home Dialysis Center, Inc. 

	
 
	
    Michigan
	
 
	
    [*]

	

    Naples Dialysis Center, LLC

	
 
	
    Florida
	
 
	
    [*]

	

    National Medical Care, Inc

	
 
	
    Delaware
	
 
	
    [*]

	

    National Nephrology Associates Management Company of Texas,
    Inc. 

	
 
	
    Texas
	
 
	
    [*]

	

    National Nephrology Associates of Texas, L.P. 

	
 
	
    Texas
	
 
	
    [*]

	

    Neomedica, Inc

	
 
	
    Delaware
	
 
	
    [*]

	

    NNA Management Company of Kentucky, Inc. 

	
 
	
    Kentucky
	
 
	
    [*]

	

    NNA Management Company of Louisiana, Inc. 

	
 
	
    Louisiana
	
 
	
    [*]

	

    NNA of Alabama, Inc. 

	
 
	
    Alabama
	
 
	
    [*]

	

    NNA of East Orange, L.L.C. 

	
 
	
    New Jersey
	
 
	
    [*]

	

    NNA of Florida, LLC

	
 
	
    Florida
	
 
	
    [*]

	

    NNA of Georgia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    NNA of Harrison, L.L.C. 

	
 
	
    New Jersey
	
 
	
    [*]

	

    NNA of Louisiana, LLC

	
 
	
    Louisiana
	
 
	
    [*]

	

    NNA of Memphis, LLC

	
 
	
    Tennessee
	
 
	
    [*]

	

    NNA of Nevada, Inc. 

	
 
	
    Nevada
	
 
	
    [*]

	

    NNA of Newark, L.L.C. 

	
 
	
    New Jersey
	
 
	
    [*]

	

    NNA of Oklahoma, Inc. 

	
 
	
    Nevada
	
 
	
    [*]

	

    NNA of Oklahoma, L.L.C. 

	
 
	
    Oklahoma
	
 
	
    [*]

	

    NNA of Rhode Island, Inc. 

	
 
	
    Rhode Island
	
 
	
    [*]

	

    NNA of Toledo, Inc. 

	
 
	
    Ohio
	
 
	
    [*]

	

    NNA Properties of Tennessee, Inc. 

	
 
	
    Tennessee
	
 
	
    [*]

	

    NNA Transportation Services Corporation

	
 
	
    Tennessee
	
 
	
    [*]

	

    NNA-Saint Barnabas, L.L.C. 

	
 
	
    New Jersey
	
 
	
    [*]

	

    NNA-Saint Barnabas-Livingston, L.L.C. 

	
 
	
    New Jersey
	
 
	
    [*]

	

    Norcross Dialysis Center, LLC

	
 
	
    Georgia
	
 
	
    [*]

	

    North Buckner Dialysis Center, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Northeast Alabama Kidney Clinic, Inc. 

	
 
	
    Alabama
	
 
	
    [*]

	

    Northern New Jersey Dialysis, L.L.C. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Northwest Dialysis, Inc. 

	
 
	
    Arkansas
	
 
	
    [*]

	

    Physicians Dialysis Company, Inc. 

	
 
	
    Pennsylvania
	
 
	
    [*]

	

    Qualicenters, Inc. 

	
 
	
    Colorado
	
 
	
    [*]

	

    RCG Arlington Heights, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG Bloomington, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG Credit Corporation

	
 
	
    Tennessee
	
 
	
    [*]

	

    RCG East Texas, LLP

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG Finance, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG Indiana, L.L.C. 

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG Irving, LLP

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG Marion, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG Martin, LLC

	
 
	
    Delaware
	
 
	
    [*]

    4

 

	 	 	 	 	 
	
 
	
 
	
    State of

    
	
 
	
 

	
    Transferring Affiliates
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    RCG Memphis East, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG Memphis, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG Mississippi, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG PA Merger Corp. 

	
 
	
    Texas
	
 
	
    [*]

	

    RCG University Division, Inc. 

	
 
	
    Tennessee
	
 
	
    [*]

	

    RCG West Health Supply, L.C. 

	
 
	
    Arizona
	
 
	
    [*]

	

    RCG Whitehaven, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    RCG/Saint Luke’s, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    RCGIH, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group Alaska, Inc. 

	
 
	
    Alaska
	
 
	
    [*]

	

    Renal Care Group Central Memphis, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group East, Inc. 

	
 
	
    Pennsylvania
	
 
	
    [*]

	

    Renal Care Group Michigan, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group Northwest, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group of the Midwest, Inc. 

	
 
	
    Kansas
	
 
	
    [*]

	

    Renal Care Group of the Ozarks, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group of the South, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group of the Southeast, Inc. 

	
 
	
    Florida
	
 
	
    [*]

	

    Renal Care Group Ohio, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group South New Mexico, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group Southwest Holdings, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group Southwest, L.P. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group Texas, Inc. 

	
 
	
    Texas
	
 
	
    [*]

	

    Renal Care Group Texas, LP

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group Westlake, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Renal Care Group, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    RenalNet Arizona, Inc. 

	
 
	
    Arizona
	
 
	
    [*]

	

    RenalNet, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    RenalPartners of Indiana, LLC

	
 
	
    Indiana
	
 
	
    [*]

	

    RenalPartners, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Renex Corp. 

	
 
	
    Florida
	
 
	
    [*]

	

    Renex Dialysis Clinic of Amesbury, Inc. 

	
 
	
    Massachusetts
	
 
	
    [*]

	

    Renex Dialysis Clinic of Bloomfield, Inc. 

	
 
	
    New Jersey
	
 
	
    [*]

	

    Renex Dialysis Clinic of Bridgeton, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Renex Dialysis Clinic of Creve Coeur, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Renex Dialysis Clinic of Doylestown, Inc. 

	
 
	
    Pennsylvania
	
 
	
    [*]

	

    Renex Dialysis Clinic of Maplewood, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Renex Dialysis Clinic of North Andover, Inc. 

	
 
	
    Massachusetts
	
 
	
    [*]

	

    Renex Dialysis Clinic of Orange, Inc. 

	
 
	
    New Jersey
	
 
	
    [*]

	

    Renex Dialysis Clinic of Penn Hills, Inc. 

	
 
	
    Pennsylvania
	
 
	
    [*]

	

    Renex Dialysis Clinic of Philadelphia, Inc. 

	
 
	
    Pennsylvania
	
 
	
    [*]

	

    Renex Dialysis Clinic of Pittsburgh, Inc. 

	
 
	
    Pennsylvania
	
 
	
    [*]

	

    Renex Dialysis Clinic of Shaler, Inc. 

	
 
	
    Pennsylvania
	
 
	
    [*]

    5

 

	 	 	 	 	 
	
 
	
 
	
    State of

    
	
 
	
 

	
    Transferring Affiliates
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Renex Dialysis Clinic of South Georgia, Inc. 

	
 
	
    Georgia
	
 
	
    [*]

	

    Renex Dialysis Clinic of St. Louis, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Renex Dialysis Clinic of Tampa, Inc. 

	
 
	
    Florida
	
 
	
    [*]

	

    Renex Dialysis Clinic of Union, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Renex Dialysis Clinic of University City, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Renex Dialysis Clinic of Woodbury, Inc. 

	
 
	
    NewJersey
	
 
	
    [*]

	

    Renex Dialysis Facilities, Inc. 

	
 
	
    Mississippi
	
 
	
    [*]

	

    Renex Dialysis Homecare of Greater St. Louis, Inc. 

	
 
	
    Missouri
	
 
	
    [*]

	

    Renex Management Services, Inc. 

	
 
	
    Florida
	
 
	
    [*]

	

    San Diego Dialysis Services, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Santa Barbara Community Dialysis Center, Inc. 

	
 
	
    California
	
 
	
    [*]

	

    Smyrna Dialysis Center, LLC

	
 
	
    Georgia
	
 
	
    [*]

	

    Spectra East, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Spectra Laboratories, Inc. 

	
 
	
    Nevada
	
 
	
    [*]

	

    SSKG, Inc. 

	
 
	
    Illinois
	
 
	
    [*]

	

    STAT Dialysis Corporation

	
 
	
    Delaware
	
 
	
    [*]

	

    Stone Mountain Dialysis Center, LLC

	
 
	
    Georgia
	
 
	
    [*]

	

    Stuttgart Dialysis, LLC

	
 
	
    Arkansas
	
 
	
    [*]

	

    Terrell Dialysis Center, L.L.C. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Three Rivers Dialysis Services, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    West Palm Dialysis, LLC

	
 
	
    Virginia
	
 
	
    [*]

	

    Wharton Dialysis, Inc. 

	
 
	
    Texas
	
 
	
    [*]

	

    WSKC Dialysis Services, Inc. 

	
 
	
    Illinois
	
 
	
    [*]

    6

 

    SCHEDULE II

 

	 	 	 	 	 	 	 
	

    1.

	
 
	
    Amendment Agreement.
	
 
	 
	
 
	 

	

    2.

	
 
	
    Fourth Amended and Restated Transfer and Administration
    Agreement.
	
 
	 
	
 
	 

	

    3.

	
 
	
    Amended and Restated Parent Agreement, relating to changes in
    financial covenants and transfer of rights of Agent to WestLB.
	
 
	 
	
 
	 

	

    4.

	
 
	
    Amended and Restated Receivables Purchase Agreement.
	
 
	 
	
 
	 

	

    5.

	
 
	
    Amended and Restated Transferring Affiliate Letter.
	
 
	 
	
 
	 

	

    6.

	
 
	
    Opinion of Douglas G. Kott.
	
 
	 
	
 
	 

	

    7.

	
 
	
    Opinion of Arent Fox Kintner Plotkin & Kahn relating
    to corporate, UCC and other matters.
	
 
	 
	
 
	 

	

    8.

	
 
	
    True sale and non-consolidation opinion of Arent Fox Kintner
    Plotkin & Kahn.
	
 
	 
	
 
	 

	

    9.

	
 
	
    Opinion of German counsel.
	
 
	 
	
 
	 

	

    10.

	
 
	
    Certificate of the Secretary of the Transferor.
	
 
	 
	
 
	 

	

    11.

	
 
	
    Certificate of the Secretary of the Collection Agent.
	
 
	 
	
 
	 

	

    12.

	
 
	
    Certificate of the Secretary of each Transferring Affiliate.
	
 
	 
	
 
	 

	

    13.

	
 
	
    Good Standing Certificates for the Transferor from the Secretary
    of the Commonwealth of Massachusetts and the Secretary of State
    of Delaware.
	
 
	 
	
 
	 

	

    14.

	
 
	
    Good Standing Certificates for the Collection Agent from the
    Secretary of the Commonwealth of Massachusetts and the Secretary
    of State of Delaware.
	
 
	 
	
 
	 

	

    15.

	
 
	
    Good Standing Certificates for each Transferring Affiliate from
    the Secretary of the Commonwealth of Massachusetts and the
    Secretary of State of Delaware.
	
 
	 
	
 
	 

	

    16.

	
 
	
    Fourth Amended and Restated Investor Fee Letter.
	
 
	 
	
 
	 

	

    17.

	
 
	
    Amended and Restated Agent Fee Letter.
	
 
	 
	
 
	 

	

    18.

	
 
	
    Amended and Restated Liquidity Asset Purchase Agreement for
    Paradigm Funding LLC.
	
 
	 
	
 
	 

	

    19.

	
 
	
    Third Amended and Restated Fee Letter (Helaba) relating to
    Paradigm LAPA.
	
 
	 
	
 
	 

	

    20.

	
 
	
    Amended and Restated Fee Letter (WestLB) relating to Paradigm
    LAPA.
	
 
	 
	
 
	 

	

    21.

	
 
	
    Bank of America Account Control Agreements.
	
 
	 
	
 
	 

	

    22.

	
 
	
    UCC summary.
	
 
	 
	
 
	 

    

    7

 

    EXHIBIT A

 

    The following is an excerpt from the
    Form 6-K
    filing of Fresenius Medical Care G & Co. KGaA (the
    “Company”) with the Securities and Exchange Commission
    for the period ending June 30, 2008:

 

    Legal
    Proceedings

 

    Commercial
    Litigation

 

    The Company was originally formed as a result of a series of
    transactions it completed pursuant to the Agreement and Plan of
    Reorganization dated as of February 4,1996, by and between
    W.R. Grace & Co. and Fresenius SE (the
    “Merger”). At the time of the Merger, a W.R.
    Grace & Co. subsidiary known as W.R. Grace &
    Co.-Conn. had, and continues to have, significant liabilities
    arising out of product-liability related litigation (including
    asbestos-related actions), pre-Merger tax claims and other
    claims unrelated to National Medical Care, Inc.
    (“NMC”), which was W.R. Grace & Co.’s
    dialysis business prior to the Merger. In connection with the
    Merger, W.R. Grace & Co.-Conn. agreed to indemnify the
    Company, FMCH, and NMC against all liabilities of W.R.
    Grace & Co., whether relating to events occurring
    before or after the Merger, other than liabilities arising from
    or relating to NMC’s operations. W.R. Grace & Co.
    and certain of its subsidiaries filed for reorganization under
    Chapter 11 of the U.S. Bankruptcy Code (the
    “Grace Chapter 11 Proceedings”) on April 2,
    2001.

 

    Prior to and after the commencement of the Grace Chapter 11
    Proceedings, class action complaints were filed against W.R.
    Grace & Co. and FMCH by plaintiffs claiming to be
    creditors of W.R. Grace & Co.-Conn., and by the
    asbestos creditors’ committees on behalf of the W.R.
    Grace & Co. bankruptcy estate in the Grace
    Chapter 11 Proceedings, alleging among other things that
    the Merger was a fraudulent conveyance, violated the uniform
    fraudulent transfer act and constituted a conspiracy. All such
    cases have been stayed and transferred to or are pending before
    the U.S. District Court as part of the Grace
    Chapter 11 Proceedings.

 

    In 2003, the Company reached agreement with the asbestos
    creditors’ committees on behalf of the W.R.
    Grace & Co. bankruptcy estate and W.R.
    Grace & Co. in the matters pending in the Grace
    Chapter 11 Proceedings for the settlement of all fraudulent
    conveyance and tax claims against it and other claims related to
    the Company that arise out of the bankruptcy of W.R.
    Grace & Co. Under the terms of the settlement
    agreement as amended (the “Settlement Agreement”),
    fraudulent conveyance and other claims raised on behalf of
    asbestos claimants will be dismissed with prejudice and the
    Company will receive protection against existing and potential
    future W.R. Grace & Co. related claims, including
    fraudulent conveyance and asbestos claims, and indemnification
    against income tax claims related to the non-NMC members of the
    W.R. Grace & Co. consolidated tax group upon
    confirmation of a W.R. Grace & Co. bankruptcy
    reorganization plan that contains such provisions. Under the
    Settlement Agreement, the Company will pay a total of $115,000
    without interest to the W.R. Grace & Co. bankruptcy
    estate, or as otherwise directed by the Court, upon plan
    confirmation. No admission of liability has been or will be
    made. The Settlement Agreement has been approved by the
    U.S. District Court. Subsequent to the Merger, W.R.
    Grace & Co. was involved in a multi-step transaction
    involving Sealed Air Corporation (“Sealed Air,”
    formerly known as Grace Holding, Inc.). The Company is engaged
    in litigation with Sealed Air to confirm its entitlement to
    indemnification from Sealed Air for all losses and expenses
    incurred by the Company relating to pre-Merger tax liabilities
    and Merger-related claims. Under the Settlement Agreement, upon
    confirmation of a plan that satisfies the conditions of the
    Company’s payment obligation, this litigation will be
    dismissed with prejudice.

 

    In April 2008, W.R. Grace & Co. announced an agreement
    in principle with the asbestos creditors’ and equity
    security holders’ committees in the Grace Chapter 11
    Proceedings to settle all present and future asbestos-related
    personal injury claims. The agreement in principle and W.R.
    Grace & Co.’s related bankruptcy reorganization
    plan are subject to conditions including resolution of claims of
    other creditors and Bankruptcy Court and District Court
    approvals.

 

    On April 4, 2003, FMCH filed a suit in the
    U.S. District Court for the Northern District of
    California, styled Fresenius USA, Inc., et al., v. Baxter
    International Inc., et al., Case No. C
    03-1431,
    seeking a declaratory judgment that FMCH does not infringe on
    patents held by Baxter International Inc. and its subsidiaries
    and affiliates (“Baxter”), that the patents are
    invalid, and that Baxter is without right or authority to
    threaten or maintain suit against FMCH for alleged infringement
    of Baxter’s patents. In general, the alleged patents
    concern the use of touch

    

    1

 

    screen interfaces for hemodialysis machines. Baxter filed
    counterclaims against FMCH seeking more than $140,000 in
    monetary damages and injunctive relief, and alleging that FMCH
    willfully infringed on Baxter’s patents. On July 17,
    2006, a jury verdict was entered in favor of FMCH finding that
    all the asserted claims of the Baxter patents are invalid as
    obvious
    and/or
    anticipated in light of prior art. On February 13, 2007,
    the court granted Baxter’s motion to set aside the
    jury’s verdict in favor of FMCH and reinstated the patents
    and entered judgment of infringement. Following a retrial on
    damages, the court entered judgment on November 6, 2007 in
    favor of Baxter on a jury award of $14,300. On April 4,
    2008, the court denied Baxter’s motion for a new trial,
    established a royalty payable to Baxter of 10% of the sales
    price for continuing sales of FMCH’s 2008K hemodialysis
    machines and 7% of the sales price of related disposables, parts
    and service beginning November 7, 2007, and enjoined sales
    of the 2008K machine effective January 1, 2009. We have
    appealed the court’s rulings to the Court of Appeals for
    the Federal Circuit. We are confident that we will prevail on
    appeal and have made no provision in our financial statements
    for any potential liability in this matter. If we are
    unsuccessful on all appeals, including any appeal of the
    royalty, the royalties payable to Baxter on the machines and
    disposable supplies that are subject to the court’s order
    are estimated to be in the range of $2 million to
    $4 million per month. In the interim period until our
    appeal is decided, we are funding a court-approved escrow
    account at the rate noted above. If we win the appeal, the
    escrowed funds will be returned to us with interest. We are
    pursuing design modifications to the 2008K machine that we
    expect will limit the scope of royalty payment exposure and
    permit the continued sale of the modified 2008K machine after
    the January 1, 2009 injunction effective date, irrespective
    of the outcome of our appeal.

 

    Gambro Pty Limited and Gambro Lundia AB (“Gambro AB”
    and, together with Gambro Pty Limited, “the Gambro
    Group”) commenced litigation against FMC AG & Co.
    KGaA’s Australian subsidiary, Fresenius Medical Care
    Australia Pty Limited (“Fresenius Medical Care
    Australia”) regarding infringement and damages with respect
    to a Gambro AB patent protecting intellectual property in
    relation to a system for preparation of dialysis or replacement
    fluid, the Gambro Bicart device in Australia (the “Gambro
    Patent”). As a result of the commercialization of a system
    for the preparation of dialysis fluid based on the Fresenius
    Medical Care Bibag device in Australia, the Australian courts
    concluded that Fresenius Medical Care Australia infringed the
    Gambro Patent. In May 2008, the Gambro Group and Fresenius
    Medical Care Australia and FMC AG & Co. KGaA entered
    into a Deed of Settlement and Release pursuant to which
    Fresenius Medical Care made certain cash payments to the Gambro
    Group and pursuant to which the proceedings and all claims under
    the Gambro Patent, including any claims for relief for losses
    alleged to have been incurred after the expiry of the Gambro
    Patent, were resolved.

 

    Two patent infringement actions have been pending in Germany
    between Gambro Industries (“Gambro”) on the one side
    and D-GmbH and FMC AG & Co. KGaA on the other side
    (hereinafter collectively “Fresenius Medical Care”).
    Gambro herein alleged patent infringements concerning a patent
    on a device for the preparation of medical solutions by
    Fresenius Medical Care. The first case was dismissed as being
    unfounded. Such decision has already become final. In the second
    case, the District Court of Mannheim rendered a judgement on
    June 27, 2008 deciding in favor of Gambro and declaring
    that Fresenius Medical Care has infringed a patent claim.
    Accordingly, the court ordered Fresenius Medical Care to pay
    compensation (to be determined in a separate court proceeding)
    for alleged infringement and to stop offering the alleged patent
    infringing technology in its current form in Germany. Such
    verdict could be enforced provisionally by way of security to be
    deposited by Gambro, however the Company has received no notice
    that Gambro has applied for provisional enforceability, as yet.
    D-GmbH brought an invalidity action in the Federal German Patent
    Court (“BPatG”) against Gambro’s patent. This
    case is currently pending with the Federal Court of Justice as
    the court of appeal. Fresenius Medical Care has also filed an
    appeal against the District Court’s verdict. Irrespective
    of the outcome of the appeal, Fresenius Medical Care pursues to
    develop design modifications to the concerned devices that
    Fresenius Medical Care expects will enable it to provide an
    alternative technical solution. In view of the pending appeal
    against BPatG’s verdict and Fresenius Medical Care’s
    appeal against the District Court’s verdict, Fresenius
    Medical Care continues to believe that the alleged patent
    infringing technology does not infringe any valid patent claims
    of Gambro. Therefore, the Company has made no provision in the
    financial statements for any potential liability in this matter.

 

    Other
    Litigation and Potential Exposures

 

    Renal Care Group (“RCG”) was named as a nominal
    defendant in a second amended complaint filed September 13,
    2006 in the Chancery Court for the State of Tennessee Twentieth
    Judicial District at Nashville

    

    2

 

    against former officers and directors of RCG which purports to
    constitute a class action and derivative action relating to
    alleged unlawful actions and breaches of fiduciary duty in
    connection with the Company’s acquisition of RCG (the
    “RCG Acquisition”) and in connection with alleged
    improper backdating
    and/or
    timing of stock option grants. The amended complaint was styled
    Indiana State District Council of Laborers and Hod Carriers
    Pension Fund, on behalf of itself and all others similarly
    situated and derivatively on behalf of RCG, Plaintiff, vs. RCG,
    Gary Brukardt, William P. Johnston, Harry R. Jacobson, Joseph C.
    Hutts, William V. Lapham, Thomas A. Lowery, Stephen D. McMurray,
    Peter J. Grua, C. Thomas Smith, Ronald Hinds, Raymond Hakim and
    R. Dirk Allison, Defendants. The complaint sought damages
    against former officers and directors and did not state a claim
    for money damages directly against RCG. On August 30, 2007,
    this suit was dismissed by the trial court without leave to
    amend. Plaintiff subsequently appealed and the matter remains
    pending in the appellate court of Tennessee.

 

    In October 2004, FMCH and its subsidiaries, including RCG (prior
    to the RCG Acquisition), received subpoenas from the
    U.S. Department of Justice, Eastern District of New York in
    connection with a civil and criminal investigation, which
    requires production of a broad range of documents relating to
    FMCH’s and RCG’s operations, with specific attention
    to documents relating to laboratory testing for parathyroid
    hormone (“PTH”) levels and vitamin D therapies. The
    Company is cooperating with the government’s requests for
    information. The Company believes that it has fulfilled all
    requests for information made by government investigators in
    this matter, and that it has complied with applicable laws
    relating to PTH testing and use of vitamin D therapies.

 

    FMCH and its subsidiaries, including RCG (prior to the RCG
    Acquisition), received a subpoena from the U.S. Department
    of Justice, Eastern District of Missouri, in connection with a
    joint civil and criminal investigation. FMCH received its
    subpoena in April 2005. RCG received its subpoena in August
    2005. The subpoenas require production of a broad range of
    documents relating to FMCH’s and RCG’s operations,
    with specific attention to documents related to clinical quality
    programs, business development activities, medical director
    compensation and physician relationships, joint ventures, and
    anemia management programs, RCG’s supply company,
    pharmaceutical and other services that RCG provides to patients,
    RCG’s relationships to pharmaceutical companies, and
    RCG’s purchase of dialysis equipment from FMCH. The Office
    of the Inspector General of the U.S. Department of Health
    and Human Services and the U.S. Attorney’s office for
    the Eastern District of Texas have also confirmed that they are
    participating in the review of the anemia management program
    issues raised by the U.S. Attorney’s office for the
    Eastern District of Missouri. On July 17, 2007, the
    U.S. Attorney’s office filed a civil complaint against
    RCG and FMCH in its capacity as RCG’s current corporate
    parent in United States District Court, Eastern District of
    Missouri. The complaint seeks monetary damages and penalties
    with respect to issues arising out of the operation of
    RCG’s Method II supply company through 2005, prior to
    the date of FMCH’s acquisition of RCG. The complaint is
    styled United States of America ex rel. Julie Williams et al.
    vs. Renal Care Group, Renal Care Group Supply Company and FMCH.
    The Company believes that RCG’s operation of its
    Method II supply company was in compliance with applicable
    law and will defend this litigation vigorously. We will continue
    to cooperate in the ongoing investigation.

 

    In May 2006, RCG received a subpoena from the
    U.S. Department of Justice, Southern District of New York
    in connection with an investigation into RCG’s
    administration of its stock option programs and practices,
    including the procedure under which the exercise price was
    established for certain of the option grants. The subpoena
    required production of a broad range of documents relating to
    the RCG stock option program prior to the RCG Acquisition. The
    Company believes that is has fulfilled all requests for
    information made by government investigators in this matter, and
    that RCG complied with applicable laws relating to the issuance
    of stock options.

 

    In August 2007, the Sheet Metal Workers National Pension Fund
    filed a complaint in the United States District Court for the
    Central District of California, Western Division (Los Angeles),
    alleging that Amgen, Inc., the Company and DaVita Inc., marketed
    Amgen’s products,
    Epogen®

    and
    Aranesp®,

    to hemodialysis patients for uses not approved by the FDA and
    thereby caused a putative class of commercial insurers to pay
    for unnecessary prescriptions of these products. Although the
    court dismissed the original allegations against the Company, it
    granted plaintiff leave to amend and this litigation was
    subsequently consolidated with other cases against
    Epogen®

    and
    Aranesp®

    Off-Label Marketing and Sales Practices Multidistrict Litigation
    and assigned to the Central District of California. On
    July 2, 2008, a consolidated complaint was filed in the
    Multidistrict Litigation that renews allegations against the
    Company and DaVita, in addition to those against Amgen.

    

    3

 

    On November 27, 2007, the United States District Court for
    the Western District of Texas (El Paso) unsealed and
    permitted service of two complaints previously filed under seal
    by a qui tam relator, a former FMCH local clinic employee (Qui
    tam is a legal provision under the United States False Claims
    Act, which allows for private individuals to bring suit on
    behalf of the U.S. federal government, as far as such
    individuals believe to have knowledge of presumable fraud
    committed by third parties). The first complaint alleges that a
    nephrologist unlawfully employed in his practice an assistant to
    perform patient care tasks that the assistant was not licensed
    to perform and that Medicare billings by the nephrologist and
    FMCH therefore violated the False Claims Act. The second
    complaint alleges that FMCH unlawfully retaliated against the
    relator by discharging her from employment constructively. The
    United States Attorney for the Western District of Texas has
    declined to intervene and to prosecute on behalf of the United
    States. Counsel for the nephrologist has asserted that a
    criminal investigation of the relator’s allegations is
    continuing and has moved the Court to stay all activity in the
    qui tam until the alleged criminal investigation has
    concluded. FMCH has received no other notice of the pendency of
    any criminal investigation related to this matter.

 

    From time to time, the Company is a party to or may be
    threatened with other litigation or arbitration, claims or
    assessments arising in the ordinary course of its business.
    Management regularly analyzes current information including, as
    applicable, the Company’s defenses and insurance coverage
    and, as necessary, provides accruals for probable liabilities
    for the eventual disposition of these matters.

 

    The Company, like other health care providers, conducts its
    operations under intense government regulation and scrutiny. It
    must comply with regulations which relate to or govern the
    safety and efficacy of medical products and supplies, the
    operation of manufacturing facilities, laboratories and dialysis
    clinics, and environmental and occupational health and safety.
    The Company must also comply with the Anti-Kickback Statute, the
    False Claims Act, the Stark Statute, and other federal and state
    fraud and abuse laws. Applicable laws or regulations may be
    amended, or enforcement agencies or courts may make
    interpretations that differ from the Company’s
    interpretations or the manner in which it conducts its business.
    Enforcement has become a high priority for the federal
    government and some states. In addition, the provisions of the
    False Claims Act authorizing payment of a portion of any
    recovery to the party bringing the suit encourage private
    plaintiffs to commence “whistle blower” actions. By
    virtue of this regulatory environment, as well as the
    Company’s corporate integrity agreement with the
    U.S. federal government, the Company’s business
    activities and practices are subject to extensive review by
    regulatory authorities and private parties, and continuing
    audits, investigative demands, subpoenas, other inquiries,
    claims and litigation relating to the Company’s compliance
    with applicable laws and regulations. The Company may not always
    be aware that an inquiry or action has begun, particularly in
    the case of “whistle blower” actions, which are
    initially filed under court seal.

 

    The Company operates many facilities throughout the United
    States. In such a decentralized system, it is often difficult to
    maintain the desired level of oversight and control over the
    thousands of individuals employed by many affiliated companies.
    The Company relies upon its management structure, regulatory and
    legal resources, and the effective operation of its compliance
    program to direct, manage and monitor the activities of these
    employees. On occasion, the Company may identify instances where
    employees, deliberately or inadvertently, have submitted
    inadequate or false billings. The actions of such persons may
    subject the Company and its subsidiaries to liability under the
    Anti-Kickback Statute, the Stark Statute and the False Claims
    Act, among other laws.

 

    Physicians, hospitals and other participants in the health care
    industry are also subject to a large number of lawsuits alleging
    professional negligence, malpractice, product liability,
    worker’s compensation or related claims, many of which
    involve large claims and significant defense costs. The Company
    has been and is currently subject to these suits due to the
    nature of its business and expects that those types of lawsuits
    may continue. Although the Company maintains insurance at a
    level which it believes to be prudent, it cannot assure that the
    coverage limits will be adequate or that insurance will cover
    all asserted claims. A successful claim against the Company or
    any of its subsidiaries in excess of insurance coverage could
    have a material adverse effect upon it and the results of its
    operations. Any claims, regardless of their merit or eventual
    outcome, could have a material adverse effect on the
    Company’s reputation and business.

 

    The Company has also had claims asserted against it and has had
    lawsuits filed against it relating to alleged patent
    infringements or businesses that it has acquired or divested.
    These claims and suits relate both to operation of

    

    4

 

    the businesses and to the acquisition and divestiture
    transactions. The Company has, when appropriate, asserted its
    own claims, and claims for indemnification. A successful claim
    against the Company or any of its subsidiaries could have a
    material adverse effect upon its business, financial condition,
    and the results of its operations. Any claims, regardless of
    their merit or eventual outcome, could have a material adverse
    effect on the Company’s reputation and business.

 

    Accrued
    Special Charge for Legal Matters

 

    At December 31, 2001, the Company recorded a pre-tax
    special charge of $258,159 to reflect anticipated expenses
    associated with the defense and resolution of pre-Merger tax
    claims, Merger-related claims, and commercial insurer claims.
    The costs associated with the Settlement Agreement and
    settlements with insurers have been charged against this
    accrual. With the exception of the proposed $115,000 payment
    under the Settlement Agreement, all other matters included in
    the special charge have been resolved. While the Company
    believes that its remaining accrual reasonably estimates its
    currently anticipated costs related to the continued defense and
    resolution of this matter, no assurances can be given that its
    actual costs incurred will not exceed the amount of this accrual.

    

    5

 

    EXHIBIT B

 

    

    Fresenius Medical Care

 

    October 23, 2003

 

    Giro Multi-Funding Corporation

    c/o Global
    Securitization Services

    114 West
    47th

    Street, Suite 1715

    New York, NY 10036

 

    Paradigm Funding LLC

    c/o WestLB
    AG, New York Branch

    1211 Avenue of the Americas

    New York, NY 10036

 

    Asset One Securitization, LLC

    c/o AMACAR
    Group, LLC

    6525 Morrison Boulevard, Suite 318

    Charlotte, North Carolina 28211

 

    Liberty Street Funding Corp.

    c/o Global
    Securitization Services, LLC

    114 West
    47th

    Street, Suite 1715

    New York, NY 10036

 

    WestLB AG, New York Branch, as Administrative Agent and as Agent

    1211 Avenue of the Americas

    New York, NY 10036

 

    Bayerische Landesbank, New York Branch, as Administrative Agent

    560 Lexington Avenue

    New York, New York 10022

 

    Société Générale, as Administrative Agent

    1221 Avenue of the Americas

    New York, NY 10020

 

    The Bank of Nova Scotia, as Administrative Agent

    One Liberty Plaza

    New York, NY 10006

 

    Each of the “Bank Investors”

    (as defined in the Third Amended and Restated Transfer and

    Administration Agreement described in this letter)

 

    Arent Fox Kintner Plotkin & Kahn

    1050 Connecticut Avenue, N.W.

    Washington, D.C.
    20036-5339

 

    Fresenius Medical Care North America

    Corporate Headquarters 95 Hayden Avenue Lexington, MA
    02420-9192
    781-402-9000

    

    1

 

		
	    RE:  	
    Fresenius Medical Care Holdings, Inc., National Medical Care,
    Inc. and NMC Funding Corporation — Third Amended and
    Restated Transfer and Administration Agreement

 

    Ladies and Gentlemen

 

    I have acted as counsel to Fresenius Medical Care Holdings,
    Inc., a New York corporation (“FMCH”), and National
    Medical Care, Inc., a Delaware corporation (“NMC”), in
    connection with (a) the Receivables Purchase Agreement
    dated as of August 28, 1997 between NMC, as seller, and NMC
    Funding Corporation (the “Transferor”), as purchaser
    (as amended, the “Receivables Purchase Agreement”),
    (b) the Third Amended and Restated Transfer and
    Administration Agreement (as amended, the “TAA”) dated
    as of October 23, 2003 among the Transferor, NMC as initial
    Collection Agent, Paradigm Funding LLC (“Paradigm”),
    Giro Multi-Funding Corporation (“GMFC”), Asset One
    Securitization, LLC (“Asset One”), Liberty Street
    Funding Corp. (“Liberty Street”), the Bank Investors
    listed in such agreement, Bayerische Landesbank, New York Branch
    (“BayernLB”), Société Générale
    (“SG”), The Bank of Nova Scotia
    (“Scotiabank”) and WestLB AG, New York Branch
    (“WestLB”), as Administrative Agent and as Agent for
    the benefit of the Investors, (c) the Parent Agreement
    dated as of August 28, 1997 among FMCH and Fresenius
    Medical Care AG , a corporation organized and existing under the
    laws of the Federal Republic of Germany (“FMCAG”) in
    favor of the Transferor, and the Agent (as amended by amendments
    Nos. 1-6 and by Amendment No. 7 dated the date hereof, the
    “Parent Agreement”), (d) the Transferring
    Affiliate Letter dated as of August 28, 1997 between NMC,
    as Seller, and each of the Transferring Affiliates (as amended
    from time to time, the “Transferring Affiliate
    Letter”), (e) the Investor Fee Letter dated
    October 23, 2003 among the Transferor, WestLB, BLB, SG, and
    Scotiabank (the “Investor Fee Letter”), (f) the
    Agent Fee Letter among the Transferor and WestLB dated
    October 23, 2003 (the “Agent Fee Letter”), and
    (g) the Amendment Agreement among the Transferor, NMC,
    GMFC, Asset One, BayernLB, SG, WestLB, Bank of Ameirca, N.A.,
    and the other-parties thereto, dated as of October 23, 2003
    (the “Amendment Agreement”). I have also acted as
    counsel to (x) each of the corporations listed on
    Schedule I to this letter (each, a
    “Transferring Affiliate”, and collectively, the
    “Transferring Affiliates” and together with FMCH, NMC
    and the Transferor collectively, the “Parent Group
    Members”) and (y) for the limited purpose of rendering
    the opinion set forth in Section 9(g) hereof, FMCAG. The
    Receivables Purchase Agreement, the TAA, the Parent Agreement,
    the Transferring Affiliate Letter, the Investor Fee Letter, the
    Agent Fee Letter and the Amendment Agreement together with each
    of the other instruments and agreements listed on
    Schedule II hereto are collectively referred to
    herein as the “Transaction Documents.” I am a Deputy
    General Counsel, Vice President and the Assistant Secretary of
    FMCH. Capitalized terms not defined herein have the meanings
    assigned to them in the Transaction Documents, except as
    otherwise indicated herein.

 

    I have examined and relied upon such corporate records and
    certificates of officers of the Parent Group Members,
    certificates of public officials and the representations and
    warranties of the Parent Group Members in the relevant
    Transaction Documents, and have made such examination of law as
    I deemed relevant to the opinions set forth herein. Based upon
    the above, and subject to the qualifications set forth below, it
    is my opinion that:

 

    1.  Organization, Existence and Good Standing.

 

    (a) FMCH is a corporation duly formed, validly existing and
    in good standing under the laws of the State of New York, and is
    duly qualified and in good standing in each other state in which
    the nature of the business it conducts or the assets it owns or
    leases requires such qualification and in which the failure to
    be so qualified would have a Material Adverse Effect on its
    business or operations.

 

    (b) NMC is a corporation duly formed, validly existing and
    in good standing under the laws of the State of Delaware, and is
    duly qualified and in good standing in each other state in which
    the nature of the business it conducts or the assets it owns or
    leases requires such qualification and in which the failure to
    be so qualified would have a Material Adverse Effect on its
    business or operations.

 

    (c) Except as set forth in Schedule 1(c) hereto, each
    Transferring Affiliate is a corporation duly formed, validly
    existing and in good standing under the laws of the state of its
    incorporation, and is duly qualified and in good standing in
    each other state in which the nature of the business it conducts
    or the assets it owns or leases requires such qualification and
    in which the failure to be in good standing or so qualified
    would have a Material Adverse Effect on the business or
    operations of such Transferring Affiliate.

    

    2

 

    2.  Power and Authority.

 

    (a) FMCH has the requisite corporate power and authority to
    execute and deliver, and to perform its obligations under, each
    of the Transaction Documents to which it is a party.

 

    (b) NMC has the requisite corporate power and authority to
    execute and deliver, and to perform its obligations under, each
    of the Transaction Documents to which it is a party.

 

    (c) Each Transferring Affiliate has the requisite corporate
    power and authority to execute and deliver, and to perform its
    obligations under, each of the Transaction Documents to which it
    is a party.

 

    3.  Due Authorization.

 

    (a) The execution, delivery and performance of the Parent
    Agreement by FMCH have been duly authorized by all necessary
    corporate action of FMCH.

 

    (b) The execution, delivery and performance of the
    Transaction Documents, to which it is a party, by NMC have been
    duly authorized by all necessary corporate action of NMC.

 

    (c) The execution, delivery and performance of the
    Transaction Documents, to which it is a party, by each
    Transferring Affiliate have been duly authorized by all
    necessary corporate action of each Transferring Affiliate.

 

    4.  No Violation of Organic Documents.

 

    (a) FMCH’s execution and delivery of, and its
    performance of its obligations under, the Parent Agreement will
    not violate its charter or by-laws.

 

    (b) NMC’s execution and delivery of, and its
    performance of its obligations under, the Transaction Documents
    to which it is a party will not violate its charter or by-laws.

 

    (c) Each Transferring Affiliate’s execution and
    delivery of, and its performance of its obligations under, the
    Transaction Documents to which it is a party will not violate
    its charter or by-laws.

 

    5.  Due Execution and Delivery; Validity; Binding
    Effect and General Enforceability

 

    (a) FMCH has duly executed and delivered the Parent
    Agreement.

 

    (b) NMC has duly executed and delivered each of the
    Transaction Documents to which it is a party.

 

    (c) Each Transferring Affiliate has duly executed and
    delivered each of the Transaction Documents to which it is a
    party.

 

    (d) The Parent Agreement constitutes the legal and valid
    obligation of, and is binding on and enforceable against, FMCH
    in accordance with its terms.

 

    (e) Assuming that the transactions contemplated by the
    Transaction Documents bear a reasonable relationship to the
    State of New York, in any action or proceeding arising out of or
    relating to any Transaction Document in any court of The
    Commonwealth of Massachusetts or in any federal court sitting in
    The Commonwealth of Massachusetts, such court should recognize
    and give effect to the provisions thereof wherein the parties
    agree that such Transaction Document shall be governed by, and
    construed in accordance with, the laws of the State of New York.
    However, in the event that any such court shall determine that
    any of the Transaction Documents are governed by the laws of The
    Commonwealth of Massachusetts, each of the Transaction Documents
    constitutes the legal and valid obligation of, and is binding on
    and enforceable against, each of the Parent Group Members
    parties thereto.

 

    6.  General Qualifications.  The
    opinions set forth in Section 5 are subject to the
    following qualifications:

 

    (a) The enforceability of the Transaction Documents may be
    limited by bankruptcy, insolvency, fraudulent transfer,
    reorganization, moratorium and other laws or other equitable
    principles relating to or affecting the rights of creditors or
    other obligees generally.

    

    3

 

    (b) The enforceability of the Transaction Documents may be
    limited by applicable principles of equity, whether such
    principles are applied by a court of equity or a court of law,
    and I express no opinion on whether a court would grant specific
    performance, injunctive relief or any other equitable remedy.

 

    (c) The provisions regarding the remedies available to the
    Agent on default as set forth in the Transaction Documents may
    be subject to certain procedural requirements that are not
    expressly stated in the Transaction Documents, but neither the
    existence of these procedural requirements nor the failure to
    specify them in the Transaction Documents make the remedies
    unenforceable.

 

    (d) A court could refuse to permit the Agent to foreclose
    any security interest in favor of the Agent or enforce the
    Agent’s remedies under the Transaction Documents by reason
    of (i) a waiver by the Agent, (ii) unconscionable
    conduct by the Agent, (iii) the exercise of remedies by the
    Agent without providing adequate notice to FMCH, NMC or any of
    the Transferring Affiliates, as applicable of the default and a
    reasonable opportunity to cure the default, (iv) the
    court’s determination that FMCH, NMC or any of the
    Transferring Affiliates, as applicable are entitled to an
    opportunity to be heard by the court before the Agent is
    entitled to exercise any remedies, (v) the court’s
    determination that a remedy is a penalty or is unconscionable,
    (vi) the court’s determination that the Agent is
    seeking to exercise remedies with respect to a breach that is
    immaterial or that does not adversely affect the Agent or the
    Agent’s security, (vii) defenses arising from the
    Agent’s failure to act in accordance with the terms and
    conditions of the Transaction Documents, (viii) defenses
    arising as a consequence of the passage of time (e.g., laches or
    statutes of limitation), (ix) defenses arising as a result
    of the Agent’s failure to act in a commercially reasonable
    manner or in good faith or (x) public policy considerations.

 

    (e) I express no opinion with respect to any of the
    following provisions if they are contained in any of the
    Transaction Documents: (i) self-help, non-judicial remedies
    or provisions purporting to grant a right of possession without
    resort to judicial action to the extent inconsistent with the
    Uniform Commercial Code or other applicable law; (ii) any
    provisions that entitle the Agent, as a matter of right, to the
    appointment of a receiver; (iii) any provisions imposing
    penalties, forfeitures, increased interest/discount rates
    and/or late
    payment charges upon delinquency in payment or the occurrence of
    a default; (iv) any provisions under which FMCH, NMC or any
    of the Transferring Affiliates, as applicable, waive any of its
    legal or equitable rights except to the extent the waived rights
    are expressly waivable pursuant to a statute or constitution
    provision; (v) any provisions entitling the Agent to obtain
    reimbursement for attorneys’ fees and other costs incurred
    by the Agent; (vi) any provision permitting the Agent to
    accelerate the Obligations or exercise any remedies in the event
    of a transfer or encumbrancing of an immaterial portion of any
    collateral or immaterial changes in the beneficial ownership of
    FMCH, NMC or any of the Transferring Affiliates, as applicable;
    (vii) any provision exonerating or indemnifying the Agent
    (or any agent or employee of the Agent or any party acting on
    behalf of the Agent) from the consequences of its own acts or
    omissions; (viii) any severability provision;
    (ix) provisions relating to setoff rights; (x) any
    provision granting a power of attorney or similar right;
    (xi) any provision to the effect that rights or remedies
    are not exclusive, that every right or remedy is cumulative and
    may be exercised in addition to or with any other right or
    remedy or that the election of a particular remedy does not
    preclude recourse to one or more other remedies; (xii) any
    provision pursuant to which a party has granted to another party
    any power to execute documents, settle claims or appear in
    judicial proceedings on behalf of such party or to take any
    other action on behalf of such party; (xiii) any provision
    which purports to affect jurisdiction or venue of any specified
    court or which purports to establish evidentiary standards, or
    which waives trial by jury; (xiv) choice of law provision
    (except as discussed in Section 5 above); (xv) any
    provision by which any party agrees to take action if that
    party’s ability to take the action in question is subject
    to conditions another party to the Transaction Documents
    controls; or (xvi) any provision that purports to grant the
    Agent relief from any provisions of the Bankruptcy Code.

 

    7.  No Violations of Other Contracts.

 

    (a) FMCH’s execution, delivery and performance of the
    Parent Agreement will not breach any Other Contract.

 

    (b) NMC’s execution, delivery and performance of the
    Transaction Documents to which it is a party will not breach any
    Other Contract.

    

    4

 

    (c) Each Transferring Affiliate’s execution, delivery
    and performance of the Transaction Documents to which it is a
    party will not breach any Other Contract.

 

    (d) For purposes of this section, the term “Other
    Contract” means an indenture, mortgage, deed of trust, loan
    agreement, or other material agreement or instrument of which I
    have knowledge, to which, to the best of my knowledge, FMCH, NMC
    or any Transferring Affiliate is a party.

 

    8.  No Violations of Applicable Laws.

 

    (a) To the best of my knowledge, FMCH’s execution,
    delivery and performance of the Parent Agreement will not
    violate any Applicable Law.

 

    (b) To the best of my knowledge, NMC’s execution,
    delivery and performance of the Transaction Documents to which
    it is a party will not violate any Applicable Law.

 

    (c) To the best of my knowledge, the Transferor’s and
    each Transferring Affiliate’s execution, delivery and
    performance of the Transaction Documents to which it is a party
    will not violate any Applicable Law.

 

    (d) For purposes of this paragraph, the term Applicable Law
    means, subject to the following sentences, any provision of
    federal or Massachusetts law or regulation or Delaware General
    Corporation Law that is generally applicable to organizations
    such as FMCH, NMC or any Transferring Affiliate or that relates
    to transactions of this type. The term Applicable Law excludes
    federal and state securities and blue-sky laws, tax laws,
    healthcare laws and related rules and regulations.

 

    9.  No Violations of Court Decrees or Orders and
    other Matters.

 

    (a) FMCH’s execution, delivery and performance of the
    Parent Agreement will not violate any Court Decree or Order.

 

    (b) NMC’s execution, delivery and performance of the
    Transaction Documents to which it is a party will not violate
    any Court Decree or Order.

 

    (c) Each Transferring Affiliate’s execution, delivery
    and performance of the Transaction Documents to which it is a
    party will not violate any Court Decree or Order.

 

    (d) For purposes of this paragraph, the term Court Decree
    or Order means a decree, order or other official action of any
    court or other governmental body that is, to the best of my
    knowledge, specifically applicable to FMCH, NMC or any
    Transferring Affiliate as a named party.

 

    (e) The execution, delivery and performance by each Parent
    Group Member of the Transaction Documents to which it is named
    as a party (a) to the best of my knowledge, does not result
    in or require the creation of any lien, security interest or
    other charge or encumbrance upon or with respect to any of such
    Person’s properties (except as may be specifically
    contemplated in the Transaction Documents) and (b) does not
    require compliance with any bulk sales act or similar law.

 

    (f) To the best of my knowledge, no authorization,
    approval, consent or other action by, and no notice to or filing
    with, any governmental authority or regulatory body is required
    for the due execution, delivery and performance by any Parent
    Group Member of any Transaction Document to which it is named as
    a party.

 

    (g) To the best of my knowledge, there are no actions,
    suits, orders, decrees, investigations, or other proceedings
    pending or threatened at law, in equity, in arbitration or
    before any governmental agency, commission or official against
    or affecting any Parent Group Member or FMCAG which challenges
    or affects the legality, validity or enforceability of any
    Transaction Document or, except as otherwise disclosed in
    Exhibit A attached hereto, which would otherwise be
    reasonably likely to have a Material Adverse Effect.

 

    (h) To the best of my knowledge and belief there are no
    governmental authorization, approvals, orders, licenses,
    certificates, franchises or permits of and from any governmental
    regulatory officials and bodies, that are necessary in order for
    any Parent Group Member to own its respective properties and to
    conduct its respective businesses as now being conducted, which
    have not been obtained, except where the failure to have so
    obtained any

    

    5

 

    such authorization, approvals, orders, licenses, certificates
    franchises or permits, individually or in the aggregate, would
    not have a Material Adverse Effect.

 

    10.  Investment Company Act.  Neither
    FMCH, NMC, the Transferor nor any Transferring Affiliate is or
    is controlled by an “investment company” within the
    meaning of the Investment Company Act of 1940, as amended, and
    therefore none of them is subject to registration as an
    “investment company.”

 

    11.  Public Utility Holding Company
    Act.  Neither FMCH, NMC, the Transferor nor any
    Transferring Affiliate is a “holding company” within
    the meaning of the Public Utility Holding Company Act of 1935,
    as amended.

 

    12.  The execution, delivery and performance of the
    TAA and the Parent Agreement (collectively, the
    “Amendments”) would not cause me to modify any of the
    opinions or legal conclusions set forth in my opinion dated
    September 27, 1999 (the “Original
    Opinion”), a copy of which is attached hereto as
    Exhibit B. Subject to all applicable assumptions,
    limitations and qualifications set forth in the Original Opinion
    and in this opinion, I hereby reaffirm such opinions and legal
    conclusions as of the date hereof, both before and after giving
    effect to the Amendments.

 

    The foregoing opinion is subject in its entirety to the
    following qualifications:

 

    The opinions expressed in this letter are solely for the use of
    the Agent, the Conduit Investors, the Administrative Agents, and
    the Bank Investors and their permitted assignees and
    participants, and their legal counsel. These opinions may not be
    relied on by any other persons, may not be quoted in whole or in
    part, and may not be filed with any governmental agency, in each
    case without my express prior written approval; provided that
    these opinions may be disclosed to, and relied upon by, any
    rating agency then rating obligations of Paradigm, Asset One,
    GMFC, Liberty Street, the Related CP Issuer, any Credit Support
    Provider, any Liquidity Provider and Arent, Fox, Kintner,
    Plotkin & Kahn.

 

    The opinions expressed in this letter are rendered as of the
    date hereof and I express no opinion as to circumstances or
    events that may occur in the future. The opinions expressed in
    this letter are limited to the matters set forth in this letter,
    and no other opinions should be inferred beyond the matters
    expressly stated.

 

    This opinion is based and relies upon the current status of the
    laws of The Commonwealth of Massachusetts and the United States,
    and the General Corporation Law of the State of Delaware and in
    all respects this opinion is subject to and may be limited by
    amendments or other changes in such laws, rules and regulations,
    and any future laws, rules and regulations, as well as by
    developing case law.

 

    I have relied without investigation on certificates and other
    communications from public officials as to matters of fact. I
    have executed and delivered this opinion in my capacity as an
    officer of Fresenius Medical Care Holdings, Inc.

 

    Very truly yours,

     

    Douglas G. Kott

    Vice President, Assistant Secretary and

    Deputy General Counsel

    

    6

 

    Schedule 1(c)

 

    Dialysis Specialists of Topeka, Inc. is currently not in good
    standing. The company did not file its 2003 Annual Report. The
    company is in the process of filing the report and will then be
    in good standing.

 

    Santa Barbara Community Dialysis Services, Inc. is
    currently not in good standing. The company did not file a
    Statement of Information. The company is in the process of
    filing the statement and paying the necessary fees and will then
    be in good standing.

    

    7

 

    SCHEDULE I

    

 

    LIST
    OF TRANSFERRING AFFILIATES

 

	 	 	 
	

    Chief Executive Office for each

	
 
	
    95 Hayden Avenue

	

    Transferring Affiliate:

	
 
	
    Lexington, Massachusetts 02420-9192

 

	 	 	 	 	 
	
    Original Transferring Affiliates

    
	
 
	
    State of

    
	
 
	
 

	
    (before December 21, 2001)
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Bio-Medical Applications Management Company, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Aquadilla, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Alabama, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Anacostia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Arecibo, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Arizona, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Arkansas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Bayamon, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Caguas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of California, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Camarillo, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Capitol Hill, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Carolina, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Carson Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Columbia Heights, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Connecticut, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Delaware, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of East Orange, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Eureka, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Florida, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Fremont, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Fresno, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Georgia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Glendora, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Guayama, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Hillside, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Humacao, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Illinois, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Indiana, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Irvington, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Jersey City, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Kansas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Kentucky, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Las Americas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Long Beach, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Los Gatos, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Louisiana, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Maine, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Maryland, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Massachusetts, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Mayaguez, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Michigan, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Minnesota, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Mission Hills, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Mississippi, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

    

    1

 

	 	 	 	 	 
	
    Original Transferring Affiliates

    
	
 
	
    State of

    
	
 
	
 

	
    (before December 21, 2001)
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Bio-Medical Applications of Missouri, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of MLK, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of New Hampshire, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of New Jersey, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of New Mexico, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of North Carolina, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Northeast, D.C., Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Oakland, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Ohio, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Oklahoma, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Pennsylvania, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Pine Brook, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Ponce, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Puerto Rico, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Rhode Island, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Rio Piedras, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of San German, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of San Juan, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of South Carolina, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Southeast Washington, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Tennessee, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of The District of Columbia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Trenton, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Ukiah, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Virginia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of West Virginia, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Wisconsin, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Woonsocket, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    FMC Dialysis Services — Oregon, LLC (f/k/a
    Willamette Valley Kidney Center, LLC)

	
 
	
    Oregon
	
 
	
    [*]

	

    FMC Dialysis Services Colorado, LLC (f/k/a Bio-Medical
    Applications of Colorado, Inc.)

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius USA, Inc. 

	
 
	
    Massachusetts
	
 
	
    [*]

	

    Home Intensive Care, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    National Medical Care, Inc

	
 
	
    Delaware
	
 
	
    [*]

	

    Neomedica, Inc

	
 
	
    Delaware
	
 
	
    [*]

	

    San Diego Dialysis Services, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Spectra East, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Spectra Laboratories, Inc. 

	
 
	
    Nevada
	
 
	
    [*]

 

	 	 	 	 	 
	
    New Transferring Affiliates

    
	
 
	
    State of

    
	
 
	
 

	
    (added on or after December 21, 2001)
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Bio-Medical Applications Home Dialysis Services, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Blue Springs, Inc

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Clinton, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Dover, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Essex, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Fayetteville, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Hoboken, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

    2

 

	 	 	 	 	 
	
    New Transferring Affiliates

    
	
 
	
    State of

    
	
 
	
 

	
    (added on or after December 21, 2001)
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Bio-Medical Applications of Manchester, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of Nevada, Inc

	
 
	
    Nevada
	
 
	
    [*]

	

    Bio-Medical Applications of New York, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Bio-Medical Applications of San Antonio, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Con-Med Supply Company, Inc. 

	
 
	
    Illinois
	
 
	
    [*]

	

    Conejo Valley Dialysis, Inc. 

	
 
	
    California
	
 
	
    [*]

	

    Dialysis America Alabama, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Dialysis America Georgia, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Dialysis Associates of Northern Now Jersey, LLC

	
 
	
    New Jersey
	
 
	
    [*]

	

    Dialysis Services, Inc. 

	
 
	
    Texas
	
 
	
    [*]

	

    Dialysis Services of Cincinnati, Inc. 

	
 
	
    Ohio
	
 
	
    [*]

	

    Dialysis Specialists of Topeka, Inc. 

	
 
	
    Kansas
	
 
	
    [*]

	

    Dialysis Specialists of Tulsa, Inc. 

	
 
	
    Oklahoma
	
 
	
    [*]

	

    DuPage Dialysis Ltd. 

	
 
	
    Illinois
	
 
	
    [*]

	

    Everest Healthcare Holdings, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Everest Healthcare Indiana, Inc. 

	
 
	
    Indiana
	
 
	
    [*]

	

    Everest Healthcare Ohio, Inc. 

	
 
	
    Ohio
	
 
	
    [*]

	

    Everest Healthcare Rhode Island, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Everest Healthcare Texas Holding Corp

	
 
	
    Delaware
	
 
	
    [*]

	

    Everest Healthcare Texas, LP

	
 
	
    Delaware
	
 
	
    [*]

	

    Everest Management, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius Management Services, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius USA Home Dialysis, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius USA Marketing, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius USA of Puerto Rico, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Fresenius USA Sales, Inc. 

	
 
	
    Massachusetts
	
 
	
    [*]

	

    Gulf Region Mobile Dialysis, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Haemo-Stat, Inc. 

	
 
	
    California
	
 
	
    [*]

	

    Home Dialysis of America, Inc. 

	
 
	
    Arizona
	
 
	
    [*]

	

    Home Dialysis of Muhlenberg County, Inc. 

	
 
	
    Kentucky
	
 
	
    [*]

 

	 	 	 	 	 
	
    Original Transferring Affiliates

    
	
 
	
    State of

    
	
 
	
 

	
    (before December 21, 2001)
	
 
	
    Incorporation
	
 
	
    FEIN

	 

	

    Mercy Dialysis Center, Inc. 

	
 
	
    Wisconsin
	
 
	
    [*]

	

    NMC A, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    North Buckner Dialysis Center, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Northern New Jersey Dialysis, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    Prime Medical, Inc. 

	
 
	
    Massachusetts
	
 
	
    [*]

	

    Qualicenters, Inc. 

	
 
	
    Colorado
	
 
	
    [*]

	

    Renal Scientific Services, Inc. 

	
 
	
    Delaware
	
 
	
    [*]

	

    Santa Barbara Community Dialysis Center, Inc. 

	
 
	
    California
	
 
	
    [*]

	

    Terrell Dialysis Center, LLC

	
 
	
    Delaware
	
 
	
    [*]

	

    WSKC Dialysis Services, Inc. 

	
 
	
    Illinois
	
 
	
    [*]

    3

 

    SCHEDULE II

 

	 	 	 	 	 	 	 
	

    1.

	
 
	
    Amendment Agreement.
	
 
	 
	
 
	 

	

    2.

	
 
	
    Third Amended and Restated Transfer and Administration Agreement.
	
 
	 
	
 
	 

	

    3.

	
 
	
    Amended and Restated Transfer Certificate, reflecting transfer
    of rights of Agent to WestLB.
	
 
	 
	
 
	 

	

    4.

	
 
	
    Amendment to Concentration Account with JPMorgan Chase Bank,
    reflecting transfer of rights of Agent to WestLB.
	
 
	 
	
 
	 

	

    5.

	
 
	
    Amendment No. 7 to Parent Agreement, relating to changes in
    financial covenants and transfer of rights of Agent to WestLB.
	
 
	 
	
 
	 

	

    6.

	
 
	
    Amendment No. 4 to the Receivables Purchase Agreement,
    reflecting transfer of rights of Agent to WestLB.
	
 
	 
	
 
	 

	

    7.

	
 
	
    Amendment No. 3 to Transferring Affiliate Letter,
    reflecting transfer of rights of Agent to WestLB.
	
 
	 
	
 
	 

	

    8.

	
 
	
    Reaffirmation opinion of Douglas G. Kott.
	
 
	 
	
 
	 

	

    9.

	
 
	
    Reaffirmation opinion of Arent Fox Kintner Plotkin &
    Kahn.
	
 
	 
	
 
	 

	

    10.

	
 
	
    Certificate of the Secretary of the Transferor.
	
 
	 
	
 
	 

	

    11.

	
 
	
    Certificate of the Secretary of the Collection Agent.
	
 
	 
	
 
	 

	

    12.

	
 
	
    Good Standing Certificates for the Transferor from the Secretary
    of the Commonwealth of Massachusetts and the Secretary of State
    of Delaware.
	
 
	 
	
 
	 

	

    13.

	
 
	
    Good Standing Certificates for the Collection Agent from the
    Secretary of the Commonwealth of Massachusetts and the Secretary
    of State of Delaware.
	
 
	 
	
 
	 

	

    14.

	
 
	
    Investor Fee Letter.
	
 
	 
	
 
	 

	

    15.

	
 
	
    Agent Fee Letter.
	
 
	 
	
 
	 

	

    16.

	
 
	
    UCC financing statement assignments reflecting transfer of
    rights of Agent to WestLB.
	
 
	 
	
 
	 

	

    17.

	
 
	
    Certificate of the Secretary of NMC A, LLC.
	
 
	 
	
 
	 

	

    18.

	
 
	
    Good Standing Certificate for NMC A, LLC from the Secretary of
    State of Delaware.
	
 
	 
	
 
	 

	

    19.

	
 
	
    UCC-1 Financing Statement for NMC A, LLC.
	
 
	 
	
 
	 

	

    20.

	
 
	
    Amendment to UCC-1 for Bio-Medical Applications of Louisiana,
    Inc. (change of name to Bio-Medical Applications of Louisiana,
    LLC).
	
 
	 
	
 
	 

	

    21.

	
 
	
    Up-Front Fee Letter (WestLB).
	
 
	 
	
 
	 

	

    22.

	
 
	
    Up-Front Fee Letter (Scotiabank).
	
 
	 
	
 
	 

	

    23.

	
 
	
    Up-Front Fee Letter (SocGen).
	
 
	 
	
 
	 

	

    24.

	
 
	
    Up-Front Fee Letter (BayernLB). 
	
 
	 
	
 
	 

    

    4

 

    EXHIBIT A

 

    The following is an excerpt from the Form 10Q filing of
    Fresenius Medical Care Holdings, Inc. (the “Company”)
    with the Securities and Exchange Commission for the period
    ending June 30, 2003:

 

    LEGAL
    PROCEEDINGS

 

    COMMERCIAL
    LITIGATION

 

    The Company was formed as a result of a series of transactions
    pursuant to the Agreement and Plan of Reorganization (the
    “Merger”) dated as of February 4, 1996 by and
    between W.R. Grace & Co. and Fresenius AG. At the time
    of the Merger, a W.R. Grace & Co. subsidiary known as
    W.R. Grace & Co.-Conn. had, and continues to have,
    significant potential liabilities arising out of
    product-liability related litigation, pre-Merger tax claims and
    other claims unrelated to NMC, which was Grace’s dialysis
    business prior to the Merger. In connection with the Merger,
    W.R. Grace & Co.-Conn. agreed to indemnify the
    Company, and NMC against all liabilities of W.R.
    Grace & Co., whether relating to events occurring
    before or after the Merger, other than liabilities arising from
    or relating to NMC’s operations. W.R. Grace & Co.
    and certain of its subsidiaries filed for reorganization under
    Chapter 11 of the U.S. Bankruptcy Code (the
    “Grace Chapter 11 Proceedings”) on April 2,
    2001.

 

    Pre-Merger tax claims or tax claims that would arise if events
    were to violate the tax-free nature of the Merger, could
    ultimately be the obligation of the Company. In particular W. R.
    Grace & Co. has disclosed in its filings with
    the Securities and Exchange Commission that: its tax returns for
    the l993 to 1996 tax years are under audit by the Internal
    Revenue Service (the “Service”); W. R.
    Grace & Co. has received the Service’s
    examination report on tax periods 1993 to 1996; that during
    those years Grace deducted approximately $122.1 million in
    interest attributable to corporate owned life insurance
    (“COLI”) policy loans; that W.R. Grace & Co.
    has paid $21.2 million of tax and interest related to COLI
    deductions taken in tax years prior to 1993; that a
    U.S. District Court ruling has denied interest deductions
    of a taxpayer in a similar situation and that W.R. Grace Co. is
    seeking a settlement of the Service’s claims. Subject to
    certain representations made by W.R. Grace & Co., the
    Company and Fresenius AG, W.R. Grace & Co. and certain
    of its affiliates agreed to indemnify the Company against this
    and other pre-Merger and Merger related tax liabilities.

 

    Prior to and after the commencement of the Grace Chapter 11
    Proceedings, class action complaints were filed against W.R.
    Grace & Co. and the Company by plaintiffs claiming to
    be creditors of W.R. Grace & Co.- Conn., and by the
    asbestos creditors’ committees on behalf of the W.R.
    Grace & Co. bankruptcy estate in the Grace
    Chapter 11 Proceedings, alleging among other things that
    the Merger was a fraudulent conveyance, violated the uniform
    fraudulent transfer act and constituted a conspiracy. All such
    cases have been stayed and transferred to or are pending before
    the U.S. District Court as part of the Grace
    Chapter 11 Proceedings.

 

    On February 6, 2003, the Company reached a definitive
    agreement with the asbestos creditors’ committees on behalf
    of the W.R. Grace and Co. bankruptcy estate in the matters
    pending in the Grace Chapter 11 Proceedings for the
    settlement of all fraudulent conveyance claims against it and
    other claims related to the Company that arise out of the
    bankruptcy of W.R. Grace & Co. Subsequently, the
    settlement agreement was amended and W.R. Grace was added as a
    settling party. Under the terms of the settlement agreement as
    amended (the “Settlement Agreement”), fraudulent
    conveyance and other claims raised on behalf of asbestos
    claimants will be dismissed with prejudice and the Company will
    receive protection against existing and potential future W.R.
    Grace & Co. related claims, including fraudulent
    conveyance and asbestos claims, and indemnification against
    income tax claims related to the non-NMC members of the W.R.
    Grace & Co. consolidated tax group upon confirmation
    of a W.R. Grace & Co. bankruptcy reorganization plan
    that contains such provisions. Under the Settlement Agreement,
    the Company will pay a total of $115 million to the W.R.
    Grace & Co. bankruptcy estate, or as otherwise
    directed by the Court, upon plan confirmation. No admission of
    liability has been or will be made. The Settlement Agreement has
    been approved by the U.S. District Court. Subsequent to the
    Merger, W.R. Grace & Co. was involved in a multi-step
    transaction involving Sealed Air Corporation (formerly known as
    Grace Holding, Inc.). The Company is engaged in litigation with
    Sealed Air Corporation (“Sealed Air”) to confirm the
    Company’s entitlement to indemnification from Sealed Air
    for all losses and expenses incurred by the Company relating to
    pre-Merger tax liabilities and Merger-related claims. Under the
    Settlement Agreement, upon confirmation of a plan that satisfies
    the conditions to the Company’s payment obligation, this
    litigation will be dismissed with prejudice.

    

    1

 

    In April 2003, the Company, NMC, and the certain NMC
    subsidiaries agreed to settle all litigation filed by a group of
    insurance companies concerning allegations of inappropriate
    billing practices and misrepresentations and the Company’s
    counterclaims against the plaintiffs in these matters based on
    inappropriate claim denials and delays in claim payments. The
    costs of the settlement will be charged against previously
    established accruals. See “Accrued Special Charge for Legal
    Matters” below. Other private payors have contacted the
    Company regarding similar claims and may file their own lawsuit
    seeking reimbursement and other damages. Although the ultimate
    outcome on the Company of any such proceedings cannot be
    predicted at this time, an adverse result could have a material
    adverse effect on the Company’s business, financial
    condition and results of operations.

 

    On April 4, 2003, the Company filed a suit in the United
    States District Court for the Northern District of California,
    Fresenius USA, Inc., et al., v. Baxter International Inc.,
    et al., Case No. C
    03-1431,
    seeking a declaratory judgment that the Company does not
    infringe on patents held by Baxter International, Inc. and its
    subsidiaries and affiliates (“Baxter”), that the
    patents are invalid, and that Baxter is without right or
    authority to threaten or maintain suit against the Company for
    alleged infringement of Baxter’s patents. In general, the
    alleged patents concern touch screens, conductivity alarms,
    power failure data storages, and balance chambers for
    hemodialysis machines. Baxter has filed counterclaims against
    the Company seeking monetary damages and injunctive relief, and
    alleging that the Company willfully infringes on the
    Baxter’s patents. The Company believes its claims are
    meritorious, although the ultimate outcome of any such
    proceedings cannot be predicted at this time and an adverse
    result could have a material adverse effect on the
    Company’s business, financial condition, and results of
    operations.

 

    OTHER
    LITIGATION AND POTENTIAL EXPOSURES

 

    From time to time, the Company is a party to or may be
    threatened with other litigation arising in the ordinary course
    of its business. Management regularly analyzes current
    information including, as applicable, the Company’s
    defenses and insurance coverage and, as necessary, provides
    accruals for probable liabilities for the eventual disposition
    of these matters.

 

    The Company, like other health care providers, conducts its
    operations under intense government regulation and scrutiny. The
    Company must comply with regulations which relate to or govern
    the safety and efficacy of medical products and supplies, the
    operation of manufacturing facilities, laboratories and dialysis
    clinics, and environmental and occupational health and safety.
    The Company must also comply with the Anti-Kickback Statute, the
    False Claims Act, the Stark Statute, and other federal and state
    fraud and abuse laws. Applicable laws or regulations may be
    amended, or enforcement agencies or courts may make
    interpretations that differ from the Company’s or the
    manner in which the Company conduct its business. Enforcement
    has become a high priority for the federal government and some
    states. In addition, the provisions of the False Claims Act
    authorizing payment of a portion of any recovery to the party
    bringing the suit encourage private plaintiffs to commence
    “whistle blower” actions. By virtue of this regulatory
    environment, as well as our corporate integrity agreement with
    the government, the Company expects that its business activities
    and practices will continue to be subject to extensive review by
    regulatory authorities and private parties, and expects
    continuing inquiries, claims and litigation relating to its
    compliance with applicable laws and regulations. The Company may
    not always be aware that an inquiry or action has begun,
    particularly in the case of “whistle blower” actions,
    which are initially filed under court seal.

 

    The Company operates many facilities throughout the U.S. In
    such a decentralized system, it is often difficult to maintain
    the desired level of oversight and control over the thousands of
    individuals employed by many affiliated companies. The Company
    relies upon its management structure, regulatory and legal
    resources, and the effective operation of its compliance program
    to direct, manage and monitor the activities of these employees.
    On occasion, the Company may identify instances where employees,
    deliberately or inadvertently, have submitted inadequate or
    false billings. The actions of such persons may subject the
    Company and its subsidiaries to liability under the
    Anti-Kickback Statute, the Stark Statute and the False Claims
    Act, among other laws.

 

    Physicians, hospitals and other participants in the health care
    industry are also subject to a large number of lawsuits alleging
    professional negligence, malpractice, product liability,
    worker’s compensation or related claims, many of which
    involve large claims and significant defense costs. The Company
    has been subject to these suits due to the nature of its
    business and the Company expects that those types of lawsuits
    may continue. Although the Company maintains insurance at a
    level which it believes to be prudent, the Company cannot assure
    that the

    

    2

 

    coverage limits will be adequate or that insurance will cover
    all asserted claims. A successful claim against the Company or
    any of its subsidiaries in excess of insurance coverage could
    have a material adverse effect upon the Company and the results
    of its operations. Any claims, regardless of their merit or
    eventual outcome, also may have a material adverse effect on the
    Company’s reputation and business.

 

    The Company has also had claims asserted against it and has had
    lawsuits filed against it relating to businesses that it has
    acquired or divested. These claims and suits relate both to
    operation of the businesses and to the acquisition and
    divestiture transactions. The Company has asserted its own
    claims, and claims for indemnification. Although the ultimate
    outcome on the Company cannot be predicted at this time, an
    adverse result could have a material adverse effect upon the
    Company’s business, financial condition, and results of
    operations.

 

    ACCRUED
    SPECIAL CHARGE FOR LEGAL MATTERS

 

    At December 31, 2001, the Company recorded a pre-tax
    special charge of $258 million to reflect anticipated
    expenses associated with the continued defense and resolution of
    pre-Merger tax claims, Merger-related claims, and commercial
    insurer claims. The costs associated with the Settlement
    Agreement and settlement with insurers are charged against this
    accrual. While the Company believes that its remaining accruals
    reasonably estimate the Company’s currently anticipated
    costs related to the continued defense and resolution of the
    remaining matters, no assurances can be given that the actual
    costs incurred by the Company will not exceed the amount of
    these accruals.

    

    3

 

    

 

    September 27,
    1999
    

 

    Enterprise Funding Corporation

    c/o Bank
    of America, N.A.

    Bank of America, N.A. Corporate Center

    Charlotte, NC 28255

 

    Compass US Acquisition, LLC

    c/o Westdeutsche
    Landesbank

    Girozentrale, New York Branch

    1211 Avenue of the Americas

    New York, NY 10036

 

    Bank of America, N.A., as Administrative Agent and as Agent

    Bank of America Corporate Center

    Charlotte, North Carolina 28255

 

    Westdeutsche Landesbank

    Girozentrale, New York Branch

    1211 Avenue of the Americas

    New York, NY 10036

 

    Each of the “Bank Investors”

    (as defined in the Amended and Restated Transfer and

    Administration Agreement described in this letter)

 

    Arent Fox Kintner Plotkin & Kahn

    1050 Connecticut Avenue, N.W.

    Washington, D.C.
    20036-5339

 

 

    Fresenius
    Medical Care North America

    Corporate Headquarters: Two Ledgemont Center 95 Hayden Avenue
    Lexington, MA
    02420-9192
    (781) 402-9000

    

    1

 

		
	    RE:  	
    Fresenius Medical Care Holdings, Inc., National Medical Care,
    Inc. and NMC Funding Corporation — Amended and
    Restated Transfer and Administration Agreement

 

    Ladies and Gentlemen

 

    I have acted as counsel to Fresenius Medical Care Holdings,
    Inc., a New York corporation (“FMCH”), and National
    Medical Care, Inc., a Delaware corporation (“NMC”), in
    connection with (a) the Receivables Purchase Agreement
    dated as of August 28, 1997 between NMC, as seller, and NMC
    Funding Corporation (the “Transferor”), as purchaser
    (the “Receivables Purchase Agreement”), (b) the
    Amended and Restated Transfer and Administration Agreement (the
    “TAA”) dated as of the date hereof among the
    Transferor, NMC as initial Collection Agent, Enterprise Funding
    Corporation (“Enterprise”), Compass US Acquisition,
    LLC (“Compass”), the Bank Investors listed in such
    agreement, Westdeutsche Landesbank, Girozentrale, New York
    Branch and Bank of America, N.A., as Administrative Agent and as
    Agent for the benefit of Enterprise, Compass and the Bank
    Investors and (c) the Parent Agreement dated as of
    August 28, 1997 among FMCH and Fresenius Medical Care AG, a
    corporation organized and existing under the laws of the Federal
    Republic of Germany (“FMC AG”) in favor of the
    Transferor, Enterprise and the Agent, as amended by Amendment
    No. 1 to Parent Agreement dated as of the date hereof by
    FMCH and FMC AG (as amended, the “Parent Agreement”).
    I have also acted as counsel to (x) each of the
    corporations listed on Schedule I to this letter
    (each, a “Transferring Affiliate”, and collectively,
    the “Transferring Affiliates” and together with FMCH,
    NMC and the Transferor collectively, the “Parent Group
    Members”) and (y) for the limited purpose of rendering
    the opinion set forth in Section 9(g) hereof, FMC AG. The
    Receivables Purchase Agreement, the TAA, and the Parent
    Agreement together with each of the other instruments and
    agreements listed on Schedule II hereto are
    collectively referred to herein as the “Transaction
    Documents.” I am an Associate General Counsel, Vice
    President and Assistant Secretary of FMCH. Capitalized terms not
    defined herein have the meanings assigned to them in the
    Transaction Documents, except as otherwise indicated herein.

 

    I have examined and relied upon such corporate records and
    certificates of officers of the Parent Group Members,
    certificates of public officials and the representations and
    warranties of the Parent Group Members in the relevant
    Transaction Documents, and have made such examination of law as
    I deemed relevant to the opinions set forth herein. Based upon
    the above, and subject to the qualifications set forth below, it
    is my opinion that:

 

    1.  Organization, Existence and Good Standing.

 

    (a) FMCH is a corporation duly formed, validly existing and
    in good standing under the laws of the State of New York, and is
    duly qualified and in good standing in each other state in which
    the nature of the business it conducts or the assets it owns or
    leases requires such qualification and in which the failure to
    be so qualified would have a material adverse effect on its
    business or operations.

 

    (b) NMC is a corporation duly formed, validly existing and
    in good standing under the laws of the State of Delaware, and is
    duly qualified and in good standing in each other state in which
    the nature of the business it conducts or the assets it owns or
    leases requires such qualification and in which the failure to
    be so qualified would have a material adverse effect on its
    business or operations.

 

    (c) Each Transferring Affiliate is a corporation duly
    formed, validly existing and in good standing under the laws of
    the state of its incorporation, and is duly qualified and in
    good standing in each other state in which the nature of the
    business it conducts or the assets it owns or leases requires
    such qualification and in which the failure to be in good
    standing or so qualified would have a material adverse effect on
    the business or operations of such Transferring Affiliate.

 

    2.  Power and Authority.

 

    (a) FMCH has the requisite corporate power and authority to
    execute and deliver, and to perform its obligations under, each
    of the Transaction Documents to which it is a party.

 

    (b) NMC has the requisite corporate power and authority to
    execute and deliver, and to perform its obligations under, each
    of the Transaction Documents to which it is a party.

 

    (c) Each Transferring Affiliate has the requisite corporate
    power and authority to execute and deliver, and to perform its
    obligations under, each of the Transaction Documents to which it
    is a party.

    

    2

 

    3.  Due Authorization.

 

    (a) The execution, delivery and performance of the Parent
    Agreement by FMCH have been duly authorized by all necessary
    corporate action of FMCH.

 

    (b) The execution, delivery and performance of the
    Transaction Documents by NMC have been duly authorized by all
    necessary corporate action of NMC.

 

    (c) The execution, delivery and performance of the
    Transaction Documents by each Transferring Affiliate have been
    duly authorized by all necessary corporate action of each
    Transferring Affiliate.

 

    4.  No Violation of Organic Documents.

 

    (a) FMCH’s execution and delivery of, and its
    performance of its obligations under, the Parent Agreement will
    not violate its charter or by-laws.

 

    (b) NMC’s execution and delivery of, and its
    performance of its obligations under, the Transaction Documents
    will not violate its charter or by-laws.

 

    (c) Each Transferring Affiliate’s execution and
    delivery of, and its performance of its obligations under, the
    Transaction Documents will not violate its charter or by-laws.

 

    5.  Due Execution and Delivery; Validity; Binding
    Effect and General Enforceability

 

    (a) FMCH has duly executed and delivered the Parent
    Agreement.

 

    (b) NMC has duly executed and delivered each of the
    Transaction Documents to which it is a party.

 

    (c) Each Transferring Affiliate has duly executed and
    delivered each of the Transaction Documents to which it is a
    party.

 

    (d) The Parent Agreement constitutes the legal and valid
    obligation of, and is binding on and enforceable against, FMCH
    in accordance with its terms.

 

    (e) In any action or proceeding arising out of or relating
    to any Transaction Document in any court of The Commonwealth of
    Massachusetts or in any federal court sitting in The
    Commonwealth of Massachusetts, such court should recognize and
    give effect to the provisions thereof wherein the parties agree
    that such Transaction Document shall be governed by, and
    construed in accordance with, the laws of the State of New York.
    However, in the event that any such court shall determine that
    any of the Transaction Documents are governed by the laws of The
    Commonwealth of Massachusetts, each of the Transaction Documents
    constitutes the legal and valid obligation of, and is binding on
    and enforceable against, each of the Parent Group Members
    parties thereto.

 

    6.  General Qualifications.  The
    opinions set forth in Section 5 are subject to the
    following qualifications:

 

    (a) The enforceability of the Transaction Documents may be
    limited by bankruptcy, insolvency, fraudulent transfer,
    reorganization, moratorium and other laws or other equitable
    principles relating to or affecting the rights of creditors or
    other obligees generally.

 

    (b) The enforceability of the Transaction Documents may be
    limited by applicable principles of equity, whether such
    principles are applied by a court of equity or a court of law,
    and we express no opinion on whether a court would grant
    specific performance, injunctive relief or any other equitable
    remedy.

 

    (c) The provisions regarding the remedies available to the
    Agent on default as set forth in the Transaction Documents may
    be subject to certain procedural requirements that are not
    expressly staled in the Transaction Documents, but neither the
    existence of these procedural requirements nor the failure to
    specify them in the Transaction Documents make the remedies
    unenforceable.

 

    (d) A court could refuse to permit the Agent to foreclose
    any security interest in favor of the Agent or enforce the
    Agent’s remedies under the Transaction Documents by reason
    of (i) a waiver by the Agent, (ii) unconscionable
    conduct by the Agent, (iii) the exercise of remedies by the
    Agent without providing adequate notice to FMCH, NMC or any of
    the Transferring Affiliates, as applicable of the default and a
    reasonable opportunity to cure the default, (iv) the
    court’s determination that FMCH, NMC or any of the
    Transferring Affiliates, as applicable are

    

    3

 

    entitled to an opportunity to be heard by the court before the
    Agent is entitled to exercise any remedies, (v) the
    court’s determination that a remedy is a penalty or is
    unconscionable, (vi) the court’s determination that
    the Agent is seeking to exercise remedies with respect to a
    breach that is immaterial or that does not adversely affect the
    Agent or the Agent’s security, (vii) defenses arising
    from the Agent’s failure to act in accordance with the
    terms and conditions of the Transaction Documents,
    (viii) defenses arising as a consequence of the passage of
    time (e.g., laches or statutes of limitation),
    (ix) defenses arising as a result of the Agent’s
    failure to act in a commercially reasonable manner or in good
    faith or (x) public policy considerations.

 

    (e) I express no opinion with respect to any of the
    following provisions if they are contained in any of the
    Transaction Documents: (i) self-help, non-judicial remedies
    or provisions purporting to grant a right of possession without
    resort to judicial action to the extent inconsistent with the
    Uniform Commercial Code or other applicable law; (ii) any
    provisions that entitle the Agent, as a matter of right, to the
    appointment of a receiver; (iii) any provisions imposing
    penalties, forfeitures, increased interest/discount rates
    and/or late
    payment charges upon delinquency in payment or the occurrence of
    a default; (iv) any provisions under which FMCH, NMC or any
    of the Transferring Affiliates, as applicable, waive any of its
    legal or equitable rights except to the extent the waived rights
    are expressly waivable pursuant to a statute or constitution
    provision; (v) any provisions entitling the Agent to obtain
    reimbursement for attorneys’ fees and other costs incurred
    by the Agent; (vi) any provision permitting the Agent to
    accelerate the Obligations or exercise any remedies in the event
    of a transfer or encumbrancing of an immaterial portion of any
    collateral or immaterial changes in the beneficial ownership of
    FMCH, NMC or any of the Transferring Affiliates, as applicable;
    (vii) any provision exonerating or indemnifying the Agent
    (or any agent or employee of the Agent or any party acting on
    behalf of the Agent) from the consequences of its own acts or
    omissions; (viii) any severability provision;
    (ix) provisions relating to setoff rights; (x) any
    provision granting a power of attorney or similar right;
    (xi) any provision to the effect that rights or remedies
    are not exclusive, that every right or remedy is cumulative and
    may be exercised in addition to or with any other right or
    remedy or that the election of a particular remedy does not
    preclude recourse to one or more other remedies; (xii) any
    provision pursuant to which a party has granted to another party
    any power to execute documents, settle claims or appear in
    judicial proceedings on behalf of such party or to take any
    other action on behalf of such party; (xiii) any provision
    which purports to affect jurisdiction or venue of any specified
    court or which purports to establish evidentiary standards, or
    which waives trial by jury; (xiv) choice of law provision
    (except as discussed in paragraph 5 above); (xv) any
    provision by which any party agrees to take action if that
    party’s ability to take the action in question is subject
    to conditions another party to the Transaction Documents
    controls; or (xvi) any provision that purports to grant the
    Agent relief from any provisions of the Bankruptcy Code.

 

    7.  No Violations of Other Contracts.

 

    (a) FMCH’s execution, delivery and performance of the
    Parent Agreement and the Reaffirmation Agreement will not breach
    any Other Contract.

 

    (b) NMC’s execution, delivery and performance of the
    Transaction Documents to which it is a party will not breach any
    Other Contract.

 

    (c) Each Transferring Affiliate’s execution, delivery
    and performance of the Transaction Documents to which it is a
    party will not breach any Other Contract.

 

    (d) For purposes of this section, the term Other Contract
    means an indenture, mortgage, deed of trust, loan agreement, or
    other material agreement or instrument to which, to the best of
    my knowledge, FMCH, NMC or any Transferring Affiliate is a party.

 

    8.  No Violations of Applicable Laws.

 

    (a) To the best of my knowledge, FMCH’s execution,
    delivery and performance of the parent Agreement will not
    violate any Applicable Law.

 

    (b) To the best of my knowledge, NMC’s execution,
    delivery and performance of the Transaction Documents to which
    it is a party will not violate any Applicable Law.

 

    (c) To the best of my knowledge, the Transferor’s and
    each Transferring Affiliate’s execution, delivery and
    performance of the Transaction Documents to which it is a party
    will not violate any Applicable Law.

    

    4

 

    (d) For purposes of this paragraph, the term Applicable Law
    means, subject to the following sentences, any provision of
    federal or Massachusetts law or regulation or Delaware General
    Corporation Law that is generally applicable to organizations
    such as FMCH, NMC or any Transferring Affiliate or that relates
    to transactions of this type. The term Applicable Law excludes
    federal and state securities and blue-sky laws, tax laws,
    healthcare laws and related rules and regulations.

 

    9.  No Violations of Court Decrees or Orders and
    other Matters.

 

    (a) FMCH’s execution, delivery and performance of the
    Parent Agreement will not violate any Court Decree or Order.

 

    (b) NMC’s execution, delivery and performance of the
    Transaction Documents to which it is a party will not violate
    any Court Decree or Order.

 

    (c) Each Transferring Affiliate’s execution, delivery
    and performance of the Transaction Documents to which it is a
    party will not violate any Court Decree or Order.

 

    (d) For purposes of this paragraph, the term Court Decree
    or Order means a decree, order or other official action of any
    court or other governmental body that is, to the best of my
    knowledge, specifically applicable to FMCH, NMC or any
    Transferring Affiliate as a named party.

 

    (e) The execution, delivery and performance by each Parent
    Group Member of the Transaction Documents to which it is named
    as a party (a) to the best of my knowledge, does not result
    in or require the creation of any lien, security interest or
    other charge or encumbrance upon or with respect to any of such
    Person’s properties (except as may be specifically
    contemplated in the Transaction Documents) and (b) does not
    require compliance with any bulk sales act or similar law.

 

    (f) To the best of my knowledge, no authorization,
    approval, consent or other action by, and no notice to or filing
    with, any governmental authority or regulatory body is required
    for the due execution, delivery and performance by any Parent
    Group Member of any Transaction Document to which it is named as
    a party.

 

    (g) To the best of my knowledge, there are no actions,
    suits, orders, decrees, investigations, or other proceedings
    pending or threatened at law, in equity, in arbitration or
    before any governmental agency, commission or official against
    or affecting any Parent Group Member or FMC AG which challenges
    or affects the legality, validity or enforceability of any
    Transaction Document or, except as otherwise disclosed in
    Exhibit A attached hereto, which would otherwise be
    reasonably likely to have a Material Adverse Effect

 

    (h) To the best of my knowledge and belief there are no
    governmental authorization, approvals, orders, licenses,
    certificates, franchises or permits of and from any governmental
    regulatory officials and bodies, that are necessary in order for
    any Parent Group Member to own its respective properties and to
    conduct its respective businesses as now being conducted, which
    have not been obtained, except where the failure to have so
    obtained any such authorization, approvals, orders, licenses,
    certificates franchises or permits, individually or in the
    aggregate, would not have a Material Adverse Effect.

 

    10.  Investment Company Act.  Neither
    FMCH, NMC, the Transferor nor any Transferring Affiliate is or
    is controlled by an “investment company” within the
    meaning of the Investment Company Act of 1940, as amended, and
    therefore none of them is subject to registration as an
    “investment company.”

 

    11.  Public Utility Holding Company
    Act.  Neither FMCH, NMC, the Transferor nor any
    Transferring Affiliate is a “holding company” within
    the meaning of the Public Utility Holding Company Act of 1935,
    as amended.

 

    The foregoing opinion is subject in its entirety to the
    following qualifications:

 

    The opinions expressed in this letter are solely for the use of
    the Agent, Enterprise, Compass, the Administrative Agents and
    the Bank Investors, and their permitted assignees and
    participants, and their legal counsel. These opinions may not be
    relied on by any other persons, may not be quoted in whole or in
    part, and may not be filed with any governmental agency, in each
    case without my express prior written approval; provided that
    these opinions may be disclosed to, and relied upon by, any
    rating agency then rating obligations of Enterprise,

    

    5

 

    Compass, the Related CP Issuer, any Credit Support Provider, any
    Liquidity Provider and Arent, Fox, Kintner, Plotkin &
    Kahn.

 

    The opinions expressed in this letter are rendered as of the
    date hereof and I express no opinion as to circumstances or
    events that may occur in the future. The opinions expressed in
    this letter are limited to the matters set forth in this letter,
    and no other opinions should be inferred beyond the matters
    expressly stated.

 

    This opinion is based and relies upon the current status of the
    laws of The Commonwealth of Massachusetts and the United States,
    and the General Corporation Law of the State of Delaware and in
    all respects this opinion is subject to and may be limited by
    amendments or other changes in such laws, rules and regulations,
    and any future laws, rules and regulations, as well as by
    developing case law.

 

    I have relied without investigation on certificates and other
    communications from public officials as to matters of fact.

 

    Very truly yours,

     

    Douglas G. Kott

    Vice President, Assistant Secretary and

    Associate General Counsel

    

    6

 

    September   ,
    1999

 

    SCHEDULE I

    

 

    (LIST OF
    TRANSFERRING AFFILIATES)

    

    7

 

    Exhibit [  ]

 

    EXHIBIT A

    

 

    LIST
    OF TRANSFERRING AFFILIATES

    

 

    Transferring
    Affiliates

 

	 	 	 
	
    Chief Executive Office for each 

    Transferring Affiliation:
	
 
	
    Two Ledgemont Center 

    95 Hayden Avenue 

    Lexington, Massachusetts 02420-9192

 

	 	 	 
	
    Dialysis Services
	
 
	
    State of Incorporation

	 

	

    Bio-Medical Applications Management Company, Inc

	
 
	
    Delaware

	

    Bio-Medical Applications of Aguadilla, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Alabama, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Alameda County, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Anacostia, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Arecibo, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Arizona, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Arkansas, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Bayamon, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Blue Springs, Inc

	
 
	
    Delaware

	

    Bio-Medical Applications of Caguas, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of California, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Camarillo, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Capitol Hill, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Carolina, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Carson, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Clinton, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Colorado, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Columbia Heights, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Connecticut, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Delaware, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Dover, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of East Orange, Inc

	
 
	
    Delaware

	

    Bio-Medical Applications of Essex, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Eureka, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Fayetteville, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Florida, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Fremont, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Fresno, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Georgia, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Glendora, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Guayama, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Hillside, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Hoboken, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications Home Dialysis Services, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Humacao, Inc. 

	
 
	
    Delaware

    

    1

 

 

    Exhibit [  ]

 

	 	 	 
	
    Dialysis Services
	
 
	
    State of Incorporation

	 

	

    Bio-Medical Applications of Illinois, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Indiana, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Irvington, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Jersey City, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Kansas, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Kentucky, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Las Americas, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Long Beach, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Los Angeles, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Los Gatos, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Louisiana, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Maine, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Manchester, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Maryland, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Massachusetts, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Mayaguez, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Michigan, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Minnesota, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Mission Hills, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Mississippi, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Missouri, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of MLK, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Nevada, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of New Hampshire, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of New Jersey, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of New Mexico, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of New York, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of North Carolina, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Northeast, D.C., Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Oakland, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Ohio, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Oklahoma, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Pennsylvania, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Pine Brook, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Ponce, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Port Orange, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Puerto Rico, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Rhode Island, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Rio Piedras, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of San Antonio, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of San German, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of San Juan, Inc. 

	
 
	
    Delaware

    2

 

 

    Exhibit [  ]

 

	 	 	 
	
    Dialysis Services
	
 
	
    State of Incorporation

	 

	

    Bio-Medical Applications of South Carolina, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of South Queens, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of

	
 
	
 

	

    Southeast Washington, Inc. 

	
 
	
    Delaware

	

    .Bio-Medical Applications of Tennessee, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of The District of Columbia, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Torrance, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Trenton, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Ukiah, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Union City, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Virginia, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of West Virginia, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Wisconsin, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Whittier, Inc. 

	
 
	
    Delaware

	

    Bio-Medical Applications of Woonsocket, Inc. 

	
 
	
    Delaware

	

    Conejo Valley Dialysis, Inc. 

	
 
	
    Delaware

	

    Dialysis Services, Inc. 

	
 
	
    Delaware

	

    Dialysis America, LLC

	
 
	
    Alabama Georgia

	

    FMC Dialysis Services — Oregon, LLC

	
 
	
    Oregon

	

    Gulf Region Mobile Dialysis, Inc. 

	
 
	
    Delaware

	

    Fresenius Management Services, Inc. 

	
 
	
    Delaware

	

    Haemo-Stat, Inc. 

	
 
	
    California

	

    Home Intensive Care, Inc. 

	
 
	
    Delaware

	

    National Medical Care, Inc

	
 
	
    Delaware

	

    Neomedica, Inc

	
 
	
    Delaware

	

    Qualicenters, Inc. 

	
 
	
    Colorado

	

    San Diego Dialysis Services, Inc. 

	
 
	
    Delaware

	

    Santa Barbara Community Dialysis Center, Inc

	
 
	
    Delaware

	

    Willamette Valley Kidney Center, LLC

	
 
	
    Oregon

    3

 

    Exhibit Q

 

	 	 	 
	
    Dialysis Products
	
 
	
 

	 

	

    Fresenius USA, Inc

	
 
	
    Massachusetts

	

    Fresenius USA Home Dialysis, Inc

	
 
	
    Delaware

	

    Fresenius USA Marketing, Inc

	
 
	
    Delaware

	

    Fresenius USA of Puerto Rico, Inc. 

	
 
	
    Delaware

	

    Fresenius USA Sales, Inc

	
 
	
    Massachusetts

	

    Life Assist Medical Products Corp

	
 
	
    Puerto Rico

	

    NMC Medical Products, Inc

	
 
	
    Delaware

	

    Prime Medical, Inc. 

	
 
	
    Delaware

	

    Renal Scientific Services, Inc. 

	
 
	
    Delaware

    

    4

 

    September   ,
    1999

 

    SCHEDULE II

    (LIST OF TRANSACTION DOCUMENTS)

    

    5

 

    AMENDED
    AND RESTATED

    TRANSFER AND ADMINISTRATION AGREEMENT

    

    Dated as of September 27, 1999

    

    NMC FUNDING CORPORATION,

    as Transferor

    

    LIST OF CLOSING DOCUMENTS

 

    A.  Transfer and Sale Documentation

 

    1. Amended and Restated Transfer and Administration
    Agreement (the “Amended and Restated TAA”) dated as of
    September 27, 1999 among Enterprise Funding Corporation
    (“Enterprise”), Compass US Acquisition LLC
    (“Compass”), NMC Funding Corporation (the
    “Transferor”), National Medical Care, Inc., as
    collection agent (the “Collection Agent”), the Bank
    Investors, Westdeutsche Landesbank Girozentrale, New York Branch
    (“WestLB”), as Administrative Agent, and Bank of
    America, N.A. (“Bank of America”), as Administrative
    Agent and as Agent (#127126).

 

    2. Fee Letter among the Transferor, Bank of America and
    Enterprise (#128368).

 

    3. Fee Letter among the Transferor, WestLB and Compass
    (#129611).

 

    4. Amendment to the Parent Agreement (#129357).

 

    5. Assignment Agreement between Compass and Enterprise
    (#129431).

 

    B.  Opinions

 

    6. Opinion of Douglas G. Kott.

 

    7. Opinion of Arent Fox Kintner Plotkin & Kahn,
    Special Counsel to the Transferor.

 

    8. Opinion of Nutter McClennen & Fish, LLP,
    special Massachusetts counsel.

 

    9. Opinion of Rainer Runte, General Counsel of FMC.

 

    C.  Corporate Documents

 

    10. Good Standing Certificates for the Transferor from the
    Secretary of the Commonwealth of Massachusetts and the Secretary
    of State of Delaware.

 

    11. Good Standing Certificates for the Collection Agent
    from the Secretary of the Commonwealth of Massachusetts and the
    Secretary of State of Delaware.

 

    12. A Certificate of the Secretary of the Transferor
    substantially in the form of Exhibit L of the TAA.

 

    13. A Certificate of the Secretary of the Collection Agent
    substantially in the form of Exhibit L of the TAA.

 

    14. UCC-3 Amendments to the financing statements filed
    against the Transferor, filed in the offices of the Town Clerk
    of Massachusetts and the Secretary of the Commonwealth of
    Massachusetts (#130060).

    

    1

 

    September   ,
    1999

 

    EXHIBIT A

    (LEGAL PROCEEDINGS)

    

    2

 

    EXHIBIT A

    

 

    LIST OF
    ACTIONS AND SUITS

 

    [Excerpted from Fresenius Medical Care Holdings. Inc.’s
    Report filed on
    Form 10-Q
    filed with the Securities Exchange Commission for the quarter
    ended June 30, 1999 (the
    “10-Q”).
    Defined terms not capitalized herein have the meaning given to
    them in the
    10-Q]

 

		
	
    NOTE 5.  
	
    COMMITMENTS
    AND CONTINGENCIES

 

    Contingent
    Non-NMC Liabilities of Grace New York (Now Known as Fresenius
    Medical Care Holdings, Inc.)

 

    In connection with the Merger, Grace Chemicals has agreed to
    indemnify the Company and NMC against all liabilities of the
    Company and its successors, whether relating to events occurring
    before or after the Merger, other than liabilities arising from
    or relating to NMC operations. After the Merger the Company will
    remain contingently liable for certain liabilities with respect
    to pre-Merger matters that are not related to NMC operations.
    The Company believes that in view of the nature of the non-NMC
    liabilities and the expected impact of the Merger on Grace
    Chemicals’ financial position, the risk of significant loss
    from non-NMC liabilities is remote.

 

    Were events to violate the tax-free nature of the Merger, the
    resulting tax liability would be the obligation of the Company.
    Subject to representations by Grace Chemicals, the Company, and
    Fresenius AG, Grace Chemicals has agreed to indemnify the
    Company for such a tax liability. If the Company was not able to
    collect on the indemnity, the tax liability would have a
    material adverse effect on the Company’s business, the
    financial condition of the Company and the results of operations.

 

    Legal
    Proceedings

 

    Government
    Investigations

 

    OIG
    Investigative Subpoenas

 

    In October 1995, NMC received five investigative subpoenas from
    the Office of the Inspector General (“OIG”) of the
    Department of Health and Human Services. The subpoenas were
    issued in connection with an investigation being conducted by
    the OIG, the U.S. Attorney for the District of
    Massachusetts and others concerning possible violations of
    federal laws, including the anti-kickback statutes and the False
    Claims Act (the “OIG Investigation”). The subpoenas
    call for extensive document production relating to various
    aspects of NMC’s business.

 

    In connection with the OIG Investigation, the Company continues
    to receive additional subpoenas directed to NMC or the Company
    to obtain supplemental information and documents regarding the
    above-noted issues, or to clarify the scope of the original
    subpoenas.

 

    The Company is cooperating with the OIG Investigation in
    providing supplemental information and documents. The Company
    believes that the government continues to review and evaluate
    the voluminous information the Company has provided. As
    indicated above, the government continues, from time to time, to
    seek supplementing
    and/or
    clarifying information from the Company. The Company understands
    that the government has utilized a grand jury to investigate
    these matters. The Company expects that this process will
    continue while the government completes its evaluation of the
    issues.

 

    The OIG Investigation covers the following areas:
    (a) NMC’s dialysis services business (“Dialysis
    Services”), principally relating to its Medical Director
    contracts and compensation; (b) NMC’s treatment of
    credit balances resulting from overpayments received under the
    Medicare, Medicaid, CHAMPUS and other government and commercial
    payors, its billing for home dialysis services, and its payment
    of supplemental medical insurance premiums on behalf of indigent
    patients; (c) NMC’s LifeChem laboratory
    subsidiary’s (“LifeChem”) business, including
    testing procedures, marketing, customer relationships,
    competition, overpayments totaling approximately
    $4.9 million that were received by LifeChem from the
    Medicare program with respect to laboratory services rendered
    between 1989 and 1993, a 1997 review of dialysis
    facilities’ standing orders, and the provision of discounts
    on products from NMC’s products division, grants, equipment
    and entertainment to customers; and

    

    1

 

    (d) NMC’s homecare division (“Homecare”)
    and, in particular, information concerning intradialytic
    parenteral nutrition (“IDPN”) utilization,
    documentation of claims and billing practices including various
    services, equipment and supplies and payments made to third
    parties as compensation for administering IDPN therapy.

 

    The government has indicated that the areas identified above are
    not exclusive, and that it may pursue additional areas. As
    noted, the penalties applicable under the anti-kickback
    statutes, the U.S. Federal False Claims Act (the
    “False Claims Act”) and other federal and state
    statutes and regulations applicable to NMC’s business can
    be substantial. While NMC asserts that it is able to offer legal
    and/or
    factual defenses with respect to many of the areas the
    government has identified, it is expected that the government
    will assert that NMC has violated multiple statutory and
    regulatory provisions. Additionally, qui tam actions alleging
    that NMC submitted false claims to the government have been
    filed under seal by former or current NMC employees or other
    individuals who may have familiarity with one or more of the
    issues under investigation. As noted, under the False Claims
    Act, any such private plaintiff could pursue an action against
    NMC in the name of the U.S. at his or her own expense if
    the government declines to do so.

 

    Since October 1995 when the initial subpoenas were served NMC
    and the government have met periodically to discuss issues in
    connection with the OIG Investigation, including theories of
    liability. NMC and the government have been exploring the
    possibility of settling the matters which are encompassed by the
    OIG Investigation and, as referenced below, have settled the
    diagnostics investigation matter. There can be no assurance that
    any of the other matters subject to the OIG Investigation will
    be settled. If however, one or more of the matters encompassed
    by the OIG Investigation is settled, it may result in NMC
    acknowledging that its past practices violated federal statutes,
    as well as NMC incurring substantial civil and criminal
    financial penalties which could have a material adverse effect
    on the Company. If one or more of these matters is not settled,
    the government may be expected to seek substantial civil and
    criminal financial penalties and other sanctions including the
    suspension of payments by, and the exclusion of NMC and its
    subsidiaries from, the Medicare program, Medicaid program and
    other federal health care programs. See “Management’s
    Discussion and Analysis of Financial Condition and Results of
    Operations — Contingencies.”

 

    Diagnostics
    Subpoena

 

    In October 1996, Biotrax International, Inc.
    (“Biotrax”) and NMC Diagnostics, Inc.,
    (“DSI”) both of which are subsidiaries of NMC,
    received a civil investigative subpoena from the OIG concerning
    the possible submission of false or improper claims to, and
    their payment by, the Medicare program. In May, 1999 the Company
    and the government entered into a settlement agreement pursuant
    to which, among other things, the government has agreed to
    release the Company with respect to this matter in exchange for
    a payment of approximately $16.8 million from the Company.

 

    Medical
    Director Compensation

 

    The government is investigating whether Dialysis Services
    compensation arrangements with its Medical Directors constitute
    payments to induce referrals, which would be illegal under the
    anti-kickback statutes, rather than payment for services
    rendered. Dialysis Services compensated the substantial majority
    of its Medical Directors on the basis of a percentage of the
    earnings of the dialysis center for which the Medical Director
    was responsible from the inception of NMC’s predecessor in
    1972 until January 1, 1995, the effective date of Stark II.
    Under the arrangements in effect prior to January 1, 1995,
    the compensation paid to Medical Directors was adjusted to
    include “add backs.” which represented a portion of
    the profit earned by NMC’s Medical Products Group
    (“MPG”) on products purchased by the Medical
    Director’s facility from MPG and (until January 1,
    1992) a portion of the profit earned by LifeChem on
    laboratory services provided to patients at the Medical
    Director’s facility. These adjustments were designed to
    allocate a profit factor to each dialysis center relating to the
    profits that could have been realized by the center if it had
    provided the items and services directly rather than through a
    subsidiary of NMC. The percentage of profits paid to any
    specific Medical Director was reached through negotiation, and
    was typically a provision of a multi-year consulting agreement.

 

    To comply with provisions of OBRA 93 (as hereinafter defined)
    known as “Stark II” if Designated Health Services (as
    defined in Stark II) are involved, Medical Director
    compensation must not exceed fair market value and

    

    2

 

    may not take into account the volume or value of referrals or
    other business generated between the parties. Since
    January 1, 1995, Dialysis Services has compensated its
    Medical Directors on a fixed compensation arrangement intended
    to comply with the requirements of Stark II. In renegotiating
    its Medical Director compensation arrangements in connection
    with Stark II, Dialysis Services took and continues to take
    account of the compensation levels paid to its Medical Directors
    in prior years.

 

    Certain government representatives have expressed the view in
    meetings with counsel for NMC that arrangements where the
    Medical Director was or is paid amounts in excess of the
    “fair market value” of the services rendered may
    evidence illegal payments to induce referrals, and that hourly
    compensation is a relevant measure for evaluating the “fair
    market value” of the services. Dialysis Services does not
    compensate its Medical Directors on an hourly basis and has
    asserted to the government that hourly compensation is not a
    determinative measure of fair market value. Although the Company
    believes that the compensation paid to its Medical Directors is
    generally reflective of fair market value, there can be no
    assurances that the government will agree with this position or
    that the Company ultimately will be able to defend its position
    successfully. Because of the wide variation in local market
    factors and in the profit percentage contractually negotiated
    between Dialysis Services and its Medical Directors prior to
    January 1, 1995, there is a wide variation in the amounts
    that have been paid to Medical Directors.

 

    As a result, the compensation that Dialysis Services has paid
    and is continuing to pay to a material number of its Medical
    Directors could be viewed by the government as being in excess
    of “fair market value,” both in absolute terms and in
    terms of hourly compensation. NMC has asserted to the government
    that its compensation arrangements do not constitute Illegal
    payments to induce referrals. NMC has also asserted to the
    government that OIG auditors repeatedly reviewed NMC’s
    compensation arrangements with its Medical Directors in
    connection with their audits of the costs claimed by Dialysis
    Services that the OIG stated in its audit reports that, with the
    exception of certain technical issues, NMC had complied with
    applicable Medicare laws and regulations pertaining to the ESRD
    program; and that NMC reasonably relied on these audit reports
    in concluding that its program for or compensating Medical
    Directors was lawful. There has been no indication that the
    government will accept NMC’s assertions concerning the
    legality of NMC’s arrangements generally or NMC’s
    assertion that NMC reasonably relied on OIG audits, or that the
    government will not focus on specific arrangements that Dialysis
    Services has made with one or more Medical Directors and assert
    that those specific arrangements were or are unlawful.

 

    The government is also investigating whether Dialysis Services
    profit sharing arrangements with its Medical Directors
    influenced them to order unnecessary ancillary services and
    items. NMC has asserted to the government that the rate of
    utilization of ancillary services and items by its Medical
    Directors is reasonable and that it did not provide illegal
    inducements to Medical Directors to order ancillary services and
    items.

 

    Credit
    Balances

 

    In the ordinary course of business, medical service providers
    like Dialysis Services receive overpayments from Medicare
    intermediaries and other payors for services that they provide
    to patients. Medicare intermediaries commonly direct such
    providers to notify them of the overpayment and not remit such
    amounts to the intermediary by check or otherwise unless
    specifically requested to do so. In 1992, the Health Care
    Financing Administration (“HCFA”) adopted a regulation
    requiring certain Medicare providers, including dialysis
    centers, to file a quarterly form listing unrecouped
    overpayments with the Medicare intermediary responsible for
    reimbursing the provider.

 

    The first such filing was required to be made as of
    June 30, 1992 for the period beginning with the initial
    date that the provider participated in the Medicare program and
    ending on June 30, 1992.

 

    The government is investigating whether Dialysis Services
    intentionally understated the Medicare credit balance reflected
    on its books, and records for the period ending June 30,
    1992 by reversing entries out of its credit balance account and
    taking overpayments into income in anticipation of the
    institution of the new filing requirement. Dialysis Services
    policy was to notify Medicare intermediaries in writing of
    overpayments upon receipt and to maintain unrecouped Medicare
    overpayments as credit balances on the books and records of
    Dialysis Services for four years; overpayments not recouped by
    Medicare within four years would be reversed from the credit
    balance account and would be available to be taken into income.
    NMC asserts that Medicare overpayments that have not been
    recouped by Medicare within four years are not subject to
    recovery under applicable regulations

    

    3

 

    and that its initial filing with the intermediaries disclosed
    the credit balance on the books and records of Dialysis Services
    as shown in accordance with its policy, but there can be no
    assurance that the government will accept NMC’s views. The
    government has inquired whether other divisions including
    Homecare, LifeChem and DSI have appropriately treated Medicare
    credit balances as well as credit balances of other payors.

 

    The government is also investigating whether Dialysis Services
    failed to disclose Medicare overpayments that resulted from
    Dialysis Services obligation to rebill commercial payors for
    amounts originally billed to Medicare under HCFA’s Initial
    implementation of the Omnibus Budget Reconciliation Act of 1993
    (“OBRA 93”) amendments to the secondary payor
    provisions of the Medicare Act. Dialysis Services experienced
    delays in reporting a material amount of overpayments after the
    Implementation of the OBRA 93 amendments. NMC asserts that most
    of these delays were the result of the substantial
    administrative burdens placed on Dialysis Services as a
    consequence of the changing and inconsistent instructions issued
    by HCFA with respect to the OBRA 93 amendments and were not
    intentional. Substantially all overpayments resulting from the
    rebilling effort associated with the OBRA 93 amendments have now
    been reported. Procedures are in place that are designed to
    ensure that subsequent overpayments resulting from the OBRA 93
    amendments will be reported on a timely basis.

 

    LifeChem made these disclosures to the government as part of an
    application to be admitted to a voluntary disclosure program
    begun by the government in mid-1995. At the time of the
    disclosures, LifeChem tendered repayment to the government of
    the $4.9 million in overpayments. After the OIG
    Investigation was announced, the government indicated that
    LifeChem had not been accepted into its voluntary disclosure
    program. The government has deposited the $4.9 million
    check with NMC’s approval. The matters disclosed in
    LifeChem’s September 22, 1995 voluntary disclosure are
    a subject of the OIG Investigation.

 

    On June 7, 1996, LifeChem voluntarily disclosed an
    additional billing problem to the government that had resulted
    in LifeChem’s receipt of between $40,000 and $160,000 in
    overpayments for laboratory services rendered in 1991. LifeChem
    advised the government that this overpayment resulted from the
    submission for payment of a computer billing tape that had not
    been subjected to a “billing rules” program designed
    to eliminate requests for payments for laboratory tests that are
    included in the Composite Rate and that were not eligible for
    separate reimbursement. LifeChem also advised the government
    that there may have been additional instances during the period
    from 1990 to 1992 when other overpayments were received as a
    result of the submission of computer billing tapes containing
    similar errors and that it was in the process of determining
    whether such additional overpayments were received. On
    June 21, 1996, LifeChem advised the government that the
    1991 billing problem disclosed on June 7, 1996 resulted in
    an overpayment of approximately $112,000. LifeChem also advised
    the government that certain records suggested instances in July
    1990 and August 31 through September 11, 1990, when billing
    tapes may have been processed without rules processing. LifeChem
    continued its effort to determine whether any other overpayments
    occurred relating to the “billing rules” problem and,
    in March 1997, advised the government that an additional
    overpayment of approximately $260,000 was made by Medicare.

 

    On April 6, 1999, LifeChem voluntarily disclosed an
    additional billing problem to the government that resulted in
    LifeChem’s receipt of overpayments for laboratory services
    rendered between 1994 and 1999. In 1994, as a result of the
    advice of a billing consultant, LifeChem began to bill for
    platelet testing performed in connection with complete blood
    counts. This advice was confirmed by the consultant in 1997 as
    part of a review performed by the consultant under the auspices
    of LifeChem’s then outside counsel. In 1999, however, an
    internal inquiry resulted in a reexamination of this advice and
    LifeChem determined that the prior advice was incorrect. As a
    result LifeChem voluntarily disclosed and repaid the overpayment
    to the government in the amount of $8.6 million. LifeChem
    also has notified the government of the disclosure. There can be
    no assurances that the government will agree that
    LifeChem’s disclosure should not result in a sanction
    beyond repayment of the overpayment amount.

 

    Capitation for routine tests and panel
    design.  In October 1994, the OIG issued a special
    fraud alert in which it stated its view that the industry
    practice of offering to perform or performing the routine tests
    covered by the composite rate payment method (the
    “Composite Rate”) at a price below fair market value,
    coupled with an agreement by a dialysis center to refer all or
    most of its non-Composite Rate tests to the laboratory,

    

    4

 

    Supplemental
    Medical Insurance

 

    Dialysis Services provided grants or loans for the payment of
    premiums for supplemental medical insurance (under which
    Medicare Part B coverage is provided) on behalf of a small
    percentage of its patients who are financially needy. The
    practice of providing loans or grants for the payment of
    supplemental medical insurance premiums by NMC was one of the
    subjects of review by the government as part of the OIG
    Investigation.

 

    The Government, however, advised the Company orally that it is
    no longer pursuing this issue. Furthermore, as a result of the
    passage of HIPAA, the Company terminated making such payments on
    behalf of its patients. Instead, the Company, together with
    other representatives of the industry, obtained an advisory
    opinion from the OIG, whereby, consistent with specified
    conditions, the Company and other similarly situated providers
    may make contributions to a non-profit organization that has
    volunteered to make these payments on behalf of indigent ESRD
    patients, Including patients of the Company. In addition, the
    government has indicated that it is investigating the method by
    which NMC made Medigap payments on behalf of its indigent
    patients.

 

    Overpayments
    for Home Dialysis Services

 

    NMC acquired Home Intensive Care, Inc. (“HIC”), an
    in-center and home dialysis service provider, in 1993. At the
    time of the acquisition, HIC was the subject of a claim by HCFA
    that HIC had received payments for home dialysis services in
    excess of the Medicare reasonable charge for services rendered
    prior to February 1, 1990. NMC settled the HCFA claim
    against HIC in 1994. The government is investigating whether the
    settlement concerning the alleged overpayments made to HIC
    resolved all issues relating to such alleged overpayments. The
    government is also investigating Whether an NMC subsidiary, Home
    Dialysis Services, Inc. (“HDS”), received payments
    similar to the payments that HIC received, and whether HDS
    improperly billed for home dialysis services in excess of the
    monthly cost cap for services rendered on or after
    February 1, 1990. The government is investigating whether
    NMC was overpaid for services rendered. NMC asserts that the
    billings by HDS were proper, but there can be no assurance that
    the government will accept NMC’s view.

 

    LifeChem

 

    Overpayments.  On September 22, 1995,
    LifeChem voluntarily disclosed certain billing problems to the
    government that had resulted In LifeChem’s receipt of
    approximately $4.9 million in overpayments from the
    Medicare program for laboratory services rendered between 1989
    and 1993. LifeChem asserts that most of these overpayments
    relate to errors caused by a change in LifeChem’s computer
    systems and that the remainder of the overpayments were the
    result of the incorrect practice of billing for a complete blood
    count with differential when only a complete blood count was
    ordered and performed, and of the incorrect practice of billing
    for a complete blood count when only a hemoglobin or hematocrit
    test was ordered. LifeChem asserts that the overpayments it
    received were not caused by fraudulent activity, but there can
    be no assurance that the government will accept LifeChem’s
    view.

 

    violates the anti-kickback statutes. In response to this alert,
    LifeChem changed its practices with respect to testing covered
    by the Composite Rate to increase the amount charged to both
    Dialysis Services and third-party dialysis centers and reduce
    the number of tests provided for the fixed rate. The government
    is investigating LifeChem’s practices with respect to these
    tests.

 

    Benefits provided to dialysis centers and persons associated
    with dialysis centers.  The government is
    investigating whether Dialysis Services or any third-party
    dialysis center or any person associated with any such center
    was provided with benefits in order to induce them to use
    LifeChem services. Such benefits could include, for example,
    discounts on products or supplies, the provision of computer
    equipment, the provision of money for the purchase of computer
    equipment, the provision of research grants and the provision of
    entertainment to customers. NMC has identified certain instances
    in which benefits were provided to customers who purchased
    medical products from NMC Medical Products, Inc., NMC’s
    products company, and used LifeChem’s laboratory services.
    The government may assert that the provision of such benefits
    violates, among other things, the anti-kickback statutes. In
    December 1998, the former Vice President of Sales responsible
    for NMC’s laboratory and products divisions plead guilty to
    the payment of illegal kickbacks to obtain laboratory business
    for LifeChem. In

    

    5

 

    February 1999, the former President of NMC Medical Products,
    Inc. was indicted by the government for the payment of these
    same and/or
    similar kickbacks.

 

    Business and testing practices.  As noted
    above, the government has identified a number of specific
    categories of documents that it is requiring NMC to produce in
    connection with LifeChem business and testing practices. In
    addition to documents relating to the areas discussed above, the
    government has also required LifeChem to produce documents
    relating to the equipment and systems used by LifeChem in
    performing and billing for clinical laboratory blood tests, the
    design of the test panels offered and equisition forms used by
    LifeChem, the utilization rate for certain tests performed by
    LifeChem, recommendations concerning diagnostic codes to be used
    in ordering tests for patients with given illnesses or
    conditions, internal and external audits and Investigations
    relating to LifeChem’s billing and testing. Subsequently,
    the government served an investigative subpoena for documents
    concerning the Company’s 1997 review of dialysis
    facilities’ standing orders, and responsive documents were
    provided. The government has served investigative subpoenas
    requiring NMC to update its production on the above issues and
    to produce contract files for twenty-three identified dialysis
    clinic customers. The government is investigating each of these
    areas, and asserts that LifeChem
    and/or NMC
    have violated the False Claims Act
    and/or the
    Anti-Kickback Statute through the test ordering, paneling,
    requisitioning, utilization, coding, billing and auditing
    practices described above. In June 1999, a former Vice President
    of Marketing of NMC Medical Products, Inc. plead guilty to a
    charge of conspiracy to defraud Medicare in connection with the
    marketing of certain hepatitis tests.

 

    Intradialytic
    Parenteral Nutrition

 

    Administration kits.  One of the activities of
    SRM is to provide IDPN therapy to dialysis patients at both
    NMC-owned facilities and at facilities owned by other providers.

 

    IDPN therapy was provided by Homecare prior to its divestiture.
    IDPN therapy is typically provided to the patient
    12-13 times
    per month during dialysis treatment. Bills are submitted to
    Medicare on a monthly basis and include separate claims for
    reimbursement for supplies, including, among other things,
    nutritional solutions, administration kits and infusion pumps.
    In February 1991, the Medicare carrier responsible for
    processing Homecare’s IDPN claims issued a Medicare
    advisory to all parenteral and enteral nutrition suppliers
    announcing a coding change for reimbursement of administration
    kits provided in connection with IDPN therapy for claims filed
    for items provided on or after April 1, 1991. The Medicare
    allowance for administration kits during this period was
    approximately $625 per month per patient. The advisory stated
    that IDPN providers were to indicate the “total number of
    actual days” when administration kits were
    “used,” instead of indicating that a one-month supply
    of administration kits had been provided. In response, Homecare
    billed for administration kits on the basis of the number of
    days that the patient was on an IDPN treatment program during
    the billing period, which typically represented the entire
    month, as opposed to the number of days the treatment was
    actually administered. During the period from April 1991 to June
    1992, Homecare had an average of approximately 1,200 IDPN
    patients on service.

 

    In May 1992, the carrier issued another Medicare advisory to all
    PEN suppliers in which it stated that it had come to the
    carrier’s attention that some IDPN suppliers had not been
    prorating their billing for administration kits used by IDPN
    patients and that providers should not bill for administration
    kits on the basis of the number of days that the patient was on
    an IDPN treatment program during the billing period. The
    advisory stated further that the carrier would be conducting
    “a special study to determine whether or not overpayments
    have occurred as a result of incorrect billing” and that
    “if overpayments have resulted, providers that have
    incorrectly billed” would “be contacted so that
    refunds can be recovered.” Homecare revised its billing
    practices in response to this advisory for claims filed for
    items provided or after July 1, 1992. Home care was not
    asked to refund any amounts relating to its billings for
    administration kits following the issuance of the second
    advisory.

 

    The government asserts that NMC submitted false claims for
    administration kits during the period from 1988 to June 30,
    1996, and that Homecare’s billing for administration kits
    during this period violated, among other things, the False
    Claims Act.

 

    Infusion Pumps and IV Poles.  During the
    time period covered by the subpoenas, Medicare regulations
    permitted IDPN providers to bill Medicare for the infusion pumps
    and, until 1992, for IV poles provided to IDPN patients in
    connection with the administration of IDPN treatments. These
    regulations do not expressly specify that a

    

    6

 

    particular pump and IV pole be dedicated to a specific
    patient, and NMC asserts that these regulations permitted
    Homecare to bill Medicare for an infusion pump and IV pole
    so long as the patient was infused using a pump and IV
    pole. Despite the absence of an express regulatory
    specification, Homecare developed a policy to deliver to a
    dialysis center a dedicated infusion pump and IV pole for
    each patient, although the Company cannot represent that
    Homecare followed this policy in every instance. The government
    is investigating the propriety of Homecare’s billings for
    infusion pumps and IV poles and asserts that
    Homecare’s billings violate the False Claims Act.

 

    As noted above, under the new policies published by HCFA with
    respect to IDPN therapy, the Company has not been able to bill
    for infusion pumps after July 1, 1996. The government
    discontinued reimbursement for IV poles in 1992.

 

    “Hang fees” and other payments.  IDPN
    therapy is typically provided to the patient during dialysis by
    personnel employed by the dialysis center treating the patient
    with supplies provided and billed to Medicare by Homecare in
    accordance with the Medicare parenteral nutrition supplier
    rules. In order to compensate dialysis centers for the costs
    incurred in administering IDPN therapy and monitoring the
    patient during therapy, Homecare followed the practice common in
    the industry of paying a “hang fee” to the center.
    Dialysis centers are responsible for reporting such fees to HCFA
    on their cost reports. For Dialysis Services dialysis centers,
    the fee was $30 per administration, based upon internal Dialysis
    Services cost calculations. For third-party dialysis centers,
    the fee was negotiated with each center, typically pursuant to a
    written contract, and ranged from $15 to $65 per administration.
    The Company has identified instances in which other payments and
    amounts beyond that reflected in a contract were paid to these
    third-party centers. The Company has stopped paying “hang
    fees” to both Dialysis Services and third-party facilities.

 

    In July 1993, the OIG issued a management advisory alert to HCFA
    in which it stated that “hang fees” and other payments
    made by suppliers of IDPN to dialysis centers “appear to be
    illegal as well as unreasonably high.” The government is
    investigating the nature and extent of the “hang fees”
    and other payments made by Homecare as well as payments by
    Homecare to physicians whose patients have received IDPN
    therapy. The government asserts that the payments by Homecare to
    dialysis centers violate, among other things, the anti-kickback
    statutes.

 

    Utilization of IDPN.  Since 1984, when HCFA
    determined that Medicare should cover IDPN and other parenteral
    nutrition therapies, the Company has been an industry leader in
    identifying situations in which IDPN therapy is beneficial to
    end-stage renal disease (“ESRD”) patients. It is the
    policy of the Company to seek Medicare reimbursement for IDPN
    therapy only when it is prescribed by a patient’s treating
    physician and when it believes that the circumstances satisfy
    the requirements published by HCFA and its carrier agents. Prior
    to 1994, HCFA and its carriers approved for payment more than
    90% of the IDPN claims submitted by Homecare. After 1993, the
    rate of approval for Medicare reimbursement for IDPN claims
    submitted by Homecare for new patients and by the infusion
    industry in general, fell to approximately 9%. The Company
    contends that the reduction in rates of approval occurred
    because HCFA and its carriers implemented an unauthorized change
    in coverage policy without giving notice to providers. While NMC
    continued to offer IDPN to patients pursuant to the prescription
    of the patients’ treating physicians and to submit claims
    for Medicare reimbursement when it believed the requirements
    stated in HCFA’s published regulations were satisfied,
    other providers responded to the drop in the approval rate for
    new Medicare IDPN patients by abandoning the Medicare IDPN
    business, cutting back on the number of Medicare patients to
    whom they provide IDPN, or declining to add new Medicare
    patients. Beginning in 1994 the number of patients to whom NMC
    provided IDPN increased as a result.

 

    The government is investigating the utilization rate of IDPN
    therapy among NMC patients, whether NMC submitted IDPN claims to
    Medicare for patients who were not eligible for coverage, and
    whether documentation of eligibility was adequate. NMC asserts
    that the utilization rate of IDPN therapy among its dialysis
    patients, which, in 1995, averaged less than 3.5%, is the result
    of the factors discussed above and that it is the policy of
    Homecare to seek Medicare reimbursement for IDPN therapy
    prescribed by the patients’ treating physician in
    accordance with the requirements published by HCFA and its
    carrier agents. There can be no assurance that the government
    will accept NMC’s view. The government asserts that
    Homecare submitted IDPN claims for individuals who were not
    eligible for coverage
    and/or with
    inadequate documentation of eligibility.

 

    The Company believes that it has presented to the government
    substantial defenses which support NMC’s interpretation of
    coverage rules of IDPN as HCFA and its carriers published and
    explained them, and which

    

    7

 

    demonstrated that HCFA and its carriers improperly implemented
    unpublished, more restrictive criteria after 1993. Nevertheless,
    the government is expected to assert in the OIG Investigation
    that, on a widespread basis, NMC submitted and received payments
    on claims for IDPN to Medicare for patients who were not
    eligible for coverage, and for whom the documentation of
    eligibility was inadequate.

 

    In addition, the government asserts that, in a substantial
    number of cases, documentation of eligibility was false or
    inaccurate. With respect to some claims, the Company has
    determined that false or inaccurate documentation was submitted,
    deliberately or otherwise. The government continues to
    investigate the IDPN claims.

 

    Qui Tam
    Actions

 

    The Company and NMC is aware that certain qui tam actions have
    been filed in various jurisdictions. Each of these actions is
    under seal and in each action, pursuant to court order the seal
    has been modified to permit the Company, NMC and other
    affiliated defendants to disclose the complaint to any relevant
    investors, financial institutions
    and/or
    underwriters, their successors and assigns and their respective
    counsel and to disclose the allegations in the complaints in
    their respective U.S. Securities and Exchange Commission
    (the “SEC” or the “Commission”) and New York
    Stock Exchange (“NYSE”) periodically required filings.

 

    A qui tam action was filed in the United States District Court
    for the Southern District of Florida in June 1994, amended on
    July 8, 1996 and disclosed to the Company on July 10,
    1996. It alleges, among other things, that Grace Chemicals and
    NMC violated the False Claims Act in connection with certain
    billing practices regarding IDPN and the administration of EPO
    and that as a result of this allegedly wrongful conduct, the
    United States suffered actual damages in excess of
    $200 million. The Amended Complaint also seeks the
    imposition of a constructive trust on the proceeds of the NMC
    dividend to Grace Chemicals for the benefit of the United States
    on the ground that the Merger constitutes a fraudulent
    conveyance that will render NMC unable to satisfy the claims
    asserted in the Amended Complaint.

 

    A qui tam action was filed in the United States District Court
    for the Southern District of Florida in December 1994 and
    disclosed to the Company on April 16, 1999. It alleges,
    among other things, that NMC violated the False Claims Act in
    connection with certain billing practices regarding IDPN and the
    cost relating thereto. The second qui tam was filed by the same
    relator which filed the first qui tam and covers the same
    services covered by the first qui tam complaint.

 

    A qui tam action was filed in the United States District Court
    for the Middle District of Florida in 1995 and disclosed to the
    Company on or before November 7, 1996. It alleges, among
    other things, that NMC and certain NMC subsidiaries violated the
    False Claims Act in connection with the alleged retention of
    over-payments made under the Medicare program, the alleged
    submission of claims in violation of applicable cost caps and
    the payment of supplemental Medicare insurance premiums as an
    alleged inducement to patients to obtain dialysis products and
    services from NMC. The complaint alleges that as a result of
    this allegedly wrongful conduct, the United States suffered
    damages in excess of $10 million including applicable fines.

 

    A qui tam action was filed in the United States District Court
    for the Eastern District of Pennsylvania in May 1995 and was
    disclosed to the Company in August 1997. It alleges, among other
    things, that Biotrax violated the False Claims Act in connection
    with its submission of claims to the Medicare program for
    diagnostic tests and induced overutilization of such tests in
    the medical community through improper marketing practices also
    in violation of the False Claims Act. This qui tam action was
    dismissed as part of the diagnostics civil investigation
    settlement reached in May 1999. See
    “Note 5 — Commitments and
    Contingencies — Diagnostics Subpoena.”

 

    A qui tam action was filed in the United States District Court
    for the Eastern District of Pennsylvania in August 1996 and was
    disclosed to the Company in August 1997. It alleges, among other
    things, that Biotrax and NMC Diagnostic Services induced
    overutilization of diagnostic tests by several named and unnamed
    physician defendants in the local medical community, through
    improper marketing practices and fee arrangements, in violation
    of the False Claims Act. This qui tam action was dismissed as
    part of the diagnostics civil investigation settlement reached
    in May 1999. See “Note 5 — Commitments and
    Contingencies — Diagnostics Subpoena.”

 

    A qui tam action was filed in the United States District Court
    for the Eastern District of Pennsylvania in November 1996 and
    was disclosed to the Company in August 1997. It alleges, among
    other things, that NMC, DSI

    

    8

 

    and Biotrax violated the False Claims Act in connection with the
    submission of claims to the Medicare program by improperly
    upcoding and otherwise billing for various diagnostic tests.
    This qui tam action was dismissed as part of the diagnostics
    civil investigation settlement reached in May 1999. See
    “Note 5 — Commitments and
    Contingencies — Diagnostics Subpoena.”

 

    A qui tam action was filed in the United States District Court
    for the District of Delaware in January 1997 and was disclosed
    to the Company in September 1997. It alleges, among other
    things, that NMC and Biotrax violated the False Claims Act in
    connection with the submission of claims to the Medicare program
    for diagnostic tests, and induced overutilization of such tests
    through improper marketing practices which provided
    impermissible incentives to health care providers to order these
    tests. This qui tam action was dismissed as part of the
    diagnostics civil investigation settlement reached in May 1999.
    See “Note 5 — Commitments and
    Contingencies — Diagnostics Subpoena.”

 

    A qui tam action was filed in the United States District Court
    for the District of New Jersey in February 1997 and was
    disclosed to the Company in September 1997. It alleges, among
    other things, that DSI and NMC violated the False Claims Act in
    connection with the submission of claims to the Medicare program
    for reimbursement for diagnostic tests, by causing unnamed
    physicians to overutilize these tests though a variety of fee
    arrangements and other impermissible inducements. This qui tam
    action was dismissed as part of the diagnostics civil
    investigation settlement reached in May 1999. See
    “Note 5 — Commitments and
    Contingencies — Diagnostics Subpoena.”

 

    A qui tam was filed in the United States District Court for the
    District of Massachusetts in 1994 and was disclosed to the
    Company in February 1999. It alleges among other things that NMC
    violated the False Claims Act and the Anti-Kickback Statute in
    connection with certain billing and documentation practices
    regarding IDPN therapy, home oxygen therapy and certain medical
    billings in NMC’s Chicago office.

 

    Each of the qui tam complaints asserts that as a result of the
    allegedly wrongful conduct, the United States suffered damages
    and that the defendants are liable to the United States for
    three times the amount of the alleged damages plus civil
    penalties of up to $10,000 per false claim. An adverse result in
    any of the qui tam actions could have a material adverse effect
    on the Company’s business, financial condition or results
    of operations.

 

    OIG
    Agreements

 

    As a result of discussions with representatives of the United
    States in connection with the OIG Investigation, certain
    agreements (the “OIG Agreements”) have been entered
    into to guarantee the payment of any obligations of NMC to the
    United States (an “Obligation”) relating to or arising
    out of the OIG Investigation and the qui tam action filed in the
    Southern District of Florida (the “Government
    Claims”). For the purposes of the OIG Agreements, an
    Obligation is (a) a liability or obligation of NMC to the
    United States in respect of a Government Claim pursuant to a
    court order (i) which is final and nonappealable or
    (ii) the enforcement of which has not been stayed pending
    appeal or (b) a liability or obligation agreed to be an
    Obligation in a settlement agreement executed by Fresenius
    Medical Care, the Company or NMC, on the one hand, and the
    United States, on the other hand. As stated elsewhere herein,
    the outcome of the OIG Investigation cannot be predicted.

 

    Pursuant to the OIG Agreements, upon consummation of the Merger,
    FMC, the Company and NMC provided the United States with a joint
    and several unconditional guarantee of payment when due of all
    Obligations (the “Primary Guarantee”). As credit
    support for this guarantee, NMC delivered an irrevocable standby
    letter of credit in the amount of $150 million. The United
    States will return such letter of credit (or any renewal or
    replacement) for cancellation when all Obligations have been
    paid in full or it is determined that NMC has no liability in
    respect of the Government Claims. Under the terms of the Merger,
    any potential resulting monetary liability has been retained by
    NMC, and the Company has indemnified Grace Chemicals against all
    potential liability arising from or relating to the OIG
    Investigation.

 

    FMC and the Company and the United States state in the OIG
    Agreements that they will negotiate in good faith to attempt to
    arrive at a consensual resolution of the Government Claims and,
    in the context of such negotiations, will negotiate in good
    faith as to the need for any restructuring of the payment of any
    Obligations arising under such resolution, taking into account
    the ability of FMC and the Company to pay the Obligations. The
    OIG Agreements state that the foregoing statements shall not be
    construed to obligate any person to enter into any settlement of
    the

    

    9

 

    Government Claims or to agree to a structured settlement.
    Moreover, the OIG Agreements state that the statements described
    in the first sentence of this paragraph are precatory and
    statements of intent only and that (a) compliance by the
    United States with such provisions is not a condition or defense
    to the obligations of FMC and the Company under the OIG
    Agreements and (b) breach of such provisions by the United
    States cannot and will not be raised by FMC and the Company to
    excuse performance under the OIG Agreements. Neither the
    entering into of the OIG Agreements nor the providing of the
    Primary Guarantee and the $150 million letter of credit is
    an admission of liability by any party with respect to the OIG
    Investigation, nor does it indicate the liability, if any, which
    may result therefrom.

 

    The foregoing describes the material terms of the OIG
    Agreements, copies of which were previously filed with the
    Commission and copies of which may be examined without charge at
    the public reference facilities maintained by the Commission at
    Room 1024, 450 Fifth Street, N.W.
    Washington, D.C. 20549, and at the Regional Offices of the
    Commission located at Suite 1400, Citicorp Center,
    500 West Madison Street, Chicago, Illinois
    60661-2551
    and Room 1300, 7 World Trade Center, New York, New York
    10048. Copies of such material will also be made available by
    mail from the Public Reference Branch of the Commission at
    450 Fifth Street, N.W. Washington, D.C. 20549, at
    prescribed rates. The foregoing description does not purport to
    be complete and is qualified in its entirety by reference to
    such agreements.

 

    An adverse determination with respect to any of the issues
    addressed by the subpoenas, or any of the other issues that have
    been or may be identified by the government, could result in the
    payment of substantial fines, penalties and forfeitures, the
    suspension of payments or exclusion of the Company or one or
    more of its subsidiaries from the Medicare program and other
    federal programs, and changes in billing and other practices
    that could adversely affect the Company’s revenues. Any
    such result could have a material adverse effect on the
    Company’s business, financial condition and results of
    operations.

 

    Omnibus
    Budget Reconciliation Act of 1993

 

    OBRA 93 affected the payment of benefits under Medicare and
    employer health plans for certain eligible ESRD patients. In
    July 1994, HCFA issued an instruction to Medicare claims
    processors to the effect that Medicare benefits for the patients
    affected by OBRA 93 would be subject to a new
    18-month
    “coordination of benefits” period. This instruction
    had a positive impact on NMC’s dialysis revenues because,
    during the
    18-month
    coordination of benefits period, patients’ employer health
    plans were responsible for payment, which was generally at rates
    higher than that provided under Medicare.

 

    In April 1995, HCFA issued a new instruction, reversing its
    original instruction in a manner that would substantially
    diminish the positive effect of the original instruction on
    NMC’s dialysis business. HCFA further proposed that its new
    instruction be effective retroactive to August 1993, the
    effective date of OBRA 93.

 

    NMC ceased to recognize the incremental revenue realized under
    the original Program Memorandum as of July 1, 1995, but it
    continued to bill employer health plans as primary payors for
    patients affected by OBRA 93 through December 31, 1995. As
    of January 1, 1996, NMC commenced billing Medicare as
    primary payor for dual eligible ESRD patients affected by OBRA
    93, and then began to rebill in compliance with the revised
    policy for services rendered between-April 24 and
    December 31, 1995.

 

    On May 5, 1995, NMC filed a complaint in the
    U.S. District Court for the District of Columbia
    (National Medical Care, Inc. and Bio-Medical Applications of
    Colorado, Inc. d/b/a Northern Colorado Kidney Center v.
    Shalala, C.A.
    No. 95-0860
    (WBB)) seeking to preclude HCFA from retroactively enforcing its
    April 24, 1995 implementation of the OBRA 93 provisions
    relating to the coordination of benefits for dual eligible ESRD
    patients. On May 9, 1995, NMC moved for a preliminary
    injunction to preclude HCFA from enforcing its new policy
    retroactively, that is, to billings for services provided
    between August 10, 1993 and April 23, 1995. On
    June 6, 1995, the court granted NMC’s request for a
    preliminary injunction and in December of 1996, NMC moved for
    partial summary judgment seeking a declaration from the Court
    that HCFA’s retroactive application of the April 1995 rule
    was legally invalid. HCFA cross moved for summary judgment on
    the grounds that the April 1995 rule was validly applied
    prospectively. In January 1998, the court granted NMC’s
    motion for partial summary judgment and entered a declaratory
    judgment in favor of NMC, holding HCFA’s retroactive
    application of the April 1995 rule legally invalid, and based on
    its finding, the Court also permanently enjoined HCFA from
    enforcing and applying the April

    

    10

 

    1995 rule retroactively against NMC. The Court took no action on
    HCFA’s motion for summary judgment pending completion of
    outstanding discovery. On October 5, 1998 NMC filed
    it’s own motion for summary judgment requesting that the
    Court declare HCFA’s prospective application of the April
    1995 rule invalid and permanently enjoin HCFA from prospectively
    enforcing and applying the April 1995 rule. The Court has not
    yet ruled on the parties’ motions. HCFA elected not to
    appeal from the Court’s June 1995 and January 1998 orders.
    HCFA may, however, appeal all rulings at the conclusion of the
    litigation. If HCFA should successfully appeal so that the
    revised interpretation would be applied retroactively, Dialysis
    Services may be required to refund the payments received from
    employer health plans for services provided after
    August 10, 1993 under HCFA’s original implementation,
    and to re-bill Medicare for the same services, which would
    result in a net loss to Dialysis Services of approximately
    $120 million attributable to all periods prior to
    December 31, 1995. Also, in such event, the Company’s
    business, financial position and results of operations would be
    materially adversely affected.

 

    Intradialytic
    Parenteral Nutrition Coverage Issues

 

    SRM administers IDPN therapy to chronic dialysis patients who
    suffer from severe gastrointestinal malfunctions. IDPN therapy
    was provided by Homecare prior to its divestiture. After 1993,
    Medicare claims processors sharply reduced the number of IDPN
    claims approved for payment as compared to prior periods. NMC
    believes that the reduction in IDPN claims represented an
    unauthorized policy coverage change. Accordingly, NMC and other
    IDPN providers pursued various administrative and legal
    remedies, including administrative appeals, to address this
    reduction.

 

    In November 1995, NMC filed a complaint in the
    U.S. District Court for the Middle District of Pennsylvania
    seeking a declaratory judgment and injunctive relief to prevent
    the implementation of this policy coverage change. (National
    Medical Care, Inc. v. Shalala, 3:CV-95-1922 (RPC)).
    Subsequently, the District Court affirmed a prior report of the
    magistrate judge dismissing NMC’s complaint, without
    considering any substantive claims, on the grounds that the
    underlying cause of action should be submitted fully to the
    administrative review processes available under the Medicare
    Act. NMC decided not to appeal the Court’s decision, but
    rather, to pursue the claims through the available
    administrative processes.

 

    NMC was successful in pursuing these claims through the
    administrative process, receiving favorable decisions from
    Administrative Law Judges in more than 80% of its cases. In
    early 1998, a group of claims which had been ruled on favorably
    were remanded by the Medicare Appeals Council to a single
    Administrative Law Judge (the “ALJ”) with extensive
    instructions concerning the review of these decisions. A hearing
    was scheduled on the remanded claims to take place in July, but
    later postponed until October 1998.

 

    Prior to the July hearing date, the United States Attorney for
    the District of Massachusetts requested that the hearing be
    stayed pending resolution of the OIG Investigation, on the basis
    that proceeding could adversely effect the government’s
    investigation as well as the government’s efforts to
    confirm its belief that these claims are false. Prior to the ALJ
    issuing a decision on the stay request, the
    U.S. Attorney’s Office requested that NMC agree to a
    stay in the proceedings in order to achieve a potential
    resolution of the IDPN claims subject to the OIG Investigation
    as well as those which are subject to the administrative appeals
    process. NMC agreed to this request, and together with the
    U.S. Attorney’s Office requested a stay. The ALJ
    agreed to this request in order to allow the parties the
    opportunity to resolve both the IDPN claims which are the
    subject of the OIG Investigation and the IDPN claims which are
    the subject of the administrative proceedings. In March 1999
    negotiations between NMC and the U.S. Attorney’s
    Office failed to progress and NMC requested that the stay be
    lifted. The ALJ agreed to NMC’s request and on
    April 19, 1999 the ALJ hearing began. The hearing process
    is expected to proceed for several months. At the same time, NMC
    and the U.S. Attorney’s Office are continuing to
    discuss potential settlement of both the claims relating to the
    OIG Investigation and the claims which are subject to
    administrative appeals. At this time, it is not possible to
    determine whether NMC and the government will be able to resolve
    issues surrounding the IDPN claims. Further proceedings on other
    administrative appeals related to unpaid claims remain stayed.

 

    Although NMC management believes that those unpaid IDPN claims
    were consistent with published Medicare coverage guidelines and
    ultimately will be approved for payment, there can be no
    assurance that the claims on appeal will be approved for payment
    or, to the extent approved, collected in full. Such claims
    represent substantial accounts receivable of NMC, amounting to
    approximately $150 million as of June 30, 1999.

    

    11

 

    If NMC is unable to collect its IDPN receivable, either through
    the administrative appeal process or through negotiation, or if
    IDPN coverage is reduced or eliminated, depending on the amount
    of the receivable that is not collected
    and/or the
    nature of the coverage change, the Company’s business,
    financial condition and results of operations could be
    materially adversely affected. NMC’s IDPN receivables are
    included in the net assets of the Company’s discontinued
    operations. However, these receivables have not been sold and
    will remain classified as discontinued operations until they
    have been settled. See Notes to Consolidated Financial
    Statements Note 4 —“Discontinued Operations.”

 

    Other
    Legal Proceedings

 

    District
    of New Jersey Investigation

 

    NMC has received multiple subpoenas from a federal grand jury in
    the District of New Jersey investigating, among other things,
    whether NMC sold defective products, the manner in which NMC
    handled customer complaints and certain matters relating to the
    development of a new dialyzer product line. NMC is cooperating
    with this investigation and has provided the grand jury with
    extensive documents. In February, 1996, NMC received a letter
    from the U.S. Attorney for the District of New Jersey
    indicating that it is the target of a federal grand jury
    investigation into possible violations of criminal law-in
    connection with Its efforts to persuade the FDA to lift a
    January 1991 import hold issued with respect to NMC’s
    Dublin, Ireland, manufacturing facility. In June 1996, NMC
    received a letter from the U.S. Attorney for the District
    of New Jersey indicating that the U.S. Attorney had
    declined to prosecute NMC with respect to a submission related
    to NMC’s effort to lift the import hold. The letter added
    that NMC remains a subject of a federal grand jury’s
    investigation into other matters. NMC has produced documents in
    response to a June 1996 subpoena from the federal grand jury
    requesting certain documents in connection with NMC’s
    imports of the FOCUS(R) dialyzer from January 1991 to November
    1995. The government investigators and the Company have narrowed
    the issues with respect to which the government has previously
    expressed concerns and are continuing discussions in order to
    resolve this investigation. However, the outcome and impact, if
    any, of these discussions and potential resolution on the
    Company’s business, financial condition or results of
    operations cannot be predicted at this time.

 

    Commercial
    Insurer Litigation

 

    In 1997, the Company, NMC and certain named NMC subsidiaries,
    were served with a civil complaint filed by Aetna Life Insurance
    Company in the U.S. District Court for the Southern
    District of New York (Aetna Life Insurance Company v.
    National Medical Care, Inc. et al, 97-Civ-9310). In April
    1999, Aetna amended its complaint to include its affiliate,
    Aetna U.S. Healthcare, Inc., as an additional plaintiff,
    and to make certain other limited changes in its pleading. Based
    in large part on information contained in prior securities
    filings, the lawsuit alleges inappropriate billing practices for
    nutritional therapy, diagnostic and clinical laboratory tests
    and misrepresentations. The amended complaint seeks unspecified
    damages and costs. This matter is at a relatively early stage in
    the litigation process, with substantial discovery just
    beginning and its outcome and impact on the Company cannot be
    predicted at this time. However, the Company, NMC and its
    subsidiaries believe that they have substantial defenses to the
    claims asserted, and intend to continue to vigorously defend the
    lawsuit. Other private payors have contacted the Company and may
    assert that NMC received excess payments and similarly, may join
    the lawsuit and seek reimbursement and other damages from NMC.
    An adverse result could have a material adverse effect on the
    Company’s business, financial condition or results of
    operations.

 

    In May 1999, the Company filed counter-claims against Aetna Life
    Insurance Company and Aetna U.S. Healthcare, Inc. based on
    inappropriate claim denials and delays in claim payments. The
    Company is also investigating similar counter-claims against the
    other private payors which have contacted the Company.

 

    Administrative
    Appeals

 

    The Company regularly pursues various administrative appeals
    relating to reimbursement issues in connection with its dialysis
    facilities. One such appeal consists of a challenge to the
    Medicare regulation which capped reimbursement for the bad debts
    incurred by dialysis facilities. In 1998, the United States
    Court of Appeals for the District of Columbia ruled in favor of
    the Company in connection with the bad debt Issue, holdinig that
    the

    

    12

 

    Secretary of Health & Human Services had not
    adequately justified the bad debt regulation and ruling that the
    government’s order adopting the rule was arbitary and
    capricious. The Court of Appeals remanded the matter to the
    Secretary to provide a more adequate explanation of the bad debt
    cap or to abandon It. Subsequently, the Court modified its
    holding to continue the bad debt regulation in effect pending
    remand. The Company is continuing settlement discussions with
    the government in an attempt to recover reimbursement for
    disallowed bad debt expenses. The Company cannot predict the
    outcome of these discussions.

 

		
	
    ITEM 1.  
	
    LEGAL
    PROCEEDINGS

 

    As discussed in greater detail below, most aspects of NMC’s
    U.S. businesses are the subject of criminal or civil
    investigations by several federal agencies and authorities, the
    outcome of which cannot be predicted. If the government were
    successfully to pursue claims arising from any of these
    investigations, NMC and one or more of its subsidiaries could be
    subject to civil or criminal penalties, including substantial
    fines, suspension of payments or exclusion from the Medicare and
    Medicaid programs as well as other federal health care benefit
    programs, which provide over 60% of NMC’s revenues. In
    addition, NMC could be required to change billing or other
    practices which could adversely affect NMC’s revenues. In
    addition, as discussed below, NMC has become aware that it is
    the subject of qui tam or “whistleblower” actions with
    respect to some or all of the issues raised by the government
    investigations, which whistleblower actions are filed under seal
    as a matter of law in the first instance, thereby preventing
    disclosure to the Company and to the public except by court
    order. In the process of unsealing federal whistleblower
    complaints, it is not unusual for courts to allow the government
    to inform the Company and its counsel of a complaint prior to
    the time the Company may be legally permitted to disclose it to
    the public. NMC may be the subject of other
    “whistleblower” actions not known to the Company.
    Fresenius Medical Care and the Company have guaranteed
    NMC’s obligations relating to or arising out of the OIG
    Investigation and the qui tam proceedings, and indemnified Grace
    Chemicals for any such liabilities.

 

    An adverse determination with respect to any of the issues
    addressed by the subpoenas, or any of the other issues that have
    been or may be identified by the government, could result in the
    payment of substantial fines, penalties and forfeitures, the
    suspension of payments or exclusion of the Company or one or
    more of its subsidiaries from the Medicare program and other
    federal programs, and changes in billing and other practices
    that could adversely affect the Company’s revenues. Any
    such result could have a material adverse effect on the
    Company’s business, financial condition and results of
    operations.

 

    OIG
    Investigation

 

    In October 1995, NMC received five investigative subpoenas from
    the OIG. The subpoenas were issued in connection with an
    investigation being conducted by the OIG, the U.S. Attorney
    for the District of Massachusetts and others concerning possible
    violations of federal laws, including the anti-kickback statutes
    and the False Claims Act. The subpoenas call for extensive
    document production relating to various aspects of NMC’s
    business.

 

    In connection with the OIG Investigation, the Company continues
    to receive additional subpoenas directed to NMC or the Company
    to obtain supplemental information and documents regarding the
    above-noted issues, or to clarify the scope of the original
    subpoenas.

 

    The Company is cooperating with the OIG Investigation in
    providing supplemental information and documents. The Company
    believes that the government continues to review and evaluate
    the voluminous information the Company has provided. As
    indicated above, the government continues, from time to time, to
    seek supplementing
    and/or
    clarifying information from the Company. The Company understands
    that the government has utilized a grand jury to investigate
    these matters. The Company expects that this process will
    continue while the government completes its evaluation of the
    issues.

 

    The OIG Investigation covers the following areas:
    (a) NMC’s dialysis services business (“Dialysis
    Services”), principally relating to its Medical Director
    contracts and compensation; (b) NMC’s treatment of
    credit balances resulting from overpayments received under the
    Medicare, Medicaid, CHAMPUS and other government and commercial
    payors, its billing for home dialysis services, and its payment
    of supplemental medical insurance premiums on behalf of indigent
    patients; (c) LifeChem’s laboratory business,
    including testing procedures, marketing, customer relationships,
    competition, overpayments totaling approximately
    $4.9 million that were

    

    13

 

    received by LifeChem from the Medicare program with respect to
    laboratory services rendered between 1989 and 1993, a 1997
    review of dialysis facilities’ standing orders, and the
    provision of discounts on products from NMC’s products
    division, grants, equipment and entertainment to customers; and
    (d) Homecare and, in particular, information concerning
    IDPN utilization, documentation of claims and billing practices
    including various services, equipment and supplies and payments
    made to third parties as compensation for administering IDPN
    therapy.

 

    The government has indicated that the areas identified above are
    not exclusive, and that it may pursue additional areas. As
    noted, the penalties applicable under the anti-kickback
    statutes, the False Claims Act and other federal and state
    statutes and regulations applicable to NMC’s business can
    be substantial. While NMC asserts that it is able to offer legal
    and/or
    factual defenses with respect to many of the areas the
    government has identified, it is expected that the government
    will assert that NMC has violated multiple statutory and
    regulatory provisions. Additionally, qui tam actions alleging
    that NMC submitted false claims to the government have been
    filed under seal by former or current NMC employees or other
    individuals who may have familiarity with one or more of the
    issues under investigation. As noted, under the False Claims
    Act, any such private plaintiff could pursue an action against
    NMC in the name of the U.S. at his or her own expense if
    the government declines to do so.

 

    Since October 1995 when the initial subpoenas were served NMC
    and the government have met periodically to discuss issues in
    connection with the OIG Investigation, including theories of
    liability. NMC and the government have been exploring the
    possibility of settling the matters which are encompassed by the
    OIG Investigation and, as referenced below, have settled the
    diagnostics investigation matter. There can be no assurance that
    any of the other matters subject to the OIG Investigation will
    be settled. If, however, one or more of the matters encompassed
    by the OIG Investigation is settled, it may result in NMC
    acknowledging that its past practices violated federal statutes,
    as well as NMC incurring substantial civil and criminal
    financial penalties which could have a material adverse effect
    on the Company. If one or more of these matters is not settled,
    the government may be expected to seek substantial civil and
    criminal financial penalties and other sanctions including the
    suspension of payments by, and the exclusion of NMC and its
    subsidiaries from, the Medicare program, Medicaid program and
    other federal health care programs. See “Management’s
    Discussion and Analysis of Financial Condition and Results of
    Operations — Contingencies.”

 

    An adverse determination with respect to any of the issues
    addressed by the subpoenas, or any of the other issues that have
    been or may be identified by the government, could result in the
    payment of substantial fines, penalties and forfeitures, the
    suspension of payments or exclusion of the Company or one or
    more of its subsidiaries from the Medicare program and other
    federal programs, and changes in billing and other practices
    that could adversely affect the Company’s revenues. Any
    such result could have a material adverse effect on the
    Company’s business, financial condition and results of
    operations. Under the terms of the Merger, any potential
    resulting monetary liability has been retained by NMC, and the
    Company has indemnified Grace Chemicals against all potential
    liability arising from or relating to the OIG Investigation. The
    Company has provided the U.S. government with a guarantee
    of payment of the obligations, if any, arising from the OIG
    Investigation. In support of this guarantee, the Company has
    delivered to the U.S. government a standby letter of credit
    in the amount of $150 million.

 

    Medical
    Director Compensation

 

    The government is investigating whether Dialysis Services,
    compensation arrangements with its Medical Directors constitute
    payments to induce referrals, which would be illegal under the
    anti-kickback statutes, rather than payment for services
    rendered. Dialysis Services compensated the substantial majority
    of its Medical Directors on the basis of a percentage of the
    earnings of the dialysis center for which the Medical Director
    was responsible from the inception of NMC’s predecessor in
    1972 until January 1, 1995, the effective date of Stark II.
    Under the arrangements in effect prior to January 1, 1995,
    the compensation paid to Medical Directors was adjusted to
    include “add backs,” which represented a portion of
    the profit earned by MPG on products purchased by the Medical
    Director’s facility from MPG and (until January 1,
    1992) a portion of the profit earned by LifeChem on
    laboratory services provided to patients at the Medical
    Director’s facility. These adjustments were designed to
    allocate a profit factor to each dialysis center relating to the
    profits that could have been realized by the center if it had
    provided the items and services directly rather than through a
    subsidiary of NMC. The percentage of profits paid to any
    specific

    

    14

 

    Medical Director was reached through negotiation, and was
    typically a provision of a multi-year consulting agreement.

 

    To comply with Stark II if Designated Health Services are
    involved, Medical Director compensation must not exceed fair
    market value and may not take into account the volume or value
    of referrals or other business generated between the parties.
    Since January 1, 1995, Dialysis Services has compensated
    its Medical Directors on a fixed compensation arrangement
    intended to comply with the requirements of Stark II. In
    renegotiating its Medical Director compensation arrangements in
    connection with Stark II, Dialysis Services took and continues
    to take account of the compensation levels paid to its Medical
    Directors in prior years.

 

    Certain government representatives have expressed the view in
    meetings with counsel for NMC that arrangements where the
    Medical Director was or is paid amounts in excess of the
    “fair market value” of the services rendered may
    evidence illegal payments to induce referrals, and that hourly
    compensation is a relevant measure for evaluating the “fair
    market value” of the services. Dialysis Services does not
    compensate its Medical Directors on an hourly basis and has
    asserted to the government that hourly compensation is not a
    determinative measure of fair market value. Although the Company
    believes that the compensation paid to its Medical Directors is
    generally reflective of fair market value, there can be no
    assurances that the government will agree with this position or
    that the Company ultimately will be able to defend its position
    successfully. Because of the wide variation in local market
    factors and in the profit percentage contractually negotiated
    between Dialysis Services and its Medical Directors prior to
    January 1, 1995, there is a wide variation in the amounts
    that have been paid to Medical Directors.

 

    As a result, the compensation that Dialysis Services has paid
    and is continuing to pay to a material number of its Medical
    Directors could be viewed by the government as being in excess
    of “fair market value,” both in absolute terms and in
    terms of hourly compensation. NMC has asserted to the government
    that its compensation arrangements do not constitute illegal
    payments to induce referrals. NMC has also asserted to the
    government that OIG auditors repeatedly reviewed Dialysis
    Services’ compensation arrangements with its Medical
    Directors in connection with their audits of the costs claimed
    by Dialysis Services; that the OIG stated in its audit reports
    that, with the exception of certain technical issues, Dialysis
    Services had complied with applicable Medicare laws and
    regulations pertaining to the ESRD program; and that Dialysis
    Services reasonably relied on these audit reports in concluding
    that its program for compensating Medical Directors was lawful.
    There has been no indication that the government will accept
    NMC’s assertions concerning the legality of its
    arrangements generally or NMC’s assertion that it
    reasonably relied on OIG audits, or that the government will not
    focus on specific arrangements that DSD has made with one or
    more Medical Directors and assert that those specific
    arrangements were or are unlawful.

 

    The government is also investigating whether Dialysis
    Services’ profit sharing arrangements with its Medical
    Directors influenced them to order unnecessary ancillary
    services and items. NMC has asserted to the government that the
    rate of utilization of ancillary services and items by its
    Medical Directors is reasonable and that it did not provide
    illegal inducements to Medical Directors to order ancillary
    services and items.

 

    Credit
    Balances

 

    In the ordinary course of business, medical service providers
    like Dialysis Services receive overpayments from Medicare
    intermediaries and other payors for services that they provide
    to patients. Medicare intermediaries commonly direct such
    providers to notify them of the overpayment and not remit such
    amounts to the intermediary by check or otherwise unless
    specifically requested to do so. In 1992, HCFA adopted a
    regulation requiring certain Medicare providers, including
    dialysis centers, to file a quarterly form listing unrecouped
    overpayments with the Medicare intermediary responsible for
    reimbursing the provider. The first such filing was required to
    be made as of June 30, 1992 for the period beginning with
    the initial date that the provider participated in the Medicare
    program and ending on June 30, 1992.

 

    The government is investigating whether DSD intentionally
    understated the Medicare credit balance reflected on its books
    and records for the period ending June 30, 1992 by
    reversing entries out of its credit balance account and taking
    overpayments into income in anticipation of the institution of
    the new filing requirement. Dialysis Services policy was to
    notify Medicare intermediaries in writing of overpayments upon
    receipt and to maintain unrecouped Medicare overpayments as
    credit balances on the books and records of Dialysis Services
    for four years; overpayments not recouped by Medicare within
    four years would be reversed from the credit balance account and

    

    15

 

    would be available to be taken into income. NMC asserts that
    Medicare overpayments that have not been recouped by Medicare
    within four years are not subject to recovery under applicable
    regulations and that its initial filing with the intermediaries
    disclosed the credit balance on the books and records of
    Dialysis Services as shown in accordance with its policy, but
    there can be no assurance that the government will accept
    NMC’s views. The government has inquired whether other
    divisions including Homecare, LifeChem and DSI have
    appropriately treated Medicare credit balances as well as credit
    balances of other payors.

 

    The government is also investigating whether Dialysis Services
    failed to disclose Medicare overpayments that resulted from
    Dialysis Services, obligation to rebill commercial payors for
    amounts originally billed to Medicare under HCFA’s initial
    implementation of the OBRA 93 amendments to the secondary payor
    provisions of the Medicare Act. Dialysis Services experienced
    delays in reporting a material amount of overpayments after the
    implementation of the OBRA 93 amendments. NMC asserts that most
    of these delays were the result of the substantial
    administrative burdens placed on Dialysis Services as a
    consequence of the changing and inconsistent instructions issued
    by HCFA with respect to the OBRA 93 amendments and were not
    intentional. Substantially all overpayments resulting from the
    rebilling effort associated with the OBRA 93 amendments have now
    been reported. Procedures are in place that are designed to
    ensure that subsequent overpayments resulting from the OBRA 93
    amendments will be reported on a timely basis.

 

    Supplemental
    Medical Insurance

 

    Dialysis Services provided grants or loans for the payment of
    premiums for supplemental medical insurance (under which
    Medicare Part B coverage is provided) on behalf of a small
    percentage of its patients who are financially needy. The
    practice of providing loans or grants for the payment of
    supplemental medical insurance premiums by NMC was one of the
    subjects of review by the government as part of the OIG
    Investigation.

 

    The Government, however, advised the Company orally that it is
    no longer pursuing this issue. Furthermore, as a result of the
    passage of HIPAA, the Company terminated making such payments on
    behalf of its patients. Instead, the Company, together with
    other representatives of the industry, obtained an advisory
    opinion from the OIG, whereby, consistent with specified
    conditions, the Company and other similarly situated providers
    may make contributions to a non-profit organization that has
    volunteered to make these payments on behalf of indigent ESRD
    patients, including patients of the Company. In addition, the
    government has indicated that it is investigating the method by
    which NMC made Medigap payments on behalf of its indigent
    patients.

 

    Overpayments
    for Home Dialysis Services

 

    NMC acquired HIC, an in-center and home dialysis service
    provider, in 1993. At the time of the acquisition, HIC was the
    subject of a claim by HCFA that HIC had received payments for
    home dialysis services in excess of the Medicare reasonable
    charge for services rendered prior to February 1, 1990. NMC
    settled the HCFA claim against HIC in 1994. The government is
    investigating whether the settlement concerning the alleged
    overpayments made to HIC resolved all issues relating to such
    alleged overpayments. The government is also investigating
    whether HDS received payments similar to the payments that HIC
    received, and whether HDS improperly billed for home dialysis
    services in excess of the monthly cost cap for services rendered
    on or after February 1, 1990. The government is
    investigating whether NMC was overpaid for services rendered.
    NMC asserts that the billings by HDS were proper, but there can
    be no assurance that the government will accept NMC’s view.

 

    LifeChem

 

    Overpayments.  On September 22, 1995,
    LifeChem voluntarily disclosed certain billing problems to the
    government that had resulted in LifeChem’s receipt of
    approximately $4.9 million in overpayments from the
    Medicare program for laboratory services rendered between 1989
    and 1993. LifeChem asserts that most of these overpayments
    relate to errors caused by a change in LifeChem’s computer
    systems and that the remainder of the overpayments were the
    result of the incorrect practice of billing for a complete blood
    count with differential when only a complete blood count was
    ordered and performed, and of the incorrect practice of billing
    for a complete blood count when only a hemoglobin or hematocrit
    test was ordered. LifeChem asserts that the overpayments it

    

    16

 

    received were not caused by fraudulent activity, but there can
    be no assurance that the government will accept LifeChem’s
    view.

 

    LifeChem made these disclosures to the government as part of an
    application to be admitted to a voluntary disclosure program
    begun by the government in mid-1995. At the time of the
    disclosures, LifeChem tendered repayment to the government of
    the $4.9 million in overpayments. After the OIG
    Investigation was announced, the government indicated that
    LifeChem had not been accepted into its voluntary disclosure
    program. The government has deposited the $4.9 million
    check with NMC’s approval. The matters disclosed in
    LifeChem’s September 22, 1995 voluntary disclosure are
    a subject of the OIG Investigation.

 

    On June 7, 1996, LifeChem voluntarily disclosed an
    additional billing problem to the government that had resulted
    in LifeChem’s receipt of between $40,000 and $160,000 in
    overpayments for laboratory services rendered in 1991. LifeChem
    advised the government that this overpayment resulted from the
    submission for payment of a computer billing tape that had not
    been subjected to a “billing rules” program designed
    to eliminate requests for payments for laboratory tests that are
    included in the Composite Rate and that were not eligible for
    separate reimbursement. LifeChem also advised the government
    that there may have been additional instances during the period
    from 1990 to 1992 when other overpayments were received as a
    result of the submission of computer billing tapes containing
    similar errors and that it was in the process of determining
    whether such additional overpayments were received. On
    June 21, 1996, LifeChem advised the government that the
    1991 billing problem disclosed on June 7, 1996 resulted in
    an overpayment of approximately $112,000. LifeChem also advised
    the government that certain records suggested instances in July
    1990 and August 31 through September 11, 1990, when billing
    tapes may have been processed without rules processing. LifeChem
    continued its effort to determine whether any other overpayments
    occurred relating to the “billing rules” problem and,
    in March 1997, advised the government that an additional
    overpayment of approximately $260,000 was made by Medicare.

 

    On April 6, 1999, LifeChem voluntarily disclosed an
    additional billing problem to the government that resulted in
    LifeChem’s receipt of overpayments for laboratory services
    rendered between 1994 and 1999. In 1994, as a result of the
    advice of a billing consultant, LifeChem began to bill for
    platelet testing performed in connection with complete blood
    counts. This advice was confirmed by the consultant in 1997 as
    part of a review performed by the consultant under the auspices
    of LifeChem’s then outside counsel. In 1999, however, an
    internal inquiry resulted in a reexamination of this advice and
    LifeChem determined that the prior advice was incorrect. As a
    result LifeChem voluntarily disclosed and repaid the overpayment
    to the government in the amount of $8.6 million. LifeChem
    also has notified the government of the disclosure. There can be
    no assurances that the government will agree that
    LifeChem’s disclosure should not result in a sanction
    beyond repayment of the overpayment amount.

 

    Capitation for routine tests and panel
    design.  In October 1994, the OIG issued a special
    fraud alert in which it stated its view that the industry
    practice of offering to perform or performing the routine tests
    covered by the Composite Rate at a price below fair market
    value, coupled with an agreement by a dialysis center to refer
    all or most of its non-Composite Rate tests to the laboratory,
    violates the anti-kickback statutes. In response to this alert,
    LifeChem changed its practices with respect to testing covered
    by the Composite Rate to increase the amount charged to both
    Dialysis Services and third-party dialysis centers and reduce
    the number of tests provided for the fixed rate. The government
    is investigating LifeChem’s practices with respect to these
    tests.

 

    Benefits provided to dialysis centers and persons associated
    with dialysis centers.  The government is
    investigating whether Dialysis Services or any third-party
    dialysis center or any person associated with any such center
    was provided with benefits in order to induce them to use
    LifeChem services. Such benefits could include, for example,
    discounts on products or supplies, the provision of computer
    equipment, the provision of money for the purchase of computer
    equipment, the provision of research grants and the provision of
    entertainment to customers. NMC has identified certain instances
    in which benefits were provided to customers who purchased
    medical products from NMC Medical Products, Inc., NMC’s
    products company, and used LifeChem’s laboratory services.
    The government asserts that the provision of such benefits
    violates, among other things, the anti-kickback statutes. In
    December 1998, the former Vice President of Sales responsible
    for NMC’s laboratory and products divisions plead guilty to
    the payment of illegal kickbacks to obtain laboratory business
    for LifeChem. In February 1999, the former President of NMC
    Medical Products, Inc., was indicted by the government for the
    payment of these same
    and/or
    similar kickbacks.

    

    17

 

    Business and testing practices.  As noted
    above, the government has identified a number of specific
    categories of documents that it is requiring NMC to produce in
    connection with LifeChem business and testing practices. In
    addition to documents relating to the areas discussed above, the
    government has also required LifeChem to produce documents
    relating to the equipment and systems used by LifeChem in
    performing and billing for clinical laboratory blood tests, the
    design of the test panels offered and requisition forms used by
    LifeChem, the utilization rate for certain tests performed by
    LifeChem, recommendations concerning diagnostic codes to be used
    in ordering tests for patients with given illnesses or
    conditions, Internal and external audits and investigations
    relating to LifeChem’s billing and testing. Subsequently,
    the government served an investigative subpoena for documents
    concerning the Company’s 1997 review of dialysis facilities
    standing orders, and responsive documents were provided. The
    government has served investigative subpoenas requiring NMC to
    update its production on the above issues and to produce
    contract files for twenty-three identified dialysis clinic
    customers. The government is investigating each of these areas,
    and asserts that LifeChem
    and/or NMC
    have violated the False Claims Act
    and/or the
    Anti-Kickback Statute through the test ordering, paneling,
    requisitioning, utilization, coding, billing and auditing
    practices described above. In June 1999, a former Vice President
    of Marketing of NMC Medical Products, Inc. plead guilty to a
    charge of conspiracy to defraud Medicare in connection with the
    marketing of certain hepatitis tests.

 

    IDPN

 

    Administration kits.  As discussed above, one
    of the activities of SRM is to provide IDPN therapy to dialysis
    patients at both NMC-owned facilities and at facilities owned by
    other providers. IDPN therapy was provided by Homecare prior to
    its divestiture. IDPN therapy is typically provided to the
    patient
    12-13 times
    per month during dialysis treatment. Bills are submitted to
    Medicare on a monthly basis and include separate claims for
    reimbursement for supplies, including, among other things,
    nutritional solutions, administration kits and infusion pumps.
    In February 1991, the Medicare carrier responsible for
    processing Homecare’s IDPN claims issued a Medicare
    advisory to all parenteral and enteral nutrition suppliers
    announcing a coding change for reimbursement of administration
    kits provided in connection with IDPN therapy for claims filed
    for items provided on or after April 1, 1991. The Medicare
    allowance for administration kits during this period was
    approximately $625 per month per patient. The advisory stated
    that IDPN providers were to indicate the “total number of
    actual days” when administration kits were
    “used,” instead of indicating that a one-month supply
    of administration kits had been provided. In response, Homecare
    billed for administration kits on the basis of the number of
    days that the patient was on an IDPN treatment program during
    the billing period, which typically represented the entire
    month, as opposed to the number of days the treatment was
    actually administered. During the period from April 1991 to June
    1992, Homecare had an average of approximately 1,200 IDPN
    patients on service.

 

    In May 1992, the carrier issued another Medicare advisory to all
    PEN suppliers in which it stated that it had come to the
    carrier’s attention that some IDPN suppliers had not been
    prorating their billing for administration kits used by IDPN
    patients and that providers should not bill for administration
    kits on the basis of the number of days that the patient was on
    an IDPN treatment program during the billing period. The
    advisory stated further that the carrier would be conducting
    “a special study to determine whether or not overpayments
    have occurred as a result of incorrect billing” and that
    “if overpayments have resulted, providers that have
    incorrectly billed” would “be contacted so that
    refunds can be recovered.” Homecare revised its billing
    practices in response to this advisory for claims filed for
    items provided on or after July 1, 1992. Homecare was not
    asked to refund any amounts relating to its billings for
    administration kits following the issuance of the second
    advisory.

 

    The government asserts that NMC submitted false claims for
    administration kits during the period from 1998 to June 30,
    1996, and that Homecare’s billing for administration kits
    during this period violated, among other things, the False
    Claims Act.

 

    Infusion Pumps and IV Poles.  During the
    time period covered by the subpoenas, Medicare regulations
    permitted IDPN[ providers to bill Medicare for the infusion
    pumps and, until 1992, for IV poles provided to IDPN
    patients in connection with the administration of IDPN
    treatments. These regulations do not expressly specify that a
    particular pump and IV pole be dedicated to a specific
    patient, and NMC asserts that these regulations permitted
    Homecare to bill Medicare for an infusion pump and IV pole
    so long as the patient was infused using a pump and IV
    pole. Despite the absence of an express regulatory
    specification, Homecare developed a policy to deliver to a

    

    18

 

    dialysis center a dedicated infusion pump and IV pole for
    each patient, although the Company cannot represent that
    Homecare followed this policy in every instance. The government
    is investigating the propriety of Homecare’s billings for
    infusion pumps and IV poles and asserts that
    Homecare’s billings violate the False Claims Act.

 

    As noted above, under the new policies published by HCFA with
    respect to IDPN therapy, the Company has not been able to bill
    for infusion pumps after July 1, 1996. The government
    discontinued reimbursement for IV poles in 1992.

 

    “Hang fees” and other payments.  IDPN
    therapy is typically provided to the patient during dialysis by
    personnel employed by the dialysis center treating the patient
    with supplies provided and billed to Medicare by Homecare in
    accordance with the Medicare parenteral nutrition supplier
    rules. In order to compensate dialysis centers for the costs
    incurred in administering IDPN therapy and monitoring the
    patient during therapy, Homecare followed the practice common in
    the industry of paying a “hang fee” to the center.
    Dialysis centers are responsible for reporting such fees to HCFA
    on their cost reports. For Dialysis Services dialysis centers,
    the fee was $30 per administration, based upon internal Dialysis
    Services cost calculations. For third-party dialysis centers,
    the fee was negotiated with each center, typically pursuant to a
    written contract, and ranged from $15 to $65 per administration.
    The Company has identified instances in which other payments and
    amounts beyond that reflected in a contract were paid to these
    third-party centers. The Company has stopped paying “hang
    fees” to both Dialysis Services and third-party facilities.

 

    In July 1993, the OIG issued a management advisory alert to HCFA
    in which it stated that “hang fees” and other payments
    made by suppliers of IDPN to dialysis centers “appear to be
    illegal as well as unreasonably high.” The government is
    investigating the nature and extent of the “hang fees”
    and other payments made by Homecare as well as payments by
    Homecare to physicians whose patients have received IDPN
    therapy. The government asserts that the payments by Homecare to
    dialysis centers violate, among other things, the anti-kickback
    statutes.

 

    Utilization of IDPN.  Since 1984, when HCFA
    determined that Medicare should cover IDPN and other parenteral
    nutrition therapies, the Company has been an industry leader in
    identifying situations in which IDPN therapy is beneficial to
    ESRD patients. It is the policy of the Company to seek Medicare
    reimbursement for IDPN therapy only when it is prescribed by a
    patient’s treating physician and when it believes that the
    circumstances satisfy the requirements published by HCFA and its
    carrier agents. Prior to 1994, HCFA and its carriers approved
    for payment more than 90% of the IDPN claims submitted by
    Homecare. After 1993, the rate of approval for Medicare
    reimbursement for IDPN claims submitted by Homecare for new
    patients, and by the infusion industry in general, fell to
    approximately 9%. The Company contends that the reduction in
    rates of approval occurred because HCFA and its carriers
    implemented an unauthorized change in coverage policy without
    giving notice to providers. While NMC continued to offer IDPN to
    patients pursuant to the prescription of the patients’
    treating physicians and to submit claims for Medicare
    reimbursement when it believed the requirements stated in
    HCFA’s published regulations were satisfied, other
    providers responded to the drop in the approval rate for new
    Medicare IDPN patients by abandoning the Medicare IDPN,
    business, cutting back on the number of Medicare patients to
    whom they provide IDPN, or declining to add new Medicare
    patients. Beginning in 1994 the number of patients to whom NMC
    provided IDPN increased as a result.

 

    The government is investigating the utilization rate of IDPN
    therapy among the NMC patients, whether the NMC submitted IDPN
    claims to Medicare for patients who were not eligible for
    coverage, and whether documentation of eligibility was adequate.
    NMC asserts that the utilization rate of IDPN therapy among its
    dialysis patients, which, in 1995, averaged less than 3.5%, is
    the result of the factors discussed above and that it is the
    policy of Homecare to seek Medicare reimbursement for IDPN
    therapy prescribed by the patients’ treating physician in
    accordance with the requirements published by HCFA and its
    carrier agents. There can be no assurance that the government
    will accept the NMC’s view. The government asserts that
    Homecare submitted IDPN claims for individuals who were not
    eligible for coverage
    and/or with
    inadequate documentation of eligibility.

 

    The Company believes that it has presented to the government
    substantial defenses which support NMC’s interpretation of
    coverage rules of IDPN as HCFA and its carriers published and
    explained them, and which demonstrated that HCFA and its
    carriers improperly implemented unpublished, more restrictive
    criteria after 1993. Nevertheless, the government is expected to
    assert in the OIG Investigation that, on a widespread basis, NMC

    

    19

 

    submitted and received payments on claims for IDPN to Medicare
    for patients who were not eligible for coverage, and for whom
    the documentation of eligibility was inadequate.

 

    In addition, the government asserts that, in a substantial
    number of cases, documentation of eligibility was false or
    inaccurate. With respect to some claims, the Company has
    determined that false or inaccurate documentation was submitted,
    deliberately or otherwise. The government continues to
    investigate the IDPN claims.

 

    Qui Tam
    Actions

 

    The Company and NMC is aware that certain qui tam actions have
    been filed in various jurisdictions. Each of these actions is
    under seal and in each action, pursuant to court order the seal
    has been modified to permit the Company, NMC and other
    affiliated defendants to disclose the complaint to any relevant
    investors, financial institutions
    and/or
    underwriters, their successors and assigns and their respective
    counsel and to disclose the allegations in the complaints in
    their respective U.S. Securities and Exchange Commission
    (the “SEC” or the Commission”) and New York Stock
    Exchange (“NYSE”) periodically required filings.

 

    A qui tam action was filed in the United States District Court
    for the Southern District of Florida in June 1994, amended on
    July 8, 1996 and disclosed to the Company on July 10,
    1996. It alleges, among other things, that Grace Chemicals and
    NMC violated the False Claims Act in connection with certain
    billing practices regarding IDPN and the administration of EPO
    and that as a result of this allegedly wrongful conduct, the
    United States suffered actual damages in excess of
    $200 million. The Amended Complaint also seeks the
    imposition of a constructive trust on the proceeds of the NMC
    dividend to Grace Chemicals for the benefit of the United States
    on the ground that the Merger constitutes a fraudulent
    conveyance that will render NMC unable to satisfy the claims
    asserted in the Amended Complaint.

 

    A qui tam action was filed in the United States District Court
    for the Southern District of Florida in December 1994 and
    disclosed to the Company on April 16, 1999. It alleges,
    among other things, that NMC violated the False Claims Act in
    connection with certain billing practices regarding IDPN and the
    cost relating thereto. The second qui tam was filed by the same
    relator which filed the first qui tam and covers the same
    services covered by the first qui tam complaint.

 

    A qui tam action was filed in the United States District Court
    for the Middle District of Florida in 1995 and disclosed to the
    Company on or before November 7, 1996. It alleges, among
    other things, that NMC and certain NMC subsidiaries violated the
    False Claims Act in connection with the alleged retention of
    over-payments made under the Medicare program, the alleged
    submission of claims in violation of applicable cost caps and
    the payment of supplemental Medicare insurance premiums as an
    alleged inducement to patients to obtain dialysis products and
    services from NMC. The complaint alleges that as a result of
    this allegedly wrongful conduct, the United States suffered
    damages in excess of $10 million including applicable fines.

 

    A qui tam action was filed in the United States District Court
    for the Eastern District of Pennsylvania in May 1995 and was
    disclosed to the Company in August 1997. It alleges, among other
    things, that Biotrax violated the False Claims Act in connection
    with its submission of claims to the Medicare program for
    diagnostic tests and induced overutilization of such tests in
    the medical community through improper marketing practices also
    in violation of the False Claims Act. This qui tam action was
    dismissed as part of the diagnostics civil investigation
    settlement reached in May 1999. See “Part II,
    Item 1, Legal Proceedings — Commitments and
    Contingencies — Diagnostics Subpoena.”

 

    A qui tam action was filed in the United States District Court
    for the Eastern District of Pennsylvania in August 1996 and was
    disclosed to the Company in August 1997. It alleges, among other
    things, that Biotrax and NMC Diagnostic Services induced
    overutilization of diagnostic tests by several named and unnamed
    physician defendants in the local medical community, through
    improper marketing practices and fee arrangements, in violation
    of the False Claims Act. This qui tam action was dismissed as
    part of the diagnostics civil investigation settlement reached
    in May 1999. See “Part II, Item 1. Legal
    Proceedings — Commitments and
    Contingencies — Diagnostics Subpoena.”

 

    A qui tam action was filed in the United States District Court
    for the Eastem District of Pennsylvania in November 1996 and was
    disclosed to the Company in August 1997. It alleges, among other
    things, that NMC, DSI

    

    20

 

    and Biotrax violated the False Claims Act in connection with the
    submission of claims to the Medicare program by improperly
    upcoding and otherwise billing for various diagnostic tests.
    This qui tam action was dismissed as part of the diagnostics
    civil investigation settlement reached in May 1999. See
    “Part II, Item 1, Legal Proceedings —
    Commitments and Contingencies — Diagnostics
    Subpoena.”

 

    A qui tam action was filed in the United States District Court
    for the District of Delaware in January 1997 and was disclosed
    to the Company in September 1997. It alleges, among other
    things, that NMC and Biotrax violated the False Claims Act in
    connection with the submission of claims to the Medicare program
    for diagnostic tests, and induced overutilization of such tests
    through improper marketing practices which provided
    impermissible incentives to health care providers to order these
    tests. This qui tam action was dismissed as part of the
    diagnostics civil investigation settlement reached in May 1999.
    See “Part II, Item 1, Legal
    Proceedings — Commitments and
    Contingencies — Diagnostics Subpoena.”

 

    A qui tam action was filed in the United States District Court
    for the District of New Jersey in February 1997 and was
    disclosed to the Company in September 1997. It alleges, among
    other things, that DSI and NMC violated the False Claims Act in
    connection with the submission of claims to the Medicare program
    for reimbursement for diagnostic tests, by causing unnamed
    physicians to overutilize these tests though a variety of fee
    arrangements and other impermissible inducements. This qui tam
    action dismissed as part of the diagnostics civil investigation
    settlement reached in May 1999. See “Part II,
    Item 1, Legal Proceedings — Commitments and
    Contingencies — Diagnostics Subpoena.”

 

    A qui tam was filed in the United States District Court for the
    District of Massachusetts in 1994 and was disclosed to the
    Company in February 1999. It alleges among other things that NMC
    violated the False Claims Act and the Anti-Kickback Statute in
    connection with certain billing and documentation practices
    regarding IDPN therapy, home oxygen therapy and certain medical
    billings in NMC’s Chicago office.

 

    Each of the qui tam complaints asserts that as a result of the
    allegedly wrongful conduct, the United States suffered damages
    and that the defendants are liable to the United States for
    three times the amount of the alleged damages plus civil
    penalties of up to $10,000 per false claim. An adverse result in
    any of the qui tam actions could have a material adverse effect
    on the Company’s business, financial condition or results
    of operations.

 

    OIG
    Agreements

 

    As a result of discussions with representatives of the United
    States in connection with the OIG Investigation, certain
    agreements (the “OIG Agreements”) have been entered
    into to guarantee the payment of any obligations of NMC to the
    United States (an “Obligation”) relating to or arising
    out of the OIG Investigation and the qui tam action filed in the
    Southern District of Florida (the “Government
    Claims”). For the purposes of the OIG Agreements, an
    Obligation is (a) a liability or obligation of NMC to the
    United States in respect of a Government Claim pursuant to a
    court order (i) which is final and nonappealable or
    (ii) the enforcement of which has not been stayed pending
    appeal or (b) a liability or obligation agreed to be an
    Obligation in a settlement agreement executed by Fresenius
    Medical Care, the Company or NMC, on the one hand, and the
    United States, on the other hand. As stated elsewhere herein,
    the outcome of the OIG Investigation cannot be predicted.

 

    Pursuant to the OIG Agreements, upon consummation of the Merger,
    Fresenius Medical Care, the Company and NMC provided the United
    States with a joint and several unconditional guarantee of
    payment when due of all Obligations (the “Primary
    Guarantee”). As credit support for this guarantee, NMC
    delivered an irrevocable standby letter of credit in the amount
    of $150 million. The United States will return such letter
    of credit (or any renewal or replacement) for cancellation when
    all Obligations have been paid in full or it is determined that
    NMC has no liability in respect of the Government Claims. Under
    the terms of the Merger, any potential resulting monetary
    liability has been retained by NMC, and the Company has
    indemnified Grace Chemicals against all potential liability
    arising from or relating to the OIG Investigation.

 

    FMC and the Company and the United States state in the OIG
    Agreements that they will negotiate in good faith to attempt to
    arrive at a consensual resolution of the Government Claims and,
    in the context of such negotiations, will negotiate in good
    faith as to the need for any restructuring of the payment of any
    Obligations arising under such resolution, taking into account
    the ability of FMC and the Company to pay the Obligations. The
    OIG Agreements

    

    21

 

    state that the foregoing statements shall not be construed to
    obligate any person to enter into any settlement of the
    Government Claims or to agree to a structured settlement.
    Moreover, the OIG Agreements state that the statements described
    in the first sentence of this paragraph are precatory and
    statements of intent only and that (a) compliance by the
    United States with such provisions is not a condition or defense
    to the obligations of FMC and the Company under the OIG
    Agreements and (b) breach of such provisions by the United
    States cannot and will not be raised by FMC and the Company to
    excuse performance under the OIG Agreements. Neither the
    entering into of the OIG Agreements nor the providing of the
    Primary Guarantee and the $150 million letter of credit is
    an admission of liability by any party with respect to the OIG
    Investigation, nor does it indicate the liability which may
    result therefrom.

 

    The foregoing describes the material terms of the OIG
    Agreements, copies of which were previously filed with the
    Commission and copies of which may be examined without charge at
    the public reference facilities maintained by the Commission at
    Room 1024, 450 Fifth Street, N.W.
    Washington, D.C. 20549, and at the Regional Offices of the
    Commission located at Suite 1400, Citicorp Center,
    500 West Madison Street, Chicago, Illinois
    60661-2551
    and Room 1300, 7 World Trade Center, New York, New York
    10048. Copies of such material will also be made available by
    mail from the Public Reference Branch of the commission at
    450 Fifth Street, N.W. Washington, D.C. 20549, at
    prescribed rates. The foregoing description does not purport to
    be completes and is qualified in its entirety by reference to
    such agreements.

 

    Diagnostics
    Subpoena

 

    In October 1996, Biotrax International, Inc.
    (“Biotrax”) and NMC Diagnostics, Inc.,
    (“DSl”) both of which are subsidiaries of NMC,
    received a civil investigative subpoena from the OIG concerning
    the possible submission of false or improper claims to, and
    their payment by, the Medicare program. In May, 1999 the Company
    and the government entered into a settlement agreement pursuant
    to which, among other things, the government has agreed to
    release the Company with respect to this matter in exchange for
    a payment of approximately $16.8 million from the Company.

 

    District
    of New Jersey Investigation

 

    NMC has received multiple subpoenas from a federal grand jury in
    the District of New Jersey investigating, among other things,
    whether NMC sold defective products, the manner in which NMC
    handled customer complaints and certain matters relating to the
    development of a new dialyzer product line NMC is cooperating
    with this investigation and has provided the grand jury with
    extensive documents. In February, 1996, NMC received a letter
    from the U.S. Attorney for the District of New Jersey
    indicating that it is the target of a federal grand jury
    investigation into possible violations of criminal law in
    connection with its efforts to persuade the FDA to lift a
    January 1991 import hold issued with respect to NMC’s
    Dublin, Ireland manufacturing facility. In June 1996, NMC
    received a letter from the U.S. Attorney for the District
    of New Jersey indicating that the U.S. Attorney had
    declined to prosecute NMC with respect to a submission related
    to NMC’s effort to lift the import hold. The letter added
    that NMC remains a subject of a federal grand jury’s
    investigation into other matters. NMC has produced documents in
    response to a June 1996 subpoena from the federal grand jury
    requesting certain documents in connection with NMC’s
    imports of the FOCUS(R) dialyzer from January 1991 to November
    1995. The government investigators and the Company have narrowed
    the issues with respect to which the government has previously
    expressed concerns and are continuing discussions in order to
    resolve this investigation. However, the outcome and impact, if
    any, of these discussions and potential resolution on the
    Company’s business, financial condition or results of
    operations cannot be predicted at this time.

 

    Commercial
    Insurer Litigation

 

    In 1997, the Company, NMC, and certain named NMC subsidiaries,
    were served with a civil complaint filed by Aetna Life Insurance
    Company in the U.S. District Court for the Southern
    District of New York (Aetna Life Insurance Company v.
    National Medical Care, Inc. et al, 97-Civ-9310). In April
    1999, Aetna amended its complaint to include its affiliate,
    Aetna U.S. Healthcare, Inc., as an additional plaintiff,
    and to make certain other limited changes in its pleading. Based
    in large part on information contained in prior securities
    filings, the lawsuit alleges inappropriate billing practices for
    nutritional therapy, diagnostic and clinical laboratory tests
    and

    

    22

 

    misrepresentations. The amended complaint seeks unspecified
    damages and costs. This matter is at a relatively early stage in
    the litigation process, with substantial discovery just
    beginning, and its outcome and impact on the Company cannot be
    predicted at this time. However, the Company, NMC and its
    subsidiaries believe that they have substantial defenses to the
    claims asserted, and intend to continue to vigorously defend the
    lawsuit. Other private payors have contacted the Company and may
    assert that NMC received excess payments and similarly, may join
    the lawsuit and seek reimbursement and other damages from NMC.
    An adverse result could have a material adverse effect on the
    Company’s business, financial condition or results of
    operations.

 

    In May 1999, the Company filed counter-claims against Aetna Life
    Insurance Company and Aetna U.S. Healthcare, Inc. based on
    inappropriate claim denials and delays in claim payments. The
    Company is also investigating similar counter-claims against two
    other private payors which have contacted the Company.

 

    OBRA
    93

 

    OBRA 93 affected the payment of benefits under Medicare and
    employer health plans for certain eligible ESRD patients. In
    July 1994, HCFA issued an instruction to Medicare claims
    processors to the effect that Medicare benefits for the patients
    affected by OBRA 93 would be subject to a new
    18-month
    “coordination of benefits” period. This instruction
    had a positive impact on NMC’s dialysis revenues because,
    during the
    18-month
    coordination of benefits period, patients’ employer health
    plans were responsible for payment, which was generally at rates
    higher than that provided under Medicare.

 

    In April 1995, HCFA issued a new instruction, reversing its
    original instruction in a manner that would substantially
    diminish the positive effect of the original instruction on
    NMC’s dialysis business. HCFA further proposed that its new
    instruction be effective retroactive to August 1993, the
    effective date of OBRA 93.

 

    NMC ceased to recognize the incremental revenue realized under
    the original Program Memorandum as of July 1, 1995, but it
    continued to bill employer health plans as primary payors for
    patients affected by OBRA 93 through December 31, 1995. As
    of January 1, 1996, NMC commenced billing Medicare as
    primary payor for dual eligible ESRD patients affected by OBRA
    93, and then began to rebill in compliance with the revised
    policy for services rendered between April 24 and
    December 31,1995.

 

    On May 5, 1995, NMC filed a complaint in the
    U.S. District Court for the District of Columbia
    (National Medical Care, Inc. and Bio-Medical
    Applications of Colorado, Inc. d/b/a Northern Colorado Kidney
    Center v. Shalala, C.A.
    No. 95-0860
    (WBB)) seeking to preclude HCFA from retroactively enforcing its
    April 24, 1995 implementation of the OBRA 93 provisions
    relating to the coordination of benefits for dual eligible ESRD
    patients. On May 9, 1995, NMC moved for a preliminary
    injunction to preclude HCFA from enforcing its new policy
    retroactively, that is, to billings for services provided
    between August 10, 1993 and April 23, 1995. On
    June 6, 1995, the court granted NMC’s request for a
    preliminary injunction and in December of 1996, NMC moved for
    partial summary judgment seeking a declaration from the Court
    that HCFA’s retroactive application of the April 1995 rule
    was legally invalid. HCFA cross-moved for summary judgment on
    the grounds that the April 1995 rule was validly applied
    prospectively. In January 1998, the court granted NMC’s
    motion for partial summary judgment and entered a declaratory
    judgment in favor of NMC, holding HCFA’s retroactive
    application of the April 1995 rule legally invalid, and based on
    its finding, the Court also permanently enjoined HCFA from
    enforcing and applying the April 1995 rule retroactively against
    NMC. The Court took no action on HCFA’s motion for summary
    judgment pending completion of the outstanding discovery. On
    October 5, 1998 NMC filed it’s own motion for summary
    judgment requesting that the Court declare HCFA’s
    prospective application of the April 1995 rule invalid and
    permanently enjoin HCFA from prospectively enforcing and
    applying the April 1995 rule. The Court has not yet ruled on the
    parties’ motions. HCFA elected not to appeal from the
    Court’s June 1995 and January 1998 orders. HCFA may,
    however, appeal all rulings at the conclusion of the litigation.
    If HCFA should successfully appeal so that the revised
    interpretation would be applied retroactively NMC may be
    required to refund the payments received from employer health
    plans for services provided after August 10, 1993 under
    HCFA’s original implementation, and to re-bill Medicare for
    the same services, which would result in a net loss to NMC of
    approximately $120 Million attributable to all periods prior to
    December 31,1995. Also, in such event, the Company’s
    business, financial position and results of operations would be
    materially adversely affected.

    

    23

 

    IDPN
    Coverage Issues

 

    SRM administers IDPN therapy to chronic dialysis patients who
    suffer from severe gastrointestinal malfunctions. IDPN therapy
    was provided by Homecare prior to its divestiture. After 1993,
    Medicare claims processors sharply reduced the number of IDPN
    claims approved for payment as compared to prior periods. NMC
    believes that the reduction in IDPN claims represented an
    unauthorized policy coverage change. Accordingly, NMC and other
    IDPN providers pursued various administrative and legal
    remedies, including administrative appeals, to address this
    reduction.

 

    In November 1995, NMC filed a complaint in the
    U.S. District Court for the Middle District of Pennsylvania
    seeking a declaratory judgment and injunctive relief to prevent
    the implementation of this policy coverage change. (National
    Medical Care, Inc. v. Shalala, 3:CV-95-1922 (RPC)).
    Subsequently, the District Court affirmed a prior report of the
    magistrate judge dismissing NMC’s complaint, without
    considering any substantive claims, on the grounds that the
    underlying cause of action should be submitted fully to the
    administrative review processes available under the Medicare
    Act. NMC decided not to appeal the Court’s decision, but
    rather, to pursue the claims through the available
    administrative processes.

 

    NMC was successful in pursuing these claims through the
    administrative process, receiving favorable decisions from
    Administrative Law Judges in more than 80% of its cases. In
    early 1998, a group of claims which had been ruled on favorably
    were remanded by the Medicare Appeals Council to a single
    Administrative Law Judge (the “ALJ”) with extensive
    instructions concerning the review of these decisions. A hearing
    was scheduled on the remanded claims to take place in July, but
    later postponed until October 1998.

 

    Prior to the July hearing date, the United States Attorney for
    the District of Massachusetts requested that the hearing be
    stayed pending resolution of the OIG Investigation, on the basis
    that proceeding could adversely effect the government’s
    investigation as well as the government’s efforts to
    confirm it belief that these claims are false. Prior to the ALJ
    issuing a decision on the stay request, the
    U.S. Attorney’s Office requested that NMC agree to a
    stay in the proceedings in order to achieve a potential
    resolution of the IDPN claims subject to the OIG Investigation
    as well as those which are subject to the administrative appeals
    process. NMC agreed to this request, and together with the
    U.S. Attorney’s Office requested a stay. The ALJ
    agreed to this request in order to allow the parties the
    opportunity to resolve both the IDPN claims which are the
    subject of the OIG Investigation and the IDPN claims which are
    the subject of the administrative proceedings. In March 1999
    negotiations between NMC and the U.S. Attorney’s
    Office failed to progress and NMC requested that the stay be
    lifted. The ALJ agreed to NMC’s request and on
    April 19, 1999 the ALJ hearing began. The hearing process
    is expected to proceed for several months. At the same time, NMC
    and the U.S. Attorney’s Office are continuing to
    discuss potential settlement of both the claims relating to the
    OIG investigation and the claims which are subject to
    administrative appeals. At this time, it is not possible to
    determine whether NMC and the government will be able to resolve
    issues surrounding the IDPN claims. Further proceedings on other
    administrative appeals related to unpaid claims remain stayed.

 

    Although NMC management believes that those unpaid IDPN claims
    were consistent with published Medicare coverage guidelines and
    ultimately will be approved for payment, there can be no
    assurance that the claims on appeal will be approved for payment
    in full or, to the extent approved, collected in full. Such
    claims represent substantial accounts receivable of NMC,
    amounting to approximately $150 million as of June 30,
    1999.

 

    If NMC is unable to collect its IDPN receivable, either through
    the administrative appeal process or through negotiation, or if
    IDPN coverage is reduced or eliminated, depending on the amount
    of the receivable that is not collected
    and/or the
    nature of the coverage change, NMC’s business, financial
    condition and results of operations could be materially
    adversely affected. NMC’s IDPN receivables are included in
    the net assets of the Company’s discontinued operations.
    However, these receivables have not been sold and will remain
    classified as discontinued operations until they have been
    settled. See Notes to Consolidated Financial Statements,
    Note 4 — “Discontinued Operations.”

 

    Administrative
    Appeals

 

    The Company regularly pursues various administrative appeals
    relating to reimbursement issues in connection with its dialysis
    facilities. One such appeal consists of a challenge to the
    Medicare regulation which capped

    

    24

 

    reimbursement for the bad debts incurred by dialysis facilities.
    In 1998, the United States Court of Appeals for the District of
    Columbia ruled in favor of the Company in connection with the
    bad debt issue, holding that the Secretary of Health &
    Human Services had not adequately justified the bad debt
    regulation, and ruling that the government’s order adopting
    the rule was arbitrary and capricious. The Court of Appeals
    remanded the matter to the Secretary to provide a more adequate
    explanation of the bad debt cap or to abandon it. Subsequently,
    the Court modified its holding to continue the bad debt
    regulation in effect pending remand. The Company is continuing
    settlement discussions with the government in an attempt to
    recover reimbursement for disallowed bad debt expenses. The
    Company cannot predict the outcome of these discussions.

 

    Spectra
    Corporate Integrity Agreement

 

    Spectra was acquired by the Company in June 1997. Prior to
    Spectra’s acquisition by the Company, Spectra settled an
    investigation by the government and entered into a Corporate
    Integrity Agreement (the “Agreement”). In February
    1999 the government advised Spectra that it may be in breach of
    the Agreement and on March 15, 1999 issued a subpoena to
    Spectra requesting certain documents related to the Agreement.
    Spectra has complied with the subpoena and is currently working
    with the government to determine if any corrective action is
    necessary. While there can be no assurances, the Company does
    not believe the outcome of this matter will have a material
    adverse effect on the company.

 

    Other
    Litigation and Potential Exposures

 

    In recent years, physicians, hospitals and other participants in
    the health care industry have become subject to an increasing
    number of lawsuits alleging professional negligence,
    malpractice, product liability, workers’ compensation or
    related claims, many of which involve large claims and
    significant defense costs. The Company and NMC and their
    subsidiaries have been, and the Company can be expected to
    continue from time to time to be, subject to such suits due to
    the nature of the Company’s business. Although the Company
    maintains insurance at a level which it believes to be prudent,
    there can be no assurance that the coverage limits will be
    adequate or that all asserted claims will be covered by
    insurance. In addition, there can be no assurance that liability
    insurance will continue to be available at acceptable costs. A
    successful claim against the Company or any of its subsidiaries
    in excess of insurance coverage could have a material adverse
    effect upon the Company and the results of its operations. Any
    claims, regardless of their merit or eventual outcome, also may
    have a material adverse effect on the reputation and business of
    the Company. The Company, NMC and their subsidiaries operate a
    large number and wide variety of facilities throughout the
    U.S. in such a decentralized system it is often difficult
    to maintain the desired level of oversight and control over the
    thousands of individuals employed by many affiliate companies.
    The Company relies upon its management structure, regulatory and
    legal resources, and the effective operation of its compliance
    program to direct, manage and monitor the activities of these
    employees. However, on occasion, the Company, NMC and their
    subsidiaries have identified instances where employees,
    deliberately or inadvertently, have submitted inadequate or
    false billings while employed by an affiliated company. The
    illegal actions of such persons may subject NMC to liability
    under the False Claims Act, among other laws, and the Company
    cannot predict whether such law enforcement authorities may use
    such information to initiate further investigations of the
    business practices disclosed or any other business activities of
    the Company. In addition, the Company asserts claims and suits
    arising in the ordinary course of business, the ultimate
    resolution of which would not, in the opinion of the Company,
    have a material adverse effect on its financial condition.

    

    25

 

    EXHIBIT L

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORMS OF
    SECRETARY’S CERTIFICATE

 

    Certificate
    of Secretary

 

    I, the undersigned, being the Secretary of NMC Funding
    Corporation, a Delaware corporation (the “Company”),
    DO HEREBY CERTIFY that:

 

    The person named below has been duly appointed, is duly
    qualified as and is on the date hereof an officer of the
    Company, and the signature below set opposite his name is his
    genuine signature.

 

	 	 	 	 	 
	
    Name
	
 
	
    Office
	
 
	
    Signature

	 

	

    Mark Fawcett

	
 
	
    Treasurer
	
 
	
    /s/  Mark
    Fawcett

    

 

    Attached hereto as Exhibit A is a true and complete copy of
    the Company’s Certificate/Articles of Incorporation, or its
    equivalent, as filed in the Office of the Secretary of State, or
    its equivalent, of the State of incorporation, together with all
    amendments thereto adopted through the date hereof.

 

    Attached hereto as Exhibit B is a true and complete copy of
    the Company’s by-laws as in effect on the date hereof,
    together with all amendments thereto adopted through the date
    hereof.

 

    Attached hereto as Exhibit C are true and correct copies of
    the resolutions duly adopted by the Company’s board of
    directors on October 16, 2008 by written consent, which
    resolutions have not been revoked, modified, amended, or
    rescinded and are in full force and effect as of the date
    hereof. Except as attached hereto as Exhibit C, no
    resolutions have been adopted by the Company’s board of
    directors which deal with matters set forth in Exhibit C.

 

    IN WITNESS WHEREOF, I have hereunto set my hand this
    16th day of October, 2008.

 

    /s/  Douglas
    G. Kott

    Douglas G. Kott

    Secretary

    

    1

 

    PAGE 1

 

    State of
    Delaware

    

 

    Office of
    the Secretary of State

 

 

    I, EDWARD J. FREEL, SECRETARY OF STATE OF THE STATE OF DELAWARE,
    DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE
    CERTIFICATE OF INCORPORATION OF “NMC FUNDING
    CORPORATION”, FILED IN THIS OFFICE ON THE FOURTEENTH DAY OF
    AUGUST, A.D. 1997, AT 12:15 O’CLOCK P.M.

 

    A CERTIFIED COPY OF THIS CERTIFICATE HAS BEEN FORWARDED TO THE
    NEW CASTLE COUNTY RECORDER OF DEEDS FOR RECORDING.

 

	 	 	 	 	 	 	 
	
 
	
 
	
    
	
 
	
    /s/  Edward
    J. Freel

    
Edward
    J. Freel, Secretary of State

	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    2785199 8100

	
 
	
 
	
 
	
    AUTHENTICATION:
	
 
	
    8606253

	

    971272145

	
 
	
 
	
 
	
                   DATE:
	
 
	
    08-14-97

 

    CERTIFICATE
    OF INCORPORATION

    

 

    of

    

 

    NMC
    FUNDING CORPORATION

 

    FIRST:  This corporation’s name is
    “NMC Funding Corporation” (hereinafter called
    the“Corporation”).

 

    SECOND:  The address of the Corporation’s
    registered office in the State of Delaware is 1209 Orange
    Street, Wilmington, New Castle County, Delaware 19801. The name
    of the Corporation’s registered agent at such address is
    The Corporation Trust Company

 

    THIRD:  The nature of the business or purposes
    to be conducted or promoted by the Corporation are:

 

    (a) to enter into, perform and comply with a receivables
    purchase agreement (the “Purchase Agreement”) with
    National Medical Care, Inc. (“Seller”), pursuant to
    which agreement the Corporation may, among other things,
    purchase from Seller some or all of its accounts receivable and
    related security interests and rights (the
    “Receivables”);

 

    (b) to own, hold and service (or arrange for an agent to
    service) the Receivables;

 

    (c) to fund the Corporation’s purchases of Receivables
    by selling interests in the Receivables to, or borrowing from,
    one or more trusts, banks, financial institutions, commercial
    paper issuers, insurance companies or similar entities
    (collectively, “Financial Entities”), and, in
    connection with any such financing arrangements (whether a sale
    or a borrowing, a “Financial Transaction”), to sell,
    or pledge as security, all or substantially all of the
    Corporation’s assets, including all of its right, title and
    interest to and in the Receivables;

 

    (d) to invest the proceeds derived from the sale or
    ownership of the Receivables as determined by the
    Corporation’s board of directors (the
    “Board”); and

 

    (e) to engage in any lawful act or activity and to exercise
    any powers permitted to corporations organized under the General
    Corporation Law of the State of Delaware (“Delaware General
    Corporation Law”) that, in either case, are incidental to
    and necessary or convenient for the accomplishment of the
    above-mentioned purposes.

 

    FOURTH:  The total number of shares of all
    classes of capital stock that the Corporation is authorized to
    issue is One Thousand (1,000) shares, all of which shares shall
    be common stock, par value $.10 per share (“Common
    Stock”). All Common Stock will be identical and will
    entitle the holders thereof to the same rights and privileges.

 

    a. Voting Rights.  Except as set
    forth herein or as otherwise required by law, all outstanding
    Common Stock shall be entitled to vote on each matter on which
    the Corporation’s stockholders shall be entitled to vote,
    and each holder of Common Stock shall be entitled to one vote
    for each share of Common Stock held by such holder.

 

    b. Dividends and Other
    Distributions.  The Board may cause dividends
    to be paid to holders of Common Stock out of funds legally
    available for the payment of dividends. Any dividend or
    distribution on the Common Stock shall be payable on all Common
    Stock share and share alike.

 

    c. Liquidation.  In the event of
    any voluntary or involuntary liquidation, dissolution or winding
    up of the Corporation, after payment or provision for payment of
    the Corporation’s debts and other liabilities, the holders
    of Common Stock shall be entitled to share ratably, share alike,
    in the Corporation’s remaining net assets.

 

    FIFTH:  In furtherance and not in limitation of
    the powers conferred by statute, the Board is expressly
    authorized to alter, amend, repeal or adopt the
    Corporation’s bylaws (the “Bylaws”);
    provided, however, that any such alteration,
    amendment, repeal or adoption that relates to or affects in any
    way the criteria for, qualifications of, or requirement that the
    Corporation maintain at least one “Independent
    Director” (as defined in the Seventh Article), must receive
    the prior affirmative vote or written consent of each
    Independent Director.

 

    SIXTH:  Elections of directors need not be by
    written ballot unless, and to the extent, so provided in the
    Bylaws.

    

    1

 

    SEVENTH:  The Corporation shall at all times
    (except as noted hereafter in the event of death, incapacity,
    resignation or removal) have at least one director (an
    “Independent Director”) who (a) is not and has
    not, during the past five years, been a stockholder (whether
    direct, indirect or beneficial), customer, advisor or supplier
    of Seller or any of its affiliates (provided that
    indirect stock ownership of Seller or of any affiliate by any
    person through a mutual fund or similar diversified investment
    pool shall not disqualify such person from being an Independent
    Director unless such person maintains direct or indirect control
    of the investment decisions of such mutual fund or similar
    diversified investment pool); (b) is not and has not,
    during the past five years, been a director, officer, employee,
    affiliate or associate of Seller or any of its affiliates (other
    than the Corporation) (Seller and its affiliates other than the
    Corporation being hereinafter referred to as the “Corporate
    Group”); (c) is not a person related to any person
    referred to in clauses (a) and (b); (d) is not and has
    not, during the past five years, been a trustee, conservator or
    receiver for any member of the Corporate Group; and (e) has
    (i) prior experience as an independent director for a
    corporation whose charter documents required the unanimous
    consent of all independent directors thereof before such
    corporation could consent to the institution of bankruptcy or
    insolvency proceedings against it or could file a petition
    seeking relief under any applicable federal or state law
    relating to bankruptcy and (ii) at least three years of
    employment experience with one or more entities that provide, in
    the ordinary course of their respective businesses, advisory,
    management or placement services to issuers of securitization or
    structured finance instruments, agreements or securities. The
    Corporation shall cause each Independent Director to be paid a
    fee of at least $1,000 per year. In the event of the death,
    incapacity, resignation or removal of any Independent Director,
    the Board shall promptly appoint a replacement Independent
    Director. The Board shall not vote on any matter requiring the
    vote of an Independent Director under this Certificate of
    Incorporation unless at least one Independent Director is then
    serving on the Board.

 

    EIGHTH:  To the extent permitted under the
    Delaware General Corporation Law, none of the Corporation’s
    directors shall be liable to the Corporation or its stockholders
    for monetary damages as a result of breaching any fiduciary duty
    as a director. Any repeal or modification of this Eighth Article
    by the Corporation’s stockholders shall be prospective
    only, and shall not adversely affect any limitation on the
    personal liability of any director of the Corporation existing
    at the time of such repeal or modification.

 

    NINTH:  Subject to the limitations of an
    Independent Director in the Seventh Article, to the extent
    permitted under the Delaware General Corporation Law, any person
    (including stockholders, directors, officers and employees of
    the Corporation or any affiliate of the Corporation) may engage
    in or possess an interest in other business ventures of every
    nature and description, independently or with others, whether
    such ventures are competitive with the Corporation or otherwise,
    and neither the Corporation nor its stockholders shall have any
    right in or to such independent ventures or to the income or
    profits derived therefrom.

 

    TENTH:  Notwithstanding any other provision of
    this Certificate of Incorporation and any provision of law, the
    Corporation shall not do any of the following:

 

    (a) engage in any business or activity other than as set
    forth in the Third Article hereof;

 

    (b) without the affirmative vote of all of the Board
    members (which must include the affirmative vote of at least one
    duly appointed Independent Director), (i) dissolve or
    liquidate, in whole or in part, or institute proceedings to be
    adjudicated bankrupt or insolvent, (ii) consent to the
    institution of bankruptcy or insolvency proceedings against it,
    (iii) file a petition seeking or consenting to
    reorganization or relief under any applicable federal or state
    law relating to bankruptcy or insolvency, (iv) consent to
    the appointment of a receiver, liquidator, assignee, trustee,
    sequestrator (or other similar official) of the Corporation or a
    substantial part of its property, (v) make a general
    assignment for the benefit of creditors, (vi) admit in
    writing its inability to pay its debts generally as they become
    due or (vii) take any corporate action in furtherance of
    the actions set forth in clauses (i) through (vi) of
    this paragraph;

 

 

    (c) without the affirmative vote of all of the Board
    members (which must include the affirmative vote of at least one
    duly appointed Independent Director) merge or consolidate with
    any other corporation, company or entity or, except to the
    extent contemplated by the Third Article hereof, sell all or
    substantially all of its assets or acquire all or substantially
    all of the assets or capital stock or other ownership interest
    of any other corporation, company or entity; or

    

    2

 

    (d) without the affirmative vote of all of the Board
    members (which must include the affirmative vote of at least one
    duly appointed Independent Director), incur or assume any
    indebtedness for borrowed money except (i) indebtedness
    contemplated by paragraph (c) of the Third Article hereof
    or (ii) indebtedness to Seller for the purchase of
    Receivables on a deferred payment basis and incurred pursuant to
    the Purchase Agreement.

 

    When voting on whether the Corporation will take any action
    described in paragraph (b), (c) or (d) above, each
    Director shall owe its primary fiduciary duty or other
    obligation to the Corporation (including the Corporation’s
    creditors) and not to the stockholders (except as may otherwise
    be required by the Delaware General Corporation Law). Every
    stockholder of the Corporation shall be deemed to have consented
    to the foregoing by virtue of such stockholder’s consent to
    this Certificate of Incorporation.

 

    ELEVENTH:  The Corporation shall ensure at all
    times that (a) it conducts its business from an office that
    is separate and distinct from those of each member of the
    Corporate Group, even if such office space is subleased from, or
    is on or near premises occupied by, a Corporate Group member,
    (b) it maintains separate corporate records and books of
    account from those of each member of the Corporate Group,
    (c) none of the Corporation’s assets will be
    commingled with those of any member of the Corporate Group;
    (d) any employee, consultant or agent of the Corporation or
    any other operating expense incurred by the Corporation, will be
    paid from the assets of the Corporation; and (e) it
    maintains an arm’s length relationship with Seller and each
    other member of the Corporate Group.

 

    TWELFTH:  The Corporation reserves the right to
    amend, alter, change or repeal any provision contained in this
    Certificate of Incorporation in any manner now or hereafter
    provided herein or by statute; provided, however,
    that the Corporation shall not amend, alter, change or repeal
    any provision of the Third, Fifth, Seventh, Tenth, Eleventh, or
    Twelfth Article of this Certificate of Incorporation (the
    “Restricted Articles”) without the affirmative vote of
    all (which shall be at least one) Independent Directors, and
    provided, further, that the Corporation shall not
    amend or change any provision of any Article other than the
    Restricted Articles so as to be inconsistent with the Restricted
    Articles.

 

    THIRTEENTH:  The sole incorporator’s name
    and mailing address are as follows:

 

	 	 	 
	

    Carter Strong

	
 
	
    1050 Connecticut Avenue, N.W.

	
 
	
 
	
    Washington, D.C. 20036-5339

 

    THE UNDERSIGNED, being the sole incorporator hereinbefore named,
    for the purpose of forming a corporation pursuant to the
    Delaware General Corporation Law, makes this Certificate, hereby
    declaring and certifying that the facts herein stated are true,
    and accordingly has hereunto set his hand this
    14th day

    of August 1997

 

    /s/  Carter
    Strong

    Carter Strong

    Incorporator

    

    3

 

    BYLAWS

    

 

    OF

    

 

    NMC
    FUNDING CORPORATION*

 

 

    ARTICLE I
    

 

 

    OFFICES

 

    Section 1.  The
    registered office of NMC Funding Corporation (the
    “Corporation”) shall be in the City of Wilmington,
    State of Delaware.

 

    Section 2.  The
    Corporation may also have offices at such other places both
    within and without the State of Delaware as the board of
    directors (the “Board”) may from time to time
    determine or the Corporation’s business may require.

 

    Section 3.  The
    Corporation shall maintain a business office through which its
    business will be conducted separate from those of National
    Medical Care, Inc. and its affiliates.

 

    ARTICLE II
    

 

    MEETINGS
    OF STOCKHOLDERS

 

    Section 1.  Meetings
    of stockholders shall be held at any place within or outside the
    State of Delaware designated by the Board. In the absence of any
    such designation, stockholders’ meetings shall be held at
    the Corporation’s principal executive office.

 

    Section 2.  The
    annual meeting of stockholders shall be held each year on a date
    and at a time designated by the Board. At each annual meeting,
    directors shall be elected and any other proper business may be
    transacted.

 

    Section 3.  A
    majority of the Corporation’s capital stock outstanding and
    entitled to vote at any meeting of stockholders, the holders of
    which are present in person or represented by proxy, shall
    constitute a quorum for the transaction of business except as
    otherwise provided by law, by the Corporation’s Certificate
    of Incorporation (the “Certificate of Incorporation”),
    or by these Bylaws. A quorum, once established, shall not be
    broken by the withdrawal of enough votes to leave less than a
    quorum and the votes present may continue to transact business
    until adjournment. If, however, such quorum shall not be present
    or represented at any meeting of the stockholders, a majority of
    the voting stock represented in person or by proxy may adjourn
    the meeting from time to time, without notice other than
    announcement at the meeting, until a quorum shall be present or
    represented. At such adjourned meeting at which a quorum shall
    be present or represented, any business may be transacted which
    might have been transacted at the meeting as originally
    notified. If the adjournment is for more than 30 days, or
    if after the adjournment a new record date is fixed for the
    adjourned meeting, a notice of the adjourned meeting shall be
    given to each stockholder of record entitled to vote thereat.

 

    Section 4.  When
    a quorum is present at any meeting, the vote of the holders of a
    majority of the stock having voting power present in person or
    represented by proxy shall decide any question brought before
    such meeting, unless the question is one upon which by express
    provision of the statutes, or the Certificate of Incorporation,
    or these Bylaws, a different vote is required in which case such
    express provision shall govern and control the decision of such
    question.

 

    Section 5.  At
    each meeting of the stockholders, each stockholder having the
    right to vote may vote in person or may authorize another person
    or persons to act for him by proxy appointed by an instrument in
    writing subscribed by such stockholder and bearing a date not
    more than three years prior to said meeting, unless said
    instrument provides for a longer period. All proxies must be
    filed with the Corporation’s Secretary at the beginning of
    each

 

 

          * As duly adopted by
    the Corporation’s sole incorporator on August 14, 1997
    and by the Board as of August 15, 1997.

    

    1

 

    meeting in order to be counted in any vote at the meeting. Each
    stockholder shall have one vote for each share of stock having
    voting power, registered in his name on the Corporation’s
    books on the record date set by the Board as provided in
    Article  V, Section 6 hereof. All elections shall
    be had and all questions decided by a plurality vote.

 

    Section 6.  Special
    meetings of the stockholders, for any purpose, or purposes,
    unless otherwise prescribed by statute or by the Certificate of
    Incorporation, may be called by the President and shall be
    called by the President or the Secretary at the request in
    writing of a majority of the Board, or at the request in writing
    of stockholders owning a majority in amount of the
    Corporation’s capital stock outstanding and entitled to
    vote. Such request shall state the purpose or purposes of the
    proposed meeting. Business transacted at any special meeting of
    stockholders shall be limited to the purposes stated in the
    notice.

 

    Section 7.  Whenever
    stockholders are required or permitted to take any action at a
    meeting, a written notice of the meeting shall be given which
    notice shall state the place, date and hour of the meeting, and,
    in the case of a special meeting, the purpose or purposes for
    which the meeting is called. The written notice of any meeting
    shall be given to each stockholder entitled to vote at such
    meeting not fewer than 10 nor more than 60 days before the
    date of the meeting. If mailed, notice is given when deposited
    in the United States mail, postage prepaid, directed to the
    stockholder at his address as it appears on the
    Corporation’s records.

 

    Section 8.  The
    officer who has charge of the Corporation’s stock ledger
    shall prepare and make, at least 10 days before every
    meeting of stockholders a complete list of the stockholders
    entitled to vote at the meeting, arranged in alphabetical order,
    and showing the address of each stockholder and the number of
    shares registered in the name of each stockholder. Such list
    shall be open to the examination of any stockholder, for any
    purpose germane to the meeting, during ordinary business hours,
    for a period of at least 10 days prior to the meeting,
    either at a place within the city where the meeting is to be
    held, which place shall be specified in the notice of the
    meeting, or, if not so specified, at the place where the meeting
    is to be held. The list shall also be produced and kept at the
    time and place of the meeting during the whole time thereof, and
    may be inspected by any stockholder who is present.

 

    Section 9.  Unless
    otherwise provided in the Certificate of Incorporation, any
    action required to be taken at any annual or special meeting of
    stockholders, or any action which may be taken at any annual or
    special meeting of such stockholders, may be taken without a
    meeting, without prior notice and without a vote, if a consent
    in writing, setting forth the action so taken, shall be signed
    by the holders of outstanding stock having not less than the
    minimum number of votes that would be necessary to authorize or
    take such action at a meeting at which all shares entitled to
    vote thereon were present and voted. Prompt notice of the taking
    of the corporate action without a meeting by less than unanimous
    written consent shall be given to those stockholders who have
    not consented in writing.

 

    ARTICLE III
    

 

    DIRECTORS

 

    Section 1.  The
    number of directors which shall constitute the whole Board shall
    be not fewer than two nor more than six. The directors need not
    be stockholders or citizens of the United States or residents of
    the State of Delaware. The Corporation shall at all times,
    except as noted hereafter, have at least one Independent
    Director (as such term is defined in the Certificate of
    Incorporation). In the event of the death, incapacity,
    resignation or removal of any Independent Director, or if any
    director acting as an Independent Director shall cease to
    satisfy the eligibility conditions for an Independent Director,
    the Board shall promptly appoint a replacement Independent
    Director; provided, however, that the Board shall
    not vote on any matter requiring the vote of an Independent
    Director unless and until at least one Independent Director has
    been duly appointed to serve on the Board. The directors shall
    be elected at the annual meeting of the stockholders, except as
    provided in Section 2 of this Article, and each director
    elected shall hold office until his successor is elected and
    qualified; provided, however that unless otherwise
    restricted by the Certificate of Incorporation or by law, any
    director or the entire Board may be removed, either with or
    without cause, from the Board at any meeting of stockholders by
    a majority of the stock represented and entitled to wrote
    thereat.

    

    2

 

    Section 2.  Vacancies
    on the Board by reason of death, resignation, retirement,
    disqualification, or increase in the authorized number of
    directors may, subject to Section 1 above, be filled by a
    majority of the directors then office, although less than a
    quorum, or by a sole remaining director. The directors so chosen
    shall hold office until the next annual election of directors
    and until their successors are duly elected and shall quality,
    unless sooner displaced. If there are no directors in office,
    then an election of directors may be held in the manner provided
    by statute. If, at the time of filling any vacancy, the
    directors then in office shall constitute less than a majority
    of the whole Board (as constituted immediately prior to any such
    increase), the Court of Chancery may, upon application of
    stockholders holding at least ten percent of the total number of
    the shares at the time outstanding having the right to vote for
    such directors, summarily order an election to be held to fill
    any such vacancies or newly created directorships, or to replace
    the directors chosen by the directors then in office.

 

    Section 3.  The
    Corporation’s property and business shall be managed by or
    under the direction of the Board. In addition to the powers and
    authorities by these Bylaws expressly conferred upon them, the
    Board may exercise all such powers of the corporation and do all
    such lawful acts and things as are not by statute or by the
    Certificate of Incorporation or by these Bylaws directed or
    required to be exercised or done by the stockholders.

 

    MEETING
    OF THE BOARD

 

    Section 4.  The
    directors may hold their meetings and have one or more offices,
    and keep the Corporation’s books outside of the State of
    Delaware.

 

    Section 5.  Regular
    meetings of the Board may be held without notice at such time
    and place as shall from time to time be determined by the Board.

 

    Section 6.  Special
    meetings of the Board may be called by the President on
    forty-eight hours’ notice to each director, either
    personally, by telegram or by telecopy. Special meetings shall
    be called by the President or the Secretary in like manner and
    on like notice on the written request of two directors unless
    the Board consists of only one director; in which case special
    meetings shall be called by the President or Secretary in like
    manner or on like notice on the written request of the sole
    director.

 

    Section 7.  At
    all meetings of the Board, one-half of the entire Board shall be
    necessary and sufficient to constitute a quorum for the
    transaction of business, and the vote of a majority of the
    directors present at any meeting at which there is a quorum,
    shall be the act of the Board, except as may be otherwise
    specifically provided by statute, by the Certificate of
    Incorporation or by these Bylaws and except that one Independent
    Director must be present to form a quorum for any matter which,
    pursuant to the Certificate of Incorporation or these Bylaws,
    requires the vote of each Independent Director. If a quorum
    shall not be present at any meeting of the Board, the directors
    present thereat may adjourn the meeting from time to time,
    without notice other than announcement at the meeting, until a
    quorum shall be present. If only one director is authorized,
    such director shall constitute quorum.

 

    Section 8.  Unless
    otherwise restricted by the Certificate of Incorporation or
    these Bylaws, any action required or permitted to be taken at
    any meeting of the Board or of any committee designated by the
    Board (“Committee”) may be taken without a meeting, if
    all members of the Board or Committee, as the case may be,
    consent thereto in writing, and the writing or writings are
    filed with the minutes of proceedings of the Board or Committee.

 

    Section 9.  Unless
    otherwise restricted by the Certificate of Incorporation or
    these Bylaws, members of the Board, or any Committee designated
    by the Board, may participate in a meeting of the Board or any
    Committee, by means of conference telephone or similar
    communications equipment by means of which all persons
    participating in the meeting can hear each other, and such
    participation in a meeting shall constitute presence in person
    at such meeting.

 

    COMMITTEES
    OF DIRECTORS

 

    Section 10.  The
    Board may, by resolution passed by a majority of the whole
    Board, designate one or more Committees, each such Committee to
    consist of one or more of the Board members. The Board may
    designate one or more directors as alternate members of any
    Committee, who may replace any absent or disqualified member at
    any meeting of the Committee. In the absence or disqualification
    of a member of a Committee, the member or

    

    3

 

    members thereof present at any meeting and not disqualified from
    voting, whether or not he or they constitute a quorum, may
    unanimously appoint another Board member to act at the meeting
    in the place of any absent or disqualified member. Any such
    Committee, to the extent provided in the resolution of the
    Board, and subject to the requirements of Article III,
    shall have and may exercise all the powers and authority of the
    Board in the management of the Corporation’s business and
    affairs, and may authorize the seal for the Corporation to be
    affixed to all papers which say require it; but no such
    Committee shall have the power or authority in reference to
    amending the Certificate of Incorporation, adopting an agreement
    of merger or consolidation, recommending to the stockholders the
    sale, lease or exchange of all or substantially all of the
    Corporation’s property and assets, recommending to the
    stockholders a dissolution of the Corporation or a revocation of
    a dissolution, amending the Bylaws, or taking any other action
    which, pursuant to the Certificate of Incorporation, requires
    the vote of each Independent Director; and, unless the
    resolution or the Certificate of Incorporation expressly so
    provides, no such Committee shall have the power or authority to
    declare a dividend or to authorize the issuance of stock.

 

    Section 11.  Each
    Committee shall keep regular minutes of its meetings and report
    the same to the Board when required.

 

    COMPENSATION
    OF DIRECTORS

 

    Section 12.  Unless
    otherwise restricted by the Certificate of Incorporation or
    these Bylaws, the Board shall have the authority to fix the
    compensation of directors. The directors may be paid their
    expenses, if any, of attendance at each Board meeting and may be
    paid a fixed sum for attendance at each meeting of the Board or
    a stated salary as director; provided, however,
    that services provided by any director which are determined by
    the Board to be ministerial and of negligible value will not be
    compensated. No such payment shall preclude any director from
    serving the Corporation in any other capacity and receiving
    compensation therefor. Members of special or standing Committees
    may be allowed like compensation for attending Committee
    meetings.

 

    INDEMNIFICATION

 

    Section 13.  The
    Corporation shall indemnify every person who was or is a party
    or is or was threatened to be made a party to any action, suit,
    or proceeding, whether civil, criminal, administrative or
    investigative, by reason of the fact that he is or was a
    director officer or employee of the Corporation or, while a
    director, officer or employee of the Corporation, is or was
    serving at the request of the Corporation as a director,
    officer, employee, agent or trustee of another corporation,
    partnership, joint venture, trust, employee benefit plan or
    other enterprise, against expenses (including counsel fee),
    judgments, fines and amounts paid in settlement actually and
    reasonably incurred by him in connection with such action, suit
    or proceeding, to the full extent permitted by applicable law.

 

    ARTICLE IV
    

 

    OFFICERS

 

    Section 1.  The
    Corporation’s officers shall be chosen by the Board and
    shall include a President, a Secretary, and a Treasurer. The
    Corporation may also have at the Board’s discretion such
    other officers as are desired, including a chairman of the
    Board, one or more Vice Presidents, one or more Assistant
    Secretaries and Assistant Treasurers, and such other officers as
    may be appointed in accordance with the provisions of
    Section 2 hereof. If there are two or more Vice Presidents,
    then one or more may be designated as Executive Vice President,
    Senior Vice President, or other similar or dissimilar title. At
    the time of the election of officers, the directors may by
    resolution determine the order of their rank. Any number of
    offices may be held by the same person, unless the Certificate
    of Incorporation or these Bylaws otherwise provide.

 

    Section 2.  The
    Board may appoint such other officers and agents as it shall
    deem necessary who shall hold their offices for such terms and
    shall exercise such powers and perform such duties, as shall be
    determined from time to time by the Board.

 

    Section 3.  The
    salaries of all officers and agents of the Corporation shall be
    fixed by the Board.

    

    4

 

    Section 4.  The
    Corporation’s officers shall hold office until their
    successors are chosen and qualify in their stead. Any officer
    elected or appointed by the Board may be removed at any time by
    the affirmative vote of a majority of the Board. If the office
    of any officer or officers becomes vacant for any reason, the
    vacancy shall be filled by the Board.

 

    CHAIRMAN
    OF THE BOARD

 

    Section 5.  The
    Chairman of the Board, if such an officer be elected, shall, if
    present, preside at all meetings of the Board and exercise and
    perform such other powers and duties as may be from time to time
    assigned to him by the Board or prescribed by these Bylaws. If
    there is no President, the Chairman of the Board shall in
    addition be the Corporation’s Chief Executive Officer and
    shall have the powers and duties prescribed in Section 6 of
    this Article IV.

 

    PRESIDENT

 

    Section 6.  Subject
    to such supervisory powers, if any, as may be given by the Board
    to the Chairman of the Board, if there be such an officer, the
    President shall be the Corporation’s Chief Executive
    Officer and shall, subject to the Board’s control, have
    general supervision, direction and control of the
    Corporation’s business and officers. He shall preside at
    all meetings of the stockholders and, in the absence of the
    Chairman of the Board, or if there be none, at all Board
    meetings. He shall be an ex-officio member of all Committees and
    shall have the general powers and duties of management usually
    vested in the office of President and Chief Executive Officer of
    corporations, and shall have such other powers and duties as may
    be prescribed by the Board or these Bylaws.

 

    VICE
    PRESIDENTS

 

    Section 7.  In
    the absence or disability of the President, the Vice Presidents
    in order of their rank as fixed by the Board, or if not ranked,
    the Vice President designated by the Board, shall perform all
    the duties of the President, and when so acting shall have all
    the powers of and be subject to all the restrictions upon the
    President. The Vice Presidents shall have such other duties as
    from time to time may be prescribed for them, respectively, by
    the Board.

 

    Section 8.  The
    Secretary shall attend all Board meetings and all meetings of
    the stockholders and record all votes and the minutes of all
    proceedings in a book to be kept for that purpose; and shall
    perform like duties for the standing Committees when required by
    the Board. He shall give, or cause to be given, notice of all
    meetings of the stockholders and of the Board, and shall perform
    such other duties as may be prescribed by the Board or these
    Bylaws. He shall keep in safe custody the seal of the
    Corporation, and when authorized by the Board, affix the same to
    any instrument requiring it, and when so affixed it shall be
    attested by his signature or by the signature of an Assistant
    Secretary. The Board may give general authority to any other
    officer to affix the seal of the Corporation and to attest the
    affixing by his signature.

 

    Section 9.  The
    Assistant Secretary, or if there be more than one, the Assistant
    Secretaries in the order determined by the Board, or if there be
    no such determination, the Assistant Secretary designated by the
    Board, shall, in the absence or disability of the Secretary,
    perform the duties and exercise the powers of the Secretary and
    shall perform such other duties and have such other powers as
    the Board may from time to time prescribe.

 

    TREASURER
    AND ASSISTANT TREASURER

 

    Section 10.  The
    Treasurer shall have the custody of the corporate funds and
    securities and shall keep full and accurate accounts of receipts
    and disbursements in books belonging to the Corporation and
    shall deposit all moneys and other valuable effects, in the name
    and to the credit of the Corporation, in such depositories as
    may be designated by the Board. He shall disburse the
    Corporation’s funds as may be ordered by the Board, taking
    proper vouchers for such disbursements, and shall render to the
    Board, at its regular meetings, or when the Board so requires,
    an account of all his transactions as Treasurer and of the
    Corporation’s financial condition. If required by the
    Board, he shall give the Corporation a bond, in such sum and
    with such surety or sureties as shall be satisfactory to the
    Board, for the faithful performance of the duties of his office
    and for the restoration to the Corporation, in case of his
    death, resignation, retirement or removal from office, of all
    books, papers, vouchers, money and other property of whatever
    kind in his possession or under his control belonging to the
    Corporation.

    

    5

 

    SECRETARY
    AND ASSISTANT TREASURER

 

    Section 11.  The
    Assistant Treasurer, or if there shall be more than one, the
    Assistant Treasurers in the order determined by the Board, or if
    there be no such determination, the Assistant Treasurer
    designated by the Board, shall, in the absence or disability of
    the Treasurer, performs the duties and exercise the powers of
    the Treasurer and shall perform such other duties and have such
    other powers as the Board may from time to time prescribe.

 

    ARTICLE V
    

 

    CERTIFICATES
    OF STOCK

 

    Section 1.  Every
    holder of stock of the Corporation shall be entitled to have a
    certificate signed by, or in the name of the Corporation by, the
    Chairman or Vice Chairman of the Board, or the President or a
    Vice President, and by the Secretary or an Assistant Secretary,
    or the Treasurer or an Assistant Treasurer of the Corporation,
    certifying the number of shares represented by the certificate
    owned by such stockholder in the Corporation.

 

    Section 2.  Any
    or all of the signatures on the certificate may be a facsimile.
    In case any officer, transfer agent, or registrar who has signed
    or whose facsimile signature has been placed upon a certificate
    shall have ceased to be such officer, transfer agent, or
    registrar before such certificate is issued, it may be issued by
    the Corporation with the same effect as if he were such officer,
    transfer agent, or registrar at the date of issue.

 

    Section 3.  If
    the Corporation shall be authorized to issue more than one class
    of stock or more than one series of any class, the powers,
    designations, preferences and relative, participating, optional
    or other special rights of each class of stock or series thereof
    and the qualification, limitations or restrictions of such
    preferences
    and/or
    rights shall be set forth in full or summarized on the face or
    back of the certificate which the Corporation shall issue to
    represent such class or series of stock, provided that, except
    as otherwise provided in section 202 of the General
    Corporation Law of the State of Delaware, in lieu of the
    foregoing requirements, there may be set forth on the face or
    back of the certificate, which the Corporation shall issue to
    represent such class or series of stock, a statement that the
    Corporation will furnish without charge to each stockholder who
    so requests the powers, designations, preferences and relative,
    participating, optional or other special rights of each class of
    stock or series thereof and the qualifications, limitations or
    restrictions of such preferences
    and/or
    rights.

 

    LOST,
    STOLEN OR DESTROYED CERTIFICATES

 

    Section 4.  The
    Board may direct a new certificate or certificates to be issued
    in place of any certificate or certificates theretofore issued
    by the Corporation alleged to have been lost, stolen or
    destroyed, upon the miking of an affidavit of that fact by the a
    person claiming the certificate of stock to be lost, stolen or
    destroyed. When authorizing such issue of a new certificate or
    certificates, the Board may, in its discretion and as a
    condition precedent to the issuance thereof, require the owner
    of such lost, stolen or destroyed certificate or certificates,
    or his legal representative, to advertise the same in such
    manner as it shall require
    and/or to
    give the Corporation a bond in such sum as it may direct as
    indemnity against any claim that may be made against the
    Corporation with respect to the certificate alleged to have been
    lost, stolen or destroyed.

 

    TRANSFER
    OF STOCK

 

    Section 5.  Upon
    surrender to the Corporation, or the Corporation’s transfer
    agent, of a certificate for shares duly endorsed or accompanied
    by proper evidence of succession, assignation or authority to
    transfer, it shall be the duty of the Corporation to issue a new
    certificate to the person entitled thereto, cancel the old
    certificate and record the transaction upon its books.

 

    FIXING
    RECORD DATE

 

    Section 6.  In
    order that the Corporation may determine the stockholders
    entitled to notice of or to vote at any meeting of the
    stockholders, or any adjournment thereof, or to express consent
    to corporate action in writing without a meeting, or entitled to
    receive payment of any dividend or other distribution or
    allotment of any rights, or entitled to exercise any rights in
    respect of any change, conversion or exchange of stock or for
    the purpose of any

    

    6

 

    other lawful action, the Board may fix a record date which shall
    not be more than 60 nor fewer than 10 days before the date
    of such meeting, nor more than sixty days prior to any other
    action. A determination of stockholders of record entitled to
    notice of or to vote at a meeting of stockholders shall apply to
    any adjournment of the meeting; provided, however, that the
    Board may fix a new record date for the adjourned meeting.

 

    REGISTERED
    STOCKHOLDERS

 

    Section 7.  The
    Corporation shall be entitled to treat the holder of record of
    any share or shares of stock as the holder in fact thereof and
    accordingly shall not be bound to recognize any equitable or
    other claim or interest in such share on the part of any other
    person, whether or not it shall have express or other notice
    thereof, except as expressly provided by the laws of the State
    of Delaware.

 

    ARTICLE VI

    

 

    GENERAL
    PROVISIONS

 

    DIVIDENDS

 

    Section 1.  Dividends
    upon the Corporation’s capital stock, subject to the
    provisions of the Certificate of Incorporation, if any, may be
    declared by the Board at any regular or special meeting,
    pursuant to law. Dividends may be paid in cash, in property, or
    in capital stock, subject to the provisions of the Certificate
    of Incorporation.

 

    Section 2.  Before
    payment of any dividend there may be set aside out of any funds
    of the Corporation available for dividends such sum or sums as
    the directors from time to time, in their absolute discretion,
    think proper as a reserve fund to meet contingencies, or for
    equalizing dividends, or for repairing or maintaining any
    property of the Corporation, or for such other purpose as the
    directors shall think conducive to the interests of the
    Corporation, and the directors may abolish any such reserve. The
    Corporation will not pay dividends out of funds other than
    retained earnings unless the Board determines that the funds to
    be paid as dividends are no longer needed by the Corporation in
    the operations of its business and that the Corporation will not
    require any additional capital contributions after the payment
    of such dividend.

 

    CHECKS

 

    Section 3.  All
    checks, drafts or other orders for the payment of money issued
    in the name of the Corporation shall be signed by such officers,
    employees or agents of the Corporation as shall from time to
    time be designated by the Chairman of the Board, the President,
    the Vice President-Finance, the Treasurer or an Assistant
    Treasurer.

 

    All funds of the Corporation not otherwise employed shall be
    deposited from time to time to the credit of the Corporation in
    such banks, trust companies or other depositories as shall from
    time to time be designated by the Chairman of the Board, the
    President, the Vice President-Finance, the Treasurer or an
    Assistant Treasurer; and such officers may designate any type of
    depository arrangement (including but not limited to depository
    arrangements resulting in net debits against the Corporation) as
    from time to time offered or available.

 

    FISCAL
    YEAR

 

    Section 4.  The
    Corporation’s fiscal year shall be fixed by resolution of
    the Board.

 

    SEAL

 

    Section 5.  The
    corporate seal shall have inscribed thereon the name of the
    Corporation, the year of its organization and the words
    “Corporate Seal, Delaware.” Said seal may be used by
    causing it or a facsimile thereof to be impressed or affixed or
    reproduced or otherwise.

 

    NOTICES

 

    Section 6.  Whenever,
    under the provisions of the statutes or of the Certificate of
    Incorporation or of these Bylaws, notice is required to be given
    to any director or stockholder, it shall not be construed to
    mean personal

    

    7

 

    notice, but such notice may be given in writing, by mail,
    addressed to such director or stockholder, at his address as it
    appears on the records of the Corporation, with postage thereon
    prepaid, and such notice shall be deemed to be given at the time
    when the same shall be deposited in the United States mail.
    Notice to directors may also be given by telegram.

 

    Section 7.  Whenever
    any notice is required to be given under the provisions of the
    statutes or of the Certificate of Incorporation or of these
    Bylaws, a waiver thereof in writing, signed by the person or
    persons entitled to said notice, whether before or after the
    time stated therein, shall be deemed to be equivalent.

 

    ANNUAL
    STATEMENT

 

    Section 8.  The
    Board shall present at each annual meeting, and at any special
    meeting of the stockholders when called for by vote of the
    stockholders, a full and clear statement of the
    Corporation’s business and condition.

 

    ARTICLE VII
    

 

    AMENDMENTS

 

    Section 1.  These
    Bylaws may be altered, amended or repealed or new Bylaws may be
    adopted by the stockholders or by the Board, when such power is
    conferred upon the Board by the Certificate of Incorporation, at
    any regular meeting of the stockholders or of the Board or at
    any special meeting of the stockholders or of the Board if
    notice of such alteration, amendment, repeal or adoption of new
    Bylaws is contained in the notice of such special meeting;
    provided, however, that any such alteration,
    amendment, repeal or adoption that relates to or effects in any
    way the criteria for, qualifications of, or requirement that the
    Corporation maintain one Independent Director and one
    Independent Officer must receive the prior affirmative vote or
    written consent of each Independent Director. If the power to
    adopt, amend or repeal Bylaws is conferred upon the Board by the
    Certificate of Incorporation, it shall not divest or limit the
    power of the stockholders to adopt, amend or repeal Bylaws.

    

    8

 

    NMC
    FUNDING CORPORATION

    

    Action
    by Unanimous Written Consent of the Board of Directors

    In Lieu of a Meeting

    

    October 16, 2008
    

 

    The undersigned, being all the Directors of NMC Funding
    Corporation, a Delaware corporation (the
    “Corporation”), hereby consent to the adoption of the
    following resolutions, which shall be treated as resolutions for
    all purposes and as fully as if said resolutions were adopted at
    a duly called and held meeting of the Board of Directors,
    effective as of the date set forth above:

 

    RESOLVED: That the Fourth Amended and Restated Transfer and
    Administration Agreement by and among the Corporation, as
    Transferor, National Medical Care, Inc., as Collection Agent,
    the entities party thereto as Conduit Investors, the financial
    institutions party thereto as Bank Investors, the financial
    institutions party thereto as Administrative Agents, and WestLB
    AG, New York Branch, as Agent (the “Agreement”), as
    previously provided to the Board, be and the same hereby is
    approved and adopted, and that each officer of the Corporation
    be and each hereby is authorized and directed, acting in the
    name of and on behalf of the Corporation to execute and deliver
    the Agreement, or one or more instruments evidencing the
    Agreement, with such changes as any such officer shall, in his
    sole discretion, deem necessary or advisable, the execution and
    delivery of the same to be conclusive evidence of the authority
    granted hereunder.

 

    RESOLVED: That each officer of the Corporation be, and each of
    them individually hereby is, authorized and directed, in the
    name and on behalf of the Corporation, to (a) negotiate,
    execute and deliver such other instruments, agreements
    and/or
    documents required by, in furtherance of, or in connection with
    the Agreement (collectively with the Agreement, the
    “Transaction Documents”) with such changes or
    additions thereto as such officers may approve, the execution by
    any of such officers of any such Transaction Documents or the
    doing by such officer of any action in connection with the
    foregoing establishing conclusively such officer’s approval
    and the approval of the Board of Directors, and (b) cause
    the Corporation to perform its obligations thereunder.

 

    RESOLVED: That all action taken
    and/or any
    resolutions adopted by the Corporation’s current Board of
    Directors and officers in connection with the negotiation and
    execution of the Transaction Documents be, and hereby are,
    ratified, affirmed and approved.

 

    [Signature
    page to follow]
    

 

    IN WITNESS WHEREOF, the undersigned have executed this consent
    effective as of the date set forth above.

 

    /s/  Michael
    Brosnan

    Michael Brosnan

 

    /s/  Mark
    Fawcett

    Mark Fawcett

 

        

    Jill A. Gordon

 

    IN WITNESS WHEREOF, the undersigned have executed this consent
    effective as of the date set forth above.

 

        

    Michael Brosnan

 

        

    Mark Fawcett

 

    /s/  Jill
    A. Russo

    Jill A. Russo

 

    Certificate
    of Secretary

 

    I, the undersigned, being the Secretary of National Medical
    Care, Inc, a Delaware corporation (the “Company”), DO
    HEREBY CERTIFY that:

 

    The person named below has been duly appointed, is duly
    qualified as and is on the date hereof an officer of the
    Company, and the signature below set opposite his name is his
    genuine signature.

 

	 	 	 	 	 
	
    Name
	
 
	
    Office
	
 
	
    Signature

	 

	

    Mark Fawcett

	
 
	
    Treasurer
	
 
	
    /s/  Mark
    Fawcett

    

 

    Attached hereto as Exhibit A is a true and complete copy of
    the Company’s Certificate/Articles of Incorporation, or its
    equivalent, as filed in the Office of the Secretary of State, or
    its equivalent, of the State of incorporation, together with all
    amendments thereto adopted through the date hereof.

 

    Attached hereto as Exhibit B is a true and complete copy of
    the Company’s by-laws as in effect on the date hereof,
    together with all amendments thereto adopted through the date
    hereof.

 

    Attached hereto as Exhibit C are true and correct copies of
    the resolutions duly adopted by the Company’s board of
    directors on October 16, 2008 by written consent, which
    resolutions have not been revoked, modified, amended, or
    rescinded and are in full force and effect as of the date
    hereof. Except as attached hereto as Exhibit C, no
    resolutions have been adopted by the Company’s board of
    directors which deal with matters set forth in Exhibit C.

 

    IN WITNESS WHEREOF, I have hereunto set my hand this
    16th day of October, 2008.

 

    /s/  Douglas
    G. Kott

    Douglas G. Kott

    Secretary

 

    PAGE 1

 

     

 

    I, GLENN C. KENTON, SECRETARY OF STATE OF THE STATE OF DELAWARE
    DO HEREBY CERTIFY THE ATTACHED 19 A TRUE AND CORRECT COPY OF THE
    CERTIFICATE OF INCORPORATION OF NMC HOLDING CORP, FILED IN THIS
    OFFICE ON THE SIXTH DAY OF AUGUST, A. D. 1984, AT 10
    O’CLOCK A.M.

 

    /s/  Glenn
    C. Kenton

    Glenn C. Kenton, Secretary of State

 

	 	 	 	 	 
	
 
	
 
	
    AUTHENTICATION:
	
 
	
    10301820

	

    734219006

	
 
	
                   DATE:
	
 
	
    08/06/1984

 

	 	 	 
	

CERTIFICATE OF INCORPORATION

of

NMC HOLDING CORP.

	
 
	
     

 

    FIRST.  The name of the Corporation is: NMC
    Holding Corp.

 

    SECOND.  The address of its registered office
    in the State of Delaware is Corporation Trust Center, 1209
    Orange Street, in the City of Wilmington, County of New Castle.
    The name of its registered agent at such address is The
    Corporation Trust Company.

 

    THIRD.  The nature of the business or purposes
    to be conducted or promoted by the Corporation is as follows:

 

    To engage in any lawful act or activity for which corporations
    may be organized under the General Corporation Law of Delaware.

 

    FOURTH.  (A) The Corporation shall have
    the authority to issue two classes of stock to be designated,
    respectively, “Common Stock” and “preferred
    stock”. The total number of shares which the Corporation is
    authorized to issue is 22,000,000 shares, $.01 par
    value per share, of which 17,000,000 shares shall be Common
    Stock and 5,000,000 shares shall be Preferred Stock.

 

    (B) The Preferred Stock may be issued from time to time in
    one or more series. The Board of Directors of the Corporation is
    hereby authorized, within the limitations and restrictions
    stated in this Certificate of Incorporation, to determine or
    alter the rights, preferences, powers, privileges and the
    restrictions, qualifications and limitations granted to or
    imposed upon any wholly unissued series of Preferred Stock, and
    the number of shares constituting any such series and the
    designation thereof, and to increase or decrease the number of
    shares constituting any such series; and to increase or decrease
    the number of shares of any series subsequent to the issue of
    shares of that series, but not below the number of shares of
    such series then outstanding. In case the number of shares of
    any series shall be so decreased, the shares then constituting
    such decrease shall resume the status which they had prior to
    the adoption of the resolution originally fixing the number of
    shares of such series.

 

    FIFTH.  The name and mailing address of the
    sole incorporator are as follows:

 

	 	 	 
	
    Name
	
 
	
    Mailing Address

	 

	

    Paul P. Brountas

	
 
	
    60 State Street

    Boston, MA 02109

 

    SIXTH.  In furtherance of and not in limitation
    of powers conferred by statute, it is further provided:

 

    1. Election of directors need not be by written ballot.

 

    2. The Board of Directors is expressly authorized to adopt,
    amend or repeal the By-Laws of the Corporation.

 

    SEVENTH.  Whenever a compromise or arrangement
    is proposed between this corporation and its creditors or any
    class of them
    and/or
    between this corporation and its stockholders or any class of
    them, any court of equitable jurisdiction within the State of
    Delaware may, on the application in a summary way of this
    corporation or of any creditor or stockholder thereof, or on the
    application of any receiver or receivers appointed for this
    corporation under the provisions of Section 291 of
    Title 8 of the Delaware Code or on the application of
    trustees in dissolution or of any receiver or receivers
    appointed for this corporation under the provisions of
    Section 279 of Title 8 of the Delaware Code order a
    meeting of the creditors or class of creditors,
    and/or of
    the stockholders or class of stockholders of this corporation,
    as the case may be, to be summoned in such manner as the said
    court directs. If a majority in number representing
    three-fourths in value of the creditors or class of creditors,
    and/or of
    the stockholders or class of stockholders of this corporation,
    as the case may be, agree to any compromise or arrangement and
    to any reorganization of this corporation as consequence of such
    compromise or arrangement, the

    

    1

 

    said compromise or arrangement and the said reorganization
    shall, if sanctioned by the court to which the said application
    has been made, be binding on all the creditors or class of
    creditors,
    and/or on
    all the stockholders or class of stockholders, of this
    corporation, as the case may be, and also on this corporation.

 

    EIGHTH.  The Corporation reserves the right to
    amend, alter, change or repeal any provision contained in this
    Certificate of Incorporation, in the manner now or hereafter
    prescribed by statute and the Certificate of Incorporation, and
    all rights conferred upon stockholders herein are granted
    subject to this reservation.

 

    EXECUTED at Boston, Massachusetts on August 3, 1984.

 

    /s/  Paul
    P. Brountas

    Paul P. Brountas

    Incorporator

    

    2

 

    PAGE 1

 

     

 

 

    I, MICHAEL RATCHFORD, SECRETARY OF STATE OF THE STATE OF
    DELAWARE, DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT
    COPY OF THE CERTIFICATE OF RESTATED CERTIFICATE OF INCORPORATION
    OF “NMC HOLDING CORP.” FILED IN THIS OFFICE ON THE
    NINETEENTH DAY OF DECEMBER, A.D. 1984, AT 10 O’CLOCK A.M.

 

    * * * * * * * * * *

 

    

 

	 	 	 
	

    921895304

	
 
	
    /s/  Michael
    Ratchford

    
               SECRETARY
    OF STATE

                        AUTHENTICATION:
    *3511612

                                      DATE:
    07/08/1992

 

	 	 	 
	

RESTATED CERTIFICATE OF INCORPORATION

OF

NMC HOLDING CORP.

	
 
	
     

 

    Pursuant
    to Section 242 and 245 of the General

    Corporation Law of the State of Delaware

 

    The undersigned, Constantine L. Hampers, M.D. and Ellen B.
    Corenswet, President and Assistant Secretary, respectively, of
    NMC Holding Corp., a corporation organized and existing under
    the the General Corporation Law of the State of Delaware (the
    “Corporation”), the Certificate of Incorporation of
    which was filed in the Office of the Secretary of State of
    Delaware on August 6, 1984, do hereby certify that this
    Restated certificate of incorporation was duly adopted by the
    Board of Directors and the stockholders of the Corporation in
    accordance with the provisions of Sections 242 and 245 of
    the General Corporation Law of the State of Delaware.

 

    FIRST.  The name of the Corporation
    is NMC Holding
    Corp.

 

    SECOND.  The address of its registered office
    in the State of Delaware is Corporation Trust Center, 1209
    Orange Street, in the City of Wilmington, County of New Castle.
    The name of its registered agent at such address is The
    Corporation Trust Company.

 

    THIRD.  The nature of the business or purposes
    to be conducted or promoted is as follows:

 

    To acquire and hold, directly or indirectly, all of the
    outstanding shares of capital stock of Rational Medical Care,
    Inc.

 

    To engage in any lawful act or activity for which corporations
    may be organized under the General Corporation Law of Delaware.

 

    FOURTH.  (A) The Corporation is authorized
    to issue two classes of stock to be designated, respectively,
    “Common Stock” and “Preferred Stock.” The
    total number of shares which the Corporation is authorized to
    issue is 20,000,000 shares, $.01 par value per share,
    of which 15,000,000 shares shall be Common Stock and
    5,000,000 shares shall be Preferred Stock.

 

    (B) The Preferred Stock may be issued from time to time in
    one or more series. The Board of Directors of the Corporation is
    hereby authorized, within the limitations and restrictions
    stated in this Restated Certificate of Incorporation, to
    determine or alter the rights, preferences, powers, privileges
    and the restrictions, qualifications and limitations granted to
    or imposed upon any wholly unissued series of Preferred Stock,
    and the number of shares constituting any such series and the
    designation thereof; and to increase or decrease the number of
    shares constituting any such series; and to increase or decrease
    the number of shares of any series subsequent to the issue of
    shares of that series, but not below the number of shares of
    such series which have been issued. In case the number of shares
    constituting any series shall be so decreased, the shares then
    constituting such decrease shall resure the status which they
    had prior to the adoption of the resolution originally fixing
    the number of shares of such series.

 

    (C) Three Million Five Hundred Eighty Thousand (3,580,000)
    shares of the authorized and unissued Preferred Stock of the
    Corporation are hereby designated “Series A
    Convertible Preferred Stock” (hereinafter referred to as
    “Series A Stock”). Nine Hundred Seventeen
    Thousand (917,000) shares of the authorized and unissued
    Preferred Stock of the Corporation are hereby designated
    “Series B Convertible Preferred Stock”
    (hereinafter referred to as “Series B Stock”).
    The “Series A Stock and the series B Stock”
    are hereinafter referred to collectively as the
    “Series Preferred Stock.” Four Hundred Fifty
    Thousand (450,000) shares of the authorized and unissued
    Preferred Stock of the Corporation are hereby designated
    “12% Cumulative Redeemable Preferred Stock” (the
    “12% Preferred Stock”). The rights, preferences,
    powers, privileges and restrictions, qualifications and

    

    1

 

    limitations granted to or imposed upon the shares of
    Series Preferred Stock and the 12% Preferred Stock shall be
    as follows:

 

			
	 	    1.  
	
    Dividends.

 

    (a) (i) In each fiscal year of the Corporation, the
    holders of the 12% Preferred Stock shall be entitled to receive,
    when and as declared by the Board of Directors of the
    Corporation out of the funds legally available for that purpose,
    dividends payable in cash at the rate of twelve per cent (12%)
    per annum on the Liquidation Value (as defined in subsection
    2(a) hereof) of such shares, and no more, payable quarterly on
    the first day of March, June, September and December in each
    year (each such date being referred to herein as a
    “Quarterly Dividend Date”). The dividends on shares of
    the 12% Preferred Stock shall be cumulative and shall commence
    to accrue from the date of issue of such shares, so that if in
    any year dividends on the 12% Preferred Stock at the rate of
    twelve per cent (12%) per annum of the Liquidation Value thereof
    shall not have been paid or declared and set apart, the
    deficiency shall, except as otherwise provided in paragraph
    (ii) of this subsection 1(a), remain payable by the
    Corporation to the holders of the 12% Preferred Stock. Until all
    outstanding shares of the 12% Preferred Stock have been redeemed
    by the Corporation in accordance with Sections 6 and 7
    hereof, no dividend or other distribution payable in cash shall
    be paid on any shares of the Corporation’s Series A
    Stock, Series B Stock or Common Stock.

 

    (ii) In the event that the Corporation shall, for any
    reason, be unable to pay or declare and set apart any dividend
    on the 12% Preferred Stock as provided in paragraph (i) of
    this subsection l(a) (“Defaulted Dividend”), the
    Corporation shall, to the extent it may lawfully do so, issue in
    lieu of the Defaulted Dividend, a stock dividend of additional
    shares of the 12% Preferred Stock having a Liquidation Value
    equal to the amount of the Defaulted Dividend (rounded to the
    nearest whole share with one-half share rounded upward).

 

    (b) Subject to subsection 1(a), in each fiscal year of the
    Corporation the holders of shares of Series B Stock shall
    be entitled to receive before any cash dividends shall be
    declared and paid upon or set aside for the Series A Stock
    or the Common Stock in such fiscal year, when, as and if
    declared by the Board of Directors of the Corporation out of the
    funds legally available for that purpose, dividends payable in
    cash in an amount per share for such fiscal year at least equal
    to the product of (a) $.65, multiplied by (b) the
    number of whole shares of Common Stock into which each such
    share of Series B Stock is then convertible.

 

    (c) Subject to subsection 1(a), in each fiscal year of the
    Corporation, after payment shall have been made to the holders
    of shares of Series B Stock of the full amount to which
    they are entitled as aforesaid, the holders of the shares of
    Series A Stock and Series B Stock shall be entitled to
    receive, before any cash dividends shall be paid upon or set
    aside for the Common Stock in such fiscal year, when, as and if
    declared by the Board of Directors of the Corporation out of the
    funds legally available for that purpose, dividends payable in
    cash in an amount per share for such fiscal year at least equal
    to the product of (a) the per share amount, if any, of the
    cash dividend declared, paid or set aside for the Common Stock
    during such fiscal year, multiplied by (b) the number of
    whole shares of Common Stock into which each such share of
    Series A Stock and Series B Stock is then convertible.

 

			
	 	    2.  
	
    Liquidation, Dissolution or Winding Up.

 

    (a) (i) In the event of any voluntary or involuntary
    liquidation, dissolution or winding up of the Corporation, the
    holders of the shares of 12% Preferred Stock then outstanding
    shall be entitled to be paid out of the assets of the
    Corporation available for distribution to its stockholders,
    before any payment shall be made to the holders of
    Series Preferred Stock, Common Stock or any other class or
    series of stock ranking on liquidation junior to the 12%
    Preferred Stock by reason of their ownership thereof, an amount
    equal to $600 (the “Liquidation Value”) per share
    (subject to appropriate adjustment in the event of any stock
    dividend, stock split, combination or other similar
    recapitalization affecting such shares) plus accrued but unpaid
    dividends (and, in the event that such payment shall be made on
    a date other than a Quarterly Dividend Date, together with an
    additional dividend, at the rate of twelve percent (12%) per
    annum on the Liquidation Value thereof, in respect of the period
    from the last Quarterly Dividend Date to and including the date
    of such payment). If upon any such liquidation, dissolution or
    winding up of the Corporation the assets of the Corporation
    available for distribution to its stockholders shall be
    insufficient to pay the holders of shares of 12% Preferred Stock
    the full amount to which they shall be entitled, the holders of
    shares of 12% Preferred Stock and any class or series of stock
    ranking on liquidation on a parity with the 12% Preferred Stock
    shall share ratably in any distribution of such assets and funds
    of the Corporation in proportion to the respective

    

    2

 

    amounts which would otherwise be payable in respect of the
    shares held by them upon such distribution if all amounts
    payable on or with respect to such shares were paid in full.

 

    (ii) In the event of any voluntary or involuntary
    liquidation, dissolution or winding up of the Corporation, after
    payment shall have been made to the holders of shares of 12%
    Preferred Stock of the full amount to which they are entitled as
    aforesaid, the holders of the shares of Series B Stock then
    outstanding shall be entitled to be paid out of the assets of
    the Corporation available for distribution to its stockholders,
    before any payment shall be made to the holders of Series A
    Stock or Common Stock or any other class or series of stock
    ranking on liquidation junior to the Series B Stock by
    reason of their ownership thereof, an amount equal to $6.50 per
    share (subject to appropriate adjustment in the event of any
    stock dividend, stock split, combination or other similar
    recapitalization affecting such shares) plus accrued but unpaid
    dividends. If upon any such liquidation, dissolution or winding
    up of the Corporation the remaining assets of the Corporation
    available for distribution to its stockholders shall be
    insufficient to pay the holders of shares of Series B Stock
    the full amount to which they shall be entitled, the holders of
    shares of Series B Stock and any class or series of stock
    ranking on liquidation on a parity with the Series B Stock
    shall share ratably in any distribution of the remaining assets
    and funds of the Corporation in proportion to the respective
    amounts which would otherwise be payable in respect of the
    shares held by them upon such distribution if all amounts
    payable on or with respect to such shares were paid in full.

 

    (iii) In the event of any liquidation, dissolution or
    winding up of the Corporation, after payment shall have been
    made to the holders of the shares of 12% Preferred Stock and
    Series B Stock of the full amount to which they are
    entitled as aforesaid, the holders of the shares of
    Series A Stock shall be entitled to be paid out of the
    assets of the Corporation available for distribution to its
    stockholders, before any payment shall be made to the holders of
    Common Stock or any other class or series of stock ranking on
    liquidation junior to the Series A Stock (such Common Stock
    and other stock being collectively referred to as “Junior
    Stock”) an amount equal to $1.40 per share (subject to
    appropriate adjustment in the event of any stock dividend, stock
    split, combination or other similar recapitalization affecting
    such shares) plus accrued but unpaid dividends. If upon any such
    liquidation, dissolution or winding up of the Corporation the
    remaining assets of the Corporation available for distribution
    to its stockholders shall be insufficient to pay the holders of
    the shares of Series A Stock the full amount to which they
    shall be entitled, the holders of shares of Series A Stock
    and any class or series of stock ranking on liquidation on a
    parity with the Series A Stock shall share ratably in any
    distribution of the remaining assets and funds of the
    Corporation in proportion to the respective amounts which would
    otherwise be payable in respect of the shares held by them upon
    such distribution if all amounts payable on or with respect to
    such shares were paid in full.

 

    (b) After the payment of all preferential amounts required
    to be paid to the holders of the 12% Preferred Stock, and the
    Series Preferred Stock, upon the liquidation, dissolution
    or winding up of the Corporation, the holders of the shares of
    Junior Stock then outstanding shall be entitled to receive the
    remaining assets and funds of the Corporation available for
    distribution to its stockholders.

 

    (c) The merger or consolidation of the Corporation into or
    with another corporation (except if the Corporation is the
    surviving entity and is not owned or controlled by any other
    corporation or entity), or the sale of all or substantially all
    the assets of the Corporation, shall be deemed to be a
    liquidation, dissolution or winding up of the Corporation for
    purposes of this Section 2 unless such merger or
    consolidation is not intended to effect a change in the
    ownership or control of the Corporation or of its assets and is
    not intended to alter materially the business or assets of the
    Corporation.

 

    3.  Voting

 

    (a) Except as provided by law, by the provisions of
    subsections 3(b) and 3(c) below or by the provisions
    establishing any other series of Preferred Stock, (i) each
    holder of outstanding shares of Series Preferred Stock
    shall be entitled to the number of votes equal to the number of
    whole shares of Common Stock into which the shares of
    Series Preferred Stock held by such holder are convertible
    (as adjusted from time to time pursuant to Section 4
    hereof), at each meeting of stockholders of the Corporation (and
    for written actions of stockholders in lien of meetings) with
    respect to any and all matters presented to the stockholders of
    the Corporation for their action or consideration and
    (ii) the holders of 12% Preferred Stock shall not be
    entitled to vote with respect to any matters presented to the
    stockholders of the Corporation for their action or
    consideration. The holders of Series Preferred Stock shall
    vote together with the holders of Common Stock as a single class.

    

    3

 

    (b) For so long as any shares of the 12% Preferred Stock
    shall remain outstanding, the holders of shares of the 12%
    Preferred Stock, voting separately as a class, shall be entitled
    to elect one-half of the number of directors which the
    Corporation would have (fixed by or in accordance with the
    By-Laws of the Corporation) if there were no vacancies and shall
    be entitled to remove any director so elected. Except as
    required by law or as set forth in subsection 3(c) below, the
    holders of shares of the 12% Preferred Stock shall not be
    entitled to vote on any other matter on which stockholders are
    entitled or permitted to vote; provided, however, that so long
    as any shares of the 12% Preferred Stock shall be outstanding,
    affirmative action by the holders of the 12% Preferred Stock,
    voting separately as a class, shall be required to amend this
    Restated Certificate of Incorporation so as to increase or
    decrease the aggregate number of authorized shares of the 12%
    Preferred Stock, increase or decrease the par value of the
    shares of the 12% Preferred Stock or alter or change the powers,
    preferences or special rights of the shares of the 12% Preferred
    Stock so as to affect them adversely. At all meetings of
    stockholders of the Corporation at which the holders of the 12%
    Preferred Stock are entitled to vote, the presence in person or
    by proxy of holders of a majority of the 12% Preferred Stock
    issued and outstanding as of the record date for such meeting
    shall be required to constitute a quorum for the transaction of
    the business with respect to which the holders of the 12%
    Preferred Stock are entitled to vote, and at all such meetings
    (and for written actions of the holders of the 12% Preferred
    Stock in lieu of meetings) the vote, in person or by proxy (or
    given in writing), of holders of a majority of the 12% Preferred
    Stock issued and outstanding as of the record date for such
    meeting (or as of the date of such written action) shall
    constitute the action of the holders of the 12% Preferred Stock.

 

    (c) The Corporation shall not amend, alter or repeal the
    preferences, special rights or other powers of any series of
    Preferred Stock outstanding so as to affect adversely such
    series without the written consent or affirmative vote of the
    holders of a majority of the then outstanding shares of such
    series, given in writing or by vote at a meeting, consenting or
    voting (as the case may be) separately as a class. For this
    purpose, without limiting the generality of the foregoing, the
    authorization or-issuance of any series of Preferred Stock with
    preference or priority over such series as to the right to
    receive either dividends or amounts distributable upon
    liquidation, dissolution or winding up of the Corporation shall
    be deemed to affect adversely such series. The number of
    authorized shares of any series of Preferred Stock outstanding
    may be increased or decreased (but not below the number of
    shares then outstanding) by the affirmative vote of the holders
    of a majority of the then outstanding shares of such series of
    Preferred Stock voting as a separate class.

 

    4. Optional Conversion.  The
    holders of the Series Preferred Stock shall have conversion
    rights as follows (the “Conversion Rights”) :

 

    (a) Right to Convert.  Each share
    of Series Preferred Stock shall be convertible, at the
    option of the holder thereof, at any time and from time to time,
    into such number of fully paid and nonassessable shares of
    Common Stock as is determined by dividing $1.40 in the case of
    the Series A Stock and $6.50 in the case of the
    Series B Stock by the respective Conversion Prices of the
    Series A Stock and the Series B Stock (as defined
    below) in effect at the time of conversion. The conversion price
    at which shares of Common Stock shall be deliverable upon
    conversion of Series Preferred Stock without the payment of
    additional consideration by the holder thereof (the
    “Conversion Price”) shall initially be $1.40 in the
    case of the Series A Stock and $6.50 in the case of the
    Series B Stock. Such initial Conversion Price, and the rate
    at which shares of Series Preferred Stock may be converted
    into shares of Common Stock, shall be subject to adjustment as
    provided below.

 

    In the event of a liquidation of the Corporation, the Conversion
    Rights shall terminate at the close of business on the first
    full day preceding the date fixed for the payment of any amounts
    distributable on liquidation to the holders of
    Series Preferred Stock.

 

    (b) Fractional Shares.  No
    fractional shares of Common Stock shall be issued upon
    conversion of the Series Preferred Stock. In lieu of any
    fractional shares to which the holder would otherwise be
    entitled, the Corporation shall pay cash equal to such fraction
    multiplied by the then effective Conversion Price.

 

    (c) Mechanics of Conversion.

 

    (i) In order for a holder of Series Preferred Stock to
    convert shares of Series Preferred Stock into shares of
    Common Stock, such holder shall surrender the certificate or
    certificates for such shares of Series Preferred Stock, at
    the office of the transfer agent for the Series Preferred
    Stock (or at the principal office of the

    

    4

 

    Corporation if the Corporation serves as its own transfer
    agent), together with written notice that such holder elects to
    convert all or any number of the shares of the
    Series Preferred Stock represented by such certificate or
    certificates. Such notice shall state such holder’s name or
    the names of the nominees in which such holder wishes the
    certificate or certificates for shares of Common Stock to be
    issued. If required by the Corporation, certificates surrendered
    for conversion shall be endorsed or accompanied by a written
    instrument or instruments of transfer, in form satisfactory to
    the Corporation, duly executed by the registered holder or his
    or its attorney duly authorized in writing. The date of receipt
    of such certificates and notice by the transfer agent (or by the
    Corporation if the Corporation serves as its own transfer agent)
    shall be the conversion date (“Conversion Date”). The
    Corporation shall, as soon as practicable after the Conversion
    Date, issue and deliver at such office to such holder of
    Series Preferred Stock, or to his or its nominees, a
    certificate or certificates for the number of shares of Common
    Stock to which such holder shall be entitled, together with cash
    in lieu of any fraction of a share.

 

    (ii) The Corporation shall at all times when the
    Series Preferred Stock shall be outstanding, reserve and
    keep available out of its authorized but unissued stock, for the
    purpose of effecting the conversion of the Series Preferred
    Stock, such number of its duly authorized shares of Common Stock
    as shall from time to time be sufficient to effect the
    conversion of all outstanding Series Preferred Stock.
    Before taking any action which would cause an adjustment
    reducing the Conversion Price below the then par value of the
    shares of Common Stock issuable upon conversion of the
    Series Preferred Stock, the Corporation will take any
    corporate action which may, in the opinion of its counsel, be
    necessary in order that the Corporation may validly and legally
    issue fully paid and nonassessable shares of Common Stock at
    such adjusted Conversion Price.

 

    (iii) Upon any such conversion, no adjustment to the
    Conversion Price shall be made for any accrued and unpaid
    dividends on the Series Preferred Stock surrendered for
    conversion or on the Common Stock delivered upon conversion.

 

    (iv) All shares of Series Preferred Stock which shall
    have been surrendered for conversion as herein provided shall no
    longer be deemed to be outstanding and all rights with respect
    to such shares, including the rights, if any, to receive notices
    and to vote, shall immediately cease and terminate on the
    Conversion Date, except only the right of the holders thereof to
    receive shares of Common Stock in exchange therefor and payment
    of any accrued and unpaid dividends thereon. Any shares of
    Series Preferred Stock so converted shall be retired and
    cancelled and shall not be reissued, and the Corporation may
    from time to time take such appropriate action as may be
    necessary to reduce the authorized Series Preferred Stock
    accordingly.

 

    (d) Adjustments to Conversion Price for Diluting
    Issues:

 

    (i) Special Definitions.  For
    purposes of this Subsection 4(d), the following definition shall
    apply:

 

    (A) “Option” shall mean rights,
    options or warrants to subscribe for, purchase or otherwise
    acquire Common Stock or Convertible Securities, excluding
    (1) options
    and/or stock
    awards granted to employees or consultants of the Corporation
    pursuant to any employee option plan
    and/or
    employee stock purchase plan adopted by the Board of Directors,
    and (2) an option granted to W.R. Grace & Co. to
    purchase 3,070,430 shares of Common Stock at an exercise
    price of $1.09 per share (subject, in the case of any options or
    shares excluded hereunder to appropriate adjustment for any
    stock dividend, stock split, combination or other similar
    recapitalization affecting such shares).

 

    (B) “Original Issue Date” shall
    mean the date on which a share of Series Preferred Stock
    was first issued.

 

    (C) “Convertible Securities” shall
    mean any evidences of indebtedness, shares (other than Common
    stock and Series Preferred Stock) or other securities
    directly or indirectly convertible into or exchangeable for
    Common Stock.

 

    (D) “Additional Shares of Common
    Stock” shall mean all shares of Common Stock issued
    (or, pursuant to Subsection 4(d)(iii) below, deemed to be
    issued) by the Corporation after the Original Issue Date, other
    than shares of Common Stock issued or issuable:

 

    (I) upon conversion of shares of Series Preferred
    Stock outstanding on the Original Issue Date;

    

    5

 

    (II) as a dividend or distribution on Series Preferred
    Stock;

 

    (III) by reason of a dividend, stock split,
    split-up or
    other distribution on shares of Common Stock excluded from the
    definition of Additional Shares of Common Stock by the foregoing
    clauses (I) and (II) or this clause (III); or

 

    (IV) upon the exercise of options or stock awards excluded
    from the definition of “Option” in Subsection
    4(d)(i)(A).

 

    (ii) No Adjustment of Conversion
    Price.  No adjustment in the number of shares
    of Common Stock into which the Series Preferred Stock is
    convertible shall be made, by adjustment in the applicable
    Conversion Price thereof: (a) unless the consideration per
    share (determined pursuant to Subsection 4(d)(v)) for an
    Additional Share of Common Stock issued or deemed to be issued
    by the Corporation is less than the applicable Conversion Price
    in effect on the date of, and immediately prior to, the issue of
    such Additional Shares, or (b) if prior to such issuance,
    the Corporation receives written notice from the holders of at
    least
    662/3%
    of the then outstanding shares of Series Preferred Stock
    agreeing that no such adjustment shall be made as the result of
    the issuance of Additional Shares of Common Stock.

 

    (iii) Issue of Securities Deemed Issue of Additional
    Shares of Common Stock.

 

    (A) Options and Convertible
    Securities.  If the Corporation at any time or
    from time to time after the Original Issue Date shall issue any
    Options or Convertible Securities or shall fix a record date for
    the determination of holders of any class of securities entitled
    to receive any such Options or Convertible Securities, then the
    maximum number of shares of Common Stock (as set forth in the
    instrument relating thereto without regard to any provision
    contained therein for a subsequent adjustment of such number)
    issuable upon the exercise of such Options or, in the case of
    Convertible Securities and Options therefor, the conversion or
    exchange of such Convertible Securities, shall be deemed to be
    Additional Shares of Common Stock issued as of the time of such
    issue or in case such a record date shall have been fixed, as of
    the close of business on such record date, provided that
    Additional Shares of Common Stock shall not be deemed to have
    been issued unless the consideration per share (determined
    pursuant to Subsection 4(d)(v) hereof) of such Additional Shares
    of Common Stock would be less than the applicable Conversion
    Price in effect on the date of and immediately prior to such
    issue, or such record date, as the case may be, and provided
    further that in any such case in which Additional Shares of
    Common Stock are deemed to be issued:

 

    (I) no further adjustment in the Conversion Price shall be
    made upon the subsequent issue of Convertible Securities or
    shares of Common Stock upon the exercise of such Options or
    conversion or exchange of such Convertible Securities;

 

    (II) if such Options or Convertible Securities by their
    terms provide, with the passage of time or otherwise, for any
    increase in the consideration payable to the Corporation, or
    decrease in the number of shares of Common Stock issuable, upon
    the exercise, conversion or exchange thereof, the Conversion
    Price computed upon the original issue thereof (or upon the
    occurrence of a record date with respect thereto), and any
    subsequent adjustments based thereon, shall, upon any such
    increase or decrease becoming effective, be recomputed to
    reflect such increase or decrease insofar as it affects such
    Options or the rights of conversion or exchange under such
    Convertible Securities;

 

    (III) no readjustment pursuant to clause (II) above
    shall have the effect of increasing the Conversion Price to an
    amount which exceeds the lower of (i) the Conversion Price
    on the original adjustment date, or (ii) the Conversion
    Price that would have resulted from any issuance of Additional
    Shares of Common Stock between the original adjustment date and
    such readjustment date; and

 

    (IV) upon the expiration or termination of any unexercised
    Option, the Conversion Price shall not be readjusted, but the
    Additional Shares of Common Stock deemed issued as the result of
    the original issue of such Option shall not be deemed issued for
    the purposes of any subsequent adjustment of the Conversion
    Price.

    

    6

 

    (B) Stock Dividends and
    Subdivisions.  In the event the Corporation at
    any time or from time to time after the Original Issue Date
    shall declare or pay any dividend on the Common Stock payable in
    Common Stock, or effect a subdivision of the outstanding shares
    of Common Stock (by reclassification or otherwise than by
    payment of a dividend in Common Stock), then Additional Shares
    of Common Stock shall be deemed to have been issued:

 

    (I) in the case of any such dividend, immediately after the
    close of business on the record date for the determination of
    holders of any class of securities entitled to receive such
    dividend, or

 

    (II) in the case of any subdivision, at the close of
    business on the date immediately prior to the date upon which
    such corporate action becomes effective.

 

    If such record date shall have been fixed and such dividend
    shall not have been fully paid on the date fixed therefor, the
    adjustment previously made in the applicable Conversion Price
    which became effective on such record date shall be cancelled as
    of the close of business on such record date, and thereafter the
    Conversion Price shall be adjusted pursuant to this Subsection
    4(d)(iii) as of the time of actual payment of such dividend.

 

    (iv) Adjustment of Conversion Price Upon Issuance of
    Additional Shares of Common Stock.

 

    In the event the Corporation shall issue Additional Shares of
    Common Stock (including Additional Shares of Common Stock deemed
    to be issued pursuant to Subsection 4(d)(iii)), without
    consideration or for a consideration per share less than the
    applicable Conversion Price in effect on the date of and
    immediately prior to such issue, then and in such event, such
    Conversion Price shall be reduced, concurrently with such issue,
    to a price (calculated to the nearest cent) determined by
    multiplying such Conversion Price by a fraction, the numerator
    of which shall be the number of shares of Common Stock
    outstanding immediately prior to such issue plus the number of
    shares of Common Stock which the aggregate consideration
    received by the Corporation for the total number of Additional
    Shares of Common Stock so issued would purchase at such
    Conversion Price; and the denominator of which shall be the
    number of shares of Common Stock outstanding immediately prior
    to such issue plus the number of such Additional Shares of
    Common Stock so issued; provided that, for the
    purpose of this Subsection 4(d)(iv), all shares of Common Stock
    issuable upon conversion of shares of Series Preferred
    Stock outstanding immediately prior to such issue shall be
    deemed to be outstanding, and immediately after any Additional
    Shares of Common Stock are deemed issued pursuant to Subsection
    4(d)(iii) (whether or not excluded from the definition of
    “Additional Shares of Common Stock” by virtue of
    clauses (II), (III) and (IV) of Subsection
    4(d)(i)(D)), such Additional Shares of Common Stock shall be
    deemed to be outstanding; provided further, that
    in the event the Corporation, without receiving any
    consideration, declares a dividend on Common Stock payable in
    Common Stock or effects a subdivision of the outstanding shares
    of Common Stock into a greater number of shares of Common Stock,
    the Conversion Price in effect immediately prior to such stock
    dividend or subdivision shall, on the date that Additional
    Shares of Common Stock are deemed issued pursuant to Subsection
    4(d)(iii)(B), be decreased proportionately; and provided
    further, that the applicable Conversion Price shall not
    be so reduced at such time if the amount of such reduction would
    be an amount less than $.05, but any such amount shall be
    carried forward and reduction with respect thereto made at the
    time of and together with any subsequent reduction which,
    together with such amount and any other amount or amounts so
    carried forward, shall aggregate $.05 or more.

 

    (v) Datermination of
    Consideration.  For purposes of this
    Subsection 4(d), the consideration received by the Corporation
    for the issue of any Additional Shares of Common Stock shall be
    computed as follows:

 

    (A) Cash and Property.  Such
    consideration shall:

 

    (I) insofar as it consists of cash, be computed at the
    aggregate of cash received by the Corporation, excluding amounts
    paid or payable for accrued interest or accrued dividends;

 

    (II) insofar as it consists of property other than cash, be
    computed at the fair market value thereof at the time of such
    issue, as determined in good faith by the Board of
    Directors; and

 

    (III) in the event Additional Shares of Common Stock are
    issued together with other shares or securities or other assets
    of the Corporation for consideration which covers both, be the
    proportion

    

    7

 

    of such consideration so received, computed as provided in
    clauses (I) and (II) above, as determined in good
    faith by the Board of Directors.

 

    (B) Options and Convertible
    Securities.  The consideration per share
    received by the Corporation for Additional Shares of Common
    Stock deemed to have been issued pursuant to Subsection
    4(d)(iii)(A), relating to Options and Convertible Securities,
    shall be determined by dividing

 

    (x) the total amount, if any, received or receivable by the
    Corporation as consideration for the issue of such Options or
    Convertible Securities, plus the minimum aggregate amount of
    additional consideration (as set forth in the instruments
    relating thereto, without regard to any provision contained
    therein for a subsequent adjustment of such consideration)
    payable to the Corporation upon the exercise of such Options or
    the conversion or exchange of such Convertible Securities, or in
    the case of Options for Convertible Securities, the exercise of
    such Options for Convertible Securities and the conversion or
    exchange of such Convertible Securities, by

 

    (y) the maximum number of shares of Common Stock (as set
    forth in the instruments relating thereto, without regard to any
    provision contained therein for a subsequent adjustment of such
    number) issuable upon the exercise of such Options or the
    conversion or exchange of such Convertible Securities.

 

    (C) Stock Dividends and Stock
    Subdivisions.  Any Additional Shares of Common
    Stock deemed to have been issued pursuant to Subsecticn
    4(d)(iii)(B), relating to stock dividends and stock
    subdivisions, shall be deemed to have been issued for no
    consideration.

 

    (vi) Adjustment for Combinations or Consolidation of
    Common Stock.

 

    In the event the outstanding shares of Common Stock shall be
    combined or consolidated, by reclassification or otherwise, into
    a lesser number of shares of Common Stock, the applicable
    Conversion Price in effect immediately prior to such combination
    or consolidation shall, concurrently with the effectiveness of
    such combination or consolidation, be increased proportionately.

 

    (e) No Impairment.  The Corporation
    will not, by amendment of its Certificate of Incorporation or
    through any reorganization, transfer of assets, consolidation,
    merger, dissolution, issue or sale of securities or any other
    voluntary action, avoid or seek to avoid the observance or
    performance of any of the terms to be observed or performed
    hereunder by the Corporation, but will at all times in good
    faith assist in the carrying out of all the provisions of this
    Section 4 and in the taking of all such action as may be
    necessary or appropriate in order to protect the Conversion
    Rights of the holders of the Series Preferred Stock against
    impairment.

 

    (f) Certificate as to
    Adjustments.  Upon the occurrence of each
    adjustment or readjustment of the Conversion Price pursuant to
    this Section 4, the Corporation at its expense shall
    promptly compute such adjustment or readjustment in accordance
    with the terms hereof and furnish to each holder of
    Series Preferred Stock a certificate setting forth such
    adjustment or readjustment and showing in detail the facts upon
    which such adjustment or readjustment is based. The Corporation
    shall, upon the written request at any time of any holder of
    Series Preferred Stock, furnish or cause to be furnished to
    such holder a similar certificate setting forth (i) such
    adjustments and readjustments, (ii) the Conversion Price
    then in effect, and (iii) the number of shares of Common
    Stock and the amount, if any, of other property which then would
    be received upon the conversion of Series Preferred Stock.

 

    (g) Notice of Record Date.  In the
    event:

 

    (i) that the Corporation declares a dividend (or any other
    distribution) on its Common Stock payable in Common Stock or
    other securities of the Corporation;

 

    (ii) that the Corporation subdivides or combines its
    outstanding shares of Common Stock; or

 

    (iii) of the involuntary or voluntary dissolution,
    liquidation or winding up of the Corporation;

 

    then the Corporation shall cause to be filed at its principal
    office or at the office of the transfer agent of the
    Series Preferred Stock, and shall cause to be mailed to the
    holders of the Series Preferred Stock at their last

    

    8

 

    addresses as shown on the records of the Corporation or such
    transfer agent, at least ten days prior to the record date
    specified in (A) below or twenty days before the date
    specified in (B) below, a notice stating

 

    (A) the record date of such dividend, distribution or
    subdivision, or, if a record is not to be taken, the date as of
    which the holders of Common Stock of record to be entitled to
    such dividend, distribution or subdivision are to be
    determined, or

 

    (B) the date on which such dissolution, liquidation or
    winding up is expected to become effective, and the date as of
    which it is expected that holders of Common Stock of record
    shall be entitled to exchange their shares of Common Stock for
    securities or other property deliverable upon such dissolution,
    liquidation or winding up.

 

    5.  Mandatory Conversion.

 

    (a) The Corporation may, at its option, require all (and
    not less than all) holders of shares of Series B stock then
    outstanding to convert their shares of Series B Stock into
    shares of Common Stock, at the than effective Conversion Price
    pursuant to Section 4, at any time on or after the closing
    of the sale of shares of Common Stock in a public offering
    pursuant to an effective registration statement under the
    Securities Act of 1933, as amended, resulting in at least
    $5,000,000 of gross proceeds.

 

    (b) The Corporation may, at its option, require all (and
    not less than all) holders of shares of Series B Stock then
    outstanding to convert their shares of Series B Stock into
    shares of Common Stock, at the then effective Conversion Price
    pursuant to Section 4, upon the satisfaction by the
    Corporation of either of the two financial tests set forth below
    and receipt of a written certificate from the Corporation’s
    independent auditors stating that the applicable financial test
    has been satisfied, the date such test was satisfied (the
    “Determination Date”) and the calculation used in
    determining such satisfaction. The Corporation shall have the
    rights specified in this subsection 5(b) if Test No. 1
    below is satisfied at any time after the date of this Restated
    Certificate of Incorporation or if Test No. 2 below is
    satisfied on or before December 31, 1988. If Test
    No. 2 is not satisfied on or before December 31, 1988,
    the Corporation shall have the rights specified herein only if
    and when Test No. 1 is satisfied. The calculations of Debt,
    Total Capital Employed, Excess Cash and Cash on Hand (as such
    terms are defined below) shall be made with respect to the
    Corporation and its subsidiaries on a consolidated basis, except
    as specifically noted.

 

    Test No. 1:

 

    On the Determination Date, Debt as a percentage of Total Capital
    Employed shall not exceed 50%, where:

 

    A. “Debt” is defined as the sum of
    (i) indebtedness for borrowed money (including short-and
    long-term portions); (ii) obligations under leases which
    are recorded as capital leases (including short-and long-term
    portions); (iii) any additional funds provided to the
    Corporation by W. R. Grace & Co. from the date on
    which the first shares of 12% Preferred Stock were issued (the
    “Issue Date”) until the Determination Date, including
    funds provided under the terms of the Capitalization Agreement,
    dated the Issue Date, between W. R. Grace & Co. and
    Manufacturers Hanover Trust Company, as Agent
    (“MHTC”), but excluding any funds paid to Holding upon
    exercise of an option to purchase 3,070,430 shares of
    Common Stock of Holding granted to Grace on the Issue Date; and
    (iv) an amount equal to the difference between (x) the
    cumulative dividend on the 12% Preferred Stock from the Issue
    Date until the Determination Date (the “Preferred
    Dividend”), and (y) the amount of the Preferred
    Dividend actually paid in cash or in additional shares of 12%
    Preferred Stock by the Corporation prior to the Determination
    Date.

 

    B. “Total Capital Employed” is defined as
    the sum of (i) Debt; plus (ii) the aggregate capital
    of the Corporation at the Issue Date; plus (iii) cumulative
    net income (excluding net gains from the sale of assets but
    including losses from the sale of assets); minus (iv) the
    Preferred Dividend.

 

    Test No. 2:

 

    Excess Cash on the Determination Date shall equal or exceed
    $100 million, where “Excess Cash” is defined as
    an amount equal to (i) the cumulative net income (excluding
    net gains from the sale of assets but including losses from the
    sale of assets) from the Issue Date until the Determination
    Date; (ii) plus depreciation, amortization and deferred
    taxes for such period; (iii) adjusted for changes in
    working capital during such period (increases

    

    9

 

    constituting a deduction from net income and decreases
    constituting an addition to net income); (iv) minus capital
    expenditures and capitalized acquisition costs during such
    period; (v) plus Cash on Hand (as defined below) on the
    Issue Date. “Cash on Hand” is defined as the
    difference between the total cash, deposits and marketable
    securities of the Corporation (including for this purpose the
    $315,000,000 available to the Corporation under the Credit
    Agreement, dated as of December 14, 1984, among the
    Corporation, MHTC and the banks named therein (the “Credit
    Agreement”)) and an amount equal to the sum of the
    following : (A) the net proceeds from the sale of capital
    assets of the Corporation between August 23, 1984 and the
    Issue Date; (E) the fees and expenses incurred or
    contracted for at or before the Issue Date In connection with
    the merger of National Medical Care, Inc. (“NMC”) into
    NMC Acquisition Corp., Including (by way of example but not
    limitation) legal, accounting, printing and certain banking fees
    due at or before the Issue Date and the total contribution to be
    made to Dartmouth College, but not including banking fees to be
    incurred under the Credit Agreement after such time and not
    including fees and expenses paid by NMC prior to the Issue Date;
    (C) the cash payments (whether or not payable at the Issue
    Date) to be made for shares of, and retirement of options to
    acquire shares of, NMC; (D) the amount of indebtedness of
    NMC outstanding immediately prior to the Issue Date which is
    repaid at or before the Issue Date; (E) the cash, deposits
    and marketable securities of Dartmouth Insurance Company LTD. on
    the Issue Date; and (F) $24,000,000.

 

    (c) The Corporation shall not have the right to require the
    holders of shares of Series A Stock to convert their shares
    into Common Stock.

 

    (d) All holders of record of shares of Series B Stock
    will be given at least 10 days’ prior written notice
    of the date fixed and the place designated for mandatory
    conversion of all such shares of Series B Stock pursuant to
    this Section 5. Such notice will be sent by first class or
    registered mail, postage prepaid, to each record holder of
    Series B Stock at such holder’s address last shown on
    the records of the transfer agent for the Series B Stock
    (or the records of the Corporation, if it serves as its own
    transfer agent). On or before the date fixed for conversion,
    each holder of shares of Series B Stock shall surrender his
    or its certificate or certificates for all such shares to the
    Corporation at the place designated in such notice, and shall
    thereafter receive certificates for the number of shares of
    common Stock to which such holder is entitled pursuant to this
    Section 5. On the date fixed for conversion, all rights
    with respect to the Series B Stock so converted, including
    the rights, if any, to receive notices and vote, will terminate,
    except only the rights of the holders thereof, upon surrender of
    their certificate or certificates therefor, to receive
    certificates for the number of shares of Common Stock into which
    such Series B Stock has been converted, and payment of any
    accrued but unpaid dividends thereon. If so required by the
    Corporation, certificates surrendered for conversion shall be
    endorsed or accompanied by written instrument or instruments of
    transfer, in form satisfactory to the Corporation, duly executed
    by the registered holder or by his or its attorney duly
    authorized in writing. As soon as practicable after the date of
    such mandatory conversion and the surrender of the certificate
    or certificates for Series B Stock, the Corporation shall
    cause to be issued and delivered to such holder, or on his or
    its written order, a certificate or certificates for the number
    of full shares of Common Stock issuable on such conversion in
    accordance with the provisions hereof and cash as provided in
    Subsection 4(b) in respect of any fraction of a share of Common
    Stock otherwise issuable upon such conversion.

 

    (d) All certificates evidencing shares of Series B
    Stock which are required to be surrendered for conversion in
    accordance with the provisions hereof shall, from and after the
    date such certificates are so required to be surrendered, be
    deemed to have been retired and cancelled and the shares of
    Series B Stock represented thereby converted into Common
    Stock for all purposes, notwithstanding the failure of the
    holder or holders thereof to surrender such certificates on or
    prior to such date. The Corporation may thereafter take such
    appropriate action as may be necessary to reduce the authorized
    Series B Stock accordingly.

 

    6.  Optional Redemption.

 

    (a) The Corporation may, at the option of its Board of
    Directors, redeem, out of the assets of the Corporation legally
    available for that purpose, on any Quarterly Dividend Date, all
    or any part of the outstanding shares of the 12% Preferred
    Stock, upon notice duly given as hereinafter provided, by paying
    for each such share, in cash, an amount equal to the Liquidation
    Value there of (subject to appropriate adjustment for stock
    splits, stock dividends, combinations or other similar
    recapitalizations affecting such shares) together with an amount
    equal to any accrued but unpaid dividends on such shares
    (hereinafter referred to as the
    “Redemption Price”); provided, however, that

    

    10

 

    any such redemption of less than all of the shares of the 12%
    Preferred Stock then outstanding, shall be of 1,700 shares
    of the 12% Preferred Stock or of any whole multiple of
    1,700 shares.

 

    (b) In the event of any redemption of only a part of the
    then outstanding 12% Preferred Stock, the Corporation shall
    effect such redemption pro rata among the holders thereof based
    on the number of shares of 12% Preferred Stock held by such
    holders on the date of the Redemption Notice (as defined
    below).

 

    (c) At least 30 days prior to the date fixed for any
    redemption of 12% Preferred Stock (hereinafter referred to as
    the “Redemption Date”), written notice shall be
    mailed, by first class or registered mail, postage prepaid, to
    each holder of record of 12% Preferred Stock to be redeemed, at
    his or its address last shown on the records of the transfer
    agent of the 12% Preferred Stock (or the records of the
    Corporation, if it serves as its own transfer agent), notifying
    such holder of the election of the Corporation to redeem such
    shares, specifying the Redemption Date and calling upon
    such holder to surrender to the Corporation, in the manner and
    at the place designated, his or its certificate or certificates
    representing the shares to be redeemed (such notice is
    hereinafter referred to as the
    “Redemption Notice”). On or prior to the
    Redemption Date, each holder of 12% Preferred Stock to be
    redeemed shall surrender his or its certificate or certificates
    representing such shares to the Corporation, in the manner and
    at the place designated in the Redemption Notice, and
    thereupon the Redemption Price of such shares shall be
    payable to the order of the person whose name appears on such
    certificate or certificates as the owner thereof and each
    surrendered certificate shall be cancelled. In the event less
    than all the shares represented by any such certificate are
    redeemed, a new certificate shall be issued representing the
    unredeemed shares. From and after the Redemption Date,
    unless there shall have been a default in payment of the
    Redemption Price, all rights of the holders of the 12%
    Preferred Stock designated for redemption in the
    Redemption Notice as holders of 12% Preferred Stock of the
    Corporation (except the right to receive the
    Redemption Price without interest upon surrender of their
    certificate or certificates) shall cease with respect to such
    shares, and such shares shall not thereafter be transferred on
    the books of the Corporation or be deemed to be outstanding for
    any purpose whatsoever.

 

    (d) On or prior to the Redemption Date, the
    Corporation shall deposit the Redemption Price of all
    shares of 12% Preferred Stock designated for redemption in the
    Redemption Notice and not yet redeemed with a bank or trust
    company having aggregate capital and surplus in excess of
    $25,000,000 as a trust fund for the benefit of the respective
    holders of the shares designated for redemption and not yet
    redeemed, with irrevocable instructions and authority to the
    bank or trust company to pay the Redemption Price for such
    shares to their respective holders on or after the
    Redemption Date upon receipt of notification from the
    Corporation that such holder has surrendered his or its share
    certificate to the Corporation. The balance of any monies
    deposited by the Corporation pursuant to this Subsection 6(d)
    remaining unclaimed at the expiration of one year following the
    Redemption Date shall thereafter be returned to the
    Corporation upon its request expressed in a resolution of its
    Board of Directors.

 

    (e) Subject to the provisions hereof, the Board of
    Directors of the Corporation shall have authority to prescribe
    the manner in which 12% Preferred Stock shall be redeemed from
    time to time. Any shares of 12% Preferred Stock so redeemed
    shall permanently be retired, shall no longer be deemed
    outstanding and shall not under any circumstances be reissued,
    and the Corporation may from time to time take such appropriate
    action as may be necessary to reduce the authorized 12%
    Preferred Stock accordingly. Nothing herein contained shall
    prevent or restrict the purchase by the Corporation, from time
    to time either at public or private sale, of the whole or any
    part of the 12% Preferred Stock at such price or prices as the
    Corporation may determine, subject to the provisions of
    applicable law.

 

			
	 	    7.  
	
    Mandatory Redemption.

 

    (a) Irrespective of the provisions of Section 6, the
    Corporation shall redeem, out of the assets of the Corporation
    legally available for that purpose, in installments on December
    1 of 1992, 1993 and 1994 (each such date being referred to
    herein as a “Mandatory Redemption Date”), the
    outstanding shares of 12% Preferred Stock, upon notice duly
    given as hereinafter provided, by paying for each such share, in
    cash, an amount equal to the Liquidation Value thereof (subject
    to appropriate adjustment in the event of any stock dividend,
    stock split, combination or other similar recapitalization
    affecting such shares) together with an amount equal to any
    accrued but unpaid dividends on such share (the “Mandatory
    Redemption Price”). The number of shares of the 12%
    Preferred Stock to be redeemed in each such installment shall be
    equal to one-third of the aggregate number of

    

    11

 

    shares of the 12% Preferred Stock issued prior to the first
    Mandatory Redemption Date (the first two such installments
    to be rounded, if necessary, upward to the next whole share and
    the third such installment to be equal to the remaining balance).

 

    (b) If the funds of the Corporation legally available for
    redemption of 12% Preferred Stock on any Mandatory
    Redemption Date are insufficient to redeem the number of
    shares of 12% Preferred Stock required under this Section 7
    to be redeemed on such date, those funds which are legally
    available will be used to redeem the maximum possible number of
    such shares of 12% Preferred Stock ratably on the basis of the
    number of shares of 12% Preferred Stock which would be redeemed
    on such date if the funds of the Corporation legally available
    therefor had been sufficient to redeem all shares of 12%
    Preferred Stock required to be redeemed on such date. At any
    time thereafter when additional funds of the Corporation become
    legally available for the redemption of 12% preferred Stock,
    such funds will be used, on the next succeeding Quarterly
    Dividend Date to redeem the balance of the shares which the
    Corporation was theretofore obligated to redeem, ratably on the
    basis set forth in the preceding sentence.

 

    (c) The Corporation shall be entitled, at its option, to
    credit against the number of shares of 12% Preferred Stock
    required to be redeemed from any holder on any Mandatory
    Redemption Date any shares of 12% Preferred Stock
    previously redeemed from such holder pursuant to Section 6
    and not previously so credited.

 

    (d) The Corporation shall provide notice of any redemption
    of 12% Preferred Stock pursuant to this Section 7
    specifying the time and place of redemption and the Mandatory
    Redemption Price, by first class or registered mail,
    postage prepaid, to each holder of record of 12% Preferred Stock
    at the address for such holder last shown on the records of the
    transfer agent therefor (or the records of the Corporation, if
    it serves as its own transfer agent), not more than 60 nor less
    than 30 days prior to the date on which such redemption is
    to be made. If less than all 12% Preferred Stock owned by such
    holder is then to be redeemed, the notice will also specify the
    number of shares which are to be redeemed. Upon mailing any such
    notice of redemption, the Corporation will become obligated to
    redeem at the time of redemption specified therein all 12%
    Preferred Stock specified therein. In case less than all 12%
    Preferred Stock represented by any certificate is redeemed in
    any redemption pursuant to this Section 7, a new
    certificate will be issued representing the unredeemed 12%
    Preferred Stock without cost to the holder thereof.

 

    (e) No share of 12% Preferred Stock as to which notice of
    redemption has been given is entitled to any dividends declared
    after its redemption on the Mandatory Redemption Date, and
    after such redemption all rights of the holder of such share as
    a stockholder of the Corporation by reason of the ownership of
    such share will cease, except the right to receive the Mandatory
    Redemption Price of such share, without interest, upon
    presentation and surrender of the certificate representing such
    share, and such share will not from and after redemption on such
    Mandatory Redemption Date be deemed to be outstanding.

 

    (f) Any 12% Preferred Stock redeemed pursuant to this
    Section 7 will be cancelled and will not under any
    circumstances be reissued, sold or transferred and the
    Corporation may from time to time take such appropriate action
    as may be necessary to reduce the authorized 12% Preferred Stock
    accordingly.

 

    (D) Each share of Common Stock issued and outstanding shall
    have one vote. Except as otherwise provided in this
    Article FOURTH or by law, holders of Series Preferred
    Stock and holders of Common Stock shall vote together as a
    single class. All rights accruing to the outstanding shares of
    capital stock of the Corporation not expressly provided for to
    the contrary herein shall be vested in the Common Stock,
    including the right, in the event of liquidation, dissolution or
    winding up of the Corporation, of the holders of Common Stock to
    participate in the net assets of the Corporation remaining after
    the distribution to holders of 12% Preferred Stock and
    Series Preferred Stock in accordance with the provisions of
    Part (C) of this Article FOURTH.

 

    FIFTH.  In furtherance and not in limitation of
    powers conferred by statute, it is further provided:

 

    1. Election of directors need not be by written ballot.

 

    2. The Board of Directors is expressly authorized to adopt,
    amend or repeal the By-Laws of the Corporation.

 

    SIXTH.  Whenever a compromise or arrangement is
    proposed between the Corporation and its creditors or any class
    of them
    and/or
    between the Corporation and its stockholders or any class of
    them, any court of equitable jurisdiction within the State of
    Delaware may, on the application in a summary way of the
    Corporation or of any

    

    12

 

    creditor or stockholder thereof, or on the application of any
    receiver or receivers appointed for the Corporation under the
    provisions of section 291 of Title 8 of the Delaware
    Code or on the application of trustees in dissolution or of any
    receiver or receivers appointed for the Corporation under the
    provisions of section 279 of Title 8 of the Delaware
    Code, order a meeting of the creditors or class of creditors,
    and/or of
    the stockholders or class of stockholders of the Corporation, as
    the case may be, to be summoned in such manner as the said court
    directs. If a majority in number representing three-fourths in
    value of the creditors or class of creditors,
    and/or of
    the stockholders of class of stockholders of the Corporation, as
    the case may be, agree to any compromise or arrangement and to
    any reorganization of the Corporation as a consequence of such
    compromise or arrangement, the said compromise or arrangement
    and the said reorganization shall, if sanctioned by the court to
    which said application has been made, be binding on all the
    creditors or class of creditors,
    and/or on
    all the stockholders or class of stockholders, of the
    Corporation, as the case may be, and also on the Corporation.

 

    SEVENTH.  The Corporation reserves the right to
    amend, alter, change or repeal any provision contained in this
    Restated Certificate of Incorporation, in the manner now or
    hereafter prescribed by statute, and all rights conferred upon
    stockholders herein are granted subject to this reservation.

    

    13

 

    IN WITNESS WHEREOF, we have hereunto subscribed our names and
    have affixed the seal of the Corporation this 18thday of
    December, 1984.

 

    [Seal]

 

    /s/  Constantine
    L. Hampers

    Constantine L. Hampers, M.D.

    President

    ATTEST:

 

    /s/  Ellen
    B. Corenswet

    Ellen B. Corenswet,

    Assistant Secretary

 

    COMMONWEALTH OF MASSACHUSETTS     )

                                                        )
    ss. :

 

    COUNTY
    OF                         )

 

    BE IT REMEMBERED, that on this 18th day of December, 1984,
    personally came before me, [ILLEGIBLE] Notary Public in and for
    the County and Commonwealth aforesaid , Constantine L. Haxpers,
    President of NMC Holding Corp., a Delaware corporation, the
    person who executed the foregoing certificate, known to me
    personally to be such and he, the said Constantine L. Hampers as
    such President, duly executed said certificate before me and
    acknowledged that said certificate was his act and deed, that
    the facts stated therein are true, that the seal affixed to said
    certificate is the corporate seal of said NMC Holding Corp., and
    that the execution, acknowledgment, filing and recording of said
    certificate have been duly authorized by resolution of the Board
    of Directors of the said corporation.

 

    GIVEN under my hand and seal of office, the day and year
    aforesaid.

 

    

 

        

    Notary Public

    My Commission Expires:

 

    PAGE
    1

    

 

    I, MICHAEL HARKINS, SECRETARY OF STATE OF THE STATE OF DELAWARE
    DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF
    CERTIFICATE OF OWNERSHIP OF THE “NMC HOLDING CORP.” A
    CORPORATION ORGANIZED AND EXISTING UNDER THE LAWS OF THE STATE
    OF DELAWARE, MERGING “NATIONAL MEDICAL CARE, INC.” A
    CORPORATION ORGANIZED AND EXISTING UNDER THE LAWS OF THE STATE
    OF DELAWARE, PURSUANT TO SECTION 253 OF THE GENERAL
    CORPORATION LAW OF THE STATE OF DELAWARE AS RECEIVED AND FILED
    IN THIS OFFICE THE THE NINETEENTH DAY OF JUNE, A.D. 1985, AT 1
    O’CLOCK P.M.

 

    AND I DO HEREBY FURTHER CERTIFY THAT THE AFORESAID CORPORATION
    SHALL BE GOVERNED BY THE LAWS OF THE STATE OF DELAWARE

 

    AND I DO HEREBY FURTHER CERTIFY THAT THE SAID “NMC HOLDING
    CORP.”, HAS RELINQUISHED ITS CORPORATE TITLE AND
    ASSUMED IN PLACE

 

    /s/  Michael
    Harkins

    Michael Harkins, Secretary of State

 

    AUTHENTICATION: 10554722

 

    DATE: 07/03/1985

 

    851700123

 

    CONTINUED ON
    PAGE 2
    

 

    PAGE
    2

    

 

    THEREOF “NATIONAL MEDICAL CARE, INC.”

 

    |  |  |  |  |  |  |  |  |  |

 

    /s/  Michael
    Harkins

    Michael Harkins, Secretary of State

 

    AUTHENTICATION: 10554722

 

    DATE: 07/03/1985

    851700123

 

    CERTIFICATE
    OF OWNERSHIP AND MERGER

    

 

    MERGING

    

 

    NATIONAL
    MEDICAL CARE, INC.

    

 

    INTO

    

 

    NMC
    HOLDING CORP.

    

 

    **********

     

 

    NMC Holding Corp., a corporation organized and existing under
    the laws of the State of Delaware,

 

    DOES HEREBY CERTIFY:

 

    FIRST:  That this corporation was incorporated
    on the 6th day of August, 1984, pursuant to the General
    Corporation Law of the State of Delaware.

 

    SECOND:  That this corporation owns all of the
    outstanding shares of the stock of National Medical Care, Inc.,
    a corporation incorporated on the 25th day of July, 1969,
    pursuant to the General Corporation Law of the State of Delaware;

 

    THIRD:  That this corporation, by the following
    resolutions of its Board of Directors, adopted at a meeting held
    on the 9th day of May, 1985, voted to merge into itself
    National Medical Care, Inc.:

 

    RESOLVED:  That, pursuant to
    section 253 of the Delaware General Corporation Law, this
    Corporation merge into itself National Medical Care, Inc., a
    Delaware corporation, all of whose stock is owned by this
    Corporation and that this Corporation succeed to all the assets
    of National Medical Care, Inc., and assume all of the
    obligations of National Medical Care, Inc.; and

 

    FURTHER RESOLVED:  That the proper
    officers of this Corporation be and they hereby are directed to
    execute and acknowledge a Certificate of Ownership and Merger
    setting forth (1) a copy of the resolutions authorizing the
    merger into this Corporation of National Medical Care, Inc. and
    the assumption by this Corporation of the liabilities and
    obligations of National Medical Care, Inc. and (2) a
    provision changing the name of this Corporation to
    “National Medical Care, Inc.”, and the date of
    adoption thereof, and to cause the same to be filed and
    recorded, all in accordance with sections 103 and 253 of
    the Delaware General Corporation Law, and to do all acts and
    things whatsoever, whether within or without the State of
    Delaware, which may be in anywise necessary or proper to effect
    said merger.

 

    FOURTH:  Such merger shall become effective
    upon the date of filing of such documents with the Secretary of
    the State of Delaware.

 

    FIFTH:  The name of the surviving corporation
    shall be “NATIONAL MEDICAL CARE, INC.”.

    

    1

 

    IN WITNESS WHEREOF, said NMC HOLDING CORP., has caused this
    certificate to be signed by Constantine L. Hampers, M.D.,
    its President, and attested by Timothy I. McFeeley, its
    Secretary, this 14th day of June, 1985.

 

    NMC HOLDING CORP.

 

			
	 	    By: 
	
    /s/  Constantine
    L. Hampers

    Constantine L. Hampers, M.D. President

 

    ATTEST:

 

			
	    By: 
	
    /s/  Timothy
    I. McFeeley

	 

    Timothy I. McFeeley

    Secretary

 

    RECEIVED FOR RECORD

    JUN 19
    1985          

    LEO J. DUGAN, Jr., Recorder

    

    2

 

    PAGE
    1

     

 

    I, MICHAEL HARKINS, SECRETARY OF STATE OF THE STATE OF DELAWARE
    DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE
    CERTIFICATE OF AMENDMENT OF NATIONAL MEDICAL CARE, INC. FILED IN
    THIS OFFICE ON THE NINTH DAY OF OCTOBER, A.D. 1986, AT 10
    O’CLOCK A.M.

 

    |  |  |  |  |  |  |  |  |  |

 

 

	 	 	 
	
    
	
 
	

Michael Harkins, Secretary of State

        AUTHENTICATION:  | 0973312

                 DATE: 10/14/1986

    726282062

 

    CERTIFICATE
    OF AMENDMENT

    

 

    OF

    

 

    CERTIFICATE
    OF INCORPORATION

    

 

    (Pursuant
    to Section 242)

    

 

    * * *
    *

      

 

    National Medical Care, Inc., a corporation organized and
    existing under and by virtue of the General Corporation Law of
    the State of Delaware, DOES HEREBY CERTIFY:

 

    FIRST:  That the Board of Directors and
    Stockholders of said corporation, at meetings duly held, adopted
    a resolution proposing and declaring advisable the following
    amendment to the Restated Certificate of Incorporation of said
    corporation:

 

    RESOLVED:  That the Restated Certificate
    of Incorporation of National Medical Care, Inc. be amended by
    deleting Test No. 2 in subsection 5(b) of section (C)
    on page 16 of the Fourth Article and substituting therefore
    the following Test No. 2:

 

    Test No. 2

 

    Excess Cash on the Determination Date shall equal or exceed
    $100 million, where “Excess Cash” is defined as
    an amount equal to (i) the cumulative net income (excluding
    net gains from the sale of assets but including losses from the
    sale of assets) from the Issue Date until the Determination
    Date; (ii) plus depreciation, amortization and deferred
    taxes for such period; (iii) adjusted for changes in
    working capital during such period (increases constituting a
    deduction from net income and decreases constituting an addition
    to net income); (iv) minus capital expenditures and
    capitalized acquisition costs during such period; (v) plus
    Cash on Hand (as defined below) on the Issue Date. For purposes
    of calculating Excess Cash, capitalized acquisition costs (which
    shall be deemed to include the costs of
    start-up
    facilities in lieu of acquisitions) on a cumulative basis shall
    not exceed: (a) $23,000,000 if the Determination Date
    occurs during 1986, or (b) $31,900,000 if the Determination
    Date occurs during 1987 or 1988. These limits will be prorated
    if the Determination Date occurs at a time other than at year
    end. For purposes of calculating changes in working capital as
    referred to in clause (iii) above, working capital
    (beginning and ending balances) shall exclude the following:
    (x) all cash (including cash, deposits and marketable
    securities of domestic and foreign subsidiaries and cash,
    deposits and marketable securities of Dartmouth Insurance
    Company, Ltd.) and (y) the current portion of all debt and
    capitalized lease obligations. Working capital as of the
    Determination Date shall include as a current liability an
    accrual for swap C interest expense, this accrual representing
    an amount equal to one-half of the maximum accrual for swap C
    interest expense reported as a current liability over the
    12-month
    period immediately preceding the Determination Date. “Cash
    on Hand” is defined as the difference between the total
    cash, deposits and marketable securities of the Corporation
    (including for this purpose the $315,000,000 available to the
    Corporation under the Credit Agreement, dated as of
    December 14, 1984, among the Corporation, MHTC and the
    banks named therein (the “Credit Agreement”) ) and an
    amount equal to the sum of the following (A) the net
    proceeds from the sale of capital assets of the Corporation
    between August 23, 1984 and the Issue Date; (B) the
    fees and expenses incurred or contracted for at or before the
    Issue Date in connection with the merger of National Medical
    Care, Inc. (“NMC”) into NMC Acquisition Corp.,
    including (by way of example but not limitation) legal,
    accounting, printing and certain banking fees due at or before
    the Issue Date and the total contribution to be made to
    Dartmouth College, but not including banking fees to be incurred
    under the Credit Agreement after such time and not including
    fees and expenses paid by NMC prior to the Issue Date;
    (C) the cash payments (whether or not payable at the Issue
    Date) to be made for shares of, and retirement of options to
    acquire

    

    1

 

    shares of, NMC; (D) $20,000,000, representing the amount of
    indebtedness of NMC outstanding prior to the Issue Date;
    (E) $3,500,000, representing the cash, deposits and
    marketable securities of Dartmouth Insurance Company, Ltd., on
    the Issue Date; and (F) $24,000,000.

 

    IN WITNESS WHEREOF, said National Medical Care, Inc., has caused
    this certificate to be signed by Constantine L. Hampers, its
    President and Chairman of the Board of Directors, and attested
    by Timothy I. McFeeley, its Secretary, this 26th day of
    September, 1986.

 

	 	 	 
	

    ATTEST:

	
 
	
    NATIONAL MEDICAL CARE, INC.

	
 
	
 
	
 

	
    /s/  Timothy
    I.
    McFeeley

Timothy
    I. McFeeley
	
 
	

    By: /s/  Constantine
    L. Hampers

    
Constantine
    L. Hampers, M.D.

    President and Chairman of the Board of Directors 

    

    2

 

    PAGE
    1

     

 

    I, MICHAEL HARKINS, SECRETARY OF STATE OF THE STATE OF DELAWARE
    DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE
    CERTIFICATE OF AMENDMENT OF NATIONAL MEDICAL CARE, INC. FILED IN
    THIS OFFICE ON THE TWENTY-SIXTH DAY OF MAY, A.D. 1987, AT 10
    O’CLOCK A.M.

 

    |  |  |  |  |  |  |  |  |  |

 

 

	 	 	 
	

     727146052

	
 
	
    /s/  Michael
    Harkins
Michael
    Harkins, Secretary of State

    AUTHENTICATION: | 1288202

 

    DATE: 06/23/1987

 

    CERTIFICATE
    OF AMENDMENT

    

 

    OF

    

 

    CERTIFICATE
    OF INCORPORATION

    

 

    (Pursuant
    to Section 242)

    

 

    * * * * *
    * * * * * *

      

 

    National Medical Care, Inc., a corporation organized and
    existing under and by virtue of the General Corporation Law of
    the State of Delaware, DOES HEREBY CERTIFY:

 

    FIRST:  That the Board of Directors and
    Stockholders of said corporation, at meetings duly held, adopted
    a resolution proposing and declaring advisable the following
    amendment to the Restated Certificate of Incorporation of said
    corporation:

 

 

    RESOLVED:  That the corporation’s
    Certificate of Incorporation be amended by inserting therein a
    new Article EIGHTH immediately following
    Article SEVENTH which new Article shall state:

 

    “No director shall be personally liable to the corporation
    or any stockholder for monetary damages for breach of fiduciary
    duty as a director, except for any matter in respect of which
    such director shall be liable under Section 174 of
    Title 8 of the Delaware Code (relating to the Delaware
    General Corporation Law) or any amendment thereto or successor
    provision thereto or shall be liable by reason that, in addition
    to any and all other requirements for such liability, he
    (i) shall have breached his duty of loyalty to the
    corporation or its stockholders, (ii) shall not have acted
    in good faith or, in failing to act, shall not have acted in
    good faith, (iii) shall have acted in a manner involving
    intentional misconduct or a knowing violation of law or, in
    failing to act, shall have acted in a manner involving
    intentional misconduct or a knowing violation of law or
    (iv) shall have derived an improper personal benefit.
    Neither the amendment nor repeal of this Article Eighth,
    nor the adoption of any provision of the certificate of
    incorporation inconsistent with this Article Eighth, shall
    eliminate or reduce the effect of this Article Eighth in
    respect of any matter occurring, or any cause of action, suit or
    claim that, but for this Article

 

    Eighth would accrue or arise, prior to such amendment, repeal or
    adoption of an inconsistent provision.”

 

    IN WITNESS WHEREOF, said National Medical Care, Inc., has caused
    this certificate to be signed by Constantine L. Hampers, its
    President and Chairman of the Board of Directors, and attested
    by Timothy I. McFeeley, its Secretary, this 19th day of
    May, 1987.

 

 

	 	 	 
	

    ATTEST:

	
 
	
    NATIONAL MEDICAL CARE, INC.

	
 
	
 
	
 

	
    /s/  Timothy
    I. McFeeley

    
  Timothy
    I. McFeeley

      Secretary
	
 
	

    By: /s/  Constantine
    L. Hampers

    
Constantine
    L. Hampers, M.D.

    President and Chairman of

    the Board of Directors 

 

    RECEIVED FOR RECORD

    JUN 24
    1987          

    William M. Honey, Recorder

    

    1

 

    PAGE
    1

 

	 	 	 	 	 
	
 
	
 
	
    
	
 
	
    

 

    I, MICHAEL HARKINS, SECRETARY OF STATE OF THE STATE OF DELAWARE
    DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE
    CERTIFICATE OF OWNERSHIP OF NATIONAL MEDICAL CARE, INC., A
    CORPORATION ORGANIZED AND EXISTING UNDER THE LAWS OF THE STATE
    OF DELAWARE, MERGING GLUCO — MED, INC. AND HUMAN
    RESOURCE INSTITUTE, INC. AND INSTITUTE FOR HEALTH MAINTENANCE,
    INC. AND NATIONAL MEDICAL CARE OF NORFOLK, INC. AND NATIONAL
    MEDICAL CARE OF PORTLAND, INC. CORPORATIONS ORGANIZED AND
    EXISTING UNDER THE LAWS OF THE STATE OF DELAWARE, PURSUANT TO
    SECTION 253 OF THE GENERAL CORPORATION LAW OF THE STATE OF
    DELAWARE, AS RECEIVED AND FILED IN THIS OFFICE THE TWENTY-FIRST
    DAY OF JUNE, A.D. 1988, AT 10:01 O’CLOCK A.M.

 

    AND I DO HEREBY FURTHER CERTIFY THAT THE AFORESAID CORPORATION
    SHALL BE GOVERNED BY THE LAWS OF THE STATE OF

 

    

    881730109

 

 

    /s/  Michael
    Harkins

    Michael Harkins, Secretary of State

 

    AUTHENTICATION: | 1764464

    DATE: 06/27/1988

 

    CONTINUED ON
    PAGE 2
    

    

    2

 

    PAGE 2

     

 

 

    DELAWARE.

 

    |  |  |  |  |  |  |  |  |  |

 

    

    881730109

 

 

    /s/  Michael
    Harkins

    Michael Harkins, Secretary of State

    

    AUTHENTICATION: | 1764464

    DATE: 06/27/1988

 

 

    CERTIFICATE
    OF OWNERSHIP AND MERGER

    

    MERGING

    

    GLUCO-MED, INC.

    INSTITUTE FOR HEALTH MAINTENANCE, INC.

    HUMAN RESOURCE INSTITUTE, INC.

    NATIONAL MEDICAL CARE OF NORFOLK, INC.

    

    AND

    

    NATIONAL MEDICAL CARE OF PORTLAND, INC.

 

    INTO

    

    NATIONAL MEDICAL CARE, INC.

    

    *****

 

    National Medical Care, Inc., a corporation organized and
    existing under the laws of the State of Delaware,

 

    DOES HEREBY CERTIFY:

 

    FIRST:  That this corporation was incorporated
    on the 6th day of August, 1984, pursuant to the Corporation
    Law of the State of Delaware.

 

    SECOND:  That this corporation owns all of the
    outstanding shares of the stock of Gluco-Med, Inc., a
    corporation incorporated on the 12th day of November, 1980,
    pursuant to the Corporation Law of the State of Delaware;

 

    That this corporation owns all of the outstanding shares of the
    stock of Institute for Health Maintenance, Inc., a corporation
    incorporated on the 3rd day of November, 1972, pursuant to
    the Corporation Law of the State of Delaware;

 

    That this corporation owns all of the outstanding shares of the
    stock of Human Resource Institute, Inc., a corporation
    incorporated on the 19th day of January, 1970, pursuant to
    the Corporation Law of the State of Delaware;

 

    That this corporation owns all of the outstanding shares of the
    stock of National Medical Care of Norfolk, Inc., a corporation
    incorporated on the 31st day of January, 1969, pursuant to
    the Corporation Law of the State of Delaware;

 

    That this corporation owns all of the outstanding shares of the
    stock of National Medical Care of Portland, Inc., a corporation
    incorporated on the 17th day of March, 1969, pursuant to
    the Corporation Law of the State of Delaware;

 

    THIRD:  That this corporation, by the following
    resolutions of its Board of Directors, by the unanimous written
    consent of its members, filed with the minutes of the board, at
    a meeting held on the 14th day of June, 1988, determined to
    and did merge into itself said:

    

    1

 

    GLUCO-MED,
    INC.

    INSTITUTE FOR HEALTH MAINTENANCE, INC.

    HUMAN RESOURCE INSTITUTE, INC.

    NATIONAL MEDICAL CARE OF NORFOLK, INC.

    

    AND

    

    NATIONAL MEDICAL CARE OF PORTLAND, INC.

 

    RESOLVED, that National Medical Care, Inc. merge, and it hereby
    does merge into itself said:

 

    GLUCO-MED,
    INC.

    INSTITUTE FOR HEALTH MAINTENANCE, INC.

    HUMAN RESOURCE INSTITUTE, INC.

    NATIONAL MEDICAL CARE OF NORFOLK, INC.

    

    AND

    

    NATIONAL MEDICAL CARE OF PORTLAND, INC.

 

    assuming all of their obligations; and

 

    FURTHER RESOLVED, that the merger is to be effective upon the
    date of filing with the Secretary of the State of Delaware.

 

    FURTHER RESOLVED, that the proper officers of this corporation
    be and they hereby are directed to make and execute a
    Certificate of Ownership and Merger setting forth a copy of the
    resolutions to merge said:

 

    GLUCO-MED,
    INC.

    INSTITUTE FOR HEALTH MAINTENANCE, INC.

    HUMAN RESOURCE INSTITUTE, INC.

    NATIONAL MEDICAL CARE OF NORFOLK, INC.

    

    AND

    

    NATIONAL MEDICAL CARE OF PORTLAND, INC.

 

    assuming their liabilities and obligations, and the date of
    adoption thereof, and to cause the same to be filed with the
    Secretary of State and a certified copy recorded in the office
    of the Recorder of Deeds of New Castle county and to do all acts
    and things whatsoever, whether within or without the State of
    Delaware, which may be in anywise necessary or proper to effect
    said merger.

 

    IN WITNESS WHEREOF, said National Medical Care, Inc., has caused
    this certificate to be signed by Constantine L.
    Hampers, M.D., President, and attested by Timothy I.
    McFeeley, its Secretary, this 14th day of June, 1988.

 

	 	 	 
	

    Attest:

	
 
	
    NATIONAL MEDICAL CARE, INC.

	
 
	
 
	
 

	

    By: /s/ Timothy I. McFeeley

    
Timothy
    I. McFeeley

    Secretary

	
 
	
    By: /s/ Constantine L. Hampers

    
Constantine
    L. Hampers, M.D.

    President

    

    2

 

    PAGE 1

 

     

 

 

    I, MICHAEL RATCHFORD, SECRETARY OF STATE OF THE STATE OF
    DELAWARE, DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT
    COPY OF THE CERTIFICATE OF CHANGE OF REGISTERED AGENT/OFFICE OF
    “NATIONAL MEDICAL CARE, INC.” FILED IN THIS OFFICE ON
    THE ELEVENTH DAY OF MARCH, A.D. 1992, AT 9 O’CLOCK A.M.

 

    * * * * * * * * * *

 

    

 

 

    /s/  Michael
    Ratchford

    Michael Ratchford, Secretary of State

 

    AUTHENTICATION: *3595347

            DATE:

 

    CERTIFICATE
    OF CHANGE OF LOCATION OF REGISTERED OFFICE

    AND OF REGISTERED AGENT

 

    It is hereby certified that:

 

    1. The name of the corporation (hereinafter called the
    “corporation”) is

 

    NATIONAL MEDICAL CARE, INC.

 

    2. The registered office of the corporation within the
    State of Delaware is hereby changed to 32 Loockerman Square,
    Suite L-100,
    City of Dover 19901, County of Kent.

 

    3. The registered agent of the corporation within the State
    of Delaware is hereby changed to The Prentice-Hall Corporation
    System, Inc., the business office of which is identical with the
    registered office of the corporation as hereby changed.

 

    4. The corporation has authorized the changes hereinbefore
    set forth by resolution of its Board of Directors.

 

    Signed on Feb.  21, 1992

 

    /s/  Jo
    Ellen Ojeda

    Jo Ellen Ojeda, Vice-President

 

    Attest:

 

    /s/  John
    Whiting

    John Whiting, Secretary

 

 

	 	 	 	 	 
	
    STATE OF DELAWARE
	
 
	
 
	
    DE dcertificate of change 4/91
	
 

	
    SECRETARY OF STATE
	
 
	
 
	
 
	
 

	

    DIVISION OF CORPORATIONS

	
 
	
 
	
 
	
 

	

    FILED 09:00 AM 03/11/1992

	
 
	
 
	
 
	
 

	

    920715122 — 2041428

	
 
	
 
	
 
	
 

 

    PAGE 1

 

    State of
    Delaware

    Office of the Secretary of State

 

 

    I, EDWARD J. FREEL, SECRETARY OF STATE OF THE STATE OF DELAWARE,
    DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE
    CERTIFICATE OF CORRECTION OF “NATIONAL MEDICAL CARE,
    INC.”, FILED IN THIS OFFICE ON THE ELEVENTH DAY OF JANUARY,
    A.D. 1993, AT 12:15 O’CLOCK P.M.

    

 

    /s/  Edward
    J. Freel

    Edward J. Freel, Secretary of State

 

	 	 	 
	

    2041428  8100

	
 
	
    AUTHENTICATION: 7621611

	

    950191973

	
 
	
    DATE: 08-28-95

 

 

    STATE OF
    DELAWARE

    SECRETARY OF STATE

    DIVISION OF CORPORATIONS

    FILED 12:15 PM
    01/11/1993

    930115319 — 2041428

 

    STATE OF
    DELAWARE

    SECRETARY OF STATE

    DIVISION OF CORPORATIONS

 

    CERTIFICATE
    OF CORRECTION FILED TO CORRECT

    A CERTAIN ERROR IN THE CERTIFICATE OF CHANCE OF LOCATION OF

    REGISTERED OFFICE AND OF REGISTERED AGENT

    OF NATIONAL MEDICAL CARE, INC.

    FILED IN THE OFFICE OF THE SECRETARY OF STATE

    OF DELAWARE ON MARCH 11, 1992

 

    National Medical Care, Inc., a corporation organized and
    existing under and by virtue of the General Corporation Law of
    the State of Delaware,

 

    DOES HEREBY CERTIFY:

 

    1.) The name of the corporation is National Medical Care,
    Inc.

 

    2.) That a Certificate of Change of Location of Registered
    Office and of Registered Agent was filed by the Secretary of
    State of Delaware on March 11, 1992, which requires
    correction as permitted by subsection (F) of
    § 103 of the General Corporation Law of the State of
    Delaware.

 

    3.) The inaccuracy or defect in said certificate to be
    corrected is the typewritten name of John Whiting as the
    Secretary of National Medical Care, Inc., located below the
    signature which attests to the document. The said signature
    being that of Robert B. Lamm, Secretary of National Medical
    Care, Inc.

 

    4.) The certificate should be amended in accordance with
    Exhibit A annexed hereto which substitutes the typewritten
    name of Robert B. Lamm for the typewritten name of John Whiting
    and should read as follows:

 

    “Attest:

 

    
Robert
    B. Lamm, secretary”

 

    IN WITNESS WHEREOF, said National Medical Care, Inc. has caused
    this certificate to be signed by Jo Ellen Ojeda, its Vice
    President and attested to by Dennis J. LaCroix, its Assistant
    Secretary, this 6th day of January, 1993.

 

    NATIONAL MEDICAL CARE, INC.

 

    /s/  Jo
    Ellen Ojeda

    Jo Ellen Ojeda

    Vice President

 

    ATTEST:

 

			
	    By: 
	
    /s/  Dennis
    J. LaCroix

	 

    Dennis J. LaCroix, Assistant Secretary

    

    1

 

    EXHIBIT
    “A”

    

 

    CERTIFICATE
    OF CHANGE OF LOCATION OF REGISTERED OFFICE

    

    AND OF
    REGISTERED AGENT

 

    It is hereby certified that:

 

    1. The name of the corporation (hereinafter called the
    “corporation”) is

 

    NATIONAL MEDICAL CARE, INC.

 

    2. The registered office of the corporation within the
    State of Delaware is hereby changed to 32 Loockerman Square,
    Suite L-100,
    City of Dover 19901, County of Kent.

 

    3. The registered agent of the corporation within the State
    of Delaware is hereby changed to The Prentice-Hall Corporation
    System, Inc., the business office of which is identical with the
    registered office of the corporation as hereby changed.

 

    4. The corporation has authorized the changes hereinbefore
    set forth by resolution of its Board of Directors.

 

    Signed on Feb 21, 1992

 

    /s/  Jo
    Ellen Ojeda,

    Jo Ellen Ojeda, Vice — President

 

    Attest:

 

    /s/  Robert
    B. Lamm

    Robert B. Lamm, Secretary

    DE dcertificate of change 4/91

 

    PAGE 1

 

    State of
    Delaware

    Office of the Secretary of State

 

 

    I, EDWARD J. FREEL, SECRETARY OF STATE OF THE STATE OF DELAWARE,
    DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE
    CERTIFICATE OF CHANGE OF REGISTERED AGENT OF “NATIONAL
    MEDICAL CARE, INC.”, FILED IN THIS OFFICE ON THE
    TWENTY-NINTH DAY OF OCTOBER, A.D. 1993, AT 10 O’CLOCK A.M.

 

    

 

	 	 	 
	
    
	
 
	
    /s/  Edward
    J. Freel

    
Edward
    J. Freel, Secretary of State

 

	 	 	 	 	 
	

    2041428  8100

	
 
	
    AUTHENTICATION:
	
 
	
    8380821

	

    971090064

	
 
	
    DATE:
	
 
	
    03-19-97

 

    CERTIFICATE
    OF CHANGE OF REGISTERED AGENT

    

 

    AND

    

 

    REGISTERED
    OFFICE

    

 

    * * * *
    *

 

    National Medical Care, Inc., a corporation organized and
    existing under and by virtue of the General Corporation Law of
    the State of Delaware, DOES HEREBY CERTIFY:

 

    The present registered agent of the corporation is The
    Prentice-Hall Corporation System, Inc. and the present
    registered office of the corporation is in the county of Kent.

 

    The Board of Directors of National Medical Care, Inc. adopted
    the following resolution on the 27th day of August, 1993.

 

    Resolved, that the registered office of Home Intensive Care,
    Inc., in the state of Delaware be and it hereby is changed to
    Corporation Trust Center, 1209 Orange Street in the City of
    Wilmington, County of New Castle, and the authorization of the
    present registered agent of this corporation be and the same is
    hereby withdrawn, and THE CORPORATION TRUST COMPANY, shall
    be and is hereby constituted and appointed the registered agent
    of this corporation at the address of its registered office.

 

    IN WITNESS WHEREOF, National Medical Care, Inc. has caused this
    statement to be signed by Charles W. Meyer, its Vice President
    and attested by Salvina Amenta-Gray, its Assistant Secretary
    this 28th day of October, 1993.

 

			
	 	    By 
	
    /s/  Charles
    W. Meyer

    Vice President

 

    ATTEST:

 

			
	    By: 
	
    /s/  Salvina
    Amenta-Gray

	 

    Assistant secretary

 

    PAGE 1

 

    State of
    Delaware

    Office of the Secretary of State

 

 

    I, EDWARD J. FREEL, SECRETARY OF STATE OF THE STATE OF DELAWARE,
    DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE
    CERTIFICATE OF OWNERSHIP, WHICH MERGES:

 

    “RENAL CARE CENTERS CORPORATION”, A PENNSYLVANIA
    CORPORATION,

 

    WITH AND INTO “NATIONAL MEDICAL CARE, INC.” UNDER THE
    NAME OF “NATIONAL MEDICAL CARE, INC.”, A CORPORATION
    ORGANIZED AND EXISTING UNDER THE LAWS OF THE STATE OF DELAWARE,
    AS RECEIVED AND FILED IN THIS OFFICE THE TWENTY-NINTH DAY OF
    SEPTEMBER, A.D. 1995, AT 9:30 O’CLOCK A.M.

 

    A CERTIFIED COPY OF THIS CERTIFICATE HAS BEEN FORWARDED TO THE
    NEW CASTLE COUNTY RECORDER OF DEEDS FOR RECORDING.

 

 

	 	 	 
	
    
	
 
	
    /s/ Edward J. Freel

    
Edward
    J. Freel, Secretary of State

 

	 	 	 	 	 
	

    2041428  8100M

	
 
	
    AUTHENTICATION:
	
 
	
    7659752

	
 
	
 
	
    DATE:
	
 
	
    09-29-95

	

    950223876

	
 
	
 
	
 
	
 

 

    CERTIFICATE
    OF OWNERSHIP AND

    MERGING

    RENAL CARE CENTERS CORPORATION

    INTO

    NATIONAL MEDICAL CARE, INC.

 

    National Medical Care, Inc., a corporation organized and
    existing under the laws of Delaware,

 

    DOES HEREBY CERTIFY:

 

    FIRST:  That this corporation was incorporated
    on the 6th day of August, 1984, pursuant to the General
    Corporation Law of the State of Delaware.

 

    SECOND:  That this corporation owns all of the
    outstanding shares of the stock of Renal Care Centers
    Corporation, a corporation incorporated on the 25th day of
    January, 1983, pursuant to the Business Corporation Law of the
    State of Pennsylvania.

 

    THIRD:  That this corporation, by the following
    resolutions of its Board of Directors, duly adopted by unanimous
    written consent of directors, filed with the minutes of the
    Board, on the 27th day of September, 1995, determined to
    and did merge into itself said Renal Care Centers Corporation:

 

    RESOLVED, that National Medical Care, Inc. merge, and it hereby
    does merge into itself said Renal Care Centers Corporation and
    assumes all of its liabilities and obligations; and

 

    FURTHER RESOLVED, that the merger shall be effective on
    September 30, 1995; and

 

    FURTHER RESOLVED, that the proper officer of this corporation be
    and he or she is hereby directed to make and execute a
    Certificate of Ownership and Merger setting forth a copy of the
    resolutions to merge said Renal Care Centers Corporation and
    assume its liabilities and obligations, and the date of adoption
    thereof, and to cause the same to be filed with the Secretary of
    State of Delaware and to do all acts and things whatsoever,
    whether within or without the State of Delaware, which may be
    necessary or proper to effect said merger.

 

    IN WITNESS WHEREOF, said National Medical Care, Inc. has caused
    this Certificate to be signed by Norman C. Alt, its Vice
    President, this 27th day of September, 1995.

 

 

    /s/  Norman
    C. Alt

    Norman C. Alt, Vice President

 

    PAGE 1

 

    State of
    Delaware

    Office of the Secretary of State

 

 

    I, EDWARD J. FREEL, SECRETARY OF STATE OF THE STATE OF DELAWARE,
    DO HEREBY CERTIFY THE ATTACHED IS A TRUE AND CORRECT COPY OF THE
    CERTIFICATE OF AMENDMENT OF “NATIONAL MEDICAL CARE,
    INC.”, FILED IN THIS OFFICE ON THE TWENTY-FIRST DAY OF
    FEBRUARY, A.D. 1997, AT 11:30 O’CLOCK A.M.

 

    A CERTIFIED COPY OF THIS CERTIFICATE HAS BEEN FORWARDED TO THE
    NEW CASTLE COUNTY RECORDER OF DEEDS FOR RECORDING.

 

 

	 	 	 
	
    
	
 
	
    /s/  Edward
    J. Freel

    
Edward
    J. Freel, Secretary of State

 

	 	 	 	 	 
	

    2041428  8100

	
 
	
    AUTHENTICATION:
	
 
	
    8342909

	
 
	
 
	
    DATE:
	
 
	
    02-24-97

	

    971057913

	
 
	
 
	
 
	
 

 

    CERTIFICATE
    OF AMENDMENT

    

 

    OF

    

 

    RESTATED
    CERTIFICATE OF INCORPORATION

    

 

    OF

    

 

    NATIONAL
    MEDICAL CARE, INC.

    

 

    (Pursuant
    to Section 242 of the General Corporation Law of the State
    of Delaware)

    

 

    ********************

 

    National Medical Care, Inc., a corporation organized and
    existing under and by virtue of the General Corporation Law of
    the State of Delaware, DOES HEREBY CERTIFY:

 

    FIRST:  That the Board of Directors of the
    Corporation, acting pursuant to Sections 141(f) and 242 of
    the General Corporation Law of the State of Delaware by written
    consent in lieu of a meeting, declared it advisable to amend the
    Restated Certificate of Incorporation of the Corporation as
    described hereinafter and, to effect such amendments, the sole
    stockholder of the Corporation, by written consent pursuant to
    Section 228(a) of the General Corporation Law of the State
    of Delaware, approved and adopted the following resolutions:

 

    RESOLVED, that the Corporation effect a reverse stock split such
    that the 10,268,701 shares of common stock of the
    Corporation, $.01 par value per share, issued and
    outstanding immediately prior to the time this amendment becomes
    effective shall be and are automatically combined and changed
    (without any further act) into 100 fully-paid and non-assessable
    shares of the common stock of the Corporation, $.01 par
    value per share.

 

    RESOLVED, that immediately after the effective date of the
    amendment combining and changing the shares of the common stock
    of the Corporation, the sole stockholder of the Corporation
    shall surrender to the Corporation its certificate(s)
    representing shares of common stock for cancellation and
    re-issuance in accordance with the provisions of such amendment.

 

    RESOLVED, that the Corporation amend its Restated Certificate of
    Incorporation by deleting Article Fourth thereof in its
    entirety and inserting in place thereof the following:

 

    “FOURTH. The Corporation is authorized to issue
    3,000 shares of Common Stock, $.01 par value per
    share.”

 

    SECOND:  That the foregoing amendments were
    duly adopted in accordance with the applicable provisions of the
    General Corporation Law of the State of Delaware.

 

    IN WITNESS WHEREOF, said National Medical Care, Inc. has caused
    this certificate to be signed by Ben J. Lipps, Ph.D., its
    President, this 11th day of February, 1997.

 

    NATIONAL MEDICAL CARE, INC.

 

    /s/  Ben
    J. Lipps

    Ben J. Lipps, Ph.D.

    President

    

    1

 

    Change of Name Only [ — ] June 19,1985

    Pursuant to Merger

    By-laws remained the same since 6/19/85

 

 

    BY-LAWS

    OF

    NATIONAL MEDICAL CARE, INC.

    (Formerly NMC HOLDING CORP.)

 

    BY-LAWS

    

 

    TABLE
    OF CONTENTS

 

	 	 	 	 	 
	
 
	
 
	
    Page

	 

	

    ARTICLE 1 — Stockholders

	
 
	 
	
    1
	 

	

    Section 1.1
    Place of Meetings

	
 
	 
	
    1
	 

	

    Section 1.2
    Annual Meeting

	
 
	 
	
    1
	 

	

    Section 1.3
    Special Meetings

	
 
	 
	
    1
	 

	

    Section 1.4
    Notice of Meetings

	
 
	 
	
    1
	 

	

    Section 1.5
    Voting List

	
 
	 
	
    1
	 

	

    Section 1.6
    Quorum

	
 
	 
	
    1
	 

	

    Section 1.7
    Adjournments

	
 
	 
	
    1
	 

	

    Section 1.8
    Voting and Proxies

	
 
	 
	
    2
	 

	

    Section 1.9
    Action at Meeting

	
 
	 
	
    2
	 

	

    Section 1.10
    Action without Meeting

	
 
	 
	
    2
	 

	

    ARTICLE 2 — Directors

	
 
	 
	
    2
	 

	

    Section 2.1
    General Powers

	
 
	 
	
    2
	 

	

    Section 2.2
    Number; Election and Qualification

	
 
	 
	
    2
	 

	

    Section 2.3
    Tenure

	
 
	 
	
    2
	 

	

    Section 2.4
    Vacancies

	
 
	 
	
    2
	 

	

    Section 2.5
    Resignation

	
 
	 
	
    2
	 

	

    Section 2.6
    Regular Meetings

	
 
	 
	
    2
	 

	

    Section 2.7
    Special Meetings

	
 
	 
	
    3
	 

	

    Section 2.8
    Notice of Special Meetings

	
 
	 
	
    3
	 

	

    Section 2.9
    Meetings by Telephone Conference Calls

	
 
	 
	
    3
	 

	

    Section 2.10
    Quorum

	
 
	 
	
    3
	 

	

    Section 2.11
    Action at Meeting

	
 
	 
	
    3
	 

	

    Section 2.12
    Action by Consent

	
 
	 
	
    3
	 

	

    Section 2.13
    Removal

	
 
	 
	
    3
	 

	

    Section 2.14
    Committees

	
 
	 
	
    3
	 

	

    Section 2.15
    Compensation of Directors

	
 
	 
	
    3
	 

	

    ARTICLE 3 — Officers

	
 
	 
	
    4
	 

	

    Section 3.1
    Enumeration

	
 
	 
	
    4
	 

	

    Section 3.2
    Election

	
 
	 
	
    4
	 

	

    Section 3.3
    Qualification

	
 
	 
	
    4
	 

	

    Section 3.4
    Tenure

	
 
	 
	
    4
	 

	

    Section 3.5
    Resignation and Removal

	
 
	 
	
    4
	 

	

    Section 3.6
    Vacancies

	
 
	 
	
    4
	 

	

    Section 3.7
    Chairman of the Board and Vice-Chairman of the Board

	
 
	 
	
    4
	 

	

    Section 3.8
    President

	
 
	 
	
    4
	 

	

    Section 3.9
    Vice Presidents

	
 
	 
	
    4
	 

	

    Section 3.10
    Secretary and Assistant Secretaries

	
 
	 
	
    4
	 

	

    Section 3.11
    Treasurer and Assistant Treasurers

	
 
	 
	
    5
	 

	

    Section 3.12
    Salaries

	
 
	 
	
    5
	 

    

    i

 

	 	 	 	 	 
	
 
	
 
	
    Page

	 

	

    ARTICLE 4 — Capital Stock

	
 
	 
	
    5
	 

	

    Section 4.1
    Issuance of Stock

	
 
	 
	
    5
	 

	

    Section 4.2
    Certificates of Stock

	
 
	 
	
    5
	 

	

    Section 4.3
    Transfers

	
 
	 
	
    5
	 

	

    Section 4.4
    Lost, Stolen or Destroyed Certificates

	
 
	 
	
    5
	 

	

    Section 4.5
    Record Date

	
 
	 
	
    6
	 

	

    ARTICLE 5 — Indemnification

	
 
	 
	
    6
	 

	

    ARTICLE 6 — General Provisions

	
 
	 
	
    7
	 

	

    Section 6.1
    Fiscal Year

	
 
	 
	
    7
	 

	

    Section 6.2
    Corporate Seal

	
 
	 
	
    7
	 

	

    Section 6.3
    Waiver of Notice

	
 
	 
	
    7
	 

	

    Section 6.4
    Voting of Securities

	
 
	 
	
    7
	 

	

    Section 6.5
    Evidence of Authority

	
 
	 
	
    7
	 

	

    Section 6.6
    Certificate of Incorporation

	
 
	 
	
    7
	 

	

    Section 6.7
    Transactions with Interested Parties

	
 
	 
	
    7
	 

	

    Section 6.8
    Severability

	
 
	 
	
    7
	 

	

    Section 6.9
    Pronouns

	
 
	 
	
    7
	 

	

    ARTICLE 7 — Amendments

	
 
	 
	
    7
	 

	

    Section 7.1
    By the Board of Directors

	
 
	 
	
    7
	 

	

    Section 7.2
    By the Stockholders

	
 
	 
	
    8
	 

	

    ARTICLE 8 — Right of First Refusal

	
 
	 
	
    8
	 

	

    Section 8.1
    Restrictions on Transfer

	
 
	 
	
    8
	 

	

    Section 8.2
    First Refusal Notice

	
 
	 
	
    8
	 

	

    Section 8.3
    Corporation’s Right to Purchase

	
 
	 
	
    8
	 

	

    Section 8.4 Shareholder’s
    Right to Purchase

	
 
	 
	
    8
	 

	

    Section 8.5
    Settlement

	
 
	 
	
    9
	 

	

    Section 8.6
    Sale by Selling Stockholder

	
 
	 
	
    9
	 

	

    Section 8.7
    Exceptions

	
 
	 
	
    9
	 

	

    Section 8.8
    Waiver

	
 
	 
	
    9
	 

	

    Section 8.9
    Legend

	
 
	 
	
    9
	 

	

    Section 8.10
    Termination of Right of First Refusal

	
 
	 
	
    9
	 

    

    ii

 

 

    BY-LAWS

    OF

    NATIONAL MEDICAL CARE, INC.

    (Formerly NMC HOLDING CORP.)

 

    ARTICLE 1 —
    Stockholders

 

    1.1 Place of Meetings.  All
    meetings of stockholders shall be held at such place within or
    without the State of Delaware as may be designated from time to
    time by the Board of Directors or the President or, if not so
    designated, at the registered office of the corporation.

 

    1.2 Annual Meeting.  The annual
    meeting of stockholders for the election of directors and for
    the transaction of such other business as may properly be
    brought before the meeting shall be held on the third Tuesday in
    May in each year, at a time fixed by the Board of Directors or
    the President. If this date shall fall upon a legal holiday at
    the place of the meeting, then such meeting shall be held on the
    next succeeding business day at the same hour. If no annual
    meeting is held in accordance with the foregoing provisions, the
    Board of Directors shall cause the meeting to be held as soon
    thereafter as convenient. If no annual meeting is held in
    accordance with the foregoing provisions, a special meeting may
    be held in lieu of the annual meeting, and any action taken at
    that special meeting shall have the same effect as if it had
    been taken at the annual meeting, and in such case all
    references in these By-Laws to the annual meeting of the
    stockholders shall be deemed to refer to such special meeting.

 

    1.3 Special Meetings.  Special
    meetings of stockholders may be called at any time by the
    Chairman of the Board, President or by the Board of Directors
    and shall be called by the Chairman, the President or the
    Secretary at the written request of stockholders holding shares
    entitled to cast not less than twenty-five per cent of the votes
    at the meeting. Business transacted at any special meeting of
    stockholders shall be limited to matters relating to the purpose
    or purposes stated in the notice of meeting.

 

    1.4 Notice of Meetings.  Except as
    otherwise provided by law, written notice of each meeting of
    stockholders, whether annual or special, shall be given not less
    than 10 nor more than 60 days before the date of the
    meeting to each stockholder entitled to vote at such meeting.
    The notices of all meetings shall state the place, date and hour
    of the meeting. The notice of a special meeting shall state, in
    addition, the purpose or purposes for which the meeting is
    called. If mailed, notice is given when deposited in the United
    States mail, postage prepaid, directed to the stockholder at his
    address as it appears on the records of the corporation.

 

    1.5 Voting List.  The officer who
    has charge of the stock ledger of the corporation shall prepare,
    at least 10 days before every meeting of stockholders, a
    complete list of the stockholders entitled to vote at the
    meeting, arranged in alphabetical order, and showing the address
    of each stockholder and the number of shares registered in the
    name of each stockholder. Such list shall be open to the
    examination of any stockholder, for any purpose germane to the
    meeting, during ordinary business hours, for a period of at
    least 10 days prior to the meeting, at a place within the
    city where the meeting is to be held. The list shall also be
    produced and kept at the time and place of the meeting during
    the whole time of the meeting, and may be inspected by any
    stockholder who is present.

 

    1.6 Quorum.  Except as otherwise
    provided by law, the Certificate of Incorporation or these
    By-Laws, the holders of such number of shares of stock issued
    and outstanding and entitled to vote at the meeting as shall
    constitute fifty-five per cent (55%) of the votes entitled to be
    cast thereat, present in person or represented by proxy, shall
    constitute a quorum for the transaction of business.

 

    1.7 Adjournments.  Any meeting of
    stockholders may be adjourned to any other time and to any other
    place at which a meeting of stockholders may be held under these
    By-Laws by the stockholders present or represented at the
    meeting and entitled to vote, although less than a quorum, or,
    if no stockholder is present, by any officer entitled to preside
    at or to act as Secretary of such meeting. It shall not be
    necessary to notify any stockholder of any adjournment of less
    than 30 days if the time and place of the adjourned meeting
    are announced at the meeting at which adjournment is taken,
    unless after the adjournment a new record date is fixed for the
    adjourned meeting. At the adjourned meeting, the corporation may
    transact any business which might have been transacted at the
    original meeting.

    

    1

 

 

    1.8 Voting and Proxies.  Each
    stockholder shall have one vote for each share of stock entitled
    to vote held of record by such stockholder and a proportionate
    vote for each fractional share so held, unless otherwise
    provided in the Certificate of Incorporation. Each stockholder
    of record entitled to vote at a meeting of stockholders, or to
    express consent or dissent to corporate action in writing
    without a meeting, may vote or express such consent or dissent
    in person or may authorize another person or persons to vote or
    act for him by written proxy executed by the stockholder or his
    authorized agent and delivered to the Secretary of the
    corporation. No such proxy shall be voted or acted upon after
    three years from the date of its execution, unless the proxy
    expressly provides for a longer period.

 

    1.9 Action at Meeting.  When a
    quorum is present at any meeting, the holders of fifty-five
    percent (55%) of the shares of stock issued and outstanding and
    entitled to vote at the meeting shall decide any matter to be
    voted upon by the stockholders at such meeting, except when a
    different vote is required by express provision of law, the
    Certificate of Incorporation or these By-Laws.

 

    1.10 Action without Meeting.  Any
    action required or permitted to be taken at any annual or
    special meeting of stockholders of the corporation may be taken
    without a meeting, without prior notice and without a vote, if a
    consent in writing, setting forth the action so taken, is signed
    by the holders of outstanding stock having not less than the
    minimum number of votes that would be necessary to authorize or
    take such action at a meeting at which all shares entitled to
    vote on such action were present and voted. Prompt notice of the
    taking of corporate action without a meeting by less than
    unanimous written consent shall be given to those stockholders
    who have not consented in writing.

 

    ARTICLE 2 —
    Directors

 

    2.1 General Powers.  The business
    and affairs of the corporation shall be managed by or under the
    direction of a Board of Directors, who may exercise all of the
    powers of the corporation except as otherwise provided by law,
    the Certificate of Incorporation or these By-Laws. In the event
    of a vacancy in the Board of Directors, the remaining directors,
    except as otherwise provided by law and subject to
    Section 2.10,
    may exercise the powers of the full Board until the vacancy is
    filled.

 

    2.2 Number; Election and
    Qualification.  The number of directors which
    shall constitute the whole Board of Directors shall be eight or
    such other number as shall be fixed from time to time by the
    Board of Directors. The number of directors may be decreased at
    any time and from time to time by a majority of the total number
    of authorized directors to eliminate vacancies existing by
    reason of the death, resignation, removal or expiration of the
    term of one or more directors. The directors shall be elected at
    the annual meeting of stockholders by such stockholders as have
    the right to vote on such election. Directors need not be
    stockholders of the corporation.

 

    2.3 Tenure.  Each director shall
    hold office until the next annual meeting and until his
    successor is elected and qualified, or until his earlier death,
    resignation or removal.

 

    2.4 Vacancies.  Any vacancy in the
    Board of Directors, however occurring, including a vacancy
    resulting from an enlargement of the Board, may be filled only
    by vote of the stockholders. A director elected to fill a
    vacancy shall be elected for the unexpired term of his
    predecessor in office, and a director chosen to fill a position
    resulting from an increase in the number of directors shall hold
    office until the next annual meeting of stockholders and until
    his successor is elected and qualified, or until his earlier
    death, resignation or removal.

 

    2.5 Resignation.  Any director may
    resign by delivering his written resignation to the corporation
    at its principal office or to the President or Secretary. Such
    resignation shall be effective upon receipt unless it is
    specified to be effective at some other time or upon the
    happening of some other event.

 

    2.6 Regular Meetings.  Regular
    meetings of the Board of Directors may be held without notice at
    such time and place, either within or without the State of
    Delaware, as shall be determined from time to time by the Board
    of Directors; provided that any director who is absent when such
    a determination is made shall be given notice of the
    determination. A regular meeting of the Board of Directors may
    be held without notice immediately after and at the same place
    as the annual meeting of stockholders.

    

    2

 

 

    2.7 Special Meetings.  Special
    meetings of the Board of Directors may be held at any time and
    place, within or without the State of Delaware, designated in a
    call by the Chairman of the Board, President, two or more
    directors, or by one director in the event that there is only a
    single director in office.

 

    2.8 Notice of Special
    Meetings.  Notice of any special meeting of
    directors shall be given to each director by the Secretary or by
    the officer or one of the directors calling the meeting. Notice
    shall be duly given to each director (i) by giving notice
    to such director in person or by telephone at least
    48 hours in advance of the meeting, (ii) by sending a
    telegram or telex, or delivering written notice by hand, to his
    last known business or home address at least 48 hours in
    advance of the meeting, or (iii) by mailing written notice
    to his last known business or home address at least
    72 hours in advance of the meeting. A notice or waiver of
    notice of a meeting of the Board of Directors need not specify
    the purposes of the meeting.

 

    2.9 Meetings by Telephone Conference
    Calls.  Directors or any members of any
    committee designated by the directors may participate in a
    meeting of the Board of Directors or such committee by means of
    conference telephone or similar communications equipment by
    means of which all persons participating in the meeting can hear
    each other, and participation by such means shall constitute
    presence in person at such meeting.

 

    2.10 Quorum.  A majority of the
    total number of directors shall constitute a quorum at all
    meetings of the Board of Directors. The total number of
    directors shall mean the number of directors the corporation
    would have if there were no vacancies. In the absence of a
    quorum at any such meeting, a majority of the directors present
    may adjourn the meeting from time to time without further notice
    other than announcement at the meeting, until a quorum shall be
    present.

 

    2.11 Action at Meeting.  At any
    meeting of the Board of Directors at which a quorum is present,
    the vote of a majority of the total number of directors shall be
    sufficient to take any action, unless a different vote is
    specified by law, the Certificate of Incorporation or these
    By-Laws.

 

    2.12 Action by Consent.  Any action
    required or permitted to be taken at any meeting of the Board of
    Directors or of any committee of the Board of Directors may be
    taken without a meeting, if all members of the Board (provided
    that a majority of the total number of directors shall then be
    in office) or committee, as the case may be, consent to the
    action in writing, and the written consents are filed with the
    minutes of proceedings of the Board or committee.

 

    2.13 Removal.  Any one or more or
    all of the directors may be removed, with or without cause, by
    such stockholders as have the right to vote for the election of
    directors, except that the directors elected by the holders of a
    particular class or series of stock may be removed only by vote
    of the holders of the outstanding shares of such class or series
    required to elect such directors.

 

    2.14 Committees.  The Board of
    Directors may, by resolution passed by a majority of the total
    number of directors, designate one or more committees, each
    committee to consist of one or more of the directors of the
    corporation. The Board may designate one or more directors as
    alternate members of any committee, who may replace any absent
    or disqualified member at any meeting of the committee. The
    number of members which shall constitute a quorum for the
    transaction of business by the committee and the vote which
    shall constitute the act of the committee shall be provided in
    the resolution establishing such committee. Any such committee,
    to the extent provided in the resolution of the Board of
    Directors and subject to the provisions of the General
    Corporation Law of the State of Delaware, shall have and may
    exercise all the powers and authority of the Board of Directors
    in the management of the business and affairs of the corporation
    and may authorize the seal of the corporation to be affixed to
    all papers which may require it. Each such committee shall keep
    minutes and make such reports as the Board of Directors may from
    time to time request. Except as the Board of Directors may
    otherwise determine, any committee may make rules for the
    conduct of its business, but unless otherwise provided by the
    directors or in such rules, its business shall be conducted as
    nearly as possible in the same manner as is provided in these
    By-Laws for the Board of Directors.

 

    2.15 Compensation of
    Directors.  Directors may be paid such
    compensation for their services and such reimbursement for
    expenses of attendance at meetings as the Board of Directors may
    from time to time determine. No such payment shall preclude any
    director from serving the corporation or any of its parent or
    subsidiary corporations in any other capacity and receiving
    compensation for such service.

    

    3

 

 

    ARTICLE 3 —
    Officers

 

    3.1 Enumeration.  The officers of
    the corporation shall consist of a President, a Secretary, a
    Treasurer and such other officers with such other titles as the
    Board of Directors shall determine, including a Chairman of the
    Board, a Vice-Chairman of the Board, and one or more Vice
    Presidents, Assistant Treasurers, and Assistant Secretaries. The
    Board of Directors may appoint such other officers as it may
    deem appropriate.

 

    3.2 Election.  The President,
    Treasurer and Secretary shall be elected annually by the Board
    of Directors at its first meeting following the annual meeting
    of stockholders. Other officers may be appointed by the Board of
    Directors at such meeting or at any other meeting.

 

    3.3 Qualification.  No officer need
    be a stockholder. Any two or more offices may be held by the
    same person.

 

    3.4 Tenure.  Except as otherwise
    provided by law, by the Certificate of Incorporation or by these
    By-Laws, each officer shall hold office until his successor is
    elected and qualified, unless a different term is specified in
    the vote choosing or appointing him, or until his earlier death,
    resignation or removal.

 

    3.5 Resignation and Removal.  Any
    officer may resign by delivering his written resignation to the
    corporation at its principal office or to the President or
    Secretary. Such resignation shall be effective upon receipt
    unless it is specified to be effective at some other time or
    upon the happening of some other event.

 

    Any officer may be removed at any time, with or without cause,
    by vote of a majority of the total number of directors.

 

    Except as the Board of Directors may otherwise determine, no
    officer who resigns or is removed shall have any right to any
    compensation as an officer for any period following his
    resignation or removal, or any right to damages on account of
    such removal, whether his compensation be by the month or by the
    year or otherwise, unless such compensation is expressly
    provided in a duly authorized written agreement with the
    corporation.

 

    3.6 Vacancies.  The Board of
    Directors may fill any vacancy occurring in any office for any
    reason and may, in its discretion, leave unfilled for such
    period as it may determine any offices other than those of
    President, Treasurer and Secretary. Each such successor shall
    hold office for the unexpired term of his predecessor and until
    his successor is elected and qualified, or until his earlier
    death, resignation or removal.

 

    3.7 Chairman of the Board and Vice-Chairman of the
    Board.  The Board of Directors shall appoint a
    Chairman of the Board who shall serve as Chief Executive
    Officer, shall preside at all meetings of Stockholders and
    directors and shall perform such duties and possess such powers
    as are assigned to him by the Board of Directors.

 

    3.8 President.  The President
    shall, subject to the direction of the Board of Directors, have
    general charge and supervision of the business of the
    corporation. The President shall perform such duties and shall
    have such other powers as the Board of Directors may from time
    to time prescribe.

 

    3.9 Vice Presidents.  Any Vice
    President shall perform such duties and possess such powers as
    the Board of Directors or the President may from time to time
    prescribe. In the event of the absence, inability or refusal to
    act of the President, the Vice President (or if there shall be
    more than one, the Vice Presidents in the order determined by
    the Board of Directors) shall perform the duties of the
    President and when so performing shall have all the powers of
    and be subject to all the restrictions upon the President. The
    Board of Directors may assign to any Vice President the title of
    Executive Vice President, Senior Vice President or any other
    title selected by the Board of Directors.

 

    3.10 Secretary and Assistant
    Secretaries.  The Secretary shall perform such
    duties and shall have such powers as the Board of Directors or
    the President may from time to time prescribe. In addition, the
    Secretary shall perform such duties and have such powers as are
    incident to the office of the secretary, including without
    limitation the duty and power to give notices of all meetings of
    stockholders and special meetings of the Board of Directors, to
    attend all meetings of stockholders and the Board of Directors
    and keep a record of the proceedings, to maintain a stock ledger
    and prepare lists of stockholders and their addresses as
    required, to be custodian of corporate records and the corporate
    seal and to affix and attest to the same on documents.

    

    4

 

 

    Any Assistant Secretary shall perform such duties and possess
    such powers as the Board of Directors, the President or the
    Secretary may from time to time prescribe. In the event of the
    absence, inability or refusal to act of the Secretary, the
    Assistant Secretary, (or if there shall be more than one, the
    Assistant Secretaries in the order determined by the Board of
    Directors) shall perform the duties and exercise the powers of
    the Secretary.

 

    In the absence of the Secretary or any Assistant Secretary at
    any meeting of stockholders or directors, the person presiding
    at the meeting shall designate a temporary secretary to keep a
    record of the meeting.

 

    3.11 Treasurer and Assistant
    Treasurers.  The Treasurer shall perform such
    duties and shall have such powers as may from time to time be
    assigned to him by the Board of Directors or the President. In
    addition, the Treasurer shall perform such duties and have such
    powers as are incident to the office of treasurer, including
    without limitation the duty and power to keep and be responsible
    for all funds and securities of the corporation, to deposit
    funds of the corporation in depositories selected in accordance
    with these By-Laws, to disburse such funds as ordered by the
    Board of Directors, to make proper accounts of such funds, and
    to render as required by the Board of Directors statements of
    all such transactions and of the financial condition of the
    corporation.

 

    The Assistant Treasurers shall perform such duties and possess
    such powers as the Board of Directors, the President or the
    Treasurer may from time to time prescribe. In the event of the
    absence, inability or refusal to act of the Treasurer, the
    Assistant Treasurer, (or if there shall be more than one, the
    Assistant Treasurers in the order determined by the Board of
    Directors) shall perform the duties and exercise the powers of
    the Treasurer.

 

    3.12 Salaries.  Officers of the
    corporation shall be entitled to such salaries, compensation or
    reimbursement as shall be fixed or allowed from time to time by
    the Board of Directors.

 

    ARTICLE 4 —
    Capital Stock

 

    4.1 Issuance of Stock.  Unless
    otherwise voted by the stockholders and subject to the
    provisions of the Certificate of Incorporation, the whole or any
    part of any unissued balance of the authorized capital stock of
    the corporation or the whole or any part of any unissued balance
    of the authorized capital stock of the corporation held in its
    treasury may be issued, sold, transferred or otherwise disposed
    of by vote of the Board of Directors in such manner, for such
    consideration and on such terms as the Board of Directors may
    determine.

 

    4.2 Certificates of Stock.  Every
    holder of stock of the corporation shall be entitled to have a
    certificate, in such form as may be prescribed by law and by the
    Board of Directors, certifying the number and class of shares
    owned by him in the corporation. Each such certificate shall be
    signed by, or in the name of the corporation by, the Chairman or
    Vice-Chairman, if any, of the Board of Directors, or the
    President or a Vice President, and the Treasurer or an Assistant
    Treasurer, or the Secretary or an Assistant Secretary of the
    corporation. Any or all of the signatures on the certificate may
    be a facsimile.

 

    Each certificate for shares of stock which are subject to any
    restriction on transfer pursuant to the Certificate of
    Incorporation, the By-Laws, applicable securities laws or any
    agreement among any number of shareholders or among such holders
    and the corporation shall have conspicuously noted on the face
    or back of the certificate either the full text of the
    restriction or a statement of the existence of such restriction.

 

    4.3 Transfers.  Except as otherwise
    established by rules and regulations adopted by the Board of
    Directors, and subject to applicable law, shares of stock may be
    transferred on the books of the corporation by the surrender to
    the corporation or its transfer agent of the certificate
    representing such shares properly endorsed or accompanied by a
    written assignment or power of attorney properly executed, and
    with such proof of authority or the authenticity of signature as
    the corporation or its transfer agent may reasonably require.
    Except as may be otherwise required by law, by the Certificate
    of Incorporation or by these By-Laws, the corporation shall be
    entitled to treat the record holder of stock as shown on its
    books as the owner of such stock for all purposes, including the
    payment of dividends and the right to vote with respect to such
    stock, regardless of any transfer, pledge or other disposition
    of such stock until the shares have been transferred on the
    books of the corporation in accordance with the requirements of
    these By-Laws.

 

    4.4 Lost, Stolen or Destroyed
    Certificates.  The corporation may issue a new
    certificate of stock in place of any previously issued
    certificate alleged to have been lost, stolen, or destroyed,
    upon such terms and conditions as

    

    5

 

    the Board of Directors may prescribe, including the presentation
    of reasonable evidence of such loss, theft or destruction and
    the giving of such indemnity as the Board of Directors may
    require for the protection of the corporation or any transfer
    agent or registrar.

 

    4.5 Record Date.  The Board of
    Directors may fix in advance a date as a record date for the
    determination of the stockholders entitled to notice of or to
    vote at any meeting of stockholders or to express consent (or
    dissent) to corporate action in writing without a meeting, or
    entitled to receive payment of any dividend or other
    distribution or allotment of any rights in respect of any
    change, conversion or exchange of stock, or for the purpose of
    any other lawful action. Such record date shall not be more than
    60 nor less than 10 days before the date of such meeting,
    nor more than 60 days prior to any other action to which
    such record date relates.

 

    If no record date is fixed, the record date for determining
    stockholders entitled to notice of or to vote at a meeting of
    stockholders shall be at the close of business on the day before
    the day on which notice is given, or, if notice is waived, at
    the close of business on the day before the day on which the
    meeting is held. The record date for determining stockholders
    entitled to express consent to corporate action in writing
    without a meeting, when no prior action by the Board of
    Directors is necessary, shall be the day on which the first
    written consent is expressed. The record date for determining
    stockholders for any other purpose shall be at the close of
    business on the day on which the Board of Directors adopts the
    resolution relating to such purpose.

 

    A determination of stockholders of record entitled to notice of
    or to vote at a meeting of stockholders shall apply to any
    adjournment of the meeting; provided, however, that the Board of
    Directors may fix a new record date for the adjourned meeting.

 

    ARTICLE 5 —
    Indemnification

 

    The corporation shall, to the fullest extent permitted by
    Section 145
    of the General Corporation Law of Delaware, as that Section may
    be amended and supplemented from time to time, indemnify any
    director, officer or trustee which it shall have power to
    indemnify under that Section against any expenses, liabilities
    or other matters referred to in or covered by that Section. The
    indemnification provided for in this Article (i) shall not
    be deemed exclusive of any other rights to which those
    indemnified may be entitled under any By-Law, agreement or vote
    of stockholders or disinterested directors or otherwise, both as
    to action in their official capacities and as to action in
    another capacity while holding such office, (ii) shall
    continue as to a person who has ceased to be a director, officer
    or trustee and (iii) shall inure to the benefit of the
    heirs, executors and administrators of such a person. The
    corporation’s obligation to provide indemnification under
    this Article shall be offset to the extent of any other source
    of indemnification or any otherwise applicable insurance
    coverage under a policy maintained by the corporation or any
    other person.

 

    To assure indemnification under this Article of all such persons
    who are determined by the corporation or otherwise to be or to
    have been “fiduciaries” of any employee benefit plan
    of the corporation which may exist from time to time, such
    Section 145
    shall, for the purposes of this Article, be interpreted as
    follows: an “other enterprise” shall be deemed to
    include such an employee benefit plan, including, without
    limitation, any plan of the corporation which is governed by the
    Act of Congress entitled “Employee Retirement Income
    Security Act of 1974,” as amended from time to time; the
    corporation shall be deemed to have requested a person to serve
    an employee benefit plan where the performance by such person of
    his duties to the corporation also imposes duties on, or
    otherwise involves services by, such person to the plan or
    participants or beneficiaries of the plan; excise taxes assessed
    on a person with respect to an employee benefit plan pursuant to
    such Act of Congress shall be deemed “fines”; and
    action taken or omitted by a person with respect to an employee
    benefit plan in the performance of such person’s duties for
    a purpose reasonably believed by such person to be in the
    interest of the participants and beneficiaries of the plan shall
    be deemed to be for a purpose which is not opposed to the best
    interests of the corporation.

    

    6

 

 

    ARTICLE 6 —
    General Provisions

 

    6.1 Fiscal Year.  Except as from
    time to time otherwise designated by the Board of Directors, the
    fiscal year of the corporation shall begin on the first day of
    January in each year and end on the last day of December in each
    year.

 

    6.2 Corporate Seal.  The corporate
    seal shall be in such form as shall be approved by the Board of
    Directors.

 

    6.3 Waiver of Notice.  Whenever any
    notice whatsoever is required to be given by law, by the
    Certificate of Incorporation or by these By-Laws, a waiver of
    such notice either in writing signed by the person entitled to
    such notice or such person’s duly authorized attorney, or
    by telegraph, cable or any other available method, whether
    before, at or after the time stated in such waiver, or the
    appearance of such person or persons at such meeting in person
    or by proxy, shall be deemed equivalent to such notice.

 

    6.4 Voting of Securities.  As
    directed by the Board of Directors, the President or Treasurer
    may waive notice of, and act as, or appoint any person or
    persons to act as, proxy or
    attorney-in-fact
    for this corporation (with or without power of substitution) at,
    any meeting of stockholders or shareholders of any other
    corporation or organization, the securities of which may be held
    by this corporation.

 

    6.5 Evidence of Authority.  A
    certificate by the Secretary, or an Assistant Secretary, or a
    temporary Secretary, as to any action taken by the stockholders,
    directors, a committee or any officer or representative of the
    corporation shall as to all persons who rely on the certificate
    in good faith be conclusive evidence of such action.

 

    6.6 Certificate of
    Incorporation.  All references in these
    By-Laws to the Certificate of Incorporation shall be deemed to
    refer to the Certificate of Incorporation of the corporation, as
    amended or restated and in effect from time to time.

 

    6.7 Transactions with Interested
    Parties.  No contract or transaction between
    the corporation and one or more of the directors or officers, or
    between the corporation and any other corporation, partnership,
    association, or other organization in which one or more of the
    directors or officers are directors or officers, or have a
    financial interest, shall be void or voidable solely for this
    reason, or solely because the director or officer is present at
    or participates in the meeting of the Board of Directors or a
    committee of the Board of Directors which authorizes the
    contract or transaction or solely because his or their votes are
    counted for such purpose, if:

 

    (1) The material facts as to his relationship or interest
    and as to the contract or transaction are disclosed or are known
    to the Board of Directors or the committee, and the Board or
    committee in good faith authorizes the contract or transaction
    by the affirmative votes of a majority of the disinterested
    directors, even though the disinterested directors be less than
    a quorum;

 

    (2) The material facts as to his relationship or interest
    and as to the contract or transaction are disclosed or are known
    to the stockholders entitled to vote thereon, and the contract
    or transaction is specifically approved in good faith by vote of
    the stockholders; or

 

    (3) The contract or transaction is fair as to the
    corporation as of the time it is authorized, approved or
    ratified, by the Board of Directors, a committee of the Board of
    Directors, or the stockholders.

 

    Common or interested directors may be counted in determining the
    presence of a quorum at a meeting of the Board of Directors or
    of a committee which authorizes the contract or transaction.

 

    6.8 Severability.  Any
    determination that any provision of these By-Laws is for any
    reason inapplicable, illegal or ineffective shall not affect or
    invalidate any other provision of these By-Laws.

 

    6.9 Pronouns.  All pronouns used in
    these By-Laws shall be deemed to refer to the masculine,
    feminine or neuter, singular or plural, as the identity of the
    person or persons may require.

 

    ARTICLE 7 —
    Amendments

 

    7.1 By the Board of
    Directors.  These By-Laws may be altered,
    amended or repealed or new by-laws may be adopted by the
    affirmative vote of a majority of the total number of directors,
    except that no provision affecting the

    

    7

 

    rights, powers, qualifications or requirements regarding the
    voting of stock pursuant to Article 1 of these By-Laws may
    be amended unless approved by the stockholders of the
    corporation.

 

    7.2 By the Stockholders.  These
    By-Laws may be altered, amended or repealed or new by-laws may
    be adopted by the affirmative vote of the holders of such
    percentage of the stock entitled to vote as is provided in
    Article 1 hereof, provided that in the case of an annual or
    special meeting of stockholders notice of such proposal to
    alter, amend or repeal these By-Laws or adopt new by-laws shall
    have been stated in the notice of meeting of stockholders.

 

    ARTICLE 8 —
    Right of First Refusal

 

    8.1 Restrictions on Transfer.  No
    stockholder shall sell, assign, pledge, or in any manner
    transfer any of the shares of stock of the corporation or any
    right or interest therein, whether voluntarily or by operation
    of law, or otherwise except for a transfer in accordance with
    this Article 8 or a transfer excepted from the provisions
    of this Article 8, provided, however, that
    said prohibition shall not apply to: (i) any shares of
    Series A Convertible Preferred Stock, $.01 par value,
    of the corporation; (ii) any shares of Common Stock of the
    corporation into which such shares of Series A Convertible
    Preferred Stock have been converted; (iii) any shares of
    the 12% Cumulative Redeemable Preferred Stock, $.01 par
    value, of the corporation; and (iv) any shares of the
    capital stock of the corporation issued with respect to any of
    the foregoing, by way of a stock dividend, stock split,
    recapitalization or otherwise. Any sale or transfer, or
    purported sale or transfer, of securities of the corporation
    shall be null and void unless the terms, conditions, and
    provisions of this By-Law are strictly observed and followed.

 

    8.2 First Refusal Notice.  If a
    stockholder receives from anyone a bona fide offer acceptable to
    the stockholder to purchase any of his shares of stock, then the
    stockholder shall first give written notice (the “First
    Refusal Notice”) thereof to the corporation (attention of
    the Secretary of the corporation). The First Refusal Notice
    shall name and describe the proposed transferee (including a
    description of any relationship or affiliation with the holder)
    and state the number of shares to be transferred, the price per
    share and all other terms and conditions of the offer.

 

    8.3 Corporation’s Right to
    Purchase.  For thirty (30) business days
    following receipt of the First Refusal Notice, the corporation
    shall have the option to purchase all or any lesser number of
    the shares specified in such Notice at the price and upon the
    terms set forth in such bona fide offer (subject to
    Section 8.5 below). The corporation may assign its rights
    hereunder to any other person or business entity.

 

    8.4 Stockholders’ Right to
    Purchase.  In the event the corporation or its
    assignee or assignees do not elect to acquire all of the shares
    specified in the First Refusal Notice, the Secretary of the
    corporation shall, within fifteen (15) business days of
    receipt of the First Refusal Notice, give written notice thereof
    to the stockholders of the corporation, other than the selling
    stockholder and other than the holders of 12% Preferred Stock.
    Said written notice shall state the number of shares that the
    corporation has elected to purchase and that the balance of the
    shares covered by the First Refusal Notice are available for
    purchase. Each of such other stockholders shall have the right
    to purchase that proportion of the shares available for purchase
    as the number of shares of Common Stock owned by each of said
    other stockholders bears to the total issued and outstanding
    shares of the Corporation, excepting those shares owned by the
    selling stockholder and excepting the shares of 12% Preferred
    Stock. For purposes of the foregoing sentence, all shares of the
    corporation’s capital stock that are convertible into
    Common Stock (other than the shares issuable from time to time
    upon an option held by W. R. Grace & Co. to purchase
    up to 3,070,430 shares of the corporation’s Common
    Stock) shall be deemed to equal that number of shares of Common
    Stock into which such convertible securities are then
    convertible. A stockholder electing to exercise such right to
    purchase shall, within ten (10) business days after mailing
    of the corporation’s notice, give written notice to the
    corporation specifying the number of shares such stockholder
    will purchase. Within such
    ten-day
    period, each of said other stockholders shall also give written
    notice stating how many additional shares such stockholder will
    purchase (including such additional number of shares as such
    stockholder wishes to purchase in the event that the number of
    shares available for purchase exceeds his pro rata allotment) if
    additional shares are made available. Failure to respond in
    writing within said
    ten-day
    period to the notice given by the Secretary of the corporation
    shall be deemed a rejection of such stockholder’s right to
    acquire a proportionate part of the shares of the selling
    stockholder. In the

    

    8

 

    event one or more stockholders do not elect to acquire the
    shares availabe to them, said shares shall be allocated on a pro
    rata basis to the stockholders who requested shares in addition
    to their pro rata allotment.

 

    8.5 Settlement.  In the event the
    corporation
    and/or
    stockholders, other than the selling stockholder, elect to
    acquire any of the shares of the selling stockholder as
    specified in the First Refusal Notice, the Secretary of the
    corporation shall so notify the selling stockholder and
    settlement thereof shall be made in cash within thirty
    (30) business days after the date on which the Secretary of
    the corporation received the First Refusal Notice;
    provided, however, that if the terms of payment
    set forth in the First Refusal Notice are other than cash
    against delivery the corporation shall pay for said shares on
    the same terms and conditions set forth in the First Refusal
    Notice or, at the option of the corporation, shall pay for such
    shares in cash in an amount equal to the fair market value
    thereof, as determined by an independent appraiser selected by
    the corporation whose determination of fair market value shall
    be conclusive.

 

    8.6 Sale by Selling
    Stockholder.  In the event the corporation and
    stockholders do not elect to acquire all of the shares specified
    in the First Refusal Notice, the selling stockholder may, within
    the
    sixty-day
    period following the expiration of the rights granted to the
    corporation, sell elsewhere the shares specified in the First
    Refusal Notice which were not acquired by the corporation and
    stockholders in accordance with the provisions of this
    Article 8; provided, that said sale shall not be on
    terms and conditions more favorable to the purchaser than those
    contained in the First Refusal Notice. All shares so sold by
    said selling stockholder shall continue to be subject to the
    provisions of this Article 8 in the same manner as before
    said transfer.

 

    8.7 Exceptions.  Anything to the
    contrary contained herein notwithstanding, a stockholder’s
    transfer by gift of any or all shares held either during such
    stockholder’s lifetime, or a transfer on death by will or
    intestacy, in either case to such stockholder’s immediate
    family shall be exempt from the provisions of this
    Article 8. “Immediate family” as used herein
    shall mean spouse, lineal descendant, father, mother, brother or
    sister of the stockholder making such transfer or any trust
    established for the benefit of any of such persons.

 

    In any such case, the transferee, assignee or other recipient
    shall receive and hold such stock subject to the provisions of
    this Article 8, and there shall be no further transfer of
    such stock except in accordance with this Article 8.

 

    8.8 Waiver.  Any or all of the
    provisions of this Article 8 may be waived with respect to
    any transfer either by the corporation, upon duly authorized
    action of its Board of Directors, or by the stockholders, upon
    the express written consent of the owners of not less than 55%
    of the shares of Capital Stock of the Corporation issued and
    outstanding and entitled to vote thereon (excluding the votes
    represented by those shares to be sold by the selling
    stockholder). This Article 8 may be amended or repealed
    only by the express written consent of the owners of not less
    than 55% of the then issued and outstanding shares of the
    capital stock of the corporation entitled to vote thereon.

 

    8.9 Legend.  The certificates
    representing shares of the corporation shall bear on their face
    the following legend so long as the foregoing right of first
    refusal remains in effect:

 

    “The shares represented by this certificate are subject to
    a right of first refusal option in favor of the corporation and
    its stockholders, as provided in the By-laws of the
    corporation.”

 

    8.10 Termination of Right of First
    Refusal.  This Article 8 shall terminate
    in its entirety and cease to be in effect on the first to occur
    of the following:

 

    (a) the closing of the first firm underwritten public
    offering of equity securities of the corporation; and

 

    (b) December 31, 1992.

    

    9

 

    NATIONAL
    MEDICAL CARE, INC.

    

    Action
    by Unanimous Written Consent of the Board of Directors

    In Lieu of a Meeting

    

    October 16, 2008
    

 

    The undersigned, being all the Directors of National Medical
    Care, Inc., a Delaware corporation (the
    “Corporation”), hereby consent to the adoption of the
    following resolutions, which shall be treated as resolutions for
    all purposes and as fully as if said resolutions were adopted at
    a duly called and held meeting of the Board of Directors,
    effective as of the date set forth above:

 

    RESOLVED:  That the Fourth Amended and Restated
    Transfer and Administration Agreement by and among the
    Corporation, as Collection Agent, NMC Funding Corporation, as
    Transferor, the entities party thereto as Conduit Investors, the
    financial institutions party thereto as Bank Investors, the
    financial institutions party thereto as Administrative Agents,
    and WestLB AG, New York Branch, as Agent (the
    “Agreement”), as previously provided to the Board, be
    and the same hereby is approved and adopted, and that each
    officer of the Corporation be and each hereby is authorized and
    directed, acting in the name of and on behalf of the Corporation
    to execute and deliver the Agreement, or one or more instruments
    evidencing the Agreement, with such changes as any such officer
    shall, in his sole discretion, deem necessary or advisable, the
    execution and delivery of the same to be conclusive evidence of
    the authority granted hereunder.

 

    RESOLVED:  That each officer of the Corporation
    be, and each of them individually hereby is, authorized and
    directed, in the name and on behalf of the Corporation, to
    (a) negotiate, execute and deliver such other instruments,
    agreements
    and/or
    documents required by, in furtherance of, or in connection with
    the Agreement (collectively with the Agreement, the
    “Transaction Documents”) with such changes or
    additions thereto as such officers may approve, the execution by
    any of such officers of any such Transaction Documents or the
    doing by such officer of any action in connection with the
    foregoing establishing conclusively such officer’s approval
    and the approval of the Board of Directors, and (b) cause
    the Corporation to perform its obligations thereunder.

 

    RESOLVED:  That all action taken
    and/or any
    resolutions adopted by the Corporation’s current Board of
    Directors and officers in connection with the negotiation and
    execution of the Transaction Documents be, and hereby are,
    ratified, affirmed and approved.

 

    [Signature
    page to follow]
    

    

    10

 

    IN WITNESS WHEREOF, the undersigned have executed this consent
    effective as of the date set forth above.

 

    /s/  Mats
    Wahlstrom

    Mats Wahlstrom

 

    /s/  Ronald
    J. Kuerbitz

    Ronald J. Kuerbitz

    

    11

 

    EXHIBIT M

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORM OF
    CERTIFICATE

 

    FORM OF

    CERTIFICATE

 

 

    THIS CERTIFICATE OR ANY INTEREST HEREIN MAY NOT BE TRANSFERRED,
    ASSIGNED, EXCHANGED OR CONVEYED EXCEPT IN ACCORDANCE WITH THE
    TRANSFER AND ADMINISTRATION AGREEMENT REFERRED TO HEREIN. THIS
    CERTIFICATE HAS NOT BEEN AND WILL NOT BE REGISTERED UNDER THE
    SECURITIES ACT OF, AS AMENDED, OR UNDER ANY STATE SECURITIES
    LAWS AND NO TRANSFER HEREOF MAY BE MADE EXCEPT IN ACCORDANCE
    WITH THE SECURITIES ACT OF 1933, AS AMENDED AND ANY OTHER
    APPLICABLE LAWS.

 

		
	    No. 1
    	     One Unit
    

    August 28, 1997

 

    Evidencing an undivided interest in a pool of accounts
    receivables generated or otherwise acquired from time to time in
    the ordinary course of business by NATIONAL MEDICAL CARE, INC.
    and acquired by NMC FUNDING CORPORATION (the
    “Transferor”).

 

    (Not an interest in or obligation of TRANSFEROR)

 

    This certifies that NATIONSBANK, N.A., on behalf of and as agent
    for Enterprise Funding Corporation and the Bank Investors (as
    defined in the Agreement), as their respective interests may
    appear from time to time, is the registered owner of an
    undivided interest in a pool of accounts receivables (the
    “Receivables”) pursuant to a Transfer and
    Administration Agreement among the Transferor, National Medical
    Care Inc, as initial “Collection Agent”, Enterprise
    Funding Corporation, NationsBank, N.A. and certain financial
    institutions named therein, dated as of August 28, 1997
    (the “Agreement”). The Receivables consist of all
    accounts receivables generated under the Contracts from time to
    time hereafter, all monies due or to become due in payment of
    the Receivables and the other assets and interests as provided
    in the Agreement.

 

    To the extent not defined herein, capitalized terms used herein
    have the meanings assigned to such terms in the Agreement. This
    Certificate is issued under and is subject to the terms,
    provisions and conditions of the Agreement, to which Agreement,
    as amended from time to time, the holder hereof by virtue of the
    acceptance hereof assents and by which the holder hereof is
    bound. In the event of any inconsistency or conflict between the
    terms of this Certificate and the terms of the Agreement shall
    control.

 

    This Certificate represents an undivided interest in the
    Receivables, including the right to receive Collections and
    other amounts at the times and in the amounts specified in the
    Agreement. The aggregate interest in the Receivables represented
    by this Certificate at any time shall equal the Percentage
    Factor as determined in accordance with the Agreement.

 

    IN WITNESS WHEREOF, the Transferor has caused this Certificate
    to be duly executed.

 

    NMC FUNDING CORPORATION

 

			
	 	    By: 
	
        

    Name: 

			
	 	    Title: 
	

    

    1

 

    EXHIBIT N

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    LIST OF
    APPROVED FISCAL INTERMEDIARIES

 

    Fresenius
    Medical Services Fiscal Intermediary List
    10/10/08

 

	 	 	 
	
    Legal Name
	
 
	
    Fiscal Intermediary

	

    Bio-Medical Applications of Aguadilla, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Alabama, Inc.

	
 
	
    Riverbend Govt Benefits

	

    Bio-Medical Applications of Anacostia, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Arecibo, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Arkansas, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Bayamon, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Blue Springs, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Caguas, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of California, Inc.

	
 
	
    TrailBlazers Hlth Enterprises Palmetto Govt Svcs

	

    Bio-Medical Applications of Camarillo, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Capitol Hill, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Carolina, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Carson, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Clinton, Inc.

	
 
	
    CAHABA

	

    Bio-Medical Applications of Columbia Heights, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Connecticut, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Delaware, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Dover, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Eureka, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Fayetteville, Inc.

	
 
	
    CAHABA

	

    Bio-Medical Applications of Florida, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Fremont, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Fresno, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Georgia, Inc.

	
 
	
    Riverbend Govt Benefits

	

    Bio-Medical Applications of Guayama, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Humacao, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Illinois, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Indiana, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Kansas, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Kentucky, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Long Beach, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Los Gatos, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Louisiana, LLC

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Maine, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Manchester, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Maryland, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Massachusetts, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Mayaguez, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Michigan, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Minnesota, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Mission Hills, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Mississippi, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Missouri, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

    

    1

 

	 	 	 
	
    Legal Name
	
 
	
    Fiscal Intermediary

	

    Bio-Medical Applications of Nevada, Inc.

	
 
	
    Noridian

	

    Bio-Medical Applications of New Hampshire, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of New Jersey, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of New Mexico, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of North Carolina, Inc.

	
 
	
    CAHABA Palmetto Govt Svcs

	

    Bio-Medical Applications of Northeast D.C., Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Oakland, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Ohio, Inc.

	
 
	
    TrailBlazers Hlth Enterprises National Government Services

	

    Bio-Medical Applications of Oklahoma, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Pennsylvania, Inc.

	
 
	
    National Government Services National Government Services

	

    Bio-Medical Applications of Ponce, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Puerto Rico, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Rio Piedras, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of San Antonio, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of San German, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of San Juan, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of South Carolina, Inc.

	
 
	
    Palmetto Govt Svcs

	

    Bio-Medical Applications of Southeast Washington, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Tennessee, Inc.

	
 
	
    National Government Services Riverbend Govt Benefits
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of Texas, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Bio-Medical Applications of the District of Columbia, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Virginia, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of West Virginia, Inc.

	
 
	
    National Government Services

	

    Bio-Medical Applications of Wisconsin, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Brazoria Kidney Center, Inc.

	
 
	
    Trailblazer

	

    Brevard County Dialysis, LLC

	
 
	
    First Coast

	

    Clayton County Dialysis, LLC

	
 
	
    BC of Georgia

	

    Clermont Dialysis Center, LLC

	
 
	
    First Coast

	

    Columbus Area Renal Alliance, LLC

	
 
	
    National Government Services

	

    Conejo Valley Dialysis, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Dialysis America Georgia, LLC

	
 
	
    Riverbend Govt Benefits

	

    Dialysis Associates of Northern New Jersey, L.L.C.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Dialysis Associates, LLC

	
 
	
    BC of Georgia

	

    Dialysis Centers of America — Illinois, Inc.

	
 
	
    National Government Services

	

    Dialysis Management Corporation

	
 
	
    Trailblazer

	

    Dialysis Specialists of Topeka, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Dialysis Specialists of Tulsa, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Douglas County Dialysis, LLC

	
 
	
    BC of Georgia

	

    Du Page Dialysis, Ltd.

	
 
	
    TrailBlazers Hlth Enterprises

    2

 

	 	 	 
	
    Legal Name
	
 
	
    Fiscal Intermediary

	

    Everest Healthcare Indiana, Inc.

	
 
	
    TrailBlazers Hlth Enterprises National Government Services

	

    Everest Healthcare Ohio, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Everest Healthcare Rhode Island, Inc.

	
 
	
    National Government Services

	

    Everest Healthcare Texas, L.P.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Fondren Dialysis Clinic, Inc.

	
 
	
    Trailblazer

	

    Fort Scott Regional Dialysis Center, Inc.

	
 
	
    Trailblazer

	

    Four State Regional Dialysis Center, Inc.

	
 
	
    Trailblazer

	

    Fresenius Medical Care Dialysis Services — Oregon, LLC

	
 
	
    TrailBlazers Hlth Enterprises

	

    Fresenius Medical Care Dialysis Services Colorado LLC

	
 
	
    TrailBlazers Hlth Enterprises

	

    Henry Dialysis Center, LLC

	
 
	
    BC of Georgia

	

    Holton Dialysis Clinic, LLC

	
 
	
    BC of Georgia

	

    Home Dialysis of Muhlenburg County, Inc.

	
 
	
    National Government Services

	

    Jefferson County Dialysis, Inc.

	
 
	
    Trailblazer

	

    KDCO, Inc.

	
 
	
    Trailblazer

	

    Kentucky Renal Care Group, LLC

	
 
	
    National Government Services

	

    Lawton Dialysis, Inc.

	
 
	
    Trailblazer

	

    Little Rock Dialysis, Inc.

	
 
	
    Trailblazer

	

    Maumee Dialysis Services, LLC

	
 
	
    National Government Services

	

    Miami Regional Dialysis Center, Inc.

	
 
	
    Trailblazer

	

    Michigan Home Dialysis Center, Inc.

	
 
	
    Riverbend Govt Benefits

	

    National Medical Care, Inc.

	
 
	
    TrailBlazers Hlth Enterprises National Government Services
    Riverbend Govt Benefits

	

    National Nephrology Associates of Texas, L.P.

	
 
	
    BC of Georgia

	

    NNA of Alabama, Inc.

	
 
	
    BC of Georga

	

    NNA of East Orange, L.L.C.

	
 
	
    BC of Georgia

	

    NNA of Florida, LLC

	
 
	
    BC of Georga

	

    NNA of Georgia, Inc.

	
 
	
    BC of Georgia

	

    NNA of Harrison, L.L.C.

	
 
	
    BC of Georgia

	

    NNA of Louisiana, LLC

	
 
	
    BC of Georga

	

    NNA of Oklahoma, L.L.C.

	
 
	
    BC of Georgia

	

    NNA of Rhode Island, Inc.

	
 
	
    BC of Georgia

	

    NNA of Toledo, Inc.

	
 
	
    BC of Georgia

	

    NNA-Saint Bamabas, L.L.C.

	
 
	
    BC of Georgia

	

    NNA-Saint Bamabas-Livingston, L.L.C.

	
 
	
    BC of Georgia

	
 
	
 
	
 

	

    Norcross Dialysis Center, LLC

	
 
	
    BC of Georgia

	
 
	
 
	
 

	

    Northern New Jersey Dialysis, LLC

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

	

    Physicians Dialysis Company, Inc.

	
 
	
    National Government Services Riverbend

	
 
	
 
	
 

	

    QUALICENTERS ALBANY, LTD.

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

	

    QUALICENTERS BEND, LLC

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

	

    QUALICENTERS COOS BAY, LTD.

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

    3

 

	 	 	 
	
    Legal Name
	
 
	
    Fiscal Intermediary

	

    QUALICENTERS EUGENE-SPRINGFIELD, LTD.

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

	

    QUALICENTERS INLAND NORTHWEST, LLC

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

	

    QUALICENTERS PUEBLO, LLC

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

	

    QUALICENTERS SALEM, LLC

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

	

    QUALICENTERS SIOUX CITY, LLC

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

	

    QUALITY CARE DIALYSIS CENTER OF VEGA BAJA, INC.

	
 
	
    TrailBlazers Hlth Enterprises

	
 
	
 
	
 

	

    RCG Bloomington, LLC

	
 
	
    National Government Services

	
 
	
 
	
 

	

    RCG East Texas, LLP

	
 
	
    Trailblazer

	
 
	
 
	
 

	

    RCG Indiana, L.L.C.

	
 
	
    National Government Services

	
 
	
 
	
 

	

    RCG Irving, LLP

	
 
	
    Trailblazer

	
 
	
 
	
 

	

    RCG Martin, LLC

	
 
	
    Riverbend

	
 
	
 
	
 

	

    RCG Memphis East, LLC

	
 
	
    Riverbend

	
 
	
 
	
 

	

    RCG Mississippi, Inc.

	
 
	
    Trailblazer Trispan

	
 
	
 
	
 

	

    RCG University Division, Inc.

	
 
	
    National Government Services Riverbend

	
 
	
 
	
 

	

    Renal Care Group Alaska, Inc.

	
 
	
    Noridian

	
 
	
 
	
 

	

    Renal Care Group East, Inc.

	
 
	
    Highmark Medicare Services

	
 
	
 
	
 

	

    Renal Care Group Northwest, Inc.

	
 
	
    Noridian

	
 
	
 
	
 

	

    Renal Care Group of the Midwest, Inc.

	
 
	
    Riverbend Trailblazer

	
 
	
 
	
 

	

    Renal Care Group of the Ozarks, LLC

	
 
	
    Trailblazer

	
 
	
 
	
 

	

    Renal Care Group of the South, Inc.

	
 
	
    Riverbend

	
 
	
 
	
 

	

    Renal Care Group of the Southeast, Inc.

	
 
	
    Riverbend

	
 
	
 
	
 

	

    Renal Care Group South New Mexico, LLC

	
 
	
    Trailblazer

	
 
	
 
	
 

	

    Renal Care Group Texas, Inc.

	
 
	
    Trailblazer

	
 
	
 
	
 

	

    Renal Care Group Westlake, LLC

	
 
	
    National Government Services

	
 
	
 
	
 

	

    Renex Dialysis Clinic of Bloomfield, Inc.

	
 
	
    BC of Georgia

	
 
	
 
	
 

	

    Renex Dialysis Clinic of Bridgeton, Inc.

	
 
	
    BC of Georgia

	
 
	
 
	
 

	

    Renex Dialysis Clinic of Creve Coeur, Inc.

	
 
	
    BC of Georgia

	
 
	
 
	
 

	

    Renex Dialysis Clinic of Doylestown, Inc.

	
 
	
    BC of Georgia

	
 
	
 
	
 

	

    Renex Dialysis Clinic of Maplewood, Inc.

	
 
	
    BC of Georgia

	
 
	
 
	
 

	

    Renex Dialysis Clinic of Orange, Inc.

	
 
	
    BC of Georgia

	

    Renex Dialysis Clinic of Penn Hills, Inc.

	
 
	
    BC of Georgia

	

    Renex Dialysis Clinic of Pittsburgh, Inc.

	
 
	
    Riverbend BC of Georgia

	

    Renex Dialysis Clinic of Shaler, Inc.

	
 
	
    BC of Georgia

	

    Renex Dialysis Clinic of South Georgia, Inc.

	
 
	
    BC of Georgia

	

    Renex Dialysis Clinic of St. Louis, Inc.

	
 
	
    BC of Georgia

	

    Renex Dialysis Clinic of Union, Inc.

	
 
	
    BC of Georgia

	

    Renex Dialysis Clinic of University City, Inc.

	
 
	
    BC of Georgia

    4

 

	 	 	 
	
    Legal Name
	
 
	
    Fiscal Intermediary

	

    Renex Dialysis Clinic of Woodbury, Inc.

	
 
	
    BC of Georgia

	

    Renex Dialysis Facilities, Inc.

	
 
	
    BC of Georgia

	

    San Diego Dialysis Services, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Santa Barbara Community Dialysis Center, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

	

    Smyma Dialysis Center, LLC

	
 
	
    BC of Georgia

	

    SSKG, Inc.

	
 
	
    National Government Services

	

    STAT Dialysis Corporation

	
 
	
    Trailblazer

	

    Stone Mountain Dialysis Center, LLC

	
 
	
    BC of Georgia

	

    Stuttgart Dialysis, LLC

	
 
	
    Trailblazer

	

    Terrell Dialysis Center, LLC

	
 
	
    TrailBlazers Hlth Enterprises

	

    Three Rivers Dialysis Services, LLC

	
 
	
    National Government Services

	

    West Palm Dialysis, LLC

	
 
	
    First Coast

	

    Wharton Dialysis, Inc.

	
 
	
    Trailblazer

	

    WSKC Dialysis Services, Inc.

	
 
	
    TrailBlazers Hlth Enterprises

    5

 

    EXHIBIT O

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORM OF
    TRANSFERRING AFFILIATE LETTER

 

    EXECUTION
    COPY

 

    AMENDED
    AND RESTATED TRANSFERRING AFFILIATE LETTER

 

    Dated as of
    October 16, 2008
    

 

    NATIONAL MEDICAL CARE, INC.

    920 Winter Street

    Waltham, MA 02451

    Attention: Mark Fawcett

 

    Dear Sirs:

 

    We refer to the Amended and Restated Receivables Purchase
    Agreement dated as of October 16, 2008 between National
    Medical Care, Inc. (the “Seller”) and NMC Funding
    Corporation (the “Purchaser”) (such Agreement, as it
    may be amended, supplemented or otherwise modified from time to
    time being the “Agreement”). The undersigned
    Transferring Affiliates are parties to that certain Transferring
    Affiliate Letter dated as of August 28, 1997 (as amended
    prior to the date hereof, the “Existing Transferring
    Affiliate Letter”). The undersigned Transferring Affiliates
    hereby desire to amend and restate the Existing Transferring
    Affiliate Letter. Capitalized terms used and not otherwise
    defined in this Amended and Restated Transferring Affiliate
    Letter (this “Transferring Affiliate Letter”) have the
    meanings specified in the Agreement or, if not defined in the
    Agreement, in the Transfer and Administration Agreement referred
    to therein.

 

    Effective as of the date hereof, this Transferring Affiliate
    Letter amends, restates and supersedes the Existing Transferring
    Affiliate Letter. This Transferring Affiliate Letter is not
    intended to constitute a novation of any obligations under the
    Existing Transferring Affiliate Letter. Upon the effectiveness
    of this Transferring Affiliate Letter, each reference to the
    Existing Transferring Affiliate Letter in any other document,
    instrument or agreement executed
    and/or
    delivered in connection therewith shall mean and be a reference
    to this Transferring Affiliate Letter.

 

    1. Each of the undersigned Transferring Affiliates will
    from time to time forthwith sell to the Seller, and the Seller
    will from time to time forthwith purchase from such Transferring
    Affiliate, all of the present and future Receivables, and all
    Related Security, if any, with respect thereto, which are owed
    from time to time to such Transferring Affiliate for an amount
    equal to the face amount of such Receivables, which amount the
    Seller shall pay to such Transferring Affiliate in cash or by
    way of a credit to such Transferring Affiliate in the
    appropriate intercompany account by the last Business Day of the
    month following the month in which such purchase was made; it
    being further agreed that (a) that each such purchase of
    each such Receivable and Related Security with respect thereto
    shall be deemed to be made on the date such Receivable is
    created, and (b) the Seller shall settle from time to time
    each such credit to the account of such Transferring Affiliate,
    by way of payments in cash or by way of credits in amounts equal
    to cash expended, obligations incurred or the value of services
    or property provided by or on behalf of the Seller, in each case
    for the benefit of such Transferring Affiliate in accordance
    with the Seller’s and such Transferring Affiliate’s
    cash management and accounting policies.

 

    It is the intention of the Seller and the Purchaser that each
    Purchase under the Agreement shall constitute a sale of such
    Receivables, together with the Related Assets with respect
    thereto, from the Seller to the Purchaser, conveying good title
    thereto free and clear of any Adverse Claims, and that such
    Receivables and Related Assets not be part of the Seller’s
    estate in the event of an insolvency. If, notwithstanding the
    foregoing, the transactions contemplated under the Agreement
    should be deemed a financing, the Seller and the Purchaser
    intend that the Seller shall be deemed to have granted to the
    Purchaser a first priority perfected and continuing security
    interest in all of the Seller’s right, title and interest
    in, to and under the Receivables, together with the Related
    Assets with respect thereto, and together with all of the
    Seller’s rights hereunder, under the BMA Transfer Agreement
    and all other Transaction Documents with respect to the
    Receivables and with respect to any obligations thereunder of
    any Originating Entity with respect to the Receivables, and that
    the Agreement shall constitute a security agreement under
    applicable law. The Seller under the Agreement has assigned to
    the Purchaser all of its rights and remedies hereunder and under
    the BMA Transfer Agreement (and all instruments, documents and
    agreements executed in connection therewith) with respect to the
    Receivables and with respect to any obligations thereunder of
    any Originating Entity with respect to the Receivables.

    

    1

 

 

    2. Each Transferring Affiliate hereby severally agrees as
    follows:

 

    (a) Such Transferring Affiliate shall make each such sale
    strictly in accordance with the terms of this Transferring
    Affiliate Letter, without regard to whether any other
    Transferring Affiliate has performed or failed to perform any of
    such other Transferring Affiliate’s obligations hereunder.

 

    (b) Such Transferring Affiliate will instruct all Obligors
    to cause all Collections to be deposited directly into a Special
    Account.

 

    (c) Such Transferring Affiliate will act as the
    Seller’s agent for any Collections received by such
    Transferring Affiliate with respect to Receivables sold by such
    Transferring Affiliate to the Seller and such Collections will
    be held in trust and segregated from the other funds of such
    Transferring Affiliate until the same are delivered to the
    Seller. Such Transferring Affiliate agrees that such Collections
    constitute the Seller’s property and shall be promptly
    deposited directly to a Special Account.

 

    (d) Such Transferring Affiliate will not add or terminate
    any bank as a Special Account Bank to or from those listed
    in Exhibit C to the Agreement, nor make any change in its
    instructions to Obligors regarding payments to be made to any
    Special Account Bank; provided that a Transferring
    Affiliate may (A) add any bank as a Special
    Account Bank for purposes of this Transferring Affiliate
    Letter at any time following delivery to the Seller and its
    assigns of written notice of such addition and a Special
    Account Letter duly executed by such bank, and
    (B) terminate any Special Account Bank at any time
    following delivery to the Seller and its assigns of written
    notice of such termination and evidence satisfactory to the
    Seller and its assigns that the affected Obligors shall have
    been instructed to remit all subsequent Collections to another
    Special Account.

 

    (e) In the event any Transferring Affiliate has instructed
    its Obligors to remit Collections to a Special Account that is
    maintained in the name of any Person other than such
    Transferring Affiliate, such Transferring Affiliate shall at all
    times ensure that such Person qualifies as a Designated
    Account Agent, including, without limitation, by causing
    such Person to execute and deliver to the Seller an
    Account Agent Agreement and by causing such
    Account Agent Agreement to remain in effect at all times.
    In furtherance of the foregoing, each such Transferring
    Affiliate hereby authorizes and directs each Person maintaining
    a Special Account on behalf of such Transferring Affiliate to
    (i) execute, and deliver to the Seller and its assigns, an
    Account Agent Agreement, (ii) execute and deliver a
    Special Account Letter in respect of each such Special
    Account maintained by such Person, and (iii) otherwise take
    all actions, or omit to take all actions, required to be taken,
    or required to be omitted to be taken, by such Transferring
    Affiliate with respect to such Special Accounts in accordance
    with the terms of this Transferring Affiliate Letter.

 

    3. Each Transferring Affiliate shall provide (or, if
    applicable, shall cause its Designated Account Agents to
    provide) standing instructions to each Special Account Bank
    (which standing instructions shall be maintained in full force
    and effect at all times) to transfer, prior to the close of
    business each banking day (i) all Collections on deposit
    during such banking day in the Special Accounts at such Special
    Account Bank to the Concentration Account or an
    Intermediate Concentration Account and (ii) if an
    Intermediate Concentration Account has been established at such
    Special Account Bank, all Collections on deposit during
    such banking day in such Intermediate Concentration Account to
    the Concentration Account; provided, however, that
    if the Collections on deposit in any Special Account during such
    banking day shall be less than $20,000.00 (the “Minimum
    Amount”), the Special Account Bank shall transfer such
    Collections to the Concentration Account, or to the Intermediate
    Concentration Account, as applicable, on the next succeeding
    banking day in which Collections in such Special Account first
    exceed the Minimum Amount.

 

    4. Each Transferring Affiliate hereby authorizes the Seller
    and its assigns, to the extent permitted by applicable law, to
    take any and all steps in such Transferring Affiliate’s
    name and on behalf of such Transferring Affiliate to collect all
    amounts due under such Receivables and Related Security,
    including, without limitation, endorsing such Transferring
    Affiliate’s name on checks and other instruments
    representing collections and enforcing such Receivables and
    Related Security and the related Contracts; provided, however,
    neither that the Seller nor any of its assigns shall have the
    power or authority to direct Obligors of Receivables or Related
    Security payable under the CHAMPUS/VA, Medicare or Medicaid
    program to make payments of amounts due or to become

    

    2

 

    due to such Transferring Affiliate in respect of such
    Receivables or Related Security directly either to the
    Intermediate Concentration Account or the Concentration Account
    or to the Seller, the Seller’s assigns or any of their
    respective designees, except for any such payment in respect of
    such Receivables or Related Security or any assignment thereof
    that is established by, or made pursuant to, the order of a
    court of competent jurisdiction.

 

    5. Each Transferring Affiliate agrees that from time to
    time, to the extent permitted by applicable law, it will
    promptly execute and deliver all further instruments and
    documents, and take all further action that the Seller or its
    assigns may reasonably request in order to perfect, protect or
    more fully evidence the ownership interest of the Seller in the
    Receivables, Related Security and Collections, and any interest
    therein acquired by any assignee of the Seller, or to enable the
    Seller or its assigns to exercise or enforce any of their
    respective rights hereunder or under the Agreement or the
    Certificate. Without limiting the generality of the foregoing,
    each Transferring Affiliate will, upon the request of the Seller
    or its assigns: (i) execute and file such financing or
    continuation statements, or amendments thereto or assignments
    thereof, and such other instruments or notices, as may be
    necessary or appropriate in order to perfect, protect or
    evidence the ownership interest of the Seller or the interest of
    any assignee thereof; (ii) mark conspicuously each of its
    records evidencing each Receivable and Related Security and the
    related Contract with a legend, acceptable to the Seller and its
    assigns, evidencing that such Receivable and Related Security
    have been sold in accordance with this Transferring Affiliate
    Letter, the Agreement or any document, instrument or agreement
    made in favor of any assignee; and (iii) mark its master
    data processing records evidencing such Receivables and Related
    Security and related Contracts with such legend. Each
    Transferring Affiliate hereby authorizes the Seller to file one
    or more financing or continuation statements, and amendments
    thereto and assignments thereof, relative to the Receivables and
    Related Security sold by it to the Seller or any assignee now
    existing or hereafter arising without the signature of such
    Transferring Affiliate where permitted by law. If any
    Transferring Affiliate fails to perform any of its agreements or
    obligations under this Letter, the Seller or any of its assigns
    may (but shall not be required to) itself perform, or cause
    performance of, such agreement or obligation, and the expenses
    of the Seller or any of its assigns incurred in connection
    therewith shall be payable by such Transferring Affiliate.

 

    6. Each Transferring Affiliate hereby severally represents
    and warrants as to itself as follows:

 

    (a) Such Transferring Affiliate is a corporation duly
    incorporated, validly existing and in good standing under the
    laws of the jurisdiction in which it is organized and existing
    and is duly qualified to do business, and is in good standing,
    in every jurisdiction where the nature of its business requires
    it to be so qualified and where the failure to so qualify would
    materially and adversely affect the business, condition,
    operations or properties of such Transferring Affiliate.

 

    (b) The execution, delivery and performance by such
    Transferring Affiliate of this Transferring Affiliate Letter are
    within such Transferring Affiliate’s corporate powers, have
    been duly authorized by all necessary corporate action, do not
    contravene (i) such Transferring Affiliate’s charter
    or by-laws, (ii) any law, rule or regulation, including,
    without limitation the Social Security Act, any CHAMPUS
    Regulation, any Medicaid Regulation or any Medicare Regulation
    or (iii) any contractual or legal restriction binding on or
    affecting such Transferring Affiliate or its properties, and do
    not result in or require the creation of any Adverse Claim
    (other than pursuant hereto) upon or with respect to any of its
    properties; and no transaction contemplated hereby requires
    compliance with any bulk sales act or similar law.

 

    (c) No authorization or approval or other action by, and no
    notice to or filing with, any governmental authority or
    regulatory body is required for the due execution, delivery and
    performance by such Transferring Affiliate of this Transferring
    Affiliate Letter or for the perfection of or the exercise by the
    Seller or any assignee thereof of their respective rights and
    remedies under this Transferring Affiliate Letter, except for
    the filings of the financing statements referred to in
    Article IV of the TAA, all of which, on or prior to the
    date of the initial purchase thereunder, will have been duly
    made and be in full force and effect.

 

    (d) This Transferring Affiliate Letter is the legal valid
    and binding obligation of such Transferring Affiliate
    enforceable against such Transferring Affiliate in accordance
    with its terms, except as may be limited by the effect of any
    applicable bankruptcy, insolvency, reorganization, moratorium or
    similar laws affecting creditors’ rights generally and by
    general principles of equity.

    

    3

 

 

    (e) Such Transferring Affiliate will be, at the time of
    each sale hereunder, the legal and beneficial owner of each
    Receivable, and any Related Security with respect thereto,
    originally owed to such Transferring Affiliate and sold from
    time to time to the Seller hereunder, free and clear of any
    Adverse Claim except as created by the Agreement (or any
    subsequent assignment by the assignee thereunder). Upon each
    such sale of each such Receivable and Related Security
    hereunder, the Seller will acquire all right, title and interest
    in and to, and a valid and perfected first priority 100%
    ownership interest in, such Receivable and Related Security, and
    Collections with respect thereto, free and clear of any Adverse
    Claim except as created by the Agreement (or any subsequent
    assignment by the assignee thereunder). No effective financing
    statement or other instrument similar in effect covering any
    such Receivable or Related Security, or Collections with respect
    thereto, is on file in any recording office, except those filed
    in favor of the Seller relating to the Agreement (or any
    subsequent assignment by the assignee thereunder).

 

    (f) Each Investor Report (to the extent that information
    contained therein is supplied by such Transferring Affiliate),
    information, exhibit, financial statement, document, book,
    record or report furnished or to be furnished at any time by
    such Transferring Affiliate to the Seller or any of its assigns
    in connection the Agreement is or will be accurate in all
    material respects as of its date or (except as otherwise
    disclosed to the Seller or the applicable assignee, as the case
    may be, at such time) as of the date so furnished, and no such
    document (if not prepared by or under the direction of such
    Transferring Affiliate or to the extent that the information
    contained therein is not supplied by such Transferring
    Affiliate, to the best of such Transferring Affiliate’s
    knowledge) contains or will contain any untrue statement of a
    material fact or omits or will omit to state a material fact
    necessary in order to make the statements contained therein, in
    the light of the circumstances under which they were made, not
    misleading.

 

    (g) (i) The chief executive office of such
    Transferring Affiliate, except NMC Medical Products, Inc., is
    located at 920 Winter Street, Waltham, Massachusetts 02451, and
    (ii) the office where such Transferring Affiliate keeps its
    records concerning the Receivables is located at the address
    specified for such Transferring Affiliate in Exhibit J to
    the Agreement (or, in the case of each of clauses (i) or
    (ii) above, at such other locations, notified to the Seller
    and its assigns in accordance with Section 2.6 of the
    Agreement, in jurisdictions where all action required by
    Section 2.6 of the Agreement has been taken and completed).

 

    (h) The names and addresses of all the Special
    Account Banks, together with the account numbers of the
    Special Accounts and the account numbers of the Intermediate
    Concentration Account, at such Special Account Banks and,
    if applicable, the name of each Designated Account Agent,
    are specified in Exhibit C to the Agreement (or at such
    other Special Account Banks, with such other Special
    Accounts, Intermediate Concentration Account or with such other
    Designated Account Agents in respect of which all of the
    requirements set forth in Section 5.2(e) of the Agreement
    have been satisfied).

 

    Each Transferring Affiliate acknowledges that it has received a
    copy of the Agreement and hereby severally represents and
    warrants that each representation and warranty made by the
    Seller under the Agreement in respect of such Transferring
    Affiliate, or in respect of any of the assets or properties of
    such Transferring Affiliate, is true and correct and shall be
    true and correct on each date under the Agreement on which the
    Seller is required to remake (or is deemed to have remade) any
    such representation and warranty for the benefit of the
    Purchaser. In addition, with respect to any covenant or
    undertaking required to be performed by the Seller under the
    Agreement which relates to any Transferring Affiliate or the
    assets or properties of such Transferring Affiliate, such
    Transferring Affiliate severally agrees to take all action, or
    if applicable to omit to take any action, the taking (or
    omission to take) of which enables the Seller to comply fully
    and on a timely basis with the terms and conditions of such
    covenant or undertaking.

 

    7. Anything to the contrary herein notwithstanding, all
    CHAMPUS/VA, Medicare or Medicaid payments which are made by an
    Obligor with respect to any Receivables shall be collected from
    such Obligor only by (i) the Transferring Affiliate which
    furnished the services for which such payments are made or
    (ii) an agent of such Transferring Affiliate, except
    to the extent that an Obligor may be required to submit any such
    payments directly to a Person other than a Transferring
    Affiliate pursuant to a court-ordered assignment which is valid,
    binding and enforceable under applicable federal and state
    CHAMPUS/VA, Medicare and Medicaid laws, rules and regulations;
    and this Transferring Affiliate Letter shall not be construed to
    permit any other Person, in violation of applicable

    

    4

 

    federal and state CHAMPUS/VA, Medicare or Medicaid laws, rules
    and regulations to collect or receive, or to be entitled to
    collect or receive, any such payments prior to a Transferring
    Affiliate’s or such agent’s receipt thereof.

 

    8. No amendment or waiver of any provision of this
    Transferring Affiliate Letter, and no consent to any departure
    by any Transferring Affiliate herefrom, shall in any event be
    effective unless the same shall be in writing and signed by the
    Seller, each assignee of the Seller and the Transferring
    Affiliate or Transferring Affiliates to be bound thereby (or, in
    the case of waiver, by the party or parties waiving the
    provision hereof), and then such amendment, waiver or consent
    shall be effective only in the specific instance and for the
    specific purpose for which given.

 

    9. All notices and other communications provided for
    hereunder shall, unless otherwise stated herein, be in writing
    (including telecopier, telegraphic, telex or cable
    communication) and mailed, telecopied, telegraphed, telexed,
    cabled or delivered, as to each party hereto, at its address set
    forth, in the case of each Transferring Affiliate, as its chief
    executive office on Exhibit J to the Agreement; in the case
    of the Seller, under its name on the signature pages of the
    Agreement; in the case of any assignee of the Seller, such
    address as shall have been notified by such assignee to the
    Transferring Affiliates; or, in the case of each party hereto
    (or any such assignee), at such other address as shall be
    designated by such party in a written notice to the Seller and
    its assignees. All such notices and communications shall, when
    mailed, telecopied, telegraphed, telexed or cabled, be effective
    when deposited in the mails, telecopied, delivered to the
    telegraph company, confirmed by telex answerback or delivered to
    the cable company, respectively.

 

    10. This Transferring Affiliate Letter shall be binding
    upon, and inure to the benefit of, and be enforceable by, each
    Transferring Affiliate, the Seller and their respective
    successors and assigns, except that no Transferring Affiliate
    shall have the right to assign its rights hereunder or any
    interest herein without the prior written consent of the Seller
    and its assigns.

 

    11. The Seller may assign at any time any or all of its
    rights and obligations hereunder and interests herein to any
    other Person without the consent of the any Transferring
    Affiliate. Without limiting the foregoing, each Transferring
    Affiliate acknowledges that (i) the Seller, pursuant to the
    Agreement, shall assign to the Purchaser all of its right, title
    and interest in and to the Receivables and the Related Security,
    together with all of its rights, remedies, powers and privileges
    hereunder, (ii) the Purchaser, pursuant to that certain
    Fourth Amended and Restated Transfer and Administration
    Agreement dated as of October 16, 2008 (as amended,
    restated, supplemented or otherwise modified from time to time,
    the “TAA”) among the Purchaser, as
    “Transferor”, the Seller, as the initial
    “Collection Agent” thereunder, the Persons parties
    thereto as “Conduit Investors”, the Persons parties
    thereto as “Bank Investors” (together with the Conduit
    Investors, the “Investors”), the Persons parties
    thereto as “Administrative Agents” and WestLB AG, New
    York Branch, as agent (in such capacity, the “Agent”),
    shall assign to the Agent, for the benefit of the Investors, an
    undivided percentage ownership interest in all of the
    Purchaser’s right, title and interest in and to the
    Receivables and the Related Security, together with all of the
    Purchaser’s rights, remedies, powers and privileges
    hereunder, and (iii) the Agent or any Investor may further
    assign such rights, interests, remedies, powers and privileges
    to the extent permitted in the TAA. Each Transferring Affiliate
    agrees that the Agent, as the assignee of the Seller, shall,
    subject to the terms of the TAA, have the right to enforce this
    Transferring Affiliate Letter and to exercise directly all of
    the Seller’s rights and remedies under this Transferring
    Affiliate Letter (including, without limitation, the right to
    give or withhold any consents or approvals of the Seller to be
    given or withheld hereunder) and each Transferring Affiliate
    agrees to cooperate fully with the Agent and the Collection
    Agent in the exercise of such rights and remedies. Each
    Transferring Affiliate agrees to give to the Agent copies of all
    notices it is required to give to the Seller hereunder and to
    permit the Agent and the Investors (and their assignees) to
    inspect the books and records of such Transferring Affiliate
    relating to the Receivables and the Related Security at any
    time, upon reasonable notice given by the Agent or such Investor
    to the Seller and such Transferring Affiliate. Each Transferring
    Affiliate agrees that, to the extent the Seller is herein
    permitted to take any action or to provide any information or
    report, the Agent and the Investors (and their assignees) may
    similarly so direct and require (with or without the concurrence
    of the Seller) such Transferring Affiliate to take such action
    or to provide such information or report. This Transferring
    Affiliate Letter shall create and constitute the continuing
    obligations of the parties hereto in accordance with its terms,
    and shall remain in full force and effect until the date (the
    “Collection Date”) that the TAA shall be terminated in
    accordance with its terms and all “Aggregate Unpaids”
    thereunder paid in full; provided, however, that
    the rights and remedies with respect to

    

    5

 

    any breach of any representation and warranty made by any
    Transferring Affiliate hereunder shall be continuing and shall
    survive any termination of this Transferring Affiliate Letter.

 

    12. Each Transferring Affiliate hereby covenants and agrees
    that, prior to the date which is one year and one day after the
    payment in full of all outstanding commercial paper or other
    indebtedness of any Conduit Investor, it will not institute
    against, or join any other Person in instituting against, such
    Conduit Investor any bankruptcy, reorganization, arrangement
    insolvency or liquidation proceedings or other similar
    proceeding under the laws of the United States or any state of
    the United States. Each Transferring Affiliate further covenants
    and agrees that, prior to the date which is one year and one day
    after the Collection Date, it will not institute against, or
    join any other Person in instituting against, the Purchaser any
    bankruptcy, reorganization, arrangement insolvency or
    liquidation proceedings or other similar proceeding under the
    laws of the United States or any state of the United States.

 

    13. No failure on the part of the Seller or any assignee
    thereof to exercise, and no delay in exercising, any right
    hereunder shall operate as a waiver thereof; nor shall any
    single or partial exercise of any right hereunder preclude any
    other or further exercise thereof or the exercise of any other
    right. The remedies herein provided are cumulative and not
    exclusive of any remedies provided by law.

 

    14. This Transferring Affiliate Letter shall be governed
    by, and construed in accordance with, the laws of the State of
    New York, except to the extent that the perfection of the
    interests of the Seller and its assigns, or remedies hereunder,
    in respect of the Receivables, any Related Security or any
    Collections in respect thereof, are governed by the laws of a
    jurisdiction other than the State of New York.

 

    15. The Seller and each of its assignees (including the
    Agent) is hereby authorized by each of the Transferring
    Affiliates and the Seller to demand specific performance of this
    Transferring Affiliate Letter at any time when any of the
    Transferring Affiliates or the Seller shall have failed to
    comply with any of the provisions of this Transferring Affiliate
    Letter applicable to any such Transferring Affiliate or the
    Seller. Each of the Transferring Affiliates and the Seller
    hereby irrevocable waives any defense based on the adequacy of a
    remedy at law, which might be asserted as a bar to such remedy
    of specific performance.

 

    16. This Transferring Affiliate Letter may be executed in
    any number of counterparts and by different parties hereto in
    separate counterparts, each of which when so executed shall be
    deemed to be an original and all of which when taken together
    shall constitute one and the same agreement.

 

    [Remainder
    of page intentionally left blank]
    

    

    6

 

    Very truly
    yours,
    

 

    ANGLETON DIALYSIS, INC.

    ARIZONA RENAL INVESTMENTS, LLC

    BIO-MEDICAL APPLICATIONS HOME DIALYSIS SERVICES, INC.

    BIO MEDICAL APPLICATIONS MANAGEMENT COMPANY, INC.

    BIO-MEDICAL APPLICATIONS OF ALABAMA, INC.

    BIO-MEDICAL APPLICATIONS OF ANACOSTIA, INC.

    BIO-MEDICAL APPLICATIONS OF AQUADILLA, INC.

    BIO-MEDICAL APPLICATIONS OF ARECIBO, INC.

    BIO-MEDICAL APPLICATIONS OF ARKANSAS, INC.

    BIO-MEDICAL APPLICATIONS OF BAYAMON, INC.

    BIO-MEDICAL APPLICATIONS OF BLUE SPRINGS, INC.

    BIO-MEDICAL APPLICATIONS OF CAGUAS, INC.

    BIO-MEDICAL APPLICATIONS OF CALIFORNIA, INC.

    BIO-MEDICAL APPLICATIONS OF CAMARILLO, INC.

    BIO-MEDICAL APPLICATIONS OF CAPITOL HILL, INC.

    BIO-MEDICAL APPLICATIONS OF CAROLINA, INC.

    BIO-MEDICAL APPLICATIONS OF CARSON, INC.

    BIO-MEDICAL APPLICATIONS OF CLINTON, INC.

    BIO-MEDICAL APPLICATIONS OF COLUMBIA HEIGHTS, INC.

    BIO-MEDICAL APPLICATIONS OF CONNECTICUT, INC.

    BIO-MEDICAL APPLICATIONS OF DELAWARE, INC.

    BIO-MEDICAL APPLICATIONS OF DOVER, INC.

    BIO-MEDICAL APPLICATIONS OF EAST ORANGE, INC.

    BIO-MEDICAL APPLICATIONS OF ESSEX, INC.

    BIO-MEDICAL APPLICATIONS OF EUREKA, INC.

    BIO-MEDICAL APPLICATIONS OF FAYETTEVILLE, INC.

    BIO-MEDICAL APPLICATIONS OF FLORIDA, INC.

    BIO-MEDICAL APPLICATIONS OF FREMONT, INC.

    BIO-MEDICAL APPLICATIONS OF FRESNO, INC.

    BIO-MEDICAL APPLICATIONS OF GEORGIA, INC.

    BIO-MEDICAL APPLICATIONS OF GLENDORA, INC.

    BIO-MEDICAL APPLICATIONS OF GUAYAMA, INC.

    BIO-MEDICAL APPLICATIONS OF HILLSIDE, INC.

    BIO-MEDICAL APPLICATIONS OF HOBOKEN, INC.

    BIO-MEDICAL APPLICATIONS OF HUMACAO, INC.

    BIO-MEDICAL APPLICATIONS OF ILLINOIS, INC.

    BIO-MEDICAL APPLICATIONS OF INDIANA, INC.

    BIO-MEDICAL APPLICATIONS OF IRVINGTON, INC.

    BIO-MEDICAL APPLICATIONS OF JERSEY CITY, INC.

    BIO-MEDICAL APPLICATIONS OF KANSAS, INC.

    BIO-MEDICAL APPLICATIONS OF KENTUCKY, INC.

    BIO-MEDICAL APPLICATIONS OF LAS AMERICAS, INC.

    BIO-MEDICAL APPLICATIONS OF LONG BEACH, INC.

    BIO-MEDICAL APPLICATIONS OF LOS GATOS, INC.

    BIO-MEDICAL APPLICATIONS OF LOUISIANA, LLC

    BIO-MEDICAL APPLICATIONS OF MAINE, INC.

    BIO-MEDICAL APPLICATIONS OF MANCHESTER, INC.

    BIO-MEDICAL APPLICATIONS OF MARYLAND, INC.

    BIO-MEDICAL APPLICATIONS OF MASSACHUSETTS, INC.

    BIO-MEDICAL APPLICATIONS OF MAYAGUEZ, INC.

    BIO-MEDICAL APPLICATIONS OF MICHIGAN, INC.

    

    7

 

    BIO-MEDICAL APPLICATIONS OF MINNESOTA, INC.

    BIO-MEDICAL APPLICATIONS OF MISSION HILLS, INC.

    BIO-MEDICAL APPLICATIONS OF MISSISSIPPI, INC.

    BIO-MEDICAL APPLICATIONS OF MISSOURI, INC.

    BIO-MEDICAL APPLICATIONS OF MLK, INC.

    BIO-MEDICAL APPLICATIONS OF NEVADA, INC.

    BIO-MEDICAL APPLICATIONS OF NEW HAMPSHIRE, INC.

    BIO-MEDICAL APPLICATIONS OF NEW JERSEY, INC.

    BIO-MEDICAL APPLICATIONS OF NEW MEXICO, INC.

    BIO-MEDICAL APPLICATIONS OF NORTH CAROLINA, INC.

    BIO-MEDICAL APPLICATIONS OF NORTHEAST, D.C., INC.

    BIO-MEDICAL APPLICATIONS OF OAKLAND, INC.

    BIO-MEDICAL APPLICATIONS OF OHIO, INC.

    BIO-MEDICAL APPLICATIONS OF OKLAHOMA, INC.

    BIO-MEDICAL APPLICATIONS OF PENNSYLVANIA, INC.

    BIO-MEDICAL APPLICATIONS OF PINE BROOK, INC.

    BIO-MEDICAL APPLICATIONS OF PONCE, INC.

    BIO-MEDICAL APPLICATIONS OF PUERTO RICO, INC.

    BIO-MEDICAL APPLICATIONS OF RHODE ISLAND, INC.

    BIO-MEDICAL APPLICATIONS OF RIO PIEDRAS, INC.

    BIO-MEDICAL APPLICATIONS OF SAN ANTONIO, INC.

    BIO-MEDICAL APPLICATIONS OF SAN GERMAN, INC.

    BIO-MEDICAL APPLICATIONS OF SAN JUAN, INC.

    BIO-MEDICAL APPLICATIONS OF SOUTH CAROLINA, INC.

    BIO-MEDICAL APPLICATIONS OF SOUTH QUEENS, INC.

    BIO-MEDICAL APPLICATIONS OF SOUTHEAST WASHINGTON, INC.

    BIO-MEDICAL APPLICATIONS OF TENNESSEE, INC.

    BIO-MEDICAL APPLICATIONS OF TEXAS, INC.

    BIO-MEDICAL APPLICATIONS OF THE DISTRICT OF COLUMBIA, INC.

    BIO-MEDICAL APPLICATIONS OF TRENTON, INC.

    BIO-MEDICAL APPLICATIONS OF UKIAH, INC.

    BIO-MEDICAL APPLICATIONS OF VIRGINIA, INC.

    BIO-MEDICAL APPLICATIONS OF WEST VIRGINIA, INC.

    BIO-MEDICAL APPLICATIONS OF WISCONSIN, INC.

    BIO-MEDICAL APPLICATIONS OF WOONSOCKET, INC.

    BRAZORIA KIDNEY CENTER, INC.

    BREVARD COUNTY DIALYSIS, LLC

    CARTERSVILLE DIALYSIS CENTER, LLC

    CLAYTON COUNTY DIALYSIS, LLC

    CLERMONT DIALYSIS CENTER, LLC

    COBB COUNTY DIALYSIS, LLC

    COLUMBUS AREA RENAL ALLIANCE, LLC

    CON MED SUPPLY COMPANY, INC.

    CONEJO VALLEY DIALYSIS, INC.

    COVINGTON DIALYSIS CENTER, LLC

    DIABETES CARE GROUP, INC.

    DIALYSIS AMERICA ALABAMA, LLC

    DIALYSIS AMERICA GEORGIA, LLC

    DIALYSIS ASSOCIATES OF NORTHERN NEW JERSEY, L.L.C.

    DIALYSIS ASSOCIATES, LLC

    DIALYSIS CENTERS OF AMERICA ILLINOIS, INC.

    DIALYSIS LICENSING CORP.

    DIALYSIS MANAGEMENT CORPORATION

    

    8

 

    DIALYSIS SERVICES OF ATLANTA, INC.

    DIALYSIS SERVICES OF CINCINNATI, INC.

    DIALYSIS SERVICES, INC.

    DIALYSIS SPECIALISTS OF TOPEKA, INC.

    DIALYSIS SPECIALISTS OF TULSA, INC.

    DOUGLAS COUNTY DIALYSIS, LLC

    DOYLESTOWN ACUTE RENAL SERVICES, L.L.C.

    DU PAGE DIALYSIS, LTD.

    EVEREST HEALTHCARE HOLDINGS, INC.

    EVEREST HEALTHCARE INDIANA, INC.

    EVEREST HEALTHCARE OHIO, INC.

    EVEREST HEALTHCARE RHODE ISLAND, INC.

    EVEREST HEALTHCARE TEXAS HOLDING CORP.

    EVEREST HEALTHCARE TEXAS, LP

    EVEREST MANAGEMENT, INC.

    FRESENIUS MEDICAL CARE DIALYSIS SERVICES

    COLORADO LLC (F/K/A BIO MEDICAL APPLICATIONS OF COLORADO, INC.)

    FRESENIUS MEDICAL CARE DIALYSIS SERVICES OREGON, LLC

    FMC DIALYSIS SERVICES-OREGON, LLC (F/K/A WILLAMETTE VALLEY
    KIDNEY CENTER, LLC)

    FMS NEW YORK, INC.

    FONDREN DIALYSIS CLINIC, INC.

    FORT SCOTT REGIONAL DIALYSIS CENTER, INC.

    FOUR STATE REGIONAL DIALYSIS CENTER, INC.

    FRESENIUS MANAGEMENT SERVICES, INC.

    FRESENIUS USA HOME DIALYSIS, INC.

    FRESENIUS USA MARKETING, INC.

    FRESENIUS USA SALES, INC.

    FRESENIUS USA, INC.

    GULF REGION MOBILE DIALYSIS, INC.

    HAEMO STAT, INC.

    HENRY DIALYSIS CENTER, LLC

    HOLTON DIALYSIS CLINIC, LLC

    HOME DIALYSIS OF AMERICA, INC.

    HOME DIALYSIS OF MUHLENBERG COUNTY, INC.

    HOME INTENSIVE CARE, INC.

    JEFFERSON COUNTY DIALYSIS, INC.

    KDCO, INC.

    KENTUCKY RENAL CARE GROUP, LLC

    LAWTON DIALYSIS, INC.

    LITTLE ROCK DIALYSIS, INC.

    MAUMEE DIALYSIS SERVICES, LLC

    MERCY DIALYSIS CENTER, INC.

    MIAMI REGIONAL DIALYSIS CENTER, INC.

    MICHIGAN HOME DIALYSIS CENTER, INC.

    NAPLES DIALYSIS CENTER, LLC

    NATIONAL MEDICAL CARE, INC.

    NATIONAL NEPHROLOGY ASSOCIATES

    MANAGEMENT COMPANY OF TEXAS, INC.

    NATIONAL NEPHROLOGY ASSOCIATES OF TEXAS, L.P.

    NEOMEDICA, INC.

    NNA MANAGEMENT COMPANY OF KENTUCKY, INC.

    NNA MANAGEMENT COMPANY OF LOUISIANA, INC.

    

    9

 

    NNA OF ALABAMA, INC.

    NNA OF EAST ORANGE, L.L.C.

    NNA OF FLORIDA, LLC

    NNA OF GEORGIA, INC.

    NNA OF HARRISON, L.L.C.

    NNA OF LOUISIANA, LLC

    NNA OF MEMPHIS, LLC

    NNA OF NEVADA, INC.

    NNA OF NEWARK, L.L.C.

    NNA OF OKLAHOMA, INC.

    NNA OF OKLAHOMA, L.L.C.

    NNA OF RHODE ISLAND, INC.

    NNA OF TOLEDO, INC.

    NNA PROPERTIES OF TENNESSEE, INC.

    NNA-SAINT BARNABAS LIVINGSTON, L.L.C.

    NNA-SAINT BARNABAS, L.L.C.

    NNA TRANSPORTATION SERVICES CORPORATION

    NORCROSS DIALYSIS CENTER, LLC

    NORTH BUCKNER DIALYSIS CENTER, INC.

    NORTHEAST ALABAMA KIDNEY CLINIC, INC.

    NORTHERN NEW JERSEY DIALYSIS, L.L.C.

    NORTHWEST DIALYSIS, INC.

    PHYSICIANS DIALYSIS COMPANY, INC.

    PRIME MEDICAL, INC.

    QUALICENTERS, INC.

    RCG ARLINGTON HEIGHTS, LLC

    RCG BLOOMINGTON, LLC

    RCG CREDIT CORPORATION

    RCG EAST TEXAS, LLP

    RCG FINANCE, INC.

    RCG INDIANA, L.L.C.

    RCG IRVING, LLP

    RCG MARION, LLC

    RCG MARTIN, LLC

    RCG MEMPHIS EAST, LLC

    RCG MEMPHIS, LLC

    RCG MISSISSIPPI, INC.

    RCG PA MERGER CORP.

    RCG UNIVERSITY DIVISION, INC.

    RCG WEST HEALTH SUPPLY, L.C.

    RCG WHITEHAVEN, LLC

    RCG/SAINT LUKE’S, LLC

    RCGIH, INC.

    RENAL CARE GROUP ALASKA, INC.

    RENAL CARE GROUP CENTRAL MEMPHIS, LLC

    RENAL CARE GROUP EAST, INC.

    RENAL CARE GROUP MICHIGAN, INC.

    RENAL CARE GROUP NORTHWEST, INC.

    RENAL CARE GROUP OF THE MIDWEST, INC.

    RENAL CARE GROUP OF THE OZARKS, LLC

    RENAL CARE GROUP OF THE SOUTH, INC.

    RENAL CARE GROUP OF THE SOUTHEAST, INC.

    RENAL CARE GROUP OHIO, INC.

    

    10

 

    RENAL CARE GROUP SOUTH NEW MEXICO, LLC

    RENAL CARE GROUP SOUTHWEST HOLDINGS, INC.

    RENAL CARE GROUP SOUTHWEST, L.P.

    RENAL CARE GROUP TEXAS, INC.

    RENAL CARE GROUP TEXAS, LP

    RENAL CARE GROUP WESTLAKE, LLC

    RENAL CARE GROUP, INC.

    RENAL SCIENTIFIC SERVICES, INC.

    RENALNET ARIZONA, INC.

    RENALNET, INC.

    RENALPARTNERS OF INDIANA, LLC

    RENALPARTNERS, INC.

    RENEX CORP.

    RENEX DIALYSIS CLINIC OF AMESBURY, INC.

    RENEX DIALYSIS CLINIC OF BLOOMFIELD, INC.

    RENEX DIALYSIS CLINIC OF BRIDGETON, INC.

    RENEX DIALYSIS CLINIC OF CREVE COEUR, INC.

    RENEX DIALYSIS CLINIC OF DOYLESTOWN, INC.

    RENEX DIALYSIS CLINIC OF MAPLEWOOD, INC.

    RENEX DIALYSIS CLINIC OF NORTH ANDOVER, INC.

    RENEX DIALYSIS CLINIC OF ORANGE, INC.

    RENEX DIALYSIS CLINIC OF PENN HILLS, INC.

    RENEX DIALYSIS CLINIC OF PHILADELPHIA, INC.

    RENEX DIALYSIS CLINIC OF PITTSBURGH, INC.

    RENEX DIALYSIS CLINIC OF SHALER, INC.

    RENEX DIALYSIS CLINIC OF SOUTH GEORGIA, INC.

    RENEX DIALYSIS CLINIC OF ST. LOUIS, INC.

    RENEX DIALYSIS CLINIC OF TAMPA, INC.

    RENEX DIALYSIS CLINIC OF UNION, INC.

    RENEX DIALYSIS CLINIC OF UNIVERSITY CITY, INC.

    RENEX DIALYSIS CLINIC OF WOODBURY, INC.

    RENEX DIALYSIS FACILITIES, INC.

    RENEX DIALYSIS HOMECARE OF GREATER ST. LOUIS, INC.

    RENEX MANAGEMENT SERVICES, INC.

    SAN DIEGO DIALYSIS SERVICES, INC.

    SANTA BARBARA COMMUNITY DIALYSIS CENTER

    SMYRNA DIALYSIS CENTER, LLC

    SPECTRA EAST, INC.

    SPECTRA LABORATORIES, INC.

    SSKG, INC.

    STAT DIALYSIS CORPORATION

    STONE MOUNTAIN DIALYSIS CENTER, LLC

    STUTTGART DIALYSIS, LLC

    TERRELL DIALYSIS CENTER, L.L.C.

    THREE RIVERS DIALYSIS SERVICES, LLC

    WEST PALM DIALYSIS, LLC

    WHARTON DIALYSIS, INC.

    WSKC DIALYSIS SERVICES, INC.

 

			
	 	    By 
	
        

    Name:      

			
	 	    Title: 
	

    

    11

 

    Acknowledged and accepted:

 

    NATIONAL MEDICAL CARE, INC.

 

			
	 	    By 
	
        

    Name:      

			
	 	    Title: 
	

 

    NMC FUNDING CORPORATION

 

			
	 	    By 
	
        

    Name:      

			
	 	    Title: 
	

 

    The undersigned acknowledges and accepts the foregoing, and
    hereby gives notice to each Transferring Affiliate that, for
    purposes of Section 9 of the Transferring Affiliate Letter,
    the address of the undersigned is WestLB AG, New York Branch.

 

    WestLB AG, New York Branch

      as Agent

 

			
	 	    By 
	
        

    Name:      

			
	 	    Title: 
	

 

			
	 	    By 
	
        

    Name:      

			
	 	    Title: 
	

    

    12

 

    EXHIBIT P

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORM OF
    PARENT AGREEMENT

 

    EXECUTION
    COPY

 

    AMENDED
    AND RESTATED PARENT AGREEMENT

 

    This AMENDED AND RESTATED PARENT AGREEMENT (this
    “Agreement”), dated as of October 16, 2008, made
    by FRESENIUS MEDICAL CARE HOLDINGS, INC., a New York corporation
    (“FMCH”), and FRESENIUS MEDICAL CARE AG &
    CO. KGaA, formerly known as Fresenius Medical Care AG, a
    partnership limited by shares organized and existing under the
    laws of the Federal Republic of Germany, and its successors and
    permitted assigns (“FME KGaA”) (FMCH and FME KGaA
    being hereinafter referred to, collectively, as the
    “Companies” and, each individually, as a
    “Company”), in favor of NMC FUNDING CORPORATION
    (“NMC Funding”) and WESTLB AG, NEW YORK BRANCH, as
    agent (the “Agent”) for the Investors under (as
    defined in) the Transfer and Administration Agreement referred
    to below.

 

    PRELIMINARY
    STATEMENTS:

 

    (1) National Medical Care, Inc., a Delaware corporation
    (“NMC”) has entered into that certain Amended and
    Restated Transferring Affiliate Letter (as the same may from
    time to time be amended, restated, supplemented or otherwise
    modified, the “Transferring Affiliate Letter”) dated
    as of even date herewith with each of the “Transferring
    Affiliates” named therein, under which each such
    Transferring Affiliate has agreed to sell and assign on each day
    hereafter all of its right, title and interest in and to each
    “Receivable” and all “Related Security”
    (each as defined therein) to NMC in accordance with the terms
    thereof.

 

    (2) NMC has entered into that certain Receivables Purchase
    Agreement (as the same may from time to time be amended,
    restated, supplemented or otherwise modified, the “BMA
    Transfer Agreement”) dated as of August 28, 1997 with
    Bio-Medical Management Company, Inc., a Delaware corporation
    (“BMA”), under which BMA has agreed to sell and assign
    on the date hereof all of its right, title and interest in and
    to each “Receivable” and all “Related
    Security” (each as defined therein) to NMC in accordance
    with the terms thereof.

 

    (3) NMC has entered into that certain Amended and Restated
    Receivables Purchase Agreement (as the same may from time to
    time be amended, restated, supplemented or otherwise modified,
    the “Receivables Agreement”) dated as of even date
    herewith with NMC Funding, under which NMC has agreed to sell
    and assign on each day hereafter all of its right, title and
    interest in and to each “Receivable” and all
    “Related Security” (each as defined therein),
    including, without limitation, all Receivables and Related
    Security acquired by NMC from the Transferring Affiliates under
    the Transferring Affiliate Letter and from BMA under the BMA
    Transfer Agreement, to NMC Funding in accordance with the terms
    thereof.

 

    (4) NMC Funding has entered into that certain Fourth
    Amended and Restated Transfer and Administration Agreement (as
    the same may from time to time be amended, restated,
    supplemented or otherwise modified, the “TAA”) dated
    as of even date herewith with NMC Funding, as
    “Transferor”, NMC, as the “Collection Agent”
    thereunder, certain “Bank Investors” from time to time
    party thereto and the Agent, under which NMC Funding shall from
    time to time sell and assign undivided percentage ownership
    interests in all “Receivables” and “Related
    Security” (each as defined therein), including, without
    limitation, in all Receivables and Related Security acquired by
    NMC Funding from NMC under the Receivables Agreement, to the
    Agent for the benefit of the Investors in accordance with the
    terms thereof. For purposes of this Agreement, the terms
    “Agent”, “Administrative Agent”,
    “Conduit Investor” and “Investor” shall have
    the meanings assigned to such terms under the TAA.

 

    (5) Certain Affiliates (each, a “Designated
    Account Agent”) of the Transferring Affiliates have
    entered, or may hereafter enter, into that certain
    Account Agent Agreement dated as of August 28, 1997 or
    an agreement in substantially the form of such
    Account Agent Agreement (collectively, and as the same may
    from time to time be amended, restated, supplemented or
    otherwise modified, the “Account Agent
    Agreement”), under which such Designated
    Account Agents agree to certain matters relating to the
    handling of Collections on Receivables originated by
    Transferring Affiliates and remitted to “Special
    Accounts” maintained by such Designated Account Agents.

 

    (6) FME KGaA owns all of the issued and outstanding common
    stock of FMCH, and FME KGaA or one of its wholly-owned
    Subsidiaries owns, directly or indirectly, all of the issued and
    outstanding shares of capital stock of

    

    1

 

    each Transferring Affiliate, BMA, each Designated
    Account Agent and NMC. It is a condition precedent to the
    effectiveness of each of the Receivables Agreement and the TAA
    that each of FME KGaA and FMCH enters into this Agreement.

 

    (7) NMC, the Transferring Affiliates (as such group is from
    time to time comprised), BMA and the Designated
    Account Agents (as such group is from time to time
    comprised) are herein sometimes referred to collectively as the
    “Parent Group Members” or any such Person individually
    as a “Parent Group Member”. The Receivables Agreement,
    the Transferring Affiliate Letter, the BMA Transfer Agreement,
    the Account Agent Agreement and each of the other
    instruments, documents and agreements executed in connection
    therewith are herein sometimes referred to collectively as the
    “Transaction Documents”. The terms
    “Receivable” and “Related Security”, and
    other terms that are used herein and not otherwise defined
    herein, shall have the meanings assigned under the Receivables
    Agreement.

 

    (8) FMCH and FME KGaA are parties to that certain Parent
    Agreement dated as of August 28, 1997 (as amended prior to
    the date hereof, the “Existing Parent
    Agreement”), which the parties hereto desire to amend
    and restate in its entirety.

 

    NOW, THEREFORE, the parties hereby agree as follows:

 

    Section 1.  Unconditional
    Undertaking.  Each Company hereby
    unconditionally and irrevocably undertakes and agrees with and
    for the benefit of NMC Funding, the Investors, the
    Administrative Agents and the Agent to cause the due and
    punctual performance and observance by each of the Parent Group
    Members with each of such Parent Group Member’s obligations
    under the Transaction Documents, including, without limitation:
    (i) by NMC and its successors and assigns of all of the
    terms, covenants, conditions, agreements and undertakings on the
    part of NMC (whether as seller, collection agent or otherwise)
    to be performed or observed by it under the Receivables
    Agreement or any other document delivered in connection with the
    Receivables Agreement, (ii) by each Transferring Affiliate
    and its successors and assigns of all of the terms, covenants,
    conditions, agreements and undertakings on the part of such
    Transferring Affiliate to be performed and observed under the
    Transferring Affiliate Letter, (iii) by BMA, and its
    successors and assigns of all of the terms, covenants,
    conditions, agreements and undertakings on the part of BMA to be
    performed and observed under the BMA Transfer Agreement, and
    (iv) by each Designated Account Agent and its
    successors and assigns of all of the terms, covenants,
    conditions, agreements and undertakings on the part of such
    Designated Account Agent to be performed under the
    Account Agent Agreement, in each case under
    clauses (i), (ii), (iii) and (iv) above in
    accordance with the terms thereof, including, without
    limitation, each indemnity and each other agreement of any
    Parent Group Member to pay or deposit any money under any
    Transaction Document (all such terms, covenants, conditions,
    agreements and undertakings on the part of the Parent Group
    Members to be performed or observed being, collectively, the
    “Obligations”).

 

    In the event that any Parent Group Member shall fail to perform
    or observe any of the Obligations when the same shall be
    required to be performed or observed under any Transaction
    Document, then each Company will itself (to the fullest extent
    permitted by law) duly and punctually perform or observe, or
    cause to be duly and punctually performed or observed, such
    Obligation, and it shall not be a condition to the accrual of
    the obligation of any Company hereunder to perform or observe,
    or cause the performance or observance of, any Obligation that
    NMC Funding, any Investor, any Administrative Agent or the Agent
    shall have first made any request of or demand upon or given any
    notice to any Company or to any Parent Group Member or their
    respective successors or assigns, or have instituted any action
    or proceeding against any Company or any Parent Group Member or
    their respective successors or assigns in respect thereof;
    provided that no Company shall be required to make any payment
    hereunder without ten days prior notice from NMC Funding, an
    Investor or the Agent.

 

    Section 2.  Obligation
    Absolute.  Each Company will perform its
    obligations under this Agreement regardless of any law, rule,
    regulation or order now or hereafter in effect in any
    jurisdiction affecting any of the terms of any Transaction
    Document, or the rights of NMC Funding, any Investor, any
    Administrative Agent or the Agent with respect thereto. The
    obligations of each Company under this Agreement are independent
    of the Obligations, and a separate action or actions may be
    brought and prosecuted against any Company to enforce this
    Agreement, irrespective of whether any action is brought against
    any Parent Group Member or whether any Parent

    

    2

 

    Group Member is joined in any such action or actions. The
    liability of each Company under this Agreement shall be absolute
    and unconditional irrespective of:

 

    (i) any lack of validity or enforceability of any
    Transaction Document;

 

    (ii) any change in the time, manner or place of payment of,
    or in any other term of, all or any of the Obligations, or any
    other amendment or waiver of or any consent to departure from
    the Transaction Documents;

 

    (iii) any taking, exchange, release or non-perfection of
    any security interest, or any taking, release or amendment or
    waiver of or consent to departure from any Related Security or
    other agreement relating to all or any of the Obligations;

 

    (iv) any manner of application by any Parent Group Member
    or any subsidiary or affiliate thereof of any Collections to all
    or any of the Obligations, or any manner of collection from or
    disposition of any Receivable or Related Security or any
    interest therein;

 

    (v) any change, restructuring or termination of the
    corporate structure or existence of any Company or any Parent
    Group Member;

 

    (vi) any failure of any Parent Group Member or any Company
    to obtain any authorization or approval from or other action by,
    or to notify or file with, any governmental authority or
    regulatory body required in connection with this Agreement, the
    Receivables Agreement or any Transaction Document;

 

    (vii) any impossibility or impracticality of performance,
    illegality, force majeure, any act of any government, or any
    other circumstance which might constitute a defense available
    to, or a discharge of any Parent Group Member or any Company;

 

    (viii) with respect to any Company, the release by NMC
    Funding, any Investor, any Administrative Agent or the Agent of
    the other Company from any or all of its obligations hereunder,
    the unenforceability of this Agreement as against such other
    Company or the release of any other guarantor in respect of its
    obligations; or

 

    (ix) any other circumstance which might otherwise
    constitute a defense available to, or a discharge of, any Parent
    Group Member or a guarantor.

 

    This Agreement shall continue to be effective or be reinstated,
    as the case may be, if at any time any payment by any Parent
    Group Member under any Transaction Document is rescinded or must
    otherwise be returned by NMC Funding, any Investor, any
    Administrative Agent or the Agent, upon the insolvency,
    bankruptcy or reorganization of any Parent Group Member or
    otherwise, all as though such payment had not been made. The
    obligations of each Company under this Agreement shall not be
    subject to reduction, termination or other impairment by reason
    of any set-off, recoupment, counterclaim or defense or for any
    other reason. The obligations of each Company under this
    Agreement shall not be discharged except by performance as
    herein provided.

 

    Section 3.  Waiver.  Each
    Company hereby waives promptness, diligence, notice of
    acceptance and any other notice with respect to any of the
    Obligations and this Agreement or any Transaction Document and
    any requirement that NMC Funding, any Investor, any
    Administrative Agent or the Agent protect, secure, perfect or
    insure any security interest or lien or any property subject
    thereto or exhaust any right or take any action against any
    Company or any Parent Group Member or any security interest.

 

    Section 4.  Waiver
    of Subrogation and Contribution.  Each Company
    hereby irrevocably waives any claim or other rights that it may
    now or hereafter acquire against any Parent Group Member that
    arise from the existence, payment, performance or enforcement of
    such Company’s obligations under this Agreement, including,
    without limitation, any right of subrogation, reimbursement,
    exoneration, contribution or indemnification and any right to
    participate in any claim or remedy of NMC Funding, any Investor,
    any Administrative Agent or the Agent against any Parent Group
    Member or any security interest that NMC Funding, any Investor,
    any Administrative Agent or the Agent hereafter acquires,
    whether or not such claim, remedy or right arises in equity or
    under contract, statute or common law, including, without
    limitation, the right to take or receive from any Parent Group
    Member, directly or indirectly, in cash or other property or by
    set-off or in any other manner, payment or security in account
    of such claim, remedy or right. If any amount shall be paid to
    any Company in violation of the preceding sentence at any

    

    3

 

    time prior to the later of (x) the payment in full of the
    Obligations and all other amounts payable under this Agreement
    and (y) the payment in full of all “Aggregate
    Unpaids” (as defined in the TAA), following the
    “Termination Date” (as defined in the TAA), such
    amount shall be held in trust for the benefit of NMC Funding,
    each Investor, each Administrative Agent and the Agent and shall
    forthwith be paid to the Agent to be credited and applied to the
    Obligations and all other amounts payable under this Agreement,
    whether matured or unmatured, in accordance with the terms of
    the TAA, the applicable Transaction Document and this Agreement,
    or to be held by the Agent as collateral security for any
    Obligations or other amounts payable under this Agreement
    thereafter arising. Each Company acknowledges that it will
    receive direct and indirect benefits from the receivables
    purchase arrangements contemplated by the Transaction Documents
    and that the waiver set forth in this Section 4 is
    knowingly made in contemplation of such benefits.

 

    Section 5.  Representations
    and Warranties.  Each Company hereby
    represents and warrants as follows:

 

    (a) Such Company is, in the case of FMCH, a corporation
    duly incorporated and, in the case of FME KGaA, an entity duly
    organized, in each case validly existing and in good standing
    under the laws of the jurisdiction in which it is organized and
    existing, and is duly qualified to do business and is in good
    standing in every jurisdiction where the nature of its business
    requires it to be so qualified, except where the failure to be
    so qualified would not have a Material Adverse Effect.

 

    (b) The execution, delivery and performance by such Company
    of this Agreement (i) are within such Company’s
    corporate powers, (ii) have been duly authorized by all
    necessary corporate action, and (iii) do not contravene
    (A) such Company’s charter or by-laws or similar
    organizational documents or (B) any law, rule or regulation
    applicable to such Company, or any of its subsidiaries or
    properties, and (iv) do not contravene or require any
    consent, approval or notice under any provision of any
    indenture, loan agreement or credit agreement or any other
    agreement, lease or instrument to which such Company or any of
    its subsidiaries is a party or by which such Company or any of
    its subsidiaries or properties may be bound or affected, except
    for any such consents and approvals that have been obtained and
    notices that have been given.

 

    (c) No authorization or approval or other action by, and no
    notice to or filing with, any governmental authority or
    regulatory body is required for the due execution, delivery and
    performance by such Company of this Agreement.

 

    (d) This Agreement constitutes the legal, valid and binding
    obligation of such Company enforceable against such Company in
    accordance with its terms, except as may be limited by the
    effect of any applicable bankruptcy, insolvency, reorganization,
    moratorium or similar laws affecting creditors’ rights
    generally and by general principles of equity.

 

    (e) Except as set forth in Exhibit F to the
    Receivables Agreement, there is no pending or threatened action
    or proceeding against or affecting such Company or its
    properties before any court, governmental agency or arbitrator
    which would have a Material Adverse Effect.

 

    (f) The consolidated balance sheet of FME KGaA and its
    subsidiaries as at December 31, 2007, and the related
    consolidated statements of income and of cash flow of FME KGaA
    and its subsidiaries for the fiscal year then ended, copies of
    which have been furnished to the Agent, fairly present the
    consolidated financial condition of FME KGaA and its
    subsidiaries as at such date and the results of the operations
    of FME KGaA and its subsidiaries for the period ended on such
    date, all in accordance with generally accepted accounting
    principles consistently applied, and since December 31,
    2007, no event has occurred which would have a Material Adverse
    Effect.

 

    (g) Each financial statement and financial book, record, or
    report or information (collectively, “Financial
    Documents”) or other document, book, record or report or
    information (collectively, “Other Documents”)
    furnished or to be furnished in writing at any time by such
    Company to NMC Funding, any Investor or the Agent, in connection
    with this Agreement is or will be (i) in the case of each
    such Financial Document, prepared in accordance with generally
    accepted accounting principles consistently applied, except as
    stated therein and subject in the case of any quarterly
    financial statement to year-end audit adjustments and to the
    abbreviation of any such financial statement and incompleteness
    of the footnotes contained therein, or (ii) in the case of
    such Other Documents, accurate in all material respects, in each
    case, as of its date or (except as

    

    4

 

    otherwise disclosed to NMC Funding, the Investors or the Agent,
    as the case may be, at such time) as of the date so furnished,
    and no such Financial Document or Other Document, to the best of
    such Company’s knowledge, contains or will contain any
    untrue statement of a material fact or omits or will omit to
    state a material fact necessary in order to make the statements
    contained therein, in the light of the circumstances under which
    they were made, not misleading.

 

    (h) All of the issued and outstanding common stock of (such
    stock being more than 80% of all voting stock of) FMCH is and
    will continue to be owned directly or indirectly by FME KGaA.

 

    (i) There are no conditions precedent to the effectiveness
    of this Agreement that have not been satisfied or waived.

 

    (j) No Termination Event or Potential Termination Event
    (each as defined in the TAA) has occurred and is continuing.

 

    (k) The execution, delivery and performance by each Parent
    Group Member of each Transaction Document to which it is named
    as a party and the transactions contemplated thereby do not
    contravene any provision of any indenture, loan agreement,
    credit agreement, or other agreement, lease or instrument to
    which any Company is a party or by which such Company or its
    properties may be bound or affected.

 

    (1) Each representation and warranty from time to time made
    or deemed made by any Parent Group Member under or in connection
    with any Transaction Document with respect to such Company or
    any Parent Group Member shall be true and correct in all
    material respects.

 

    Section 6.  Covenants.  (a) Each
    Company covenants and agrees that, as long as any Aggregate
    Unpaids shall be outstanding under the TAA, it will, unless the
    Agent and each Administrative Agent shall otherwise consent in
    writing:

 

    (i) Compliance with Laws,
    Etc.  Comply with the applicable laws, rules,
    regulations and orders with respect to it, its business and
    properties other than such provisions noncompliance with which
    would not have a Material Adverse Effect.

 

    (ii) Preservation of Corporate
    Existence.  Preserve and maintain its
    corporate existence, rights, franchises and privileges in the
    jurisdiction of its incorporation, and qualify and remain
    qualified in good standing as a foreign corporation in each
    jurisdiction where the failure to preserve and maintain such
    existence, rights, franchises, privileges and qualification
    would have a Material Adverse Effect.

 

    (iii) Maintenance of
    Ownership.  FME KGaA will maintain ownership,
    directly or indirectly, free and clear of any Adverse Claim,
    (other than a pledge made pursuant to the FME KGaA Credit
    Facility and put/call agreements, forward agreements or other
    similar arrangements among FME KGaA and its subsidiaries), of
    100% of the common stock of, and more than 80% of the
    outstanding voting stock of, FMCH and FMCH will maintain
    ownership, directly or indirectly, of all of the outstanding
    shares of stock of each Parent Group Member; provided that FME
    KGaA may own directly or indirectly stock that is not Voting
    Stock in subsidiaries of FMCH.

 

    (iv) Reporting
    Requirements.  Furnish to the Agent and each
    Administrative Agent:

 

    (A) As soon as available, but in the event within
    95 days after the end of each fiscal year of such Company,
    audited consolidated balance sheets of such Company and its
    Subsidiaries as of the end of such fiscal year and the related
    audited consolidated statements of income, retained earnings,
    shareholders’ equity and cash flows for such fiscal year,
    in each case audited by KPMG Peat Marwick LLP, KPMG Deutsche
    Treuhand Gesellschaft or other firm of independent certified
    public accountants of nationally recognized standing reasonably
    acceptable to the Agent and each Administrative Agent, setting
    forth in each case in comparative form the figures for the
    previous year, reported on without a “going concern”
    or like qualification or exception, or qualification indicating
    that the scope of the audit was inadequate to permit such
    independent certified public accountants to certify such
    financial statements without such qualification;

    

    5

 

 

    (B) As soon as available and in any event within
    50 days after the end of each of the first three fiscal
    quarters of such Company, (1) in the case of FMCH, a
    company-prepared consolidated balance sheet of such Company and
    its Subsidiaries as of the end of such quarter and the related
    company-prepared consolidated statements of income and retained
    earnings for such quarterly period and cash flows for the fiscal
    year to date and (2) in the case of FME KGaA,
    company-prepared consolidated balance sheet of FME KGaA and its
    Subsidiaries as of the end of the quarter and the related
    company-prepared consolidated statements of income and retained
    earnings for such quarterly period setting forth in each case in
    comparative form the figures for the previous year for such
    period;

 

    in each case setting forth in comparative form the consolidated
    (and consolidating, if applicable) figures for the corresponding
    period or periods of the preceding fiscal year or the portion of
    the fiscal year ending with such period, as applicable (but not
    for any period prior to September 27, 1996), in each case
    subject to normal recurring year-end audit adjustments. All such
    financial statements shall be complete and correct in all
    material respects (subject, in the case of interim statements,
    to normal recurring year-end audit adjustments) and to be
    prepared in reasonable detail and, in the case of the annual and
    quarterly financial statements provided in accordance with
    subsections (a) and (b) above, in accordance with GAAP
    applied consistently throughout the periods reflected therein
    (except as approved by such accountants and disclosed therein);

 

    (C) Promptly upon the furnishing thereof to the
    shareholders of such Company, copies of all financial
    statements, reports and proxy statements so furnished;

 

    (D) Promptly upon the filing thereof, copies of all
    registration statements and annual , quarterly, monthly or other
    regular reports which such Company or any Subsidiary files with
    the Securities and Exchange Commission;

 

    (E) Within five (5) Business Days after the date of
    any change in its public or private debt ratings, if any, a
    written certification of its public and private debt ratings
    after giving effect to such change; and

 

    (F) such other information respecting the conditions or
    operations, financial or otherwise, of such Company or any of
    its subsidiaries as the Agent or any Administrative Agent may
    from time to time reasonably request.

 

    (v) Financial Covenants.  Ensure
    that:

 

    (A) Consolidated Leverage
    Ratio.  As of the end of each fiscal quarter,
    the Consolidated Leverage Ratio will not exceed:

 

	 	 	 	 	 
	
 
	
 
	
    Maximum

    

	
 
	
 
	
    Consolidated

    

	
    Fiscal Quarters Ending
	
 
	
    Leverage Ratio

	 

	

    December 31, 2007 and December 30, 2008

	
 
	
 
	
    4.00:1.00
	
 

	

    December 31, 2008 and December 30, 2009

	
 
	
 
	
    3.50:1.00
	
 

	

    December 31, 2009 and thereafter

	
 
	
 
	
    3.00:1.00
	
 

 

    (B) Consolidated Fixed Charge Coverage
    Ratio.  As of the end of each fiscal quarter,
    the Consolidated Fixed Charge Coverage Ratio will not be less
    than 1.20:1.00.

 

    For purposes of this Section 6(a)(v), the terms
    “Consolidated Leverage Ratio,” and “Consolidated
    Fixed Charge Coverage Ratio” shall have the meanings
    specified in the FME KGaA Credit Facility (as defined in the
    TAA) as in effect on the initial effective date thereof, but
    without giving effect to any amendment, waiver, termination,
    renewal, refunding, replacement, refinancing or other
    modification to the FME KGaA Credit Facility made after such
    effective date.”

 

    (b) Each Company acknowledges that the Investors, the
    Administrative Agents and the Agent are entering into the
    transactions contemplated by the TAA in reliance upon the
    identity of NMC Funding as a separate legal entity from each
    Parent Group Member, the Companies and their other subsidiaries
    and affiliates (collectively, excluding NMC Funding, the
    “Parent Group”). Each Company shall, and shall cause
    the Parent Group to, refrain from taking any action that would
    suggest to any creditor of any entity within the Parent Group
    that NMC Funding

    

    6

 

    and such entity within the Parent Group are anything other than
    separate legal entities. Neither Company shall hold out any
    entity within the Parent Group to third parties as liable for
    the debts of NMC Funding, and neither Company shall at any time
    represent to any Person that any entity within the Parent Group
    owns any interest in the Receivables or any of the other assets
    intended to have been acquired by NMC Funding under the
    Receivables Agreement.

 

    Section 7.  Amendments,
    Etc.  No amendment or waiver of any provision
    of this Agreement, and no consent to any departure by any
    Company herefrom, shall in any event be effective unless the
    same shall be in writing and signed by NMC Funding, the Agent,
    each Administrative Agent and each Company (or, in the case of
    waiver, by the party or parties waiving any such provision) and
    then such amendment, waiver or consent shall be effective only
    in the specific instance and for the specific purpose for which
    given.

 

    Section 8.  Addresses
    for Notices.  All notices and other
    communications provided for hereunder shall be in writing
    (including telecopier, telegraphic or cable communication) and
    mailed, telecopied, telegraphed, cabled or delivered to it, if
    to (i) FME KGaA, at its address at
    Else-Kröner-Strasse 1, 61352 Bad Homburg v.d.H.,
    Germany, Attention: Dr. Rainer Runte, (ii) FMCH, at
    its address at 920 Winter Street, Waltham, Massachussetts 02451,
    Attention: Mark Fawcett, (iii) NMC Funding, at its address
    at 920 Winter Street, Waltham, Massachusetts 02451 and
    (iv) if to the Agent, at its address specified in the TAA
    or, as to any party, at such other address as shall be
    designated by such party in a written notice to each other
    party. All such notices and other communications shall, when
    mailed, telecopied, telegraphed or cabled, be effective when
    deposited in the mails, telecopied, delivered to the telegraph
    company or delivered to the cable company, respectively.

 

    Section 9.  No
    Waiver, Remedies.  No failure on the part of
    NMC Funding, any Investor or the Agent to exercise, and no delay
    in exercising, any right hereunder shall operate as a waiver
    thereof; nor shall any single or partial exercise of any right
    hereunder preclude any other or further exercise thereof or the
    exercise of any other right. The remedies herein provided are
    cumulative and not exclusive of any remedies provided by law.

 

    Section 10.  Continuing
    Agreement; Assignments under Agreement.  This
    Agreement is a continuing agreement and shall (i) remain in
    full force an effect until the later of the Termination Date
    under the TAA and the date on which no Aggregate Unpaids
    thereunder shall be outstanding and no amount owed by NMC under
    the Receivables Agreement shall remain unpaid, (ii) be
    binding upon each Company and its successors and assigns and
    (iii) inure to the benefit of, and be enforceable by each
    of NMC Funding, each Investor and the Agent and their respective
    successors, transferees and assigns. Without limiting the
    generality of the foregoing clause (iii), any Investor, any
    Administrative Agent or the Agent may assign any of its rights
    under this Agreement to any assignee, and such assignee shall
    thereupon become vested with all the benefits in respect thereof
    granted to such Investor or the Agent, as applicable, herein or
    otherwise.

 

    Section 11.  Joint
    and Several Liability.  The liabilities and
    obligations of the Companies under this Agreement shall be joint
    and several.

 

    Section 12.  Taxes.  (a) Any
    and all payments by any of the Companies hereunder shall be made
    free and clear of and without deduction for any and all present
    or future taxes, levies, imposts, deductions, charges or
    withholdings, and all liabilities with respect thereto,
    excluding taxes imposed on net income and all income and
    franchise taxes of the United States and any political
    subdivisions thereof (all such non-excluded taxes, levies,
    imposts, deductions, charges, withholding and liabilities being
    hereinafter referred to as “Taxes”). If any of the
    Companies shall be required by law to deduct any Taxes from or
    in respect of any sum payable hereunder, (i) the sum
    payable shall be increased as may be necessary so that after
    making all required deductions (including deductions applicable
    to additional sums payable under this Section 12) NMC
    Funding, any affected Investor and the Agent receives an amount
    equal to the sum it would have received had no such deductions
    been made, (ii) such Company shall make such deductions and
    (iii) such Company shall pay the full amount deducted to
    the relevant taxation authority or other authority in accordance
    with applicable law.

 

    (b) In addition, each Company agrees to pay any present or
    future stamp or documentary taxes or any other excise or
    property taxes, charges or similar levies which arise from any
    payment made hereunder or from the execution, delivery or
    registration of, or otherwise with respect to, this Agreement
    (hereinafter referred to as “Other Taxes”).

    

    7

 

 

    (c) Each Company will indemnify NMC Funding, any affected
    Investor, any affected Administrative Agent and the Agent, for
    the full amount of Taxes or Other Taxes (including, without
    limitation, any Taxes or Other Taxes imposed by any jurisdiction
    or amounts payable under this Section 12) paid by NMC
    Funding, any affected Investor, any affected Administrative
    Agent and the Agent or any liability (including penalties,
    interest and expenses) arising therefrom or with respect thereto.

 

    Section 13.  Judgment.  (a) If
    for the purposes of obtaining judgment in any court it is
    necessary to convert a sum due hereunder in lawful money of the
    United States (“Dollars”) into another currency, the
    parties hereto agree, to the fullest extent that they may
    effectively do so, that the rate of exchange used shall be that
    at which in accordance with normal banking procedures that the
    Agent would purchase Dollars with such other currency in New
    York, New York on the Business Day preceding that on which final
    judgment is given.

 

    (b) The obligation of each Company in respect of any sum
    due from it to NMC Funding, any Investor, any Administrative
    Agent or the Agent hereunder shall, notwithstanding any judgment
    in a currency other than Dollars, be discharged only to the
    extent that on the Business Day following receipt by NMC
    Funding, such Investor, such Administrative Agent or the Agent,
    as applicable, of any sum adjudged to be so due in such other
    currency such Person may in accordance with normal banking
    procedures purchase Dollars with such other currency; if the
    Dollars so purchased are less than the sum originally due to
    such Person in Dollars, such Company agrees, as a separate
    obligation and notwithstanding any such judgment, to indemnify
    such Person against such loss, and if the Dollars so purchased
    exceed the sum originally due to such Person in Dollars, such
    Person agrees to remit to such Company such excess.

 

    (c) To the extent that any Company has or hereafter may
    acquire any immunity from jurisdiction of any court or from any
    legal process (whether through service or notice, attachment
    prior to judgment, attachment in aid of execution, execution or
    otherwise) with respect it or its property, such Company hereby
    irrevocably waives such immunity in respect of its obligations
    under this Agreement and, without limiting the generality of the
    foregoing, each Company agrees that the waivers set forth in
    this Agreement shall have the fullest scope permitted under the
    Foreign Sovereign Immunities Act of 1976 of the United States
    and are intended to be irrevocable for purposes of such Act.

 

    Section 14.  Consent
    to Jurisdiction.  (a) Each Company hereby
    irrevocably submits to the jurisdiction of any New York State or
    Federal court sitting in New York City and any appellate court
    from any thereof in any action or proceeding arising out of or
    relating to this Agreement, and each Company hereby irrevocably
    agrees that all claims in respect of such action or proceeding
    may be heard and determined in such New York State court or in
    such Federal court. Each Company hereby irrevocably waives, to
    the fullest extent it may effectively do so, the defense of an
    inconvenient forum to the maintenance of such action or
    proceeding. Each Company hereby irrevocably appoints Arent Fox
    LLP, located at 1675 Broadway, New York, New York 10019 (the
    “Process Agent”), as its agent to receive on behalf of
    such Company and its property service of copies of the summons
    and compliant and any other process which may be served in any
    such action or proceeding. Such service may be made by mailing
    or delivering a copy of such process to each Company in care of
    the Process Agent at the Process Agent’s above address, and
    each Company hereby irrevocably authorizes and directs the
    Process Agent to accept such service on its behalf. As an
    alternative method of service, each Company also irrevocably
    consents to the services of any and all process in any such
    action or proceeding by the mailing of copies of such process to
    such Company at its address specified in Section 8. Each
    Company agrees that a final judgment in any such action or
    proceeding shall be conclusive and may be enforced in other
    jurisdictions by suit on the judgment or in any other manner
    provided by law, to the extent permitted by law.

 

    (b) Nothing in this Section 14 shall affect the right
    of NMC Funding, any Investor or the Agent, to serve legal
    process in any other manner permitted by law or affect the right
    of NMC Funding, any Investor or the Agent, to bring any action
    or proceeding against any Company or its property in the courts
    of other jurisdictions.

 

    Section 15.  Governing
    Law.  This Agreement shall be governed by, and
    construed in accordance with, the laws of the State of New York.

 

    Section 16.  Covenant
    not to Institute Bankruptcy Proceedings.  Each
    Company agrees that, so long as any commercial paper notes or
    other indebtedness issued by a Conduit Investor shall be
    outstanding or there shall not

    

    8

 

    have elapsed one year plus one day since the last day on which
    any such commercial paper shall have been outstanding, it will
    not institute against a Conduit Investor any proceeding seeking
    to adjudicate a Conduit Investor a bankrupt or insolvent, or
    seeking liquidation, winding up, reorganization, arrangement,
    adjustment, protection, relief, or composition of a Conduit
    Investor or its debts under any law relating to bankruptcy,
    insolvency or reorganization or relief of debtors, or seeking
    the entry of an order for relief or the appointment of a
    receiver, trustee, or other similar official for it or for any
    substantial part of its property.

 

    Section 17.  Execution
    in Counterparts.  This Agreement may be
    executed in any number of counterparts and by different parties
    hereto in separate counterparts, each of which when so executed
    shall be deemed to be an original and all of which when taken
    together shall constitute one and the same agreement.

 

    Section 18.  Amendment
    and Restatement.  This Agreement amends and
    restates the Existing Parent Agreement in its entirety. This
    Agreement is not intended to constitute a novation of the
    Existing Parent Agreement. Upon the effectiveness of this
    Agreement (the “Effective Date”), each
    reference to the Existing Parent Agreement in any other
    document, instrument or agreement executed
    and/or
    delivered in connection therewith shall mean and be a reference
    to this Agreement.

 

    [Remainder
    of Page Intentionally Left Blank]
    

    

    9

 

    IN WITNESS WHEREOF, each Company has caused this Agreement to be
    duly executed and delivered by its officer thereunto duly
    authorized as of the date first above written.

 

    FRESENIUS MEDICAL CARE AG & Co. KGaA

    By Fresenius Medical Care

    Management AG (General Partner)

 

			
	 	    By: 
	
        

    Name:      

			
	 	    Title: 
	

 

    FRESENIUS MEDICAL CARE HOLDINGS, INC.

 

			
	 	    By: 
	
        

    Name:      

			
	 	    Title: 
	

 

    Accepted and
    Agreed as of

    the date first above written:
    

 

    NMC FUNDING CORPORATION

 

			
	    By: 
	
        

	 

    Name:      

				
	 	    Title: 
	

	 

 

    WESTLB AG, NEW YORK BRANCH,

      as Agent

 

			
	    By: 
	
        

	 

    Name:      

				
	 	    Title: 
	

	 

 

			
	    By: 
	
        

	 

    Name:      

				
	 	    Title: 
	

	 

 

    Signature
    Page to the Amended and Restated

    Parent Agreement dated as of October 16, 2008

    

    10

 

    EXHIBIT Q

    to

    FOURTH AMENDED AND RESTATED

    TRANSFER AND ADMINISTRATION AGREEMENT

    

    LIST OF TRANSFERRING AFFILIATES

 

	 	 	 
	
    Chief Executive Office for each

    Transferring Affiliate:
	
 
	
    920 Winter Street

    Waltham, Massachusetts 02451-1457

 

	 	 	 	 	 
	
    Original Transferring Affiliates

    
	
 
	
 

	
    (before October 19, 2006)
	
 
	
    State of Incorporation

	 

	

    Bio-Medical Applications Home Dialysis Services, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications Management Company, Inc

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Alabama, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Anacostia, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Aquadilla, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Arecibo, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Arkansas, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Bayamon, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Blue Springs, Inc

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Caguas, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of California, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Camarillo, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Capitol Hill, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Carolina, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Carson, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Clinton, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Columbia Heights, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Connecticut, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Delaware, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Dover, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Eureka, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Fayetteville, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Florida, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Fremont, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Fresno, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Georgia, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Glendora, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Guayama, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Hoboken, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Humacao, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Illinois, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Indiana, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Kansas, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Kentucky, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Las Americas, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Long Beach, Inc. 

	
 
	 
	
    Delaware
	 

    

    1

 

	 	 	 	 	 
	
    Original Transferring Affiliates

    
	
 
	
 

	
    (before October 19, 2006)
	
 
	
    State of Incorporation

	 

	

    Bio-Medical Applications of Los Gatos, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Louisiana, LLC

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Maine, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Manchester, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Maryland, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Massachusetts, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Mayaguez, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Michigan, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Minnesota, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Mission Hills, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Mississippi, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Missouri, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of MLK, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Nevada, Inc

	
 
	 
	
    Nevada
	 

	

    Bio-Medical Applications of New Hampshire, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of New Jersey, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of New Mexico, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of North Carolina, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Northeast, D.C., Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Oakland, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Ohio, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Oklahoma, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Pennsylvania, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Ponce, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Puerto Rico, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Rhode Island, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Rio Piedras, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of San Antonio, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of San German, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of San Juan, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of South Carolina, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Southeast Washington, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Tennessee, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Texas, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of The District of Columbia, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Ukiah, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Virginia, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of West Virginia, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Wisconsin, Inc. 

	
 
	 
	
    Delaware
	 

	

    Bio-Medical Applications of Woonsocket, Inc. 

	
 
	 
	
    Delaware
	 

	

    Dialysis America Alabama, LLC

	
 
	 
	
    Delaware
	 

	

    Dialysis America Georgia, LLC

	
 
	 
	
    Delaware
	 

	

    Dialysis Associates of Northern New Jersey, L.L.C. 

	
 
	 
	
    New Jersey
	 

	

    Everest Healthcare Holdings, Inc. 

	
 
	 
	
    Delaware
	 

    2

 

	 	 	 	 	 
	
    Original Transferring Affiliates

    
	
 
	
 

	
    (before October 19, 2006)
	
 
	
    State of Incorporation

	 

	

    Everest Healthcare Indiana, Inc. 

	
 
	 
	
    Indiana
	 

	

    Everest Healthcare Rhode Island, Inc. 

	
 
	 
	
    Delaware
	 

	

    Everest Healthcare Texas Holding Corp

	
 
	 
	
    Delaware
	 

	

    Everest Healthcare Texas, LP

	
 
	 
	
    Delaware
	 

	

    Everest Management, Inc. 

	
 
	 
	
    Delaware
	 

	

    Fresenius Medical Care Dialysis Services Colorado LLC

	
 
	 
	
    Delaware
	 

	

    Fresenius Medical Care Dialysis Services-Oregon, LLC

	
 
	 
	
    Oregon
	 

	

    FMS New York, Inc. 

	
 
	 
	
    Delaware
	 

	

    Fresenius Management Services, Inc. 

	
 
	 
	
    Delaware
	 

	

    Fresenius USA Home Dialysis, Inc. 

	
 
	 
	
    Delaware
	 

	

    Fresenius USA Marketing, Inc. 

	
 
	 
	
    Delaware
	 

	

    Fresenius USA, Inc. 

	
 
	 
	
    Massachusetts
	 

	

    Gulf Region Mobile Dialysis, Inc. 

	
 
	 
	
    Delaware
	 

	

    Home Dialysis of America, Inc. 

	
 
	 
	
    Arizona
	 

	

    Home Dialysis of Muhlenberg County, Inc. 

	
 
	 
	
    Kentucky
	 

	

    Home Intensive Care, Inc. 

	
 
	 
	
    Delaware
	 

	

    Mercy Dialysis Center, Inc. 

	
 
	 
	
    Wisconsin
	 

	

    National Medical Care, Inc. 

	
 
	 
	
    Delaware
	 

	

    Neomedica, Inc

	
 
	 
	
    Delaware
	 

	

    North Buckner Dialysis Center, Inc. 

	
 
	 
	
    Delaware
	 

	

    Northern New Jersey Dialysis, L.L.C. 

	
 
	 
	
    Delaware
	 

	

    Qualicenters, Inc. 

	
 
	 
	
    Colorado
	 

	

    San Diego Dialysis Services, Inc. 

	
 
	 
	
    Delaware
	 

	

    Spectra East, Inc. 

	
 
	 
	
    Delaware
	 

	

    Spectra Laboratories, Inc. 

	
 
	 
	
    Nevada
	 

	

    Terrell Dialysis Center, L.L.C. 

	
 
	 
	
    Delaware
	 

	

    Conejo Valley Dialysis, Inc. 

	
 
	 
	
    California
	 

	

    Dialysis Services of Cincinnati, Inc. 

	
 
	 
	
    Ohio
	 

	

    Dialysis Services, Inc. 

	
 
	 
	
    Texas
	 

	

    Dialysis Specialists of Topeka, Inc. 

	
 
	 
	
    Kansas
	 

	

    Dialysis Specialists of Tulsa, Inc. 

	
 
	 
	
    Oklahoma
	 

	

    Everest Healthcare Ohio, Inc. 

	
 
	 
	
    Ohio
	 

	

    Fresenius USA Sales, Inc. 

	
 
	 
	
    Massachusetts
	 

	

    Haemo-Stat, Inc. 

	
 
	 
	
    California
	 

	

    Santa Barbara Community Dialysis Center, Inc. 

	
 
	 
	
    California
	 

	

    Con-Med Supply Company, Inc. 

	
 
	 
	
    Illinois
	 

	

    WSKC Dialysis Services, Inc. 

	
 
	 
	
    Illinois
	 

	

    Du Page Dialysis, Ltd. 

	
 
	 
	
    Illinois
	 

 

	 	 	 	 	 
	
    Additional Transferring Affiliates

    
	
 
	
 

	
    (added October 19, 2006)
	
 
	
    State of Incorporation

	 

	

    Angleton Dialysis, Inc. 

	
 
	 
	
    Texas
	 

	

    Arizona Renal Investments, LLC

	
 
	 
	
    Delaware
	 

	

    Brazoria Kidney Center, Inc. 

	
 
	 
	
    Texas
	 

    3

 

	 	 	 	 	 
	
    Additional Transferring Affiliates

    
	
 
	
 

	
    (added October 19, 2006)
	
 
	
    State of Incorporation

	 

	

    Brevard County Dialysis, LLC

	
 
	 
	
    Florida
	 

	

    Cartersville Dialysis Center, LLC

	
 
	 
	
    Georgia
	 

	

    Clayton County Dialysis, LLC

	
 
	 
	
    Georgia
	 

	

    Clermont Dialysis Center, LLC

	
 
	 
	
    Georgia
	 

	

    Cobb County Dialysis, LLC

	
 
	 
	
    Georgia
	 

	

    Columbus Area Renal Alliance, LLC

	
 
	 
	
    Delaware
	 

	

    Covington Dialysis Center, LLC

	
 
	 
	
    Georgia
	 

	

    Diabetes Care Group, Inc. 

	
 
	 
	
    Delaware
	 

	

    Dialysis Associates, LLC

	
 
	 
	
    Tennessee
	 

	

    Dialysis Centers of America — Illinois, Inc. 

	
 
	 
	
    Illinois
	 

	

    Dialysis Licensing Corp. 

	
 
	 
	
    Delaware
	 

	

    Dialysis Management Corporation

	
 
	 
	
    Texas
	 

	

    Dialysis Services of Atlanta, Inc. 

	
 
	 
	
    Georgia
	 

	

    Douglas County Dialysis, LLC

	
 
	 
	
    Georgia
	 

	

    Doylestown Acute Renal Services, L.L.C. 

	
 
	 
	
    Pennsylvania
	 

	

    Fondren Dialysis Clinic, Inc. 

	
 
	 
	
    Texas
	 

	

    Fort Scott Regional Dialysis Center, Inc. 

	
 
	 
	
    Missouri
	 

	

    Four State Regional Dialysis Center, Inc. 

	
 
	 
	
    Missouri
	 

	

    Henry Dialysis Center, LLC

	
 
	 
	
    Georgia
	 

	

    Holton Dialysis Clinic, LLC

	
 
	 
	
    Georgia
	 

	

    Jefferson County Dialysis, Inc. 

	
 
	 
	
    Arkansas
	 

	

    KDCO, Inc. 

	
 
	 
	
    Missouri
	 

	

    Kentucky Renal Care Group, LLC

	
 
	 
	
    Delaware
	 

	

    Lawton Dialysis, Inc. 

	
 
	 
	
    Arkansas
	 

	

    Little Rock Dialysis, Inc. 

	
 
	 
	
    Arkansas
	 

	

    Maumee Dialysis Services, LLC

	
 
	 
	
    Delaware
	 

	

    Miami Regional Dialysis Center, Inc. 

	
 
	 
	
    Missouri
	 

	

    Michigan Home Dialysis Center, Inc. 

	
 
	 
	
    Michigan
	 

	

    Naples Dialysis Center, LLC

	
 
	 
	
    Florida
	 

	

    National Nephrology Associates Management Company of Texas,
    Inc. 

	
 
	 
	
    Texas
	 

	

    National Nephrology Associates of Texas, L.P. 

	
 
	 
	
    Texas
	 

	

    NNA Management Company of Kentucky, Inc. 

	
 
	 
	
    Kentucky
	 

	

    NNA Management Company of Louisiana, Inc. 

	
 
	 
	
    Louisiana
	 

	

    NNA of Alabama, Inc. 

	
 
	 
	
    Alabama
	 

	

    NNA of East Orange, L.L.C. 

	
 
	 
	
    New Jersey
	 

	

    NNA of Florida, LLC

	
 
	 
	
    Florida
	 

	

    NNA of Georgia, Inc. 

	
 
	 
	
    Delaware
	 

	

    NNA of Harrison, L.L.C. 

	
 
	 
	
    New Jersey
	 

	

    NNA of Louisiana, LLC

	
 
	 
	
    Louisiana
	 

	

    NNA of Memphis, LLC

	
 
	 
	
    Tennessee
	 

	

    NNA of Nevada, Inc. 

	
 
	 
	
    Nevada
	 

	

    NNA of Newark, L.L.C. 

	
 
	 
	
    New Jersey
	 

	

    NNA of Oklahoma, Inc. 

	
 
	 
	
    Nevada
	 

	

    NNA of Oklahoma, L.L.C. 

	
 
	 
	
    Oklahoma
	 

    4

 

	 	 	 	 	 
	
    Additional Transferring Affiliates

    
	
 
	
 

	
    (added October 19, 2006)
	
 
	
    State of Incorporation

	 

	

    NNA of Rhode Island, Inc. 

	
 
	 
	
    Rhode Island
	 

	

    NNA of Toledo, Inc. 

	
 
	 
	
    Ohio
	 

	

    NNA Properties of Tennessee, Inc. 

	
 
	 
	
    Tennessee
	 

	

    NNA Transportation Services Corporation

	
 
	 
	
    Tennessee
	 

	

    NNA-Saint Barnabas, L.L.C. 

	
 
	 
	
    New Jersey
	 

	

    NNA-Saint Barnabas-Livingston, L.L.C. 

	
 
	 
	
    New Jersey
	 

	

    Norcross Dialysis Center, LLC

	
 
	 
	
    Georgia
	 

	

    Northeast Alabama Kidney Clinic, Inc. 

	
 
	 
	
    Alabama
	 

	

    Northwest Dialysis, Inc. 

	
 
	 
	
    Arkansas
	 

	

    Physicians Dialysis Company, Inc. 

	
 
	 
	
    Pennsylvania
	 

	

    RCG Arlington Heights, LLC

	
 
	 
	
    Delaware
	 

	

    RCG Bloomington, LLC

	
 
	 
	
    Delaware
	 

	

    RCG Credit Corporation

	
 
	 
	
    Tennessee
	 

	

    RCG East Texas, LLP

	
 
	 
	
    Delaware
	 

	

    RCG Finance, Inc. 

	
 
	 
	
    Delaware
	 

	

    RCG Indiana, L.L.C. 

	
 
	 
	
    Delaware
	 

	

    RCG Irving, LLP

	
 
	 
	
    Delaware
	 

	

    RCG Marion, LLC

	
 
	 
	
    Delaware
	 

	

    RCG Martin, LLC

	
 
	 
	
    Delaware
	 

	

    RCG Memphis East, LLC

	
 
	 
	
    Delaware
	 

	

    RCG Memphis, LLC

	
 
	 
	
    Delaware
	 

	

    RCG Mississippi, Inc. 

	
 
	 
	
    Delaware
	 

	

    RCG PA Merger Corp. 

	
 
	 
	
    Texas
	 

	

    RCG University Division, Inc. 

	
 
	 
	
    Tennessee
	 

	

    RCG West Health Supply, L.C. 

	
 
	 
	
    Arizona
	 

	

    RCG Whitehaven, LLC

	
 
	 
	
    Delaware
	 

	

    RCG/Saint Luke’s, LLC

	
 
	 
	
    Delaware
	 

	

    RCGIH, Inc. 

	
 
	 
	
    Delaware
	 

	

    Renal Care Group Alaska, Inc. 

	
 
	 
	
    Alaska
	 

	

    Renal Care Group Central Memphis, LLC

	
 
	 
	
    Delaware
	 

	

    Renal Care Group East, Inc. 

	
 
	 
	
    Pennsylvania
	 

	

    Renal Care Group Michigan, Inc. 

	
 
	 
	
    Delaware
	 

	

    Renal Care Group Northwest, Inc. 

	
 
	 
	
    Delaware
	 

	

    Renal Care Group of the Midwest, Inc. 

	
 
	 
	
    Kansas
	 

	

    Renal Care Group of the Ozarks, LLC

	
 
	 
	
    Delaware
	 

	

    Renal Care Group of the South, Inc. 

	
 
	 
	
    Delaware
	 

	

    Renal Care Group of the Southeast, Inc. 

	
 
	 
	
    Florida
	 

	

    Renal Care Group Ohio, Inc. 

	
 
	 
	
    Delaware
	 

	

    Renal Care Group South New Mexico, LLC

	
 
	 
	
    Delaware
	 

	

    Renal Care Group Southwest Holdings, Inc. 

	
 
	 
	
    Delaware
	 

	

    Renal Care Group Southwest, L.P. 

	
 
	 
	
    Delaware
	 

	

    Renal Care Group Texas, Inc. 

	
 
	 
	
    Texas
	 

	

    Renal Care Group Texas, LP

	
 
	 
	
    Delaware
	 

	

    Renal Care Group Westlake, LLC

	
 
	 
	
    Delaware
	 

    5

 

	 	 	 	 	 
	
    Additional Transferring Affiliates

    
	
 
	
 

	
    (added October 19, 2006)
	
 
	
    State of Incorporation

	 

	

    Renal Care Group, Inc. 

	
 
	 
	
    Delaware
	 

	

    RenalNet Arizona, Inc. 

	
 
	 
	
    Arizona
	 

	

    RenalNet, Inc. 

	
 
	 
	
    Delaware
	 

	

    RenalPartners of Indiana, LLC

	
 
	 
	
    Indiana
	 

	

    RenalPartners, Inc. 

	
 
	 
	
    Delaware
	 

	

    Renex Corp. 

	
 
	 
	
    Florida
	 

	

    Renex Dialysis Clinic of Amesbury, Inc. 

	
 
	 
	
    Massachusetts
	 

	

    Renex Dialysis Clinic of Bloomfield, Inc. 

	
 
	 
	
    New Jersey
	 

	

    Renex Dialysis Clinic of Bridgeton, Inc. 

	
 
	 
	
    Missouri
	 

	

    Renex Dialysis Clinic of Creve Coeur, Inc. 

	
 
	 
	
    Missouri
	 

	

    Renex Dialysis Clinic of Doylestown, Inc. 

	
 
	 
	
    Pennsylvania
	 

	

    Renex Dialysis Clinic of Maplewood, Inc. 

	
 
	 
	
    Missouri
	 

	

    Renex Dialysis Clinic of North Andover, Inc. 

	
 
	 
	
    Massachusetts
	 

	

    Renex Dialysis Clinic of Orange, Inc. 

	
 
	 
	
    New Jersey
	 

	

    Renex Dialysis Clinic of Penn Hills, Inc. 

	
 
	 
	
    Pennsylvania
	 

	

    Renex Dialysis Clinic of Philadelphia, Inc. 

	
 
	 
	
    Pennsylvania
	 

	

    Renex Dialysis Clinic of Pittsburgh, Inc. 

	
 
	 
	
    Pennsylvania
	 

	

    Renex Dialysis Clinic of Shaler, Inc. 

	
 
	 
	
    Pennsylvania
	 

	

    Renex Dialysis Clinic of South Georgia, Inc. 

	
 
	 
	
    Georgia
	 

	

    Renex Dialysis Clinic of St. Louis, Inc. 

	
 
	 
	
    Missouri
	 

	

    Renex Dialysis Clinic of Tampa, Inc. 

	
 
	 
	
    Florida
	 

	

    Renex Dialysis Clinic of Union, Inc. 

	
 
	 
	
    Missouri
	 

	

    Renex Dialysis Clinic of University City, Inc. 

	
 
	 
	
    Missouri
	 

	

    Renex Dialysis Clinic of Woodbury, Inc. 

	
 
	 
	
    New Jersey
	 

	

    Renex Dialysis Facilities, Inc. 

	
 
	 
	
    Mississippi
	 

	

    Renex Dialysis Homecare of Greater St. Louis, Inc. 

	
 
	 
	
    Missouri
	 

	

    Renex Management Services, Inc. 

	
 
	 
	
    Florida
	 

	

    Smyrna Dialysis Center, LLC

	
 
	 
	
    Georgia
	 

	

    SSKG, Inc. 

	
 
	 
	
    Illinois
	 

	

    STAT Dialysis Corporation

	
 
	 
	
    Delaware
	 

	

    Stone Mountain Dialysis Center, LLC

	
 
	 
	
    Georgia
	 

	

    Stuttgart Dialysis, LLC

	
 
	 
	
    Arkansas
	 

	

    Three Rivers Dialysis Services, LLC

	
 
	 
	
    Delaware
	 

	

    West Palm Dialysis, LLC

	
 
	 
	
    Georgia
	 

	

    Wharton Dialysis, Inc. 

	
 
	 
	
    Texas
	 

    6

 

    EXHIBIT R

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    FORM OF
    ACCOUNT AGENT AGREEMENT

 

    ACCOUNT
    AGENT AGREEMENT

 

    ACCOUNT AGENT AGREEMENT (this “Agreement”), dated as
    of August 28, 1997, made by each of the parties identified
    on the signature pages hereto as being a
    “Titleholder”, for the benefit of NMC Funding
    Corporation, a Delaware corporation (“NMC Funding”)
    and NationsBank, N.A., as agent (the “Agent” ) for
    certain “Investors” (as defined below).

 

    PRELIMINARY
    STATEMENTS:

 

    (1) National Medical Care, Inc., a Delaware corporation
    (“NMC”) has entered into that certain Transferring
    Affiliate Letter (as the same may from time to time be amended,
    restated, supplemented or otherwise modified, the
    “Transferring Affiliate Letter”) dated as of even date
    herewith with each of the “Transferring Affiliates”
    named therein, under which each Such Transferring Affiliate has
    agreed to sell and assign on each day hereafter all of its
    right, title and interest in and to each “Receivable”
    and all “Related Security” (each as defined therein)
    to NMC in accordance with the terms thereof.

 

    (2) NMC has entered into that certain Receivables Purchase
    Agreement (as the same may from time to time be amended,
    restated, supplemented or otherwise modified, the “BMA
    Transfer Agreement”) dated as of even date herewith with
    Bio-Medical Applications Management Company, Inc., a Delaware
    corporation (“BMA”), under which BMA has agreed to
    sell and assign on the date hereof all of its right, title and
    interest in and to each “Receivable” and all
    “Related Security” (each as defined therein) to NMC in
    accordance with the terms thereof.

 

    (3) NMC has entered into that certain Receivables Purchase
    Agreement (as the same may from time to time be amended,
    restated, supplemented or otherwise modified, the
    “Receivables Agreement”) dated as of even date
    herewith with NMC Funding, under which NMC has agreed to sell
    and assign on each day hereafter all of its right, title and
    interest in and to each “Receivable” and all
    “Related Security” (each as defined therein),
    including, without limitation, all Receivables and Related
    Security acquired by NMC from the Transferring Affiliates under
    the Transferring Affiliate Letter and from BMA under the BMA
    Transfer Agreement, to NMC Funding in accordance with the terms
    thereof.

 

    (4) NMC Funding has entered into that certain Transfer and
    Administration Agreement (as the same may from time to time be
    amended, restated, supplemented or otherwise modified, the
    “TAA”) dated as of even date herewith with Enterprise
    Funding Corporation (“Enterprise”), NMC, as the
    “Collection Agent” thereunder, certain “Bank
    Investors” from time to time party thereto (together with
    Enterprise, the “Investors”) and the Agent, under
    which NMC Funding shall from time to time sell and assign
    undivided percentage ownership interests in all
    “Receivables” and “Related Security” (each
    as defined therein), including, without limitation, in all
    Receivables and Related Security acquired by NMC Funding from
    NMC under the Receivables Agreement, to the Agent for the
    benefit of the Investors in accordance with the terms thereof.
    Terms used herein and not otherwise defined herein shall have
    the meanings assigned under the TAA.

 

    (5) Each Titleholder maintains, for the benefit of certain
    of the Transferring Affiliates, one or more deposit accounts
    (each, a “Remittance Account”) to which Obligors on
    Receivables that have been originated by such Transferring
    Affiliate have been directed to remit payment on such
    Receivables.

 

    (6) NMC Funding, as a condition to its entering into the
    Receivables Agreement, and the Investors and the Agent, as a
    condition to their entering into the TAA, have required that the
    Titleholders enter into this Agreement.

 

    NOW, THEREFORE, in consideration of the premises and other good
    and valuable consideration (the sufficiency and receipt of which
    are acknowledged), each Titleholder agrees as follows:

 

    Section 1.  Representations
    and Warranties.  Each Titleholder represents
    and warrants that:

 

    (a) Such Titleholder maintains one or more Remittance
    Accounts for the benefit of one or more Transferring Affiliates.
    In each case, such Titleholder is acting exclusively in its
    capacity as agent for such Transferring Affiliate in the
    establishment and maintenance of each Remittance Account, and
    acts exclusively at the direction of such Transferring Affiliate
    in respect of the handling and disposition of all monies,
    checks, instruments, collections, remittances or other payment
    items received in the Remittance Accounts (the

    

    1

 

    “Payment Items”). Each Remittance Account exists
    solely for the administrative convenience of the applicable
    Transferring Affiliate.

 

    (b) Such Titleholder does not hold or claim any lien,
    security interest, charge or encumbrance, or other right or
    claim in, of or on (i) any Receivables originated by any
    Transferring Affiliate, (ii) any Payment Items in respect
    of any such Receivables or (iii) any Related Security with
    respect to any of the foregoing (collectively, the
    “Affected Assets”). To the extent that the Titleholder
    at any time comes into possession, whether by reason of a
    remittance to a Remittance Account or otherwise, of any Affected
    Assets, such Titleholder holds such Affected Assets in trust for
    the benefit of the applicable Transferring Affiliate.

 

    (c) Such Titleholder satisfies, upon execution and delivery
    of this Agreement, the requirements set forth in the Receivables
    Agreement and the TAA for being a “Designated Account
    Agent” for purposes of those agreements.

 

    (d) Such Titleholder is a corporation duly organized,
    validly existing and in good standing under the laws of its
    jurisdiction of incorporation and has all corporate power and
    all material governmental licenses, authorizations, consents and
    approvals required to carry on its business in each jurisdiction
    in which its business is now conducted. Such Titleholder is duly
    qualified to do business in, and is in good standing in, every
    other jurisdiction in which the nature of its business requires
    it to be so qualified, except where the failure to be so
    qualified or in good standing would not have a Material Adverse
    Effect.

 

    (e) The maintenance of each Remittance Account for the
    benefit of the applicable Transferring Affiliates, and the
    execution, delivery and performance by such Titleholder of this
    Agreement, are within such Titleholder’s corporate powers,
    have been duly authorized by all necessary corporate action,
    require no action by or in respect of, or filing with, any
    Official Body or official thereof and do not contravene, or
    constitute a default under, any provision of applicable law,
    rule or regulation (including, without limitation, any
    CHAMPUS/VA Regulation, any Medicaid Regulation or any Medicare
    Regulation) or of the Certificate of Incorporation or By-laws of
    such Titleholder or of any agreement, judgment, injunction,
    order, writ, decree or other instrument binding upon such
    Titleholder.

 

    (f) This Agreement constitutes the legal, valid and binding
    obligation of such Titleholder enforceable against it in
    accordance with its terms, subject to applicable bankruptcy,
    insolvency, moratorium or other similar laws affecting the
    rights of creditors generally.

 

    (g) Each Remittance Account meets the requirements for
    being a Special Account under the terms of each of the
    Receivables Agreement and the TAA, and a Special
    Account Letter is in effect with respect thereto. The names
    and addresses of each Remittance Account, together with the
    account numbers thereof and the Special Account Banks with
    respect thereto, are specified in Exhibit C to the
    Receivables Agreement (as the same may be amended from time to
    time in accordance with the terms of the Receivables Agreement).
    Neither such Titleholder nor, to the best of such
    Titleholder’s knowledge, any Transferring Affiliate has
    granted to any Person dominion and control over any Remittance
    Account or the right to take dominion and control over any
    Remittance Account at a future time or upon the occurrence of a
    future event and each Remittance Account is otherwise free and
    clear of any Adverse Claim.

 

    On each day that a “Purchase” is made under the
    Receivables Agreement, each Titleholder shall be deemed to have
    certified that all representations and warranties described in
    this Section 1 are correct on and as of such day as though
    made on and as of such day.

 

    Section 2.  Acknowledgment
    of Interest.  Each Titleholder acknowledges
    (i) that it has received a copy of each of the Transferring
    Affiliate Letter, the Receivables Agreement and the TAA,
    (ii) the ownership and related interests transferred to
    each of NMC, NMC Funding and the Agent, for the benefit of the
    Investors, thereunder and (iii) that for purposes of
    Uniform Commercial Code
    Section 9-305,
    it has received adequate notice of each of such interests.

    

    2

 

 

    Section 3.  Covenants.  At
    all times from the date hereof to the Collection Date, unless
    each of NMC Funding and the Agent shall otherwise consent in
    writing, each Titleholder agrees that:

 

    (a) Such Titleholder shall take all action, or omit to take
    all action, required to be taken (or to be omitted) by each
    Transferring Affiliate as it may relate to the Remittance
    Accounts under the Transferring Affiliate Letter, the
    Receivables Agreement, or the TAA, including, without limitation
    any such action that relates to any covenant or undertaking on
    the part of such Transferring Affiliate or any of its assigns in
    respect of “Special Accounts,” the “Concentration
    Account” or any “Designated Account Agent”
    thereunder.

 

    (b) Such Titleholder will furnish to each of NMC Funding
    and the Agent from time to time such information with respect to
    the activity in the Remittance Accounts as NMC Funding or the
    Agent may reasonably request, and will at any time and from time
    to time during regular business hours permit NMC Funding and the
    Agent, or any of their respective agents or representatives,
    (i) to examine and make copies of and take abstracts from
    records of such Titleholder in respect of the Remittance
    Accounts and (ii) to visit the offices and properties of
    such Titleholder for the purpose of examining such records.

 

    (c) Such Titleholder will not sell, assign (by operation of
    law or otherwise) or otherwise dispose of, or create or suffer
    to exist any Adverse claim upon (or the filing of any financing
    statement against) or with respect to any of the Affected Assets
    or any of the Remittance Accounts. The Payment Items mailed to,
    and funds deposited to or otherwise available in, the Remittance
    Accounts will not be subject to deduction, set-off,
    banker’s lien, or any other right in favor of such
    Titleholder, all of which such Titleholder hereby waives. To the
    extent there are any amounts due to any Titleholder in respect
    of its fees and expenses for the maintenance and operation of
    any of the Remittance Accounts, or in respect of any other claim
    such Titleholder may from time to time hold against any
    Transferring Affiliate or any affiliate thereof, such claims
    shall be settled separately as between such Titleholder and such
    Transferring Affiliate (or other affiliate), by disbursement
    from the general operating funds of the applicable Transferring
    Affiliate (or other affiliate), by disbursement from the general
    operating funds of the applicable Transferring Affiliate (or
    other affiliate) and not by way of set-off against, or otherwise
    from, funds at any time available in the Remittance Accounts.

 

    Section 4.  Miscellaneous.

 

    (a) This Agreement may not be terminated at any time by or
    as to any Titleholder except in accordance with the terms of the
    Receivables Agreement.

 

    (b) Neither this Agreement nor any provision hereof may be
    changed, amended, modified or waived orally but only by an
    instrument in writing signed by NMC Funding and the Agent.

 

    (c) No Titleholder may assign or transfer any of its rights
    or obligations hereunder without the prior written consent of
    NMC Funding and the Agent. Subject to the preceding sentence,
    this Agreement shall be binding upon each of the parties hereto
    and their respective successors and assigns, and shall inure to
    the benefit of, and be enforceable by, NMC Funding, the Agent,
    each of the Titleholders and their respective successors and
    assigns.

 

    [Remainder
    of page intentionally left blank]
    

    

    3

 

    IN WITNESS WHEREOF, each party hereto has caused this Agreement
    to be duly executed and delivered by its officer thereunto duly
    authorized as of the date first above written.

 

	 	 	 
	
    Titleholders:

	
 
	
    BIO-MEDICAL APPLICATIONS MANAGEMENT COMPANY, INC.

 

			
	 	    By 
	
        

			
	 	    Title: 
	

 

    HOME NUTRITIONAL SERVICES, INC.

 

			
	 	    By 
	
        

			
	 	    Title: 
	

 

    Accepted and
    agreed as of

    the date first above written:
    

 

    NMC FUNDING CORPORATION

 

			
	    By 
	
        

	 

				
	 	    Title: 
	

	 

 

    NATIONSBANK, N.A., as Agent

 

			
	    By 
	
        

	 

				
	 	    Title: 
	

	 

 

    Signature
    Page to Account Agent Agreement

    Dated as of August 28, 1997
    

    

    4

 

    

 

    EXHIBIT S

    

 

    to

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    LIST OF
    CLOSING DOCUMENTS

 

    FOURTH
    AMENDED AND RESTATED

    TRANSFER AND ADMINISTRATION AGREEMENT

    

    Dated as of October 16, 2008

    

    NMC FUNDING CORPORATION,

    as Transferor

    

    List of Closing Documents

 

	 	 	 	 	 	 	 
	

    1.

	
 
	
    Amendment Agreement.
	
 
	 
	
 
	 

	

    2.

	
 
	
    Fourth Amended and Restated Transfer and Administration
    Agreement.
	
 
	 
	
 
	 

	

    3.

	
 
	
    Amended and Restated Parent Agreement, relating to changes in
    financial covenants and transfer of rights of Agent to WestLB.
	
 
	 
	
 
	 

	

    4.

	
 
	
    Amended and Restated Receivables Purchase Agreement.
	
 
	 
	
 
	 

	

    5.

	
 
	
    Amended and Restated Transferring Affiliate Letter.
	
 
	 
	
 
	 

	

    6.

	
 
	
    Opinion of Douglas G. Kott.
	
 
	 
	
 
	 

	

    7.

	
 
	
    Opinion of Arent Fox Kintner Plotkin & Kahn relating
    to corporate, UCC and other matters.
	
 
	 
	
 
	 

	

    8.

	
 
	
    True sale and non-consolidation opinion of Arent Fox Kintner
    Plotkin & Kahn.
	
 
	 
	
 
	 

	

    9.

	
 
	
    Opinion of German counsel.
	
 
	 
	
 
	 

	

    10.

	
 
	
    Certificate of the Secretary of the Transferor.
	
 
	 
	
 
	 

	

    11.

	
 
	
    Certificate of the Secretary of the Collection Agent.
	
 
	 
	
 
	 

	

    12.

	
 
	
    Certificate of the Secretary of each Transferring Affiliate.
	
 
	 
	
 
	 

	

    13.

	
 
	
    Good Standing Certificates for the Transferor from the Secretary
    of the Commonwealth of Massachusetts and the Secretary of State
    of Delaware.
	
 
	 
	
 
	 

	

    14.

	
 
	
    Good Standing Certificates for the Collection Agent from the
    Secretary of the Commonwealth of Massachusetts and the Secretary
    of State of Delaware.
	
 
	 
	
 
	 

	

    15.

	
 
	
    Good Standing Certificates for each Transferring Affiliate from
    the Secretary of the Commonwealth of Massachusetts and the
    Secretary of State of Delaware.
	
 
	 
	
 
	 

	

    16.

	
 
	
    Fourth Amended and Restated Investor Fee Letter.
	
 
	 
	
 
	 

	

    17.

	
 
	
    Amended and Restated Agent Fee Letter.
	
 
	 
	
 
	 

	

    18.

	
 
	
    Amendment to Liquidity Asset Purchase Agreement for Liberty
    Street Funding LLC.
	
 
	 
	
 
	 

	

    19.

	
 
	
    Amended and Restated Liquidity Asset Purchase Agreement for
    Paradigm Funding LLC.
	
 
	 
	
 
	 

	

    20.

	
 
	
    Third Amended and Restated Fee Letter (Helaba) relating to
    Paradigm LAPA.
	
 
	 
	
 
	 

	

    21.

	
 
	
    Amended and Restated Fee Letter (WestLB) relating to Paradigm
    LAPA.
	
 
	 
	
 
	 

	

    22.

	
 
	
    Bank of America Account Control Agreements.
	
 
	 
	
 
	 

	

    23.

	
 
	
    UCC summary.
	
 
	 
	
 
	 

	
 
	
 
	
	
 
	 
	

    (FRESENIUS)

	
 
	 
	
 
	 

 

    EXHIBIT T

    

 

    To

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT

    

 

    Agreed
    Upon Procedures

 

    Procedures performed and findings are presented as follows. For
    purposes of reporting our findings, in those instances in which
    one or both the compared amounts were rounded to the same
    degree, we have nevertheless stated that we found the compared
    amounts to be in agreement. Minor or insignificant differences,
    as determined by management of the company (“management),
    between source or testing data and the Investor Report are not
    discussed herein and are noted as such in the body of the
    report, as indicated by the tickmark “P”. All testing
    is performed on the monthly Investor Report for the period
    ending January 2008.

 

    1A.  For Dialysis Products Division (DPD) and
    Fresenius Medical Services (FMS), obtain the January 2008
    Monthly Investor Reports (IR) from management and compare gross
    receivables (line item 1), all components of the Net
    Receivables Balance calculation (line
    items 6-19b),
    Self-Pay Receivables (line
    items 26-31)
    and all components of the Monthly Activity calculation (line
    items 32-37)
    to the general ledger (GL) and aged trial balance (ATB). Obtain
    and document management’s reconciliation of differences in
    the Agreed Upon Procedures Report (the “Report”).

 

    1B.  For FMS, obtain from management a list of
    void & rebills issued in January 2008, select 60 and
    complete the following:

 

    Arrow Pointing Right Document management’s explanation
    of credit memos and void & rebills.

 

			
	 	    Arrow Pointing Right 
	
    Obtain from management a list of each obligor, amount and reason
    for the issuance of the void & rebill. Document
    management’s response in the Report in table format.

	 
	 	    Arrow Pointing Right 
	
    Calculate and document in the Report the average dilution
    horizon for each void & rebill selected above. The
    dilution horizon is defined as the period from the average of
    the original and ending claim dates to the void &
    rebill date for those claims.

 

    1B.  For DPD obtain from management a list of 20
    credit memos issued in January 2008 and complete the following:

 

			
	 	    Arrow Pointing Right 
	
    Obtain from management a list of each obligor, amount and reason
    for the issuance of the credit memo. Document management’s
    response in the Report in table format.

	 
	 	    Arrow Pointing Right 
	
    Calculate and document in the Report the weighted average
    dilution horizon for each credit memo selected above. The
    dilution horizon is defined as the period from original invoice
    date to the issuance of a credit memo against that invoice. For
    credits issued for future purchases the dilution horizon is
    zero. For cash rebates, where the A/R is not discounted and is
    paid in full, the dilution horizon is zero.

 

    2A.  Obtain from management the agings as represented
    in the selected Monthly Reports and compare amounts to the
    Company’s ATB and to the GL (DPD and FMS). For each of the
    divisions, illustrate in the Report the amount as shown in the
    aged trial balance, the GL and the selected IR. Obtain and
    document management’s reconciliation of differences.

 

    2B.  For DPD and FMS inquire of management the
    definition of the receivable aging policy utilized (i.e. invoice
    date or due date). Document management’s representation in
    the Report.

 

    2C.  For FMS, select 60 claims from the
    January 31, 2008 aging and determine if the claims were
    aged properly in accordance with the Company’s aging
    policy. Note in the report any invoices/claims that may not be
    aged in accordance with the aging policy in Procedure 2B.

    

    1

 

 

    2C.  For DPD, from the 20 invoices/claims selected in
    January 2008 in Procedure 2D, determine if the invoices were
    aged properly in January in accordance with the Company’s
    aging policy. Note in the Report any invoices/claims that may
    not be aged in accordance with the aging policy in 2B.

 

    2D.  For FMS, for January 2008, select 60 claims from
    8 predetermined commercial checks received into a lockbox
    account. Additionally, from 3 predetermined Medicare payments
    received into a lockbox account, select a total of 60 claims.
    Trace all selected claims to the medical manager/QMS system to
    determine if the cash received was applied to the appropriate
    claim.

 

    2D.  For DPD, obtain from management 20 cash receipts
    for DPD from the January 2008 monthly cash collections
    report to determine if cash was applied to the correct
    invoices/claims.

 

    3A.  For DPD and FMS, obtain from management a list of
    payment terms. Document the list of payment terms received from
    management.

 

    3B.  For DPD and FMS, inquire of management as to
    whether the Company extends/alters maturity of receivables? If
    so, under which circumstances? Inquire as to how do the
    systems/reporting track these payment term extensions (i.e., is
    the due date extended in the system)? Document management’s
    response.

 

    4A.  For DPD and FMS, compare the monthly write-off
    amounts as represented in the January 2008 IR to the monthly
    activity in the January 2008 roll forward of the allowance for
    doubtful accounts. Document management’s explanation for
    any differences greater than $100,000.

 

    4B.  For DPD and FMS, obtain from management a listing
    of the 20 largest DPD accounts that were written-off in January
    2008 and 60 written-off claims from FMS. Request of management
    the reason for the write-off and note the response.

 

    4C.  For DPD and FMS, inquire of management and note
    the response of the following:

 

			
	 	    Arrow Pointing Right 
	
    What is the methodology for reserving expected bad debts?

	 
	 	    Arrow Pointing Right 
	
    Has the Company reserved for any non-delinquent or non-defaulted
    accounts?

	 
	 	    Arrow Pointing Right 
	
    Is there a separate account in which delinquent accounts are
    placed prior to eventual charge-off whereby the amounts are not
    reflected on the aging?

 

    4D.  For DPD and FMS, of the charge offs listed in
    Procedure 4B, inquire of management as to if any of the accounts
    were converted to Notes Receivable and if so at what point in
    the aging where they converted?

 

    5.  For DPD and FMS, obtain a list of the primary
    obligors as listed in the IR as of January 2008 and compare this
    information by tracing amounts to ATB. Obtain and document
    management’s reconciliation of differences.

 

    6A.  For DPD and FMS, obtain from management a listing
    of the lockbox number and name of the depository banks in which
    collections are deposited. Compare the list of bank accounts to
    the Accepted Exhibit C, an updated schedule for the TAA.

 

    6B.  For DPD and FMS obtain from management an
    understanding of the collection process for payments not going
    directly through the accounts from 6A. Inquire as to whether any
    payments are received via ACH or wire transfer? If so, obtain
    from management a listing of bank accounts.

 

    6C.  For DPD and FMS, examine a January 2008 bank
    statement to GL reconciliation for one depository account for
    each division, noting the timeliness of completion and amount of
    unreconciled differences. Document the quantity of all
    reconciling items greater than $100,000. Document
    management’s explanation for all reconciling items greater
    than $250,000.

    

    2

 

 

    6D.  For DPD and FMS obtain from management a schedule
    for January 2008 summarizing collections within the bank
    statement from Procedure 6C by method of receipt, in a format
    similar to the one shown below.

 

	 	 	 	 	 	 	 	 	 
	
    Method of Receipt ($000s)
	
 
	
    January 2008
	
 
	
 
	
    %
	
 

	 

	

    Obligor mailed/sent payment directly to a Special
    Lock-Box Account (via check, ACH, or Wire Transfer)

	
 
	
    $
	
         
	
 
	
 
	
 
	
 
	
 

	

    Obligor sent payment to Company’s office

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    Other (describe)

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    TOTAL COLLECTIONS DEPOSITED per Bank Statement(s)

	
 
	
    $
	
 
	
 
	
 
	
 
	
    100
	
    %

	

    Reconciling items

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

    6E.  For DPD and FMS, compare the accuracy of this
    schedule by tracing this information to the bank statements,
    accounting records, and the January 2008 report.

 

    6F.  For DPD and FMS, inquire of management as to if
    more than 5% of the collections were not remitted by the
    obligors directly to one of the Special Accounts. If yes, (i.e.
    > 5%) select a sample of 5 of these cash receipts and
    inquire as to whether these collections were deposited into the
    Concentration Account within 48 hours.

 

    7.  KPMG will provide a no material weakness letter
    for FMCH for the period ending XXX.

 

    See
    Appendix          
    for the no material weakness letter.

 

    8.  Obtain from the Company the name of independent
    director and their contact information as well as the name of
    the independent director’s employer or, if retired, the
    name of their most recent employer.

 

    9.  Please note any changes made to the Company’s
    credit and collection policy since
    12/31/2006
    through the date of this Report.

    

    3

 

    EXHIBIT U

    

 

    To

    

 

    FOURTH
    AMENDED AND RESTATED

    

 

    TRANSFER
    AND ADMINISTRATION AGREEMENT EXHIBIT H

 

    To the Shareholders

    Fresenius Medical Care Holdings, Inc.:

    Waltham, MA

 

    May 6, 2008

 

    Ladies and Gentlemen:

 

    We have audited the financial statements of Fresenius Medical
    Care Holdings, Inc. and its subsidiaries (the Company) as of and
    for the year ended December 31, 2007, and have issued our
    report thereon dated May 6, 2008. In planning and
    performing our audit of the financial statements of the Company,
    in accordance with auditing standards generally accepted in the
    United States of America, we considered the Company’s
    internal control over financial reporting internal control as a
    basis for designing our auditing procedures for the purpose of
    expressing our opinion on the financial statements, but not for
    the purpose of expressing an opinion on the effectiveness of the
    Company’s internal control. Accordingly, we do not express
    an opinion on the effectiveness of the Company’s internal
    control.

 

    The maintenance of adequate control designed to fulfill control
    objectives is the responsibility of management. Because of
    inherent limitations in internal control, errors or fraud may
    nevertheless occur and not be detected. Also, controls found to
    be functioning at a point in time may later be found deficient
    because of the performance of those responsible for applying
    them, and there can be no assurance that controls currently in
    existence will prove to be adequate in the future as changes
    take place in the organization.

 

    A control deficiency exists when the design or operation of a
    control does not allow management or employees, in the normal
    course of performing their assigned functions, to prevent or
    detect misstatements on a timely basis. A significant deficiency
    is a control deficiency, or combination of control deficiencies,
    that adversely affects the entity’s ability to initiate,
    authorize, record, process, or report financial data reliably in
    accordance with generally accepted accounting principles such
    that there is more than a remote likelihood that a misstatement
    of the entity’s financial statements that is more than
    inconsequential will not be prevented or detected by the
    entity’s internal control.

 

    A material weakness is a significant deficiency, or combination
    of significant deficiencies, that results in more than a remote
    likelihood that a material misstatement of the financial
    statements will not be prevented or detected by the
    entity’s internal control.

 

    Our consideration of internal control was for the limited
    purpose described in the first paragraph and would not
    necessarily identify all deficiencies in internal control that
    might be significant deficiencies or material weaknesses. We did
    not identify any deficiencies in internal control that we
    consider to be material weaknesses, as defined above.

 

    This communication is intended solely for the information and
    use of management, Shareholders, others within the organization,
    and the Banks and is not intended to be and should not be used
    by anyone other than these specified parties.

 

    Very truly yours,

 

    (signed) KPMG LLP

    

    1exv4w3

Exhibit 4.3

RIGHTS AGREEMENT

     This Rights Agreement (this “Agreement”) is dated as of December 15, 2010 and is
made between Compellent Technologies, Inc., a Delaware corporation (the “Company”), and
Wells Fargo Bank, N.A., as rights agent (“Rights Agent”).

Recitals

     The Board of Directors of the Company (the “Board”) has authorized and declared a dividend of
one preferred share purchase right (a “Right”) for each Common Share (as such term is hereinafter
defined) outstanding at the Close of Business (as such term is hereinafter defined) on December 27,
2010 (the “Record Date”), each Right representing the right to purchase one one-hundredth of a
Preferred Share (as such term is hereinafter defined), upon the terms and subject to the conditions
herein set forth, and has further authorized and directed the issuance of one Right with respect to
each Common Share that shall become outstanding between the Record Date and the earliest to occur
of the Distribution Date, the Redemption Date and the Final Expiration Date (as such terms are
hereinafter defined); provided, however, that Rights may be issued with respect to Common Shares
that shall become outstanding after the Distribution Date and prior to the earlier of the
Redemption Date and the Final Expiration Date in accordance with the provisions of Section 22
hereof.

     The Company has entered into an Agreement and Plan of Merger (as the same may be amended from
time to time, the “Merger Agreement”), dated December 12, 2010, among the Company, Dell
International L.L.C, a Delaware limited liability company (“Parent”) and Dell Trinity Holdings
Corp., a Delaware corporation and a wholly-owned subsidiary of Parent (“Merger Sub”), pursuant to
which Merger Sub will merge with and into the Company upon the terms and subject to the conditions
set forth in the Merger Agreement (the “Merger”)

     Concurrently with the execution and delivery of the Merger Agreement, certain stockholders of
the Company (such parties, the “Voting Parties”) having executed voting and support agreements
(each a “Stockholder Support Agreement” and together the “Stockholder Support Agreements”) with
Parent and Merger Sub.

Agreement

     Accordingly, in consideration of the premises and the mutual agreements herein set forth, the
parties hereby agree as follows:

SECTION 1. Certain Definitions. For purposes of this Agreement, the following terms have
the meanings indicated:

     (a) “Agreement” shall have the meaning set forth in the first paragraph hereof.

     (b) “Acquiring Person” shall mean any Person who or that, together with all Affiliates and
Associates of such Person, without the prior written approval of the Board, shall be the Beneficial
Owner of 15% or more of the Common Shares then outstanding. Notwithstanding the foregoing, (A) the
term Acquiring Person shall not include (i) the Company,

1.

 

(ii) any Subsidiary (as such term is hereinafter defined) of the Company, (iii) any employee
benefit or compensation plan of the Company or any Subsidiary of the Company, (iv) any entity
holding Common Shares for or pursuant to the terms of any such employee benefit or compensation
plan of the Company or any Subsidiary of the Company, or (v) any Person who or that, together with
all Affiliates and Associates of such Person, is the Beneficial Owner of 15% or more of the Common
Shares outstanding as of the date of this Agreement until such time after the date of this
Agreement that such Person, together with all Affiliates and Associates of such Person, shall
become the Beneficial Owner of any additional Common Shares (other than by means of a dividend made
by the Company on the Common Shares outstanding or pursuant to a split, subdivision or other
reclassification of the Common Shares undertaken by the Company) and shall then beneficially own
more than 15% of the Common Shares then outstanding, and (B) no Person shall become an “Acquiring
Person” (x) as the result of an acquisition of Common Shares by the Company that, by reducing the
number of shares outstanding, increases the proportionate number of shares beneficially owned by
such Person to 15% or more of the Common Shares then outstanding; provided, however, that if a
Person shall become the Beneficial Owner of 15% or more of the Common Shares then outstanding by
reason of share purchases by the Company and shall, following written notice from, or public
disclosure by, the Company of such share purchases by the Company, become the Beneficial Owner of
any additional Common Shares without the prior written approval of the Board (other than by means
of a dividend made by the Company on the Common Shares outstanding or pursuant to a split,
subdivision or other reclassification of the Common Shares undertaken by the Company) and shall
then be the Beneficial Owner of more than 15% of the Common Shares then outstanding, then such
Person shall be deemed to be an “Acquiring Person,” (y) as the result of the acquisition of Common
Shares directly from the Company, provided, however, that if a Person shall become the Beneficial
Owner of 15% or more of the Common Shares then outstanding by reason of Common Share acquisitions
directly from the Company and shall, after that date, become the Beneficial Owner of any additional
Common Shares without the prior written approval of the Board (other than by means of a dividend
made by the Company on the Common Shares outstanding or pursuant to a split, subdivision or other
reclassification of the Common Shares undertaken by the Company) and shall then beneficially own
more than 15% of the Common Shares then outstanding, then such Person shall be deemed to be an
“Acquiring Person” or (z) if the Board determines in good faith that a Person who would otherwise
be an “Acquiring Person,” as defined pursuant to the foregoing provisions of this Section 1(b), has
become such inadvertently (including, without limitation, because (1) such Person was unaware that
it beneficially owned 15% or more of the Common Shares then outstanding or (2) such Person was
aware of the extent of its Beneficial Ownership of Common Shares but had no actual knowledge of the
consequences of such Beneficial Ownership under this Agreement) and had no intention of obtaining,
changing or influencing the control of the Company, and such Person divests, as promptly as
practicable (as determined in good faith by the Board), following receipt of written notice from
the Company of such event, of Beneficial Ownership of a sufficient number of Common Shares so that
such Person would no longer be an Acquiring Person, as defined pursuant to the foregoing provisions
of this Section 1(b), then such Person shall not be deemed to be an “Acquiring Person” for any
purposes of this Agreement; provided, however, that if such Person shall again become the
Beneficial Owner of 15% or more of the Common Shares then outstanding, such Person shall be deemed
an “Acquiring Person,” subject to the exceptions set forth in this Section 1(b). Notwithstanding
anything in this Agreement to the contrary, neither

2.

 

Parent nor Merger Sub (or any of Parent or Merger Sub’s Affiliates or Associates) shall be or
become an “Acquiring Person” by reason of, and the term “Acquiring Person” shall not include Parent
or Merger Sub (or any Affiliates or Associates of Parent or Merger Sub) by reason of, (i) the
approval, execution and/or delivery of the Merger Agreement or the approval, execution and/or
delivery of any amendment thereto, (ii) the approval, execution and/or delivery of any of the
Support Agreements or the approval, execution and/or delivery of any amendment to any of such
Support Agreements, (iii) the approval, execution and/or delivery of any other contract or
instrument in each case entered into by the Company in connection with the Merger Agreement or the
Support Agreements or the approval, execution and/or delivery of any amendment thereto, (iv) the
Merger of Merger Sub with and into the Company pursuant to, and on the terms and subject to the
conditions set forth in, the Merger Agreement, (v) the consummation of the Merger or any other
transactions contemplated by the Merger Agreement, the Support Agreements or the contracts or other
instruments referred to in clause (iii) above (the Merger Agreement, the Support Agreements and
such other contracts and instruments are collectively referred to in this Agreement as the “Merger
Transaction Agreements”), or (vi) the announcement of any of the Merger Transaction Agreements, the
Merger or any other transactions contemplated by the Merger Transaction Agreements, or the
announcement of any consummation thereof.

     (c) “Affiliate” and “Associate” shall have the respective meanings ascribed to such terms in
Rule 12b-2 under the Exchange Act as in effect on the date of this Agreement; provided, however,
that the limited partners of a limited partnership shall not be deemed to be Associates of such
limited partnership solely by virtue of their limited partnership interests.

     (d) A Person shall be deemed the “Beneficial Owner” of, and shall be deemed to “beneficially
own,” and shall be deemed to have “Beneficial Ownership” of, any securities:

          (i) that such Person or any of such Person’s Affiliates or Associates is deemed to
beneficially own within the meaning of Rule 13d-3 under the Exchange Act as in effect on the date
of this Agreement;

          (ii) that such Person or any of such Person’s Affiliates or Associates has (A) the right to
acquire (whether such right is exercisable immediately or only after the passage of time) pursuant
to any agreement, arrangement or understanding, whether or not in writing, or upon the exercise of
conversion rights, exchange rights, rights (other than the Rights), warrants or options, or
otherwise; provided, however, that a Person shall not be deemed the Beneficial Owner of, or to
beneficially own, securities tendered pursuant to a tender or exchange offer made by or on behalf
of such Person or any of such Person’s Affiliates or Associates until such tendered securities are
accepted for purchase or exchange; or (B) the right to vote pursuant to any agreement, arrangement
or understanding, whether or not in writing; provided, however, that a Person shall not be deemed
the Beneficial Owner of, or to beneficially own, any security if the agreement, arrangement or
understanding to vote such security (1) arises solely from a revocable proxy or consent given to
such Person in response to a public proxy or consent solicitation made pursuant to, and in
accordance with, the applicable rules and regulations promulgated under the Exchange Act and (2) is
not also then reportable on Schedule 13D or 13G under the Exchange Act (or any comparable or
successor report);

3.

 

          (iii) that are beneficially owned, directly or indirectly, by any other Person (or an
Affiliate or Associate thereof) with which such Person (or any of such Person’s Affiliates or
Associates) has (A) any agreement, arrangement or understanding, whether or not in writing, for the
purpose of acquiring, holding, voting (except to the extent contemplated by the proviso to Section
1(d)(ii)(B) hereof) or disposing of any securities of the Company or (B) any agreement,
arrangement, or understanding, whether or not in writing, to cooperate in obtaining, changing or
influencing the control of the Company (except to the extent contemplated by the proviso to Section
1(d)(ii)(B) hereof);or

          (iv) that are the subject of, or the reference securities for, or that underlie, any
Derivative Interest of such Person or any of such Person’s Affiliates or Associates, with the
number of Common Shares deemed Beneficially Owned being the notional or other number of Common
Shares specified in the documentation evidencing the Derivative Interest as being subject to be
acquired upon the exercise or settlement of the Derivative Interest or as the basis upon which the
value or settlement amount of such Derivative Interest is to be calculated in whole or in part or,
if no such number of Common Shares is specified in such documentation, as determined by the Board
in its sole discretion to be the number of Common Shares to which the Derivative Interest relates.

     Notwithstanding the foregoing, (i) the phrase, “then outstanding,” when used with reference to
a Person’s Beneficial Ownership of securities of the Company, shall mean the number of such
securities then issued and outstanding together with the number of such securities not then
actually issued and outstanding that such Person would be deemed to beneficially own hereunder;
(ii) nothing contained in this Section 1(d) shall cause a Person ordinarily engaged in business as
an underwriter of securities to be deemed the “Beneficial Owner” of, or to “beneficially own”, or
to have “Beneficial Ownership” of, any securities acquired or to be acquired in either (A) a bona
fide underwritten public offering of securities pursuant to an underwriting agreement entered into
by the Company and such Person or (B) a bona fide offering of securities pursuant to Rule 144A
under the Securities Act pursuant to a purchase agreement entered into by the Company and such
Person; and (iii) no director or officer of the Company shall be deemed to Beneficially Own
securities Beneficially Owned by any other director or officer of the Company solely as a result of
actions taken by such directors or officers in their capacities as directors, officers, agents or
employees of the Company.

     Notwithstanding the foregoing, no party to any of the Merger Transaction Agreements shall be
deemed to be the Beneficial Owner of any Common Shares held by any other party to any such Merger
Transaction Agreement solely by virtue of the execution and delivery of any such Merger Transaction
Agreement or any amendment thereof or the performance of such party’s rights and obligations under
any such Merger Transaction Agreement or any such amendment.

     (e) “Board” shall have the meaning set forth in the Recitals hereof.

     (f) “Business Day” shall mean any day other than a Saturday, a Sunday, or a day on which
banking institutions in the State of New York are authorized or obligated by law or executive order
to close.

4.

 

     (g) “Close of Business” on any given date shall mean 5:00 p.m., Eastern time, on such date;
provided, however, that if such date is not a Business Day it shall mean 5:00 p.m., Eastern time,
on the next succeeding Business Day.

     (h) “Common Shares” shall mean the shares of common stock, par value $0.001 per share, of the
Company; provided, however, that, “Common Shares,” when used in this Agreement in connection with a
specific reference to any Person other than the Company, shall mean the shares of the class or
series of capital stock (or equity interest) with the greatest voting power of such other Person
or, if such other Person is a Subsidiary of another Person, the Person or Persons that ultimately
control such first-mentioned Person.

     (i) “Company” shall have the meaning set forth in the first paragraph hereof.

     (j) “current per share market price” shall have the meaning set forth in Section 11(d) hereof,
except as otherwise set forth in this Agreement.

     (k) “Derivative Interest” shall mean an interest in any derivative securities (as defined
under Rule 16a-1 under the Exchange Act) that increase in value as the value of the underlying
security increases, including, but not limited to, a long convertible security, a long call option
and a short put option position, in each case, regardless of whether (x) such interest conveys any
voting rights in such security, (y) such interest is required to be, or is capable of being,
settled through delivery of such security or (z) transactions hedge the economic effect of such
interest.

     (l) “Distribution Date” shall have the meaning set forth in Section 3 hereof.

     (m) “Equivalent Preferred Shares” shall have the meaning set forth in Section 11(b) hereof.

     (n) “Exchange Act” shall mean the Securities Exchange Act of 1934, as in effect on the date in
question, unless otherwise specifically provided.

     (o) “Exchange Property” shall have the meaning set forth in Section 24(e) hereof.

     (p) “Exchange Ratio” shall have the meaning set forth in Section 24(a) hereof.

     (q) “Exchange Recipient” shall have the meaning set forth in Section 24(e) hereof.

     (r) “Final Expiration Date” shall have the meaning set forth in Section 7 hereof.

     (s) “Interested Stockholder” shall mean any Acquiring Person or any Affiliate or Associate of
an Acquiring Person or any other Person in which any such Acquiring Person, Affiliate or Associate
has an interest, or any other Person acting directly or indirectly on behalf of or in concert with
any such Acquiring Person, Affiliate or Associate.

     (t) “Person” shall mean any individual, firm, corporation, limited liability company,
partnership, joint venture, association, trust, unincorporated organization or other entity, and
shall include any successor (by merger or otherwise) of such entity.

5.

 

     (u) “Preferred Shares” shall mean shares of Series A Junior Participating Preferred Stock, par
value $0.001 per share, of the Company having the designations and the powers, preferences and
rights, and the qualifications, limitations and restrictions set forth in the Company’s Certificate
of Designation for such Preferred Stock.

     (v) “Principal Party” shall have the meaning set forth in Section 13(b) hereof.

     (w) “Purchase Price” shall have the meaning set forth in Section 7(b) hereof.

     (x) “Record Date” shall have the meaning set forth in the Recitals hereof.

     (y) “Redemption Date” shall have the meaning set forth in Section 7(a) hereof.

     (z) “Redemption Price” shall have the meaning set forth in Section 23(b) hereof.

     (aa) “Right” shall have the meaning set forth in the Recitals hereof.

     (bb) “Right Certificate” shall have the meaning set forth in Section 3(a) hereof.

     (cc) “Rights Agent” shall have the meaning set forth in the first paragraph hereof.

     (dd) “Securities Act” shall mean the Securities Act of 1933, as in effect on the date
in question, unless otherwise specifically provided.

     (ee) “Shares Acquisition Date” shall mean the first date of public announcement by the Company
or an Acquiring Person, prior to the earlier of the Redemption Date and the Final Expiration Date,
that an Acquiring Person has become such; provided, however, that, if such Person is determined not
to have become an Acquiring Person pursuant to clause (z) of Section 1(b)(B) hereof, then no Shares
Acquisition Date shall be deemed to have occurred.

     (ff) “Subsidiary” of any Person shall mean any corporation or other entity of which a majority
of the voting power of the voting equity securities or equity interest is owned, directly or
indirectly, by such Person.

     (gg) “Summary of Rights” shall have the meaning set forth in Section 3(b) hereof.

     (hh) “Trading Day” shall have the meaning set forth in Section 11(d)(i).

     (ii) “Transaction” shall mean (i) any merger, consolidation or sale or transfer of assets or
earning power described in Section 13(a) hereof or (ii) any acquisition of Common Shares that would
result in a Person becoming an Acquiring Person or a Principal Party.

     (jj) “Transaction Person” with respect to a Transaction shall mean (i) any Person who (x) is
or will become an Acquiring Person or a Principal Party if the Transaction were to be consummated
and (y) directly or indirectly proposed or nominated a director of the Company, which director is
in office at the time of consideration of the Transaction, or (ii) an Affiliate or Associate of
such a Person.

6.

 

SECTION 2. Appointment of Rights Agent. The Company hereby appoints the Rights Agent to
act as agent for the Company in accordance with the terms and conditions hereof, and the Rights
Agent hereby accepts such appointment. The Company may from time to time appoint such co-rights
agents as it may deem necessary or desirable, upon written notice to the Rights Agent. The Rights
Agent shall have no duty to supervise, and in no event shall be liable for, the acts or omissions
of any such co-rights agent.

SECTION 3. Issue of Right Certificates.

     (a) Until the earlier of the Close of Business on (i) the tenth calendar day after the Shares
Acquisition Date (or, in the event that the Board determines on or before such tenth calendar day
to effect an exchange in accordance with Section 24 and determines in accordance with Section 24(e)
that a later date is advisable, such later date that is not more than 20 days after the Shares
Acquisition Date) or (ii) the tenth Business Day (or such later date as may be determined by action
of the Board prior to such time as any Person becomes an Acquiring Person) after the date of the
commencement (determined in accordance with Rule 14d-2 under the Exchange Act) by any Person (other
than the Company, any Subsidiary of the Company, any employee benefit plan of the Company or of any
Subsidiary of the Company or any entity holding Common Shares for or pursuant to the terms of any
such plan) of, or of the first public announcement of the intention of any Person (other than the
Company, any Subsidiary of the Company, any employee benefit plan of the Company or of any
Subsidiary of the Company or any entity holding Common Shares for or pursuant to the terms of any
such plan) to commence, a tender or exchange offer (which intention to commence remains in effect
for five Business Days after such announcement), the consummation of which would result in any
Person becoming an Acquiring Person (including any such date that is after the date of this
Agreement and prior to the issuance of the Rights, the earlier of such dates being herein referred
to as the “Distribution Date”), (x) the Rights will be evidenced by the certificates for Common
Shares (which certificates shall also be deemed to be Right Certificates) or, in the case of
uncertificated shares, by the balances indicated in the book-entry account system of the transfer
agent for the Common Shares (together with a transaction advise with respect to such shares),
registered in the names of the holders thereof and not by separate Right Certificates, and (y) the
Rights (and the right to receive Right Certificates therefor) will be transferable only in
connection with the transfer of Common Shares. As soon as practicable after the Distribution Date,
the Company will prepare and execute, the Rights Agent will countersign, and the Company will send
or cause to be sent (and the Rights Agent will, if requested, send) by first-class, postage-prepaid
mail, to each record holder of Common Shares as of the Close of Business on the Distribution Date,
at the address of such holder shown on the records of the Company, a Right Certificate, in
substantially the form of Exhibit A hereto (a “Right Certificate”), evidencing one Right for each
Common Share so held, subject to the adjustment provisions of Section 11. As of the Distribution
Date, the Rights will be evidenced solely by such Right Certificates.

     (b) On the Record Date, or as soon as practicable thereafter, the Company will send (directly
or through the Rights Agent or its transfer agent) a copy of a Summary of Rights to Purchase
Preferred Shares, in substantially the form of Exhibit B hereto (the “Summary of Rights”), by
first-class, postage-prepaid mail, to each record holder of Common
Shares as of the Close of Business on the Record Date, at the address of such holder shown on the records of
the Company. With respect to certificates for Common Shares outstanding as of the Record Date,

7.

 

until the Distribution Date, the Rights will be evidenced by such certificates or book-entry
accounts (together with the transaction advice with respect to such shares) registered in the names
of the holders thereof. Until the Distribution Date (or the earlier of the Redemption Date and the
Final Expiration Date), the surrender for transfer of any Common Shares outstanding on the Record
Date shall also constitute the transfer of the Rights associated with the Common Shares.

     (c) Certificates or transaction advices, as applicable, for Common Shares that become
outstanding after the Record Date but prior to the earliest of the Distribution Date, the
Redemption Date or the Final Expiration Date shall have impressed on, printed on, written on or
otherwise affixed to them substantially the following legend:

     THIS CERTIFICATE ALSO EVIDENCES AND ENTITLES THE HOLDER HEREOF TO CERTAIN
RIGHTS AS SET FORTH IN A RIGHTS AGREEMENT BETWEEN COMPELLENT TECHNOLOGIES, INC. (THE
“COMPANY”) AND WELLS FARGO BANK, N.A., AS RIGHTS AGENT (THE “RIGHTS AGENT”), DATED
AS OF DECEMBER 15, 2010, AS AMENDED FROM TIME TO TIME (THE “RIGHTS AGREEMENT”), THE
TERMS OF WHICH ARE HEREBY INCORPORATED HEREIN BY REFERENCE AND A COPY OF WHICH IS ON
FILE AT THE PRINCIPAL EXECUTIVE OFFICES OF THE COMPANY. UNDER CERTAIN
CIRCUMSTANCES, AS SET FORTH IN THE RIGHTS AGREEMENT, SUCH RIGHTS WILL BE EVIDENCED
BY SEPARATE CERTIFICATES AND WILL NO LONGER BE EVIDENCED BY THIS CERTIFICATE. THE
COMPANY WILL MAIL TO THE HOLDER OF THIS CERTIFICATE A COPY OF THE RIGHTS AGREEMENT
WITHOUT CHARGE AFTER RECEIPT OF A WRITTEN REQUEST THEREFOR ADDRESSED TO THE
SECRETARY OF THE COMPANY. AS DESCRIBED IN THE RIGHTS AGREEMENT, RIGHTS ISSUED TO
ANY PERSON WHO BECOMES AN ACQUIRING PERSON OR AN AFFILIATE OR ASSOCIATE THEREOF (AS
DEFINED IN THE RIGHTS AGREEMENT) AND CERTAIN RELATED PERSONS, WHETHER CURRENTLY HELD
BY OR ON BEHALF OF SUCH PERSON OR BY ANY SUBSEQUENT HOLDER, SHALL BECOME NULL AND
VOID.

     With respect to the Common Shares, until the earliest of the Distribution Date, the Redemption
Date or the Final Expiration Date, the Rights associated with the Common Shares represented by such
certificates or held in such book-entry accounts shall be evidenced by such certificates or such
book-entry accounts (together with the transaction advice with respect to such shares) alone, and
the transfer of any Common Shares, whether by transfer of such certificate or such book-entry
shares, shall also constitute the transfer of the Rights associated with the Common Shares. In the
event that the Company purchases or acquires any Common Shares after the Record Date but prior to
the Distribution Date, any Rights associated with such Common Shares shall be deemed canceled and
retired so that the Company shall not be entitled to exercise any Rights associated with the Common
Shares that are no longer outstanding. Notwithstanding this Section 3(c), the omission of a legend shall not affect the
enforceability of any part of this Agreement or the rights of any
holder of the Rights.

8.

 

     (d) Notwithstanding anything to the contrary contained herein, Common Shares and Rights (and
any securities issuable on their exercise) may be issued and transferred by book-entry and not
represented by physical certificates. Where Common Shares and Rights (and any securities issuable
on their exercise) are held in uncertificated form, the Company and the Rights Agent shall
cooperate in all respects to give effect to the intent of the provisions contained herein.

SECTION 4. Form of Right Certificates.

     (a) The Right Certificates (and the form of election to purchase Preferred Shares, the form of
assignment and the form of certification to be printed on the reverse thereof) shall be
substantially the same as Exhibit A hereto and may have such marks of identification or designation
and such legends, summaries or endorsements printed thereon as the Company may deem appropriate and
as are not inconsistent with the provisions of this Agreement, or as may be required to comply with
any applicable law or with any rule or regulation made pursuant thereto or with any rule or
regulation of any stock exchange or quotation system on which the Rights may from time to time be
listed, or to conform to usage. Subject to the provisions of Sections 7, 11 and 22 hereof, the
Right Certificates shall entitle the holders thereof to purchase such number of one one-hundredths
of a Preferred Share as shall be set forth therein at the Purchase Price, but the number of one
one-hundredths of a Preferred Share and the Purchase Price shall be subject to adjustment as
provided herein.

     (b) Any Right Certificate issued pursuant to Section 3(a) or Section 22 hereof that represents
Rights that are null and void pursuant to the second paragraph of Section 11(a)(ii) hereof and any
Right Certificate issued pursuant to Section 6 or Section 11 hereof upon transfer, exchange,
replacement or adjustment of any other Right Certificate referred to in this sentence shall contain
(to the extent feasible) substantially the following legend:

     THE RIGHTS REPRESENTED BY THIS RIGHT CERTIFICATE ARE OR WERE BENEFICIALLY OWNED
BY A PERSON WHO WAS OR BECAME AN ACQUIRING PERSON OR AN AFFILIATE OR ASSOCIATE OF AN
ACQUIRING PERSON (AS SUCH TERMS ARE DEFINED IN THE RIGHTS AGREEMENT). ACCORDINGLY,
THIS RIGHT CERTIFICATE AND THE RIGHTS REPRESENTED HEREBY ARE NULL AND VOID.

     The provisions of Section 11(a)(ii) hereof shall be operative whether or not the foregoing
legend is contained on any such Right Certificate.

SECTION 5. Countersignature and Registration. The Right Certificates shall be executed on
behalf of the Company by its Chairman of the Board, its Chief Executive Officer, its President, its
Vice Chairman of the Board, its Chief Financial Officer, or any of its Vice Presidents, either
manually or by facsimile signature, and shall be attested by the Secretary or an Assistant Secretary of the Company, either manually or by facsimile signature. The Right
Certificates shall be countersigned by the Rights Agent either manually or by facsimile signature
and shall not be valid for any purpose unless so countersigned. In case any officer of the Company
who shall have signed any of the Right Certificates shall cease to be such an officer before
countersignature by the Rights Agent and issuance and delivery by the Company, such

9.

 

Right
Certificates, nevertheless, may be countersigned by the Rights Agent and issued and delivered by
the Company with the same force and effect as though the person who signed such Right Certificates
had not ceased to be such an officer; and any Right Certificate may be signed on behalf of the
Company by any person who, at the actual date of the execution of such Right Certificate, shall be
a proper officer of the Company to sign such Right Certificate, although at the date of the
execution of this Agreement any such person was not such an officer.

     Following the Distribution Date, the Rights Agent will keep or cause to be kept, at its office
designated for such purpose, books for registration and transfer of the Right Certificates issued
hereunder. Such books shall show the names and addresses of the respective holders of the Right
Certificates, the number of Rights evidenced on its face by each of the Right Certificates, the
certificate number of each Right Certificate and the date of each of the Right Certificates.

SECTION 6. Transfer, Split Up, Combination and Exchange of Right Certificates; Mutilated, Destroyed, Lost or Stolen Right Certificates. Subject to the provisions of Sections
11(a)(ii), 14 and 24 hereof, at any time after the Close of Business on the Distribution Date, and
at or prior to the Close of Business on the earlier of the Redemption Date or the Final Expiration
Date, any Right Certificate or Right Certificates may be transferred, split up, combined or
exchanged for another Right Certificate or Right Certificates, entitling the registered holder to
purchase a like number of one one-hundredths of a Preferred Share as the Right Certificate or Right
Certificates surrendered then entitled such holder to purchase. Any registered holder desiring to
transfer, split up, combine or exchange any Right Certificate or Right Certificates shall make such
request in writing delivered to the Rights Agent, and shall surrender the Right Certificate or
Right Certificates to be transferred, split up, combined or exchanged at the office of the Rights
Agent designated for such purpose. Neither the Rights Agent nor the Company shall be obligated to
take any action whatsoever with respect to the transfer of any such surrendered Right Certificate
until the registered holder shall have completed and signed the certificate contained in the form
of assignment on the reverse side of such Right Certificate and shall have provided such additional
evidence of the identity of the Beneficial Owner (or former Beneficial Owner) or Affiliates or
Associates thereof as the Company shall reasonably request. Thereupon the Rights Agent shall,
subject to Sections 11(a)(ii), 14 and 24 hereof, countersign and deliver to the person entitled
thereto a Right Certificate or Right Certificates, as the case may be, as so requested. The
Company may require payment of a sum sufficient to cover any tax or governmental charge that may be
imposed in connection with any transfer, split up, combination or exchange of Right Certificates.

     Upon receipt by the Company and the Rights Agent of evidence reasonably satisfactory to them
of the loss, theft, destruction or mutilation of a Right Certificate, and, in case of loss, theft
or destruction, of indemnity or security reasonably satisfactory to them, and, at the Company’s request, reimbursement to the Company and the Rights Agent of all reasonable
expenses incidental thereto, and upon surrender to the Rights Agent and cancellation of the Right
Certificate if mutilated, the Company will issue, execute and deliver a new Right Certificate of
like tenor to the Rights Agent for countersignature and delivery to the registered holder in lieu
of the Right Certificate so lost, stolen, destroyed or mutilated.

10.

 

SECTION 7. Exercise of Rights; Purchase Price; Expiration Date of Rights.

     (a) The registered holder of any Right Certificate may exercise the Rights evidenced thereby
(except as otherwise provided herein) in whole or in part at any time after the Distribution Date
upon surrender of the Right Certificate, with the form of election to purchase on the reverse side
thereof properly completed and duly executed, to the Rights Agent at the office of the Rights Agent
designated for such purpose, together with payment of the Purchase Price in cash, or by certified
check, cashier’s check, bank draft or money order payable to the order of the Company for each one
one-hundredth of a Preferred Share (or such other number of shares or other securities) as to which
the Rights are exercised, prior to the earliest of (i) the Close of Business on December 27, 2011
(the “Final Expiration Date”), (ii) the time at which the Rights are redeemed as provided in
Section 23 hereof (the “Redemption Date”), or (iii) the time at which such Rights are exchanged as
provided in Section 24 hereof.

     (b) The purchase price for each one one-hundredth of a Preferred Share pursuant to the
exercise of a Right shall initially be $27.75 (the “Purchase Price”) and shall be subject to
adjustment from time to time as provided in Section 11 and Section 13 hereof and shall be payable
in lawful money of the United States of America in accordance with Section 7(c) below.

     (c) Upon receipt of a Right Certificate representing exercisable Rights, with the form of
election to purchase properly completed and duly executed, accompanied by payment of the Purchase
Price for the shares to be purchased and an amount equal to any applicable tax or charge required
to be paid by the holder of such Right Certificate in accordance with Section 9 hereof by certified
check, cashier’s check, bank draft or money order payable to the order of the Company, the Rights
Agent shall thereupon promptly (i) (A) requisition from any transfer agent for the Preferred Shares
certificates for the number of Preferred Shares to be purchased and the Company hereby irrevocably
authorizes its transfer agent to comply with all such requests, or (B) if the Company, in its sole
discretion, shall have elected to deposit the Preferred Shares issuable upon exercise of the Rights
hereunder into a depository, requisition from the depositary agent depositary receipts representing
such number of one one-hundredths of a Preferred Share as are to be purchased (in which case
certificates for the Preferred Shares represented by such receipts shall be deposited by the
transfer agent with the depositary agent) and the Company hereby directs the depositary agent to
comply with such request, (ii) when appropriate, requisition from the Company the amount of cash to
be paid in lieu of issuance of fractional shares in accordance with Section 14 hereof, (iii) after
receipt of such certificates or depositary receipts, cause the same to be delivered to or upon the
order of the registered holder of such Right Certificate, registered in such name or names as may
be designated by such holder and (iv) when appropriate, after receipt, deliver such cash to or upon
the order of the registered holder of such Right Certificate. In the event that the Company is
obligated to issue securities of the Company other than Preferred Shares (including Common Shares)
of the Company pursuant to Section 11(a) hereof, the Company will make all arrangements necessary so that such other
securities are available for distribution by the Rights Agent, if and when appropriate.

     In addition, in the case of an exercise of the Rights by a holder pursuant to Section
11(a)(ii) hereof, the Rights Agent shall return such Right Certificate to the registered holder
thereof after imprinting, stamping or otherwise indicating thereon that the rights represented by
such Right Certificate no longer include the rights provided by Section 11(a)(ii)

11.

 

hereof, and, if
fewer than all the Rights represented by such Right Certificate were so exercised, the Rights Agent
shall indicate on the Right Certificate the number of Rights represented thereby that continue to
include the rights provided by Section 11(a)(ii) hereof.

     (d) In case the registered holder of any Right Certificate shall exercise fewer than all the
Rights evidenced thereby (other than a partial exercise of rights pursuant to Section 11(a)(ii) as
described in Section 7(c) hereof), a new Right Certificate evidencing Rights equivalent to the
Rights remaining unexercised shall be issued by the Rights Agent to the registered holder of such
Right Certificate or to the duly authorized assigns of such holder, subject to the provisions of
Section 14 hereof.

     (e) The Company covenants and agrees that it will cause to be reserved and kept available out
of its authorized and unissued Preferred Shares or any Preferred Shares held in its treasury, the
number of Preferred Shares that will be sufficient to permit the exercise in full of all
outstanding Rights in accordance with this Section 7.

     (f) Notwithstanding anything in this Agreement to the contrary, neither the Rights Agent nor
the Company shall be obligated to undertake any action with respect to a registered holder upon the
occurrence of any purported exercise as set forth in this Section 7 unless such registered holder
shall have (i) completed and signed the certification following the form of election to purchase
set forth on the reverse side of the Right Certificate surrendered for such exercise, (ii) tendered
the Purchase Price (and an amount equal to any applicable transfer tax required to be paid by the
holder of such Right Certificate in accordance with Section 9) to the Company in the manner set
forth in Section 7(c), and (iii) provided such additional evidence of the identity of the
Beneficial Owner (or former Beneficial Owner) or Affiliates or Associates thereof as the Company
shall reasonably request.

SECTION 8. Cancellation and Destruction of Right Certificates. All Right Certificates
surrendered for the purpose of exercise, transfer, split up, combination or exchange shall, if
surrendered to the Company or to any of its agents, be delivered to the Rights Agent for
cancellation or in canceled form, or, if delivered or surrendered to the Rights Agent, shall be
canceled by it, and no Right Certificates shall be issued in lieu thereof except as expressly
permitted by any of the provisions of this Agreement. The Company shall deliver to the Rights
Agent for cancellation and retirement, and the Rights Agent shall so cancel and retire, any other
Right Certificate purchased or acquired by the Company otherwise than upon the exercise thereof.
Subject to applicable law and regulation, the Rights Agent shall maintain (i) in a retrievable
database electronic records of all cancelled or destroyed stock certificates which have been
canceled or destroyed by the Rights Agent. The Rights Agent shall maintain such electronic
records or physical records for the time period required by applicable law and regulation. Upon written request of the Corporation (and at the expense of the Corporation), the
Rights Agent shall provide to the Corporation or its designee copies of such electronic records or
physical records relating to rights certificates cancelled or destroyed by the Rights Agent.

SECTION 9. Availability of Preferred Shares. The Company covenants and agrees that so
long as the Preferred Shares (and, after the time a person becomes an Acquiring Person, Common
Shares or any other securities) issuable upon the exercise of the Rights may be listed on any
national securities exchange or quotation system, the Company shall use its best efforts to

12.

 

cause,
from and after such time as the Rights become exercisable, all shares reserved for such issuance to
be listed on such exchange or quotation system upon official notice of issuance upon such exercise.

     The Company covenants and agrees that it will take all such action as may be necessary to
ensure that all Preferred Shares (or Common Shares and other securities, as the case may be)
delivered upon exercise of Rights shall, at the time of delivery of the certificates for such
Preferred Shares (or Common Shares and other securities, as the case may be) (subject to payment of
the Purchase Price), be duly and validly authorized and issued and fully paid and nonassessable
shares or other securities.

     The Company further covenants and agrees that it will pay when due and payable any and all
federal and state transfer taxes and charges that may be payable in respect of the issuance or
delivery of the Right Certificates or of any Preferred Shares (or Common Shares and other
securities, as the case may be) upon the exercise of Rights. The Company shall not, however, be
required to pay any transfer tax that may be payable in respect of any transfer or delivery of
Right Certificates to a Person other than, or the issuance or delivery of certificates or
depositary receipts for the Preferred Shares in a name other than that of, the registered holder of
the Right Certificate evidencing Rights surrendered for exercise or to issue or to deliver any
certificates or depositary receipts for Preferred Shares upon the exercise of any Rights until any
such tax shall have been paid (any such tax being payable by the holder of such Right Certificate
at the time of surrender) or until it has been established to the Company’s reasonable satisfaction
that no such tax is due.

     As soon as practicable after the Distribution Date, the Company shall use its best efforts to:

          (i) prepare and file a registration statement under the Securities Act with respect to the
securities purchasable upon exercise of the Rights on an appropriate form, will use its best
efforts to cause such registration statement to become effective as soon as practicable after such
filing and will use its best efforts to cause such registration statement to remain effective (with
a prospectus at all times meeting the requirements of the Securities Act) until the earlier of the
Redemption Date and the Final Expiration Date; and

          (ii) use its best efforts to qualify or register the Rights and the securities purchasable
upon exercise of the Rights under the blue sky laws of such jurisdictions as may be necessary or
appropriate.

The Company may temporarily suspend, for a period of time not to exceed 120 days, the
exercisability of the Rights in order to prepare and file a registration statement under the
Securities Act and permit it to become effective. Upon any such suspension, the Company shall
issue a public announcement stating that the exercisability of the Rights has been temporarily
suspended, as well as a public announcement at such time as the suspension is no longer in effect.
Notwithstanding any provision of this Agreement to the contrary, the Rights shall not be
exercisable in any jurisdiction unless the requisite qualification in such jurisdiction shall have
been obtained and unless a registration statement under the Securities Act (if required) covering
the issuance of securities upon exercise of the Rights is effective.

13.

 

SECTION 10. Preferred Shares Record Date. Each Person in whose name any certificate for
Preferred Shares or other securities is issued upon the exercise of Rights shall for all purposes
be deemed to have become the holder of record of the Preferred Shares or other securities
represented thereby on, and such certificate shall be dated, the date upon which the Right
Certificate evidencing such Rights was duly surrendered with the forms of election and
certification duly executed and payment of the Purchase Price (and any applicable transfer taxes)
was made; provided, however, that if the date of such surrender and payment is a date upon which
the Preferred Shares or other securities transfer books of the Company are closed, such person
shall be deemed to have become the record holder of such shares on, and such certificate shall be
dated, the next succeeding Business Day on which the Preferred Shares or other securities transfer
books of the Company are open. Prior to the exercise of the Rights evidenced thereby, the holder
of a Right Certificate, as such, shall not be entitled to any rights of a holder of Preferred
Shares for which the Rights shall be exercisable, including, without limitation, the right to vote,
to receive dividends or other distributions, or to exercise any preemptive rights, and shall not be
entitled to receive any notice of any proceedings of the Company, except as provided herein.

SECTION 11. Adjustment of Purchase Price, Number of Shares or Number of Rights. The
Purchase Price, the number of Preferred Shares covered by each Right and the number of Rights
outstanding are subject to adjustment from time to time as provided in this Section 11.

     (a)

          (i) In the event the Company shall at any time after the date of this Agreement (A) declare a
dividend on the Preferred Shares payable in Preferred Shares, (B) subdivide the outstanding
Preferred Shares, (C) combine the outstanding Preferred Shares into a smaller number of Preferred
Shares or (D) issue any shares of its capital stock in a reclassification of the Preferred Shares
(including any such reclassification in connection with a consolidation or merger in which the
Company is the continuing or surviving entity), except as otherwise provided in this Section 11(a),
the Purchase Price in effect at the time of the record date for such dividend or of the effective
date of such subdivision, combination or reclassification, and the number and kind of shares of
capital stock issuable on such date, shall be proportionately adjusted so that the holder of any
Right exercised after such time shall be entitled to receive the aggregate number and kind of
shares of capital stock that, if such Right had been exercised immediately prior to such date and
at a time when the Preferred Shares transfer books of the Company were open, such holder would have owned upon such exercise and been entitled to
receive by virtue of such dividend, subdivision, combination or reclassification; provided,
however, that in no event shall the consideration to be paid upon the exercise of one Right be less
than the aggregate par value of the shares of capital stock of the Company issuable upon exercise
of one Right. If an event occurs that would require an adjustment under both Section 11(a)(i) and
Section 11(a)(ii) hereof, the adjustment provided for in this Section 11(a)(i) shall be in addition
to, and shall be made prior to any adjustment required pursuant to Section 11(a)(ii) hereof.

14.

 

          (ii) Subject to Section 24 hereof, in the event any Person becomes an Acquiring Person, each
holder of a Right shall thereafter have a right to receive, upon exercise thereof at a price equal
to the then current Purchase Price multiplied by the number of one one-hundredths of a Preferred
Share for which a Right is then exercisable, in accordance with the terms of this Agreement and in
lieu of Preferred Shares, such number of Common Shares as shall equal the result obtained by (A)
multiplying the then current Purchase Price by the number of one one-hundredths of a Preferred
Share for which a Right is then exercisable and dividing that product by (B) 50% of the then
current per share market price of the Common Shares (determined pursuant to Section 11(d) hereof)
on the date such Person became an Acquiring Person; provided, however, that if the transaction that
would otherwise give rise to the foregoing adjustment is also subject to the provisions of Section
13 hereof, then only the provisions of Section 13 hereof shall apply and no adjustment shall be
made pursuant to this Section 11(a)(ii). In the event that any Person shall become an Acquiring
Person and the Rights shall then be outstanding, the Company shall not take any action that would
eliminate or diminish the benefits intended to be afforded by the Rights.

     Notwithstanding anything in this Agreement to the contrary, from and after the time any Person
becomes an Acquiring Person, any Rights beneficially owned by (i) such Acquiring Person or an
Associate or Affiliate of such Acquiring Person, (ii) a transferee of such Acquiring Person (or of
any such Associate or Affiliate) who becomes a transferee after the Acquiring Person became such,
or (iii) a transferee of such Acquiring Person (or of any such Associate or Affiliate) who becomes
a transferee prior to or concurrently with the Acquiring Person’s becoming such and receives such
Rights pursuant to either (A) a transfer (whether or not for consideration) from the Acquiring
Person to holders of equity interests in such Acquiring Person or to any Person with whom the
Acquiring Person has any continuing agreement, arrangement or understanding regarding the
transferred Rights or (B) a transfer that the Board has determined is part of a plan, arrangement
or understanding that has as a primary purpose or effect the avoidance of this Section 11(a)(ii),
shall become null and void without any further action and no holder of such Rights shall have any
rights whatsoever with respect to such Rights, whether under any provision of this Agreement or
otherwise. The Company shall use all reasonable efforts to ensure that the provisions of this
Section 11(a)(ii) and Section 4(b) hereof are complied with, but shall have no liability to any
holder of Right Certificates or other Person as a result of the Company’s failure to make any
determinations with respect to an Acquiring Person or its Affiliates, Associates or transferees
hereunder. No Right Certificate shall be issued at any time upon the transfer of any Rights to an
Acquiring Person whose Rights would be void pursuant to the first sentence of this paragraph or any
Associate or Affiliate thereof or to any nominee of such Acquiring Person, Associate or Affiliate;
and any Right Certificate delivered to the Rights Agent for transfer to any Person whose Rights would be void pursuant to the first sentence of
this paragraph shall be canceled.

          (iii) In lieu of issuing Common Shares in accordance with Section 11(a)(ii) hereof, the
Company may, if the Board determines that such action is necessary or appropriate and not contrary
to the interests of holders of Rights, elect to (and, in the event that the Board has not exercised
the exchange right contained in Section 24(c) hereof and there are not sufficient treasury shares
and authorized but unissued Common Shares to permit the exercise in full of the Rights in
accordance with Section 11(a)(ii) hereof, the Company shall) take all such action as may be
necessary to authorize, issue or pay, upon the exercise of the Rights, cash (including by

15.

 

way of a
reduction of the Purchase Price), property, Common Shares, other securities or any combination
thereof having an aggregate value equal to the value of the Common Shares that otherwise would have
been issuable pursuant to Section 11(a)(ii) hereof, which aggregate value shall be determined by a
nationally recognized investment banking firm selected by the Board. For purposes of the preceding
sentence, the value of the Common Shares shall be determined pursuant to Section 11(d) hereof.
Following the Distribution Date, the Board may suspend the exercisability of the Rights for a
period of up to 60 days following the Distribution Date to the extent that the Board has not
determined whether to exercise its right of election under this Section 11(a)(iii). In the event
of any such suspension, the Company shall issue a public announcement stating that the
exercisability of the Rights has been temporarily suspended.

     (b) In case the Company shall fix a record date for the issuance of rights, options or
warrants to all holders of Preferred Shares entitling them to subscribe for or purchase Preferred
Shares (or shares having the same designations and the powers, preferences and rights, and the
qualifications, limitations and restrictions as the Preferred Shares (“Equivalent Preferred
Shares”)) or securities convertible into Preferred Shares or Equivalent Preferred Shares at a price
per Preferred Share or Equivalent Preferred Share (or having a conversion price per share, if a
security convertible into Preferred Shares or Equivalent Preferred Shares) less than the then
current per share market price of the Preferred Shares on such record date, the Purchase Price to
be in effect after such record date shall be determined by multiplying the Purchase Price in effect
immediately prior to such record date by a fraction, the numerator of which shall be the number of
Preferred Shares outstanding on such record date plus the number of Preferred Shares that the
aggregate offering price of the total number of Preferred Shares and/or Equivalent Preferred Shares
so to be offered (and/or the aggregate initial conversion price of the convertible securities so to
be offered) would purchase at such current market price and the denominator of which shall be the
number of Preferred Shares outstanding on such record date plus the number of additional Preferred
Shares and/or Equivalent Preferred Shares to be offered for subscription or purchase (or into which
the convertible securities so to be offered are initially convertible); provided, however, that in
no event shall the consideration to be paid upon the exercise of one Right be less than the
aggregate par value of the shares of capital stock of the Company issuable upon exercise of one
Right. In case such subscription price may be paid in a consideration part or all of which shall
be in a form other than cash, the value of such consideration shall be as determined in good faith
by the Board, whose determination shall be described in a statement filed with the Rights Agent.
Preferred Shares owned by or held for the account of the Company shall not be deemed outstanding
for the purpose of any such computation. Such adjustment shall be made successively whenever such
a record date is fixed; and in the event that such rights, options or warrants are not so issued, the Purchase Price shall be adjusted to be the Purchase Price that
would then be in effect if such record date had not been fixed.

     (c) In case the Company shall fix a record date for the making of a distribution to all
holders of the Preferred Shares (including any such distribution made in connection with a
consolidation or merger in which the Company is the continuing or surviving entity) of evidences of
indebtedness or assets (other than a regular quarterly cash dividend or a dividend payable in
Preferred Shares) or subscription rights or warrants (excluding those referred to in Section 11(b)
hereof), the Purchase Price to be in effect after such record date shall be determined by
multiplying the Purchase Price in effect immediately prior to such record date by a fraction, the
numerator of which shall be the then current per share market price of the

16.

 

Preferred Shares on such
record date, less the fair market value (as determined in good faith by the Board, whose
determination shall be described in a statement filed with the Rights Agent) of the portion of the
assets or evidences of indebtedness so to be distributed or of such subscription rights or warrants
applicable to one Preferred Share and the denominator of which shall be such current per share
market price of the Preferred Shares; provided, however, that in no event shall the consideration
to be paid upon the exercise of one Right be less than the aggregate par value of the shares of
capital stock of the Company to be issued upon exercise of one Right. Such adjustments shall be
made successively whenever such a record date is fixed; and in the event that such distribution is
not so made, the Purchase Price shall again be adjusted to be the Purchase Price that would then be
in effect if such record date had not been fixed.

     (d)

          (i) For the purpose of any computation hereunder, the “current per share market price” of any
security (a “Security” for the purpose of this Section 11(d)(i)) on any date shall be deemed to be
the average of the daily closing prices per share of such Security for the 30 consecutive Trading
Days immediately prior to such date; provided, however, that in the event that the current per
share market price of the Security is determined during a period following the announcement by the
issuer of such Security of (A) a dividend or distribution on such Security payable in shares of
such Security or securities convertible into such shares, or (B) any subdivision, combination or
reclassification of such Security or securities convertible into such shares and prior to the
expiration of 30 Trading Days after the ex-dividend date for such dividend or distribution, or the
record date for such subdivision, combination or reclassification, then, and in each such case, the
current per share market price shall be appropriately adjusted to reflect the current market price
per share equivalent of such Security. The closing price for each day shall be the last sale
price, regular way, or, in case no such sale takes place on such day, the average of the closing
bid and asked prices, regular way, in either case as reported in the principal consolidated
transaction reporting system with respect to securities listed or admitted to trading on the New
York Stock Exchange or The NASDAQ Stock Market or, if the Security is not listed or admitted to
trading on the New York Stock Exchange or The NASDAQ Stock Market, as reported in the principal
consolidated transaction reporting system with respect to securities listed on the principal
national securities exchange on which the Security is listed or, if the Security is not listed or
admitted to trading on any national securities exchange, the last quoted price or, if not so
quoted, the average of the high bid and low asked prices in the over-the-counter market, as
reported in the OTC Bulletin Board, the Pink OTC Markets, Inc. or such other system then in use,
or, if on any such date the Security is not quoted by any such organization, the average of the closing bid and asked prices as furnished by a professional market maker
making a market in the Security selected by the Board or, if on any such date no professional
market maker is making a market in the Security, the price as determined in good faith by the
Board. The term “Trading Day” shall mean a day on which the principal national securities exchange
on which the Security is listed or admitted to trading is open for the transaction of business or,
if the Security is not listed or admitted to trading on any national securities exchange, a
Business Day.

          (ii) For the purpose of any computation hereunder, the “current per share market price” of the
Preferred Shares shall be determined in accordance with the method set forth in Section 11(d)(i)
hereof. If the Preferred Shares are not publicly traded, the “current per

17.

 

share market price” of
the Preferred Shares shall be conclusively deemed to be the current per share market price of the
Common Shares as determined pursuant to Section 11(d)(i) hereof (appropriately adjusted to reflect
any stock split, stock dividend or similar transaction occurring after the date hereof) multiplied
by one hundred. If neither the Common Shares nor the Preferred Shares are publicly traded,
“current per share market price” shall mean the fair value per share as determined in good faith by
the Board, whose determination shall be set forth in a statement filed with the Rights Agent.

     (e) No adjustment in the Purchase Price shall be required unless such adjustment would require
an increase or decrease of at least 1% in the Purchase Price; provided, however, that any
adjustments that by reason of this Section 11(e) are not required to be made shall be carried
forward and taken into account in any subsequent adjustment. All calculations under this Section
11 shall be made to the nearest cent or to the nearest one one-millionth of a Preferred Share or
one one-thousandth of any other share or security as the case may be. Notwithstanding the first
sentence of this Section 11(e), any adjustment required by this Section 11 shall be made no later
than the earlier of (i) three years from the date of the transaction that requires such adjustment
or (ii) the date of the expiration of the right to exercise any Rights.

     (f) If as a result of an adjustment made pursuant to Section 11(a) hereof, the holder of any
Right thereafter exercised shall become entitled to receive any shares of capital stock of the
Company other than Preferred Shares, thereafter the number of such other shares so receivable upon
exercise of any Right shall be subject to adjustment from time to time in a manner and on terms as
nearly equivalent as practicable to the provisions with respect to the Preferred Shares contained
in Sections 11(a) through 11(c) hereof, inclusive, and the provisions of Sections 7, 9, 10, 13 and
14 hereof with respect to the Preferred Shares shall apply on like terms to any such other shares.

     (g) All Rights originally issued by the Company subsequent to any adjustment made to the
Purchase Price hereunder shall evidence the right to purchase, at the adjusted Purchase Price, the
number of one one-hundredths of a Preferred Share purchasable from time to time hereunder upon
exercise of the Rights, all subject to further adjustment as provided herein.

     (h) Unless the Company shall have exercised its election as provided in Section 11(i) hereof,
upon each adjustment of the Purchase Price as a result of the calculations made in Section 11(b)
and Section 11(c) hereof, each Right outstanding immediately prior to the making of such adjustment
shall thereafter evidence the right to purchase, at the adjusted Purchase Price, that number of one one-hundredths of a Preferred Share (calculated to the nearest one
one-millionth of a Preferred Share) obtained by (i) multiplying (x) the number of one one
hundredths of a Preferred Share covered by a Right immediately prior to this adjustment by (y) the
Purchase Price in effect immediately prior to such adjustment of the Purchase Price and (ii)
dividing the product so obtained by the Purchase Price in effect immediately after such adjustment
of the Purchase Price.

     (i) The Company may elect on or after the date of any adjustment of the Purchase Price to
adjust the number of Rights, in substitution for any adjustment in the number of one one-hundredths
of a Preferred Share purchasable upon the exercise of a Right. Each of the Rights outstanding
after such adjustment of the number of Rights shall be exercisable for the number of

18.

 

one
one-hundredths of a Preferred Share for which a Right was exercisable immediately prior to such
adjustment. Each Right held of record prior to such adjustment of the number of Rights shall
become that number of Rights (calculated to the nearest one one-hundredth) obtained by dividing the
Purchase Price in effect immediately prior to adjustment of the Purchase Price by the Purchase
Price in effect immediately after adjustment of the Purchase Price. The Company shall make a
public announcement of its election to adjust the number of Rights, indicating the record date for
the adjustment, and, if known at the time, the amount of the adjustment to be made. This record
date may be the date on which the Purchase Price is adjusted or any day thereafter, but, if the
Right Certificates have been issued, shall be at least 10 days later than the date of the public
announcement. If Right Certificates have been issued, upon each adjustment of the number of Rights
pursuant to this Section 11(i), the Company shall, as promptly as practicable, cause to be
distributed to holders of record of Right Certificates on such record date Right Certificates
evidencing, subject to Section 14 hereof, the additional Rights to which such holders shall be
entitled as a result of such adjustment, or, at the option of the Company, shall cause to be
distributed to such holders of record in substitution and replacement for the Right Certificates
held by such holders prior to the date of adjustment, and upon surrender thereof, if required by
the Company, new Right Certificates evidencing all the Rights to which such holders shall be
entitled after such adjustment. Right Certificates to be so distributed shall be issued, executed
and countersigned in the manner provided for herein and shall be registered in the names of the
holders of record of Right Certificates on the record date specified in the public announcement.

     (j) Irrespective of any adjustment or change in the Purchase Price or the number of one
one-hundredths of a Preferred Share issuable upon the exercise of the Rights, the Right
Certificates theretofore and thereafter issued may continue to express the Purchase Price and the
number of one one-hundredths of a Preferred Share that was expressed in the initial Right
Certificates issued hereunder.

     (k) Before taking any action that would cause an adjustment reducing the Purchase Price below
one one-hundredth of the then par value, if any, of the Preferred Shares issuable upon exercise of
the Rights, the Company shall take any corporate action that may, in the opinion of its counsel, be
necessary to enable the Company to validly and legally issue fully paid and nonassessable Preferred
Shares at such adjusted Purchase Price.

     (l) In any case in which this Section 11 shall require that an adjustment in the Purchase
Price be made effective as of a record date for a specified event, the Company may elect to defer until the occurrence of such event the issuing to the holder of any Right
exercised after such record date of the Preferred Shares and other capital stock or securities of
the Company, if any, issuable upon such exercise on the basis of the Purchase Price in effect prior
to such adjustment; provided, however, that the Company shall deliver to such holder a due bill or
other appropriate instrument evidencing such holder’s right to receive such additional shares upon
the occurrence of the event requiring such adjustment.

     (m) The Company covenants and agrees that, after the Distribution Date, it will not, except as
permitted by this Agreement, take (or permit any Subsidiary to take) any action the purpose of
which is to, or if at the time such action is taken it is reasonably foreseeable that the effect of
such action is to, materially diminish or eliminate the benefits intended to be afforded

19.

 

by the
Rights. Any such action taken by the Company during any period after any Person becomes an
Acquiring Person but prior to the Distribution Date shall be null and void unless such action could
be taken under this Section 11(m) from and after the Distribution Date.

     (n) Notwithstanding anything in this Section 11 to the contrary, the Company shall be entitled
to make such reductions in the Purchase Price, in addition to those adjustments expressly required
by this Section 11, as and to the extent that it in its sole discretion shall determine to be
advisable in order that any (i) consolidation or subdivision of the Preferred Shares, (ii) issuance
wholly for cash of any Preferred Shares at less than the current market price, (iii) issuance
wholly for cash of Preferred Shares or securities that by their terms are convertible into or
exchangeable for Preferred Shares, (iv) dividends on Preferred Shares payable in Preferred Shares
or (v) issuance of rights, options or warrants referred to hereinabove in Section 11(b), hereafter
made by the Company to holders of its Preferred Shares shall not be taxable to such stockholders.

     (o) In the event that at any time after the date of this Agreement and prior to the
Distribution Date, the Company shall (i) declare or pay any dividend on the Common Shares payable
in Common Shares or (ii) effect a subdivision, combination or consolidation of the Common Shares
(by reclassification or otherwise than by payment of dividends in Common Shares) into a greater or
lesser number of Common Shares, then in any such case (A) the number of one one-hundredths of a
Preferred Share purchasable after such event upon proper exercise of each Right shall be determined
by multiplying the number of one one-hundredths of a Preferred Share so purchasable immediately
prior to such event by a fraction, the numerator of which is the number of Common Shares
outstanding immediately before such event and the denominator of which is the number of Common
Shares outstanding immediately after such event, and (B) each Common Share outstanding immediately
after such event shall have issued with respect to it that number of Rights that each Common Share
outstanding immediately prior to such event had issued with respect to it. The adjustments
provided for in this Section 11(o) shall be made successively whenever such a dividend is declared
or paid or such a subdivision, combination or consolidation is effected.

     (p) The exercise of Rights under Section 11(a)(ii) hereof shall only result in the loss of
rights under Section 11(a)(ii) hereof to the extent so exercised and shall not otherwise affect the
rights represented by the Rights under this Agreement, including the rights represented by Section
13 hereof.

SECTION 12. Certificate of Adjusted Purchase Price or Number of Shares. Whenever an
adjustment is made as provided in Sections 11 and 13 hereof, the Company shall promptly (a) prepare
a certificate setting forth such adjustment, and a brief statement of the facts accounting for such
adjustment, (b) file with the Rights Agent and with each transfer agent for the Common Shares or
the Preferred Shares a copy of such certificate and (c) mail a brief summary thereof to each holder
of a Right Certificate in accordance with Section 25 hereof. The Rights Agent shall be fully
protected in relying on any such certificate and on any adjustment therein contained and shall not
be deemed to have knowledge of any adjustment unless and until it shall have received such
certificate.

20.

 

SECTION 13. Consolidation, Merger or Sale or Transfer of Assets or Earning Power.

     (a) In the event that, following the Distribution Date, directly or indirectly (x) the Company
shall consolidate with, or merge with and into, any Interested Stockholder, or if in such merger or
consolidation all holders of Common Stock are not treated alike, any other Person, (y) any
Interested Stockholder, or if in such merger or consolidation all holders of Common Stock are not
treated alike, any other Person shall consolidate with the Company, or merge with and into the
Company, and the Company shall be the continuing or surviving entity of such merger (other than, in
the case of either transaction described in (x) or (y), a merger or consolidation that would result
in all of the voting power represented by the securities of the Company outstanding immediately
prior thereto continuing to represent (either by remaining outstanding or by being converted into
securities of the surviving entity) all of the voting power represented by the securities of the
Company or such surviving entity outstanding immediately after such merger or consolidation and the
holders of such securities not having changed as a result of such merger or consolidation), or (z)
the Company shall sell or otherwise transfer (or one or more of its Subsidiaries shall sell or
otherwise transfer), in one or more transactions, assets or earning power aggregating more than 50%
of the assets or earning power of the Company and its Subsidiaries (taken as a whole) to any
Interested Stockholder or Interested Stockholders, or if in such transaction all holders of Common
Stock are not treated alike, any other Person (other than the Company or any Subsidiary of the
Company in one or more transactions each of which individually and all of which collectively do not
violate Section 13(d) hereof) then, and in each such case, proper provision shall be made so that
(i) each holder of a Right, subject to Section 11(a)(ii) hereof, shall have the right to receive,
upon the exercise thereof at a price equal to the then current Purchase Price multiplied by the
number of one one-hundredths of a Preferred Share for which a Right is then exercisable in
accordance with the terms of this Agreement and in lieu of Preferred Shares, such number of freely
tradeable Common Shares of the Principal Party, free and clear of liens, rights of call or first
refusal, encumbrances or other adverse claims, as shall be equal to the result obtained by (A)
multiplying the then current Purchase Price by the number of one one-hundredths of a Preferred
Share for which a Right is then exercisable (without taking into account any adjustment previously
made pursuant to Section 11(a)(ii) hereof) and dividing that product by (B) 50% of the then current
per share market price of the Common Shares of such Principal Party (determined pursuant to Section
11(d) hereof) on the date of consummation of such consolidation, merger, sale or transfer; (ii)
such Principal Party shall thereafter be liable for, and shall assume, by virtue of such
consolidation, merger, sale or transfer, all the obligations and duties of the Company pursuant to this Agreement; (iii) the term “Company” shall
thereafter be deemed to refer to such Principal Party, it being specifically intended that the
provisions of Section 11 hereof shall apply to such Principal Party; and (iv) such Principal Party
shall take such steps (including, but not limited to, the reservation of a sufficient number of
shares of its Common Shares) in connection with such consummation as may be necessary to assure
that the provisions hereof shall thereafter be applicable, as nearly as reasonably may be, in
relation to its Common Shares thereafter deliverable upon the exercise of the Rights.

21.

 

     (b) “Principal Party” shall mean:

          (i) in the case of any transaction described in clause (x) or (y) of Section 13(a) hereof, the
Person that is the issuer of any securities into which Common Shares are converted in such merger
or consolidation, and if no securities are so issued, the Person that is the other party to the
merger or consolidation (or, if applicable, the Company, if it is the surviving entity); and

          (ii) in the case of any transaction described in clause (z) of Section 13(a) hereof, the
Person that is the party receiving the greatest portion of the assets or earning power transferred
pursuant to such transaction or transactions;

provided, however, that in any case, (1) if the Common Shares of such Person are not at such time
and have not been continuously over the preceding 12-month period registered under Section 12 of
the Exchange Act, and such Person is a direct or indirect Subsidiary or Affiliate of another Person
the Common Shares of which are and have been so registered, “Principal Party” shall refer to such
other Person; (2) if such Person is a Subsidiary, directly or indirectly, or Affiliate of more than
one Person, the Common Shares of two or more of which are and have been so registered, “Principal
Party” shall refer to whichever of such Persons is the issuer of the Common Shares having the
greatest aggregate market value; and (3) if such Person is owned, directly or indirectly, by a
joint venture formed by two or more Persons that are not owned, directly or indirectly, by the same
Person, the rules set forth in (1) and (2) above shall apply to each of the chains of ownership
having an interest in such joint venture as if such party were a “Subsidiary” of both or all of
such joint venturers and the Principal Parties in each such chain shall bear the obligations set
forth in this Section 13 in the same ratio as their direct or indirect interests in such Person
bear to the total of such interests.

     (c) The Company shall not consummate any such consolidation, merger, sale or transfer unless
the Principal Party shall have a sufficient number of authorized Common Shares that have not been
issued or reserved for issuance to permit the exercise in full of the Rights in accordance with
this Section 13 and unless prior thereto the Company and each Principal Party and each other Person
who may become a Principal Party as a result of such consolidation, merger, sale or transfer shall
have (i) executed and delivered to the Rights Agent a supplemental agreement providing for the
terms set forth in Sections 13(a) and 13(b) hereof, and (ii) prepared, filed and had declared and
remain effective a registration statement under the Securities Act on the appropriate form with
respect to the Rights and the securities exercisable upon exercise of the Rights and further
providing that, as soon as practicable after the date of any consolidation, merger, sale or
transfer mentioned in Section 13(a) hereof, the Principal Party at its own expense will:

          (i) cause the registration statement under the Securities Act on an appropriate form with
respect to the Rights and the securities purchasable upon exercise of the Rights to remain
effective (with a prospectus at all times meeting the requirements of the Securities Act) until the
earlier of the Redemption Date and the Final Expiration Date;

22.

 

          (ii) use its best efforts to qualify or register the Rights and the securities purchasable
upon exercise of the Rights under the blue sky laws of such jurisdictions as may be necessary or
appropriate;

          (iii) list the Rights and the securities purchasable upon exercise of the Rights on each
national securities exchange on which the Common Shares were listed prior to the consummation of
such consolidation, merger, sale or transfer or, if the Common Shares were not listed on a national
securities exchange prior to the consummation of such consolidation, merger, sale or transfer, on a
national securities exchange; and

          (iv) deliver to holders of the Rights historical financial statements for the Principal Party
and each of its Affiliates that comply in all material respects with the requirements for
registration on Form 10 under the Exchange Act.

     The provisions of this Section 13 shall similarly apply to successive mergers or
consolidations or sales or other transfers.

     (d) After the Distribution Date and until the earlier of the Redemption Date and the Final
Expiration Date, the Company covenants and agrees that it shall not (i) consolidate with, (ii)
merge with or into, or (iii) sell or transfer to, in one or more transactions, assets or earning
power aggregating more than 50% of the assets or earning power of the Company and its Subsidiaries
taken as a whole, any other Person (other than a Subsidiary of the Company in a transaction that
does not violate Section 11(m) hereof), if (x) at the time of or after such consolidation, merger,
sale or transfer there are any charter or bylaw provisions or any rights, warrants or other
instruments or securities outstanding, agreements in effect or any other action taken that would
diminish or otherwise eliminate the benefits intended to be afforded by the Rights or (y) prior to,
simultaneously with or immediately after such consolidation, merger, sale or transfer, the
stockholders of the Person who constitutes, or would constitute, the “Principal Party” for purposes
of Section 13(a) hereof shall have received a distribution of Rights previously owned by such
Person or any of its Affiliates and Associates. The Company shall not consummate any such
consolidation, merger, sale or transfer unless prior thereto the Company and such other Person
shall have executed and delivered to the Rights Agent a supplemental agreement evidencing
compliance with this Section 13(d).

SECTION 14. Fractional Rights and Fractional Shares.

     (a) The Company shall not be required to issue fractions of Rights or to distribute Right
Certificates that evidence fractional Rights. In lieu of such fractional Rights, there shall be
paid to the registered holders of the Right Certificates with regard to which such fractional
Rights would otherwise be issuable, an amount in cash equal to the same fraction of the current
market value of a whole Right. For the purposes of this Section 14(a), the current market value of a whole Right shall be the closing price of the Rights for the Trading Day immediately
prior to the date on which such fractional Rights would have been otherwise issuable. The closing
price for any day shall be the last sale price, regular way, or, in case no such sale takes place
on such day, the average of the closing bid and asked prices, regular way, in either case as
reported in the principal consolidated transaction reporting system with respect to securities
listed or admitted to trading on the New York Stock Exchange or The NASDAQ Stock Market, if the
Rights are not

23.

 

listed or admitted to trading on the New York Stock Exchange of The NASDAQ Stock
Market, as reported in the principal consolidated transaction reporting system with respect to
securities listed on the principal national securities exchange on which the Rights are listed or
admitted to trading or, if the Rights are not listed or admitted to trading on any national
securities exchange, the last quoted price or, if not so quoted, the average of the high bid and
low asked prices in the over-the-counter market, as reported in the OTC Bulletin Board, the Pink
OTC Markets, Inc. or such other system then in use or, if on any such date the Rights are not
quoted by any such organization, the average of the closing bid and asked prices as furnished by a
professional market maker making a market in the Rights selected by the Board. If on any such date
no such market maker is making a market in the Rights, the fair value of the Rights on such date as
determined in good faith by the Board shall be used.

     (b) The Company shall not be required to issue fractions of Preferred Shares (other than
fractions that are integral multiples of one one-hundredth of a Preferred Share) upon exercise of
the Rights or to distribute certificates that evidence fractional Preferred Shares (other than
fractions that are integral multiples of one one-hundredth of a Preferred Share). Fractions of
Preferred Shares in integral multiples of one one-hundredth of a Preferred Share may, at the
election of the Company, be evidenced by depositary receipts; provided, however, that holders of
such depositary receipts shall have all of the designations and the powers, preferences and rights,
and the qualifications, limitations and restrictions to which they are entitled as beneficial
owners of the Preferred Shares represented by such depositary receipts. In lieu of fractional
Preferred Shares that are not integral multiples of one one-hundredth of a Preferred Share, the
Company shall pay to the registered holders of Right Certificates at the time such Rights are
exercised as herein provided an amount in cash equal to the same fraction of the current market
value of one Preferred Share. For the purposes of this Section 14(b), the current market value of
a Preferred Share shall be the closing price of a Preferred Share (as determined pursuant to the
second sentence of Section 11(d)(i) hereof) for the Trading Day immediately prior to the date of
such exercise; provided, however, that if the Preferred Shares are not publicly traded at the time
of such exercise, the current market value of a Preferred Share shall be determined in accordance
with Section 11(d)(ii) hereof for the Trading Day immediately prior to the date of such exercise.

     (c) Following the occurrence of one of the transactions or events specified in Section 11
hereof giving rise to the right to receive Common Shares or other securities (other than Preferred
Shares) upon the exercise of a Right, the Company shall not be required to issue fractions of
Common Shares or other securities upon exercise of the Rights or to distribute certificates that
evidence fractional Common Shares or other securities. In lieu of fractional Common Shares or
other securities, the Company shall pay to the registered holders of Right Certificates at the time
such Rights are exercised as herein provided an amount in cash equal to the same fraction of the
current market value of one Common Share or one such other security. For purposes of this Section
14(c), the current market value shall be the closing price for one Common Share or such other
security, as applicable (as determined pursuant to the second sentence of Section 11(d)(i) hereof) for the Trading Day immediately prior to the date of such
exercise; provided, however, that if such other security is not publicly traded at the time of such
exercise, such security shall have the value of one one-hundredth of a Preferred Share as
determined pursuant to Section 14(b) hereof.

24.

 

     (d) The holder of a Right by the acceptance of the Right expressly waives any right such
holder may have to receive any fractional Rights or any fractional shares upon exercise of a Right
(except as provided above).

SECTION 15. Rights of Action. All rights of action in respect of this Agreement,
excepting the rights of action given to the Rights Agent under Sections 18 and 20 hereof, are
vested in the respective registered holders of the Right Certificates (and, prior to the
Distribution Date, the registered holders of the Common Shares) and any registered holder of any
Right Certificate (or, prior to the Distribution Date, of the Common Shares), without the consent
of the Rights Agent or of the holder of any other Right Certificate (or, prior to the Distribution
Date, of the Common Shares), may, in such holder’s own behalf and for such holder’s own benefit,
enforce, and may institute and maintain any suit, action or proceeding against the Company to
enforce, or otherwise act in respect of, such holder’s right to exercise the Rights evidenced by
such Right Certificate in the manner provided in such Right Certificate and in this Agreement.
Without limiting the foregoing or any remedies available to the holders of Rights, it is
specifically acknowledged that the holders of Rights would not have an adequate remedy at law for
any breach of this Agreement and will be entitled to specific performance of the obligations under,
and injunctive relief against actual or threatened violations of the obligations of any Person
subject to, this Agreement. Holders of Rights shall be entitled to recover the reasonable costs
and expenses, including attorneys fees, incurred by them in any action to enforce the provisions of
this Agreement.

     Notwithstanding anything in this Agreement to the contrary, neither the Company nor the Rights
Agent shall have any liability to any holder of a Right or other Person as a result of the
inability of the Company or the Rights Agent to perform any of its obligations under this Agreement
by reason of any preliminary or permanent injunction or other order, judgment, decree or ruling
(whether interlocutory or final) issued by a court or by a governmental, regulatory,
self-regulatory or administrative agency or commission, or any statute, rule, regulation or
executive order promulgated or enacted by any governmental authority, prohibiting or otherwise
restraining performance of such obligation; provided, however, that the Company shall use all
reasonable efforts to have any such injunction, order, judgment, decree or ruling lifted or
otherwise overturned as soon as possible.

SECTION 16. Agreement of Right Holders. Every holder of a Right, by accepting the same,
consents and agrees with the Company and the Rights Agent and with every other holder of a Right
that:

     (a) prior to the Distribution Date, the Rights will be transferable only in connection with
the transfer of the Common Shares;

     (b) after the Distribution Date, the Right Certificates are transferable (subject to the
provisions of this Agreement) only on the registry books of the Rights Agent if surrendered at
the principal office of the Rights Agent, duly endorsed or accompanied by a proper instrument
of transfer; and

     (c) the Company and the Rights Agent may deem and treat the person in whose name the Right
Certificate (or, prior to the Distribution Date, the associated Common Shares

25.

 

certificate) is
registered as the absolute owner thereof and of the Rights evidenced thereby (notwithstanding any
notations of ownership or writing on the Right Certificates or the associated Common Shares
certificate made by anyone other than the Company or the Rights Agent) for all purposes whatsoever,
and neither the Company nor the Rights Agent shall be affected by any notice to the contrary.

SECTION 17. Right Certificate Holder Not Deemed a Stockholder. No holder, as such, of any
Right Certificate shall be entitled to vote, receive dividends or be deemed for any purpose the
holder of the Preferred Shares or any other securities of the Company that may at any time be
issuable on the exercise of the Rights represented thereby, nor shall anything contained herein or
in any Right Certificate be construed to confer upon the holder of any Right Certificate, as such,
any of the rights of a stockholder of the Company or any right to vote for the election of
directors or upon any matter submitted to stockholders at any meeting thereof, or to give or
withhold consent to any corporate action, or to receive notice of meetings or other actions
affecting stockholders (except as provided in Section 25 hereof), or to receive dividends or
subscription rights, or otherwise, until the Right or Rights evidenced by such Right Certificate
shall have been exercised in accordance with the provisions hereof.

SECTION 18. Concerning the Rights Agent. The Company agrees to pay to the Rights Agent
reasonable compensation for all services rendered by it hereunder and, from time to time, on demand
of the Rights Agent, its reasonable expenses and counsel fees and other disbursements incurred in
the administration and execution of this Agreement and the exercise and performance of its duties
hereunder. The Company also agrees to indemnify the Rights Agent for, and to hold it harmless
against, any loss, liability, or expense, incurred without negligence, bad faith or willful
misconduct on the part of the Rights Agent, for anything done or omitted by the Rights Agent in
connection with the acceptance and administration of this Agreement, including the costs and
expenses of defending against any claim of liability in the premises. The indemnity provided
herein shall survive the expiration of the Rights and the termination of this Agreement.

     The Rights Agent shall be protected and shall incur no liability for, or in respect of any
action taken, suffered or omitted by it in connection with, its administration of this Agreement in
reliance upon any Right Certificate or certificate for the Preferred Shares or Common Shares or for
other securities of the Company, instrument of assignment or transfer, power of attorney,
endorsement, affidavit, letter, notice, direction, consent, certificate, statement, or other paper
or document believed by it to be genuine and to be signed, executed and, where necessary, verified
or acknowledged, by the proper person or persons, or otherwise upon the advice of counsel as set
forth in Section 20 hereof. In no case will the Rights Agent be liable for special, indirect,
incidental or consequential loss or damage of any kind whatsoever (including but not limited to
lost profits), even if the Rights Agent has been advised of such loss or damage.

SECTION 19. Merger or Consolidation or Change of Name of Rights Agent. Any Person into
which the Rights Agent or any successor Rights Agent may be merged or with which it may be
consolidated, or any Person resulting from any merger or consolidation to which the Rights Agent or
any successor Rights Agent shall be a party, or any Person succeeding to the shareholder services
or corporate trust business of the Rights Agent or any successor Rights Agent, shall be the
successor to the Rights Agent under this Agreement without the execution or

26.

 

filing of any paper or
document or any further act on the part of any of the parties hereto, provided that such Person
would be eligible for appointment as a successor Rights Agent under the provisions of Section 21
hereof. In case at the time such successor Rights Agent shall succeed to the agency created by
this Agreement any of the Right Certificates shall have been countersigned but not delivered, any
such successor Rights Agent may adopt the countersignature of the predecessor Rights Agent and
deliver such Right Certificates so countersigned; and in case at that time any of the Right
Certificates shall not have been countersigned, any successor Rights Agent may countersign such
Right Certificates either in the name of the predecessor Rights Agent or in the name of the
successor Rights Agent; and in all such cases such Right Certificates shall have the full force
provided in the Right Certificates and in this Agreement.

     In case at any time the name of the Rights Agent shall be changed and at such time any of the
Right Certificates shall have been countersigned but not delivered, the Rights Agent may adopt the
countersignature under its prior name and deliver Right Certificates so countersigned; and in case
at that time any of the Right Certificates shall not have been countersigned, the Rights Agent may
countersign such Right Certificates either in its prior name or in its changed name; and in all
such cases such Right Certificates shall have the full force provided in the Right Certificates and
in this Agreement.

SECTION 20. Duties of Rights Agent. The Rights Agent undertakes the duties and
obligations imposed by this Agreement upon the following terms and conditions, by all of which the
Company and the holders of Right Certificates, by their acceptance thereof, shall be bound:

     (a) The Rights Agent may consult with legal counsel of its choice (who may be legal counsel
for the Company), and the opinion of such counsel shall be full and complete authorization and
protection to the Rights Agent as to any action taken or omitted by it in good faith and in
accordance with such opinion.

     (b) Whenever in the performance of its duties under this Agreement the Rights Agent shall deem
it necessary or desirable that any fact or matter be proved or established by the Company prior to
taking or suffering any action hereunder, such fact or matter (unless other evidence in respect
thereof be herein specifically prescribed) may be deemed to be conclusively proved and established
by a certificate signed by any one of the Chairman of the Board, the Chief Executive Officer, the
President, the Chief Financial Officer, any Vice President, the Treasurer or the Secretary of the
Company and delivered to the Rights Agent; and such certificate shall be full authorization to the
Rights Agent for any action taken or suffered in good faith by it under the provisions of this
Agreement in reliance upon such certificate.

     (c) The Rights Agent shall be liable hereunder to the Company and any other Person only for
its own gross negligence, bad faith or willful misconduct.

     (d) The Rights Agent shall not be liable for or by reason of any of the statements of fact or
recitals contained in this Agreement or in the Right Certificates (except its countersignature
thereof) or be required to verify the same, but all such statements and recitals are and shall be
deemed to have been made by the Company only.

27.

 

     (e) The Rights Agent shall not be under any responsibility in respect of the validity of this
Agreement or the execution and delivery hereof (except the due execution hereof by the Rights
Agent) or in respect of the validity or execution of any Right Certificate (except its
countersignature thereof); nor shall it be responsible for any breach by the Company of any
covenant or condition contained in this Agreement or in any Right Certificate; nor shall it be
responsible for any change in the exercisability of the Rights (including the Rights becoming void
pursuant to Section 11(a)(ii) hereof) or any adjustment in the terms of the Rights (including the
manner, method or amount thereof) provided for in Sections 3, 11, 13, 23 or 24 hereof, or the
ascertaining of the existence of facts that would require any such change or adjustment (except
with respect to the exercise of Rights evidenced by Right Certificates after receipt of a
certificate pursuant to Section 12 hereof describing such change or adjustment); nor shall it by
any act hereunder be deemed to make any representation or warranty as to the authorization or
reservation of any Preferred Shares to be issued pursuant to this Agreement or any Right
Certificate or as to whether any Preferred Shares will, when issued, be validly authorized and
issued, fully paid and nonassessable.

     (f) The Company agrees that it will perform, execute, acknowledge and deliver or cause to be
performed, executed, acknowledged and delivered all such further and other acts, instruments and
assurances as may reasonably be required by the Rights Agent for the carrying out or performing by
the Rights Agent of the provisions of this Agreement.

     (g) The Rights Agent is hereby authorized and directed to accept instructions with respect to
the performance of its duties hereunder from any one of the Chairman of the Board, the Chief
Executive Officer, the President, the Chief Financial Officer, any Vice President, the Secretary or
the Treasurer of the Company, and to apply to such officers for advice or instructions in
connection with its duties, and it shall not be liable for any action taken or suffered by it in
good faith in accordance with instructions of any such officer or for any delay in acting while
waiting for those instructions. Any application by the Rights Agent for written instructions from
the Company may, at the option of the Rights Agent, set forth in writing any action proposed to be
taken or omitted by the Rights Agent with respect to its duties or obligations under this Agreement
and the date on and/or after which such action shall be taken or omitted and the Rights Agent shall
not be liable for any action taken or omitted in accordance with a proposal included in any such
application on or after the date specified therein (which date shall not be less than three
Business Days after the date indicated in such application unless any such officer shall have
consented in writing to an earlier date) unless, prior to taking or omitting any such action, the
Rights Agent has received written instructions in response to such application specifying the
action to be taken or omitted.

     (h) The Rights Agent and any stockholder, director, officer or employee of the Rights Agent
may buy, sell or deal in any of the Rights or other securities of the Company or become pecuniarily
interested in any transaction in which the Company may be interested, or contract with or lend
money to the Company or otherwise act as fully and freely as though it were not Rights Agent under
this Agreement. Nothing herein shall preclude the Rights Agent from acting in any other capacity
for the Company or for any other legal entity.

     (i) The Rights Agent may execute and exercise any of the rights or powers hereby vested in it
or perform any duty hereunder either itself or by or through its attorneys or agents,

28.

 

and the
Rights Agent shall not be answerable or accountable for any act, default, neglect or misconduct of
any such attorneys or agents or for any loss to the Company resulting from any such act, default,
neglect or misconduct, provided reasonable care was exercised in the selection and continued
employment thereof.

     (j) No provision of this Agreement shall require the Rights Agent to expend or risk its own
funds or otherwise incur any financial liability in the performance of any of its duties hereunder
or in the exercise of its rights if there shall be reasonable grounds for believing that repayment
of such funds or adequate indemnification against such risk or liability is not reasonably assured
to it.

     (k) If, with respect to any Right Certificate surrendered to the Rights Agent for exercise or
transfer, the certificate attached to the form of assignment or form of election to purchase, as
the case may be, has not been executed, the Rights Agent shall not take any further action with
respect to such requested exercise of transfer without first consulting with the Company.

SECTION 21. Change of Rights Agent. The Rights Agent or any successor Rights Agent may
resign and be discharged from its duties under this Agreement upon 30 days’ notice in writing
mailed to the Company and, in the event the Rights Agent or one of its Affiliates is not also the
transfer agent for the Company’s securities, to each transfer agent for the Common Shares or
Preferred Shares by registered or certified mail, and to the holders of the Right Certificates by
first-class mail. The Company may remove the Rights Agent or any successor Rights Agent upon 30
days’ notice in writing, mailed to the Rights Agent or successor Rights Agent, as the case may be,
and to each transfer agent for the Common Shares or Preferred Shares by registered or certified
mail, and to the holders of the Right Certificates by first-class mail. If the Rights Agent shall
resign or be removed or shall otherwise become incapable of acting, the Company shall appoint a
successor to the Rights Agent. If the Company shall fail to make such appointment within a period
of 30 days after giving notice of such removal or after it has been notified in writing of such
resignation or incapacity by the resigning or incapacitated Rights Agent or by the holder of a
Right Certificate (which holder shall, with such notice, submit such holder’s Right Certificate for
inspection by the Company), then the registered holder of any Right Certificate may apply to any
court of competent jurisdiction for the appointment of a new Rights Agent. Any successor Rights
Agent, whether appointed by the Company or by such a court, shall be either (a) a Person organized
and doing business under the laws of the United States or of any state of the United States that is
authorized under such laws to exercise corporate trust or stock transfer powers and is subject to
supervision or examination by federal or state authority and that has at the time of its appointment as Rights Agent a combined capital and surplus of at least $50 million or (b) a direct
or indirect wholly owned Subsidiary of such Person or its wholly-owning parent. After appointment,
the successor Rights Agent shall be vested with the same powers, rights, duties and
responsibilities as if it had been originally named as Rights Agent without further act or deed;
but the predecessor Rights Agent shall deliver and transfer to the successor Rights Agent any
property at the time held by it hereunder, and execute and deliver any further assurance,
conveyance, act or deed necessary for the purpose. Not later than the effective date of any such
appointment the Company shall file notice thereof in writing with the predecessor Rights Agent and
each transfer agent for the Common Shares or Preferred Shares, and mail a notice thereof in writing
to the registered holders of the Right Certificates. Failure to

29.

 

give any notice provided for in
this Section 21, however, or any defect therein, shall not affect the legality or validity of the
resignation or removal of the Rights Agent or the appointment of the successor Rights Agent, as the
case may be.

SECTION 22. Issuance of New Right Certificates. Notwithstanding any of the provisions of
this Agreement or of the Rights to the contrary, the Company may, at its option, issue new Right
Certificates evidencing Rights in such form as may be approved by the Board to reflect any
adjustment or change in the Purchase Price and the number or kind or class of shares or other
securities or property purchasable under the Right Certificates made in accordance with the
provisions of this Agreement. In addition, in connection with the issuance or sale of Common
Shares following the Distribution Date and prior to the earlier of the Redemption Date and the
Final Expiration Date, the Company (a) shall with respect to Common Shares so issued or sold
pursuant to the exercise of stock options or under any employee plan or arrangement in existence
prior to the Distribution Date, or upon the exercise, conversion or exchange of securities, notes
or debentures issued by the Company and in existence prior to the Distribution Date, and (b) may,
in any other case, if deemed necessary or appropriate by the Board, issue Right Certificates
representing the appropriate number of Rights in connection with such issuance or sale; provided,
however, that (i) the Company shall not be obligated to issue any such Right Certificates if, and
to the extent that, the Company shall be advised by counsel that such issuance would create a
significant risk of material adverse tax consequences to the Company or the Person to whom such
Right Certificate would be issued, and (ii) no Right Certificate shall be issued if, and to the
extent that, appropriate adjustment shall otherwise have been made in lieu of the issuance thereof.

SECTION 23. Redemption.

     (a) The Rights may be redeemed by action of the Board pursuant to Section 23(b) hereof and
shall not be redeemed in any other manner.

     (b)

          (i) The Board may, at its option, at any time prior to the earlier of (A) such time as any
Person becomes an Acquiring Person, or (B) the Final Expiration Date, redeem all but not less than
all of the then outstanding Rights at a redemption price of $0.001 per Right, appropriately
adjusted to reflect any stock split, stock dividend or similar transaction occurring after the date
hereof (such redemption price being hereinafter referred to as the “Redemption Price”), and the
Company may, at its option, pay the Redemption Price in Common Shares (based on the “current per-share market price,” as such term is defined in Section 11(d)
hereof, of the Common Shares at the time of redemption), cash or any other form of consideration
deemed appropriate by the Board. The redemption of the Rights by the Board may be made effective
at such time, on such basis and subject to such conditions as the Board in its sole discretion may
establish. Notwithstanding anything contained in this Agreement to the contrary, the Rights shall
not be exercisable pursuant to Section 11(a)(ii) hereof prior to the expiration or termination of
the Company’s right of redemption under this Section 23(b)(i).

          (ii) In addition, the Board may, at its option, at any time after the time a Person becomes an
Acquiring Person but prior to any event described in clause (x), (y) or (z) of

30.

 

the first sentence
of Section 13 hereof, redeem all but not less than all of the then outstanding Rights at the
Redemption Price in connection with any merger, consolidation or sale or other transfer (in one
transaction or in a series of related transactions) of assets or earning power aggregating 50% or
more of the assets or earning power of the Company and its Subsidiaries (taken as a whole) in which
all holders of Common Shares are treated alike and not involving (other than as a holder of Common
Shares being treated like all other such holders) an Interested Stockholder or a Transaction
Person.

     (c) Immediately upon the action of the Board ordering the redemption of the Rights pursuant to
Section 23(b) hereof, and without any further action and without any notice, the right to exercise
the Rights will terminate and the only right thereafter of the holders of Rights shall be to
receive the Redemption Price. The Company shall promptly give public notice of any such
redemption; provided, however, that the failure to give, or any defect in, any such notice shall
not affect the validity of such redemption. Within 10 days after such action of the Board ordering
the redemption of the Rights pursuant to Section 23(b) hereof, the Company shall mail a notice of
redemption to all the holders of the then outstanding Rights at their last addresses as they appear
upon the registry books of the Rights Agent or, prior to the Distribution Date, on the registry
books of the transfer agent for the Common Shares, provided, however, that failure to give, or any
defect in, any such notice shall not affect the validity of such redemption. Any notice that is
mailed in the manner herein provided shall be deemed given, whether or not the holder receives the
notice. Each such notice of redemption will state the method by which the payment of the
Redemption Price will be made. Neither the Company nor any of its Affiliates or Associates may
redeem, acquire or purchase for value any Rights at any time in any manner (i) other than that
specifically set forth in this Section 23 or in Section 24 hereof, or (ii) other than in connection
with the purchase of Common Shares prior to the Distribution Date.

     (d) Notwithstanding Section 23(c) hereof, the Company may, at its option, discharge all of its
obligations with respect to any redemption of the Rights by (i) issuing a press release announcing
the manner of redemption of the Rights and (ii) mailing payment of the Redemption Price to the
registered holders of the Rights at their last addresses as they appear on the registry books of
the Rights Agent or, prior to the Distribution Date, on the registry books of the transfer agent
for the Common Shares, and upon such action, all outstanding Right Certificates shall be null and
void without any further action by the Company. In the event the Company elects to discharge all
of its obligations with respect to any redemption of Rights by mailing payment of the Redemption
Price to the registered holders of the Rights as set forth in the preceding sentence, the dollar
amount sent to each such registered holder representing the full Redemption Price to which such
registered holder is entitled shall be rounded up to the nearest whole cent.

SECTION 24. Exchange.

     (a) The Board may, at its option, at any time after any Person becomes an Acquiring Person,
exchange all or part of the then outstanding and exercisable Rights (which shall not include Rights
that have become void pursuant to the provisions of Section 11(a)(ii) hereof) for Common Shares at
an exchange ratio of one Common Share per Right, appropriately adjusted to reflect any stock split,
stock dividend or similar transaction occurring after the date hereof (such exchange ratio being
hereinafter referred to as the “Exchange Ratio”). Notwithstanding the foregoing, the Board shall
not be empowered to effect such exchange at any time after any

31.

 

Person (other than the Company, any
Subsidiary of the Company, any employee benefit plan of the Company or any such Subsidiary, or any
entity holding Common Shares for or pursuant to the terms of any such plan), together with all
Affiliates and Associates of such Person, becomes the Beneficial Owner of 50% or more of the Common
Shares then outstanding.

     (b) Immediately upon the action of the Board ordering the exchange of any Rights pursuant to
Section 24(a) hereof and without any further action and without any notice, the right to exercise
such Rights shall terminate and the only right thereafter of a holder of such Rights shall be to
receive that number of Common Shares equal to the number of such Rights held by such holder
multiplied by the Exchange Ratio. The Company shall promptly give public notice of any such
exchange; provided, however, that the failure to give, or any defect in, such notice shall not
affect the validity of such exchange. The Company promptly shall mail a notice of any such
exchange to all of the holders of such Rights at their last addresses as they appear upon the
registry books of the Rights Agent; provided, however, that the failure to give, or any defect in,
such notice shall not affect the validity of such exchange. Any notice that is mailed in the
manner herein provided shall be deemed given, whether or not the holder receives the notice. Each
such notice of exchange will state the method by which the exchange of the Common Shares for Rights
will be effected and, in the event of any partial exchange, the number of Rights that will be
exchanged. Any partial exchange shall be effected pro rata based on the number of Rights (other
than Rights that have become void pursuant to the provisions of Section 11(a)(ii) hereof) held by
each holder of Rights.

     (c) In lieu of issuing Common Shares in accordance with Section 24(a) hereof, the Company may,
if the Board determines that such action is necessary or appropriate and not contrary to the
interests of the holders of Rights, elect to (and, in the event that there are not sufficient
treasury shares and authorized but unissued Common Shares to permit any exchange of the Rights in
accordance with Section 24(a) hereof, the Company shall) take all such action as may be necessary
to authorize, issue or pay, upon the exchange of the Rights, cash, property, Common Shares, other
securities or any combination thereof having an aggregate value equal to the value of the Common
Shares that otherwise would have been issuable pursuant to Section 24(a) hereof, which aggregate
value shall be determined by a nationally recognized investment banking firm selected by the Board.
For purposes of the preceding sentence, the value of the Common Shares shall be determined
pursuant to Section 11(d) hereof. Following the Distribution Date, the Board may suspend the
exercisability of the Rights for a period of up to 60 days following the Distribution Date to the
extent that the Board has not determined whether to exercise the right of exchange under this
Section 24(c). In the event of any such suspension, the Company shall issue a public announcement
stating that the exercisability of the Rights has been temporarily suspended.

     (d) The Company shall not be required to issue fractions of Common Shares or to distribute
certificates that evidence fractional Common Shares. In lieu of such fractional Common Shares, the
Company shall pay to the registered holders of the Right Certificates with regard to which such
fractional Common Shares would otherwise be issuable an amount in cash equal to the same fraction
of the current market value of a whole Common Share. For the purposes of this Section 24(d), the
current market value of a whole Common Share shall be the closing price of a Common Share (as
determined pursuant to the second sentence of

32.

 

Section 11(d)(i) hereof) for the Trading Day
immediately after the date of the first public announcement by the Company that an exchange is to
be effected pursuant to this Section 24.

     (e) Notwithstanding anything in this Section 24 to the contrary, the exchange of the Rights
may be effected at such time, on such basis and with such conditions as the Board in its sole
discretion may establish. Without limiting the foregoing, the Board may (i) in lieu of
transferring cash, property, Common Shares, other securities or any combination thereof
contemplated by this Section 24 to the Persons entitled thereto (the “Exchange Recipients”) in
connection with the exchange issue, transfer or deposit such cash, property, Common Shares, other
securities or any combination thereof (the “Exchange Property”) to or into a trust or other Person
that is not controlled by the Company or any of its Affiliates or Associates to hold such Exchange
Property for the benefit of the Exchange Recipients, (ii) permit such trust or other entity to
exercise all of the rights that a stockholder of record would possess with respect to any Common
Shares deposited in such trust or other Person and (iii) impose such procedures as it determines to
be appropriate to verify that the Exchange Recipients are not Acquiring Persons or Affiliates or
Associates of Acquiring Persons as of any time period or periods established by the Board. In such
event, the trust or other Person shall use commercially reasonable efforts to distribute the
Exchange Property to the Exchange Recipients as promptly as practicable after its receipt of such
property. If the Board determines, before the Distribution Date, to effect an exchange in
accordance with this Section 24, the Board may delay the occurrence of the Distribution Date to
such time no later than 20 calendar days after the Shares Acquisition Date as the Board determines
to be advisable.

SECTION 25. Notice
of Certain Events. In case the Company shall at any time following the
Distribution Date propose (i) to pay any dividend payable in stock of any class to the holders of
its Preferred Shares or to make any other distribution to the holders of its Preferred Shares
(other than a regular quarterly cash dividend), (ii) to offer to the holders of its Preferred
Shares rights or warrants to subscribe for or to purchase any additional Preferred Shares or shares
of stock of any class or any other securities, rights or options, (iii) to effect any
reclassification of its Preferred Shares (other than a reclassification involving only the
subdivision of outstanding Preferred Shares), (iv) to effect any consolidation or merger into or
with, or to effect any sale or other transfer (or to permit one or more of its Subsidiaries to
effect any sale or other transfer), in one or more transactions, of 50% or more of the assets or
earning power of the Company and its Subsidiaries (taken as a whole), to any other Person, (v) to
effect the liquidation, dissolution or winding up of the Company, or (vi) to declare or pay any
dividend on the Common Shares payable in Common Shares or to effect a subdivision, combination or
consolidation of the Common Shares (by reclassification or otherwise than by payment of dividends
in Common Shares), then, in each such case, the Company shall give to each holder of a Right
Certificate, in accordance with Section 26 hereof, a notice of such proposed action, which shall
specify the record date for the purpose of such stock dividend, or distribution of rights or warrants, or the date on which such reclassification,
consolidation, merger, sale, transfer, liquidation, dissolution, or winding up is to take place and
the date of participation therein by the holders of the Common Shares and/or the Preferred Shares,
if any such date is to be fixed, and such notice shall be so given in the case of any action
covered by clause (i) or (ii) above at least 10 days prior to the record date for determining
holders of the Preferred Shares for purposes of such action, and in the case of any such other
action, at least 10 days prior to the date of the taking of such proposed

33.

 

action or the date of
participation therein by the holders of the Common Shares and/or the Preferred Shares, whichever
shall be the earlier.

SECTION 26. Notices. Notices or demands authorized by this Agreement to be given or made
by the Rights Agent or by the holder of any Right Certificate to or on the Company shall be
sufficiently given or made if sent by overnight delivery service or first-class mail, postage
prepaid, addressed (until another address is filed in writing with the Rights Agent) as follows:

Compellent Technologies, Inc.

7625 Smetana Lane

Eden Prairie, MN 55344

Attention: Chief Executive Officer

     Subject to the provisions of Section 21 hereof, any notice or demand authorized by this
Agreement to be given or made by the Company or by the holder of any Right Certificate to or on the
Rights Agent shall be sufficiently given or made if sent by overnight delivery service or
first-class mail, postage prepaid, addressed (until another address is filed in writing with the
Company) as follows:

Wells Fargo Bank, N.A.

161 N. Concord Exchange

South Saint Paul, MN 55075

Attention: Account Management Department

     Notices or demands authorized by this Agreement to be given or made by the Company or the
Rights Agent to the holder of any Right Certificate shall be sufficiently given or made if sent by
first-class mail, postage prepaid, addressed to such holder at the address of such holder as shown
on the registry books of the Company.

SECTION 27. Supplements and Amendments. Prior to the Distribution Date, the Company and
the Rights Agent shall, if the Company so directs, supplement or amend any provision of this
Agreement without the approval of any holders of the Rights. From and after the Distribution Date,
the Company and the Rights Agent shall, if the Company so directs, from time to time supplement or
amend any provision of this Agreement without the approval of any holders of Right Certificates in
order to (i) cure any ambiguity, (ii) correct or supplement any provision contained herein that may
be defective or inconsistent with any other provisions herein, or (iii) change any other provisions
with respect to the Rights that the Company may deem necessary or desirable; provided, however,
that no such supplement or amendment shall be made that would adversely affect the interests of the holders of Rights (other than the interests of an Acquiring Person or its
Affiliates or Associates). Any supplement or amendment adopted during any period after any Person
has become an Acquiring Person but prior to the Distribution Date shall be null and void unless
such supplement or amendment could have been adopted by the Company from and after the Distribution
Date. Any such supplement or amendment shall be evidenced by a writing signed by the Company and
the Rights Agent. Upon delivery of a certificate from an appropriate officer of the Company that
states that the proposed supplement or amendment is in compliance with the terms of this Section
27, the Rights Agent shall execute such supplement or amendment unless the Rights Agent shall have
reasonably determined that

34.

 

such supplement or amendment would adversely affect its interest under
this Agreement. Prior to the Distribution Date, the interests of the holders of Rights shall be
deemed coincident with the interests of the holders of Common Shares.

SECTION 28. Determination and Actions by the Board of Directors, Etc. For all purposes of
this Agreement, any calculation of the number of Common Shares outstanding at any particular time,
including for purposes of determining the particular percentage of such outstanding Common Shares
or any other securities of which any Person is the Beneficial Owner, shall be made in accordance
with the last sentence of Rule 13d-3(d)(1)(i) under the Exchange Act as in effect on the date of
this Agreement. The Board shall have the exclusive power and authority to administer this
Agreement and to exercise all rights and powers specifically granted to the Board, or the Company,
or as may be necessary or advisable in the administration of this Agreement, including without
limitation, the right and power to (i) interpret the provisions of this Agreement, and (ii) make
all determinations deemed necessary or advisable for the administration of this Agreement
(including a determination to redeem or not redeem the Rights or to amend the Agreement). All such
actions, calculations, interpretations and determinations (including, for purposes of clause (y)
below, all omissions with respect to the foregoing) that are done or made by the Board in good
faith, shall (x) be final, conclusive and binding on the Rights Agent and the holders of the
Rights, and (y) not subject the Board to any liability to the holders of the Rights.

SECTION 29. Successors. All the covenants and provisions of this Agreement by or for the
benefit of the Company or the Rights Agent shall bind and inure to the benefit of their respective
successors and assigns hereunder.

SECTION 30. Benefits of this Agreement. Nothing in this Agreement shall be construed to
give to any Person other than the Company, the Rights Agent and the registered holders of the Right
Certificates (and, prior to the Distribution Date, the Common Shares) any legal or equitable right,
remedy or claim under this Agreement; but this Agreement shall be for the sole and exclusive
benefit of the Company, the Rights Agent and the registered holders of the Right Certificates (and,
prior to the Distribution Date, the Common Shares).

SECTION 31. Severability. If any term, provision, covenant or restriction of this
Agreement is held by a court of competent jurisdiction or other authority to be invalid, void or
unenforceable, the remainder of the terms, provisions,
covenants and restrictions of this Agreement shall remain in full force and effect and shall in no
way be affected, impaired or invalidated.

SECTION 32. Governing Law. This Agreement and each Right Certificate issued hereunder
shall be deemed to be a contract made under the laws of the State of Delaware and for all purposes
shall be governed by and construed in accordance with the laws of such State applicable to
contracts to be made and performed entirely within such State.

SECTION 33. Counterparts. This Agreement may be executed in any number of counterparts
and each of such counterparts shall for all purposes be deemed to be an original, and all such
counterparts shall together constitute but one and the same instrument.

35.

 

SECTION 34. Descriptive Headings. Descriptive headings of the several Sections of this
Agreement are inserted for convenience only and shall not control or affect the meaning or
construction of any of the provisions hereof.

36.

 

     The parties whereto have caused this Agreement to be duly executed as of the day and year
first above written.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 

	Compellent Technologies, Inc.	 	 	 	Wells Fargo Bank, N.A., as Rights Agent	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	By:	 	/s/ John R. Judd	 	 	 	By:	 	/s/ Dan Loeffler	 	 
	 	 	 	 	 	 	 	 	 	 	 
	 

	 	Name:
	 	John R. Judd
	 	 	 	 	 	Name:
	 	Dan Loeffler	 	 
	 

	 	Title:
	 	Chief Financial Officer
	 	 	 	 	 	Title:
	 	Officer	 	 

37.

 

Exhibit A

FORM OF

RIGHT CERTIFICATE

			
	 	 	 
	Certificate No. R-
	 	______ Rights

NOT EXERCISABLE AFTER DECEMBER 27, 2011, OR EARLIER IF REDEMPTION OR EXCHANGE
OCCURS. THE RIGHTS ARE SUBJECT TO REDEMPTION AT $0.001 PER RIGHT AND TO AMENDMENT
AND EXCHANGE ON THE TERMS SET FORTH IN THE RIGHTS AGREEMENT.

RIGHT CERTIFICATE

COMPELLENT TECHNOLOGIES, INC.

     This certifies that [___________________] or his, her or its registered assigns, is the
registered owner of the number of Rights set forth above, each of which entitles the owner thereof,
subject to the terms, provisions and conditions of the Rights Agreement, dated as of December 15,
2010 (the “Rights Agreement”), between Compellent Technologies, Inc., a Delaware corporation (the
“Company”), and Wells Fargo Bank, N.A. (the “Rights Agent”), to purchase from the Company at any
time after the Distribution Date (as such term is defined in the Rights Agreement) and prior to
5:00 p.m., New York time, on December 27, 2011 at the office of the Rights Agent
designated for such purpose, or at the office of its successor as Rights Agent, one one-hundredth
of a fully paid non-assessable share of Series A Junior Participating Preferred Stock, par value
$0.001 per share (the “Preferred Shares”), of the Company, at a purchase price of $27.75 per one
one-hundredth of a Preferred Share (the “Purchase Price”), upon presentation and surrender of this
Right Certificate with the Form of Election to Purchase duly executed. The number of Rights
evidenced by this Right Certificate (and the number of one one-hundredths of a Preferred Share
which may be purchased upon exercise hereof) set forth above, and the Purchase Price set forth
above, are the number and Purchase Price as of December 27, 2010, based on the Preferred Shares as
constituted at such date.

     From and after the time any Person becomes an Acquiring Person (as such terms are defined in
the Rights Agreement), if the Rights evidenced by this Right Certificate are beneficially owned by
(i) such Acquiring Person or an Affiliate or Associate of such Acquiring Person (as such terms are
defined in the Rights Agreement), (ii) a transferee of such Acquiring Person (or of any such
Associate or Affiliate) who becomes a transferee after the Acquiring Person becomes such, or (iii)
under certain circumstances specified in the Rights Agreement, a transferee of such Acquiring
Person (or of any such Associate or Affiliate) who becomes a transferee prior to or concurrently
with the Acquiring Person becoming such, such Rights shall become null and void without any further
action and no holder hereof shall have any right with respect to such Rights from and after the
time any Person becomes an Acquiring Person.

A-1.

 

     As provided in the Rights Agreement, the Purchase Price and the number of one one-hundredths
of a Preferred Share which may be purchased upon the exercise of the Rights evidenced by this Right
Certificate are subject to modification and adjustment upon the happening of certain events.

     This Right Certificate is subject to all of the terms, provisions and conditions of the Rights
Agreement, as amended from time to time, which terms, provisions and conditions are hereby
incorporated herein by reference and made a part hereof and to which Rights Agreement reference is
hereby made for a full description of the rights, limitations of rights, obligations, duties and
immunities hereunder of the Rights Agent, the Company and the holders of the Right Certificates.
Copies of the Rights Agreement are on file at the principal executive offices of the Company and
the above-mentioned offices of the Rights Agent.

     This Right Certificate, with or without other Right Certificates, upon surrender at the office
of the Rights Agent designated for such purpose, may be exchanged for another Right Certificate or
Right Certificates of like tenor and date evidencing Rights entitling the holder to purchase a like
aggregate number of Preferred Shares as the Rights evidenced by the Right Certificate or Right
Certificates surrendered shall have entitled such holder to purchase. If this Right Certificate
shall be exercised in part, the holder shall be entitled to receive upon surrender hereof another
Right Certificate or Right Certificates for the number of whole Rights not exercised.

     Subject to the provisions of the Rights Agreement, the Rights evidenced by this Certificate
(i) may be redeemed by the Company at a redemption price of $0.001 per Right or (ii) may be
exchanged in whole or in part for shares of the Company’s Common Stock, par value $0.001 per share,
or, upon circumstances set forth in the Rights Agreement, cash, property or other securities of the
Company, including fractions of a share of Preferred Share (or of a share of another class or
series of the Company’s Preferred Stock.

     No fractional Preferred Shares will be issued upon the exercise of any Right or Rights
evidenced hereby (other than fractions which are integral multiples of one one-hundredth of a
Preferred Share, which may, at the election of the Company, be evidenced by depositary receipts)
but in lieu thereof a cash payment will be made, as provided in the Rights Agreement.

     No holder of this Right Certificate shall be entitled to vote or receive dividends or be
deemed for any purpose the holder of the Preferred Shares or of any other securities of the Company
which may at any time be issuable on the exercise hereof, nor shall anything contained in the
Rights Agreement or herein be construed to confer upon the holder hereof, as such, any of the
rights of a stockholder of the Company or any right to vote for the election of directors or upon
any matter submitted to stockholders at any meeting thereof, or to give or withhold consent to any
corporate action, or to receive notice of meetings or other actions affecting stockholders (except
as provided in the Rights Agreement), or to receive dividends or subscription rights, or otherwise,
until the Right or Rights evidenced by this Right Certificate shall have been exercised as provided
in the Rights Agreement.

     This Right Certificate shall not be valid or obligatory for any purpose until it shall have
been countersigned by the Rights Agent.

A-2.

 

     Witness the facsimile signature of the proper officers of the Company effective as of
______________, 20_.

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 

	Attest:	 	 	 	Compellent Technologies, Inc.	 	 
	 
	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	 	 		 	 	 	By: 	 		 	 
	 	 	 	 	 	 	 	 	 
	Name:
	 	 
	 	 	 	 	 	Name:
	 	 	 	 
	Title:
	 	 
	 	 	 	 	 	Title:
	 	 	 	 

	 	 	 	 	 
	Countersigned:

Wells Fargo Bank, N.A.,

as Rights Agent

 	 	 
	By:  	 	 	 
	 	Authorized Signature 	 	 
	 	 	 	 

A-3.

 

	 	 	 	 	 

FORM OF REVERSE SIDE OF RIGHT CERTIFICATE

FORM OF ASSIGNMENT

(To be executed by the registered holder if such

holder desires to transfer the Right Certificate.)

     For Value Received ____________________________ hereby sells, assigns and transfers
unto

 
(Please print name and address of transferee)

_____________________________ this Right Certificate, together with all right, title and interest
therein, and does hereby irrevocably constitute and appoint ________________________ Attorney, to
transfer the within Right Certificate on the books of the within-named Company, with full power of
substitution.

Dated: ____________________

	 	 	 	 	 
	 	
 	 
	 	Signature 	 
	 	 	 

A-4.

 

	 	 	 	 	 

Signature Medallion Guaranteed:

     Signatures must be guaranteed by an “eligible guarantor institution” as defined in Rule
17Ad-15 promulgated under the Securities Exchange Act of 1934, as amended.

 

     The undersigned hereby certifies that (1) the Rights evidenced by this Right Certificate are
not being sold, assigned or transferred by or on behalf of a Person who is or was an Acquiring
Person or an Affiliate or Associate thereof (as such terms are defined in the Rights Agreement);
and (2) after due inquiry and to the best of the knowledge of the undersigned, the undersigned did
not acquire the Rights evidenced by this Right Certificate from any Person who is or was an
Acquiring Person or an Affiliate or Associate thereof.

	 	 	 	 	 
	 	
 	 
	 	Signature 	 
	 	 	 

A-5.

 

	 	 	 	 	 

FORM OF ELECTION TO PURCHASE

(To be executed if holder desires to exercise

Rights represented by the Right Certificate.)

To Wells Fargo Bank, N.A.:

     The undersigned hereby irrevocably elects to exercise ___________________________ Rights
represented by this Right Certificate to purchase the Preferred Shares issuable upon the exercise
of such Rights and requests that certificates for such Preferred Shares be issued in the name of:

Please insert social security

or other identifying number: ______________

 
(Please print name and address)

 

If such number of Rights shall not be all the Rights evidenced by this Right Certificate, a new
Right Certificate for the balance remaining of such Rights shall be registered in the name of and
delivered to:

Please insert social security

or other identifying number: ______________

 
(Please print name and address)

 

Dated: _________________

	 	 	 	 	 
	 	
 	 
	 	Signature 	 
	 	 	 

A-6.

 

	 	 	 	 	 

Signature Medallion Guaranteed:

     Signatures must be guaranteed by an “eligible guarantor institution” as defined in Rule
17Ad-15 promulgated under the Securities Exchange Act of 1934, as amended.

 

     The undersigned hereby certifies that (1) the Rights evidenced by this Right Certificate are
not beneficially owned by nor are they being exercised on behalf of an Acquiring Person or an
Affiliate or Associate thereof (as such terms are defined in the Rights Agreement); and (2) after
due inquiry and to the best of the knowledge of the undersigned, the undersigned did not acquire
the Rights evidenced by this Right Certificate from any Person who is or was an Acquiring Person or
an Affiliate or Associate thereof.

	 	 	 	 	 
	 	
 	 
	 	Signature 	 
	 	 	 

 

NOTICE

     The signature in the Form of Assignment or Form of Election to Purchase, as the case may be,
must conform to the name as written upon the face of this Right Certificate in every particular,
without alteration or enlargement or any change whatsoever.

     In the event the certification set forth above in the Form of Assignment or the Form of Election to
Purchase, as the case may be, is not completed, the Company and the Rights Agent will deem the
beneficial owner of the Rights evidenced by this Right Certificate to be an Acquiring Person or an
Affiliate or Associate thereof (as defined in the Rights Agreement) and such Assignment or Election
to Purchase will not be honored.

A-7.

 

Exhibit B

FORM OF

SUMMARY OF RIGHTS TO PURCHASE

PREFERRED SHARES

COMPELLENT TECHNOLOGIES, INC.

     On December 12, 2010, the Board of Directors (the “Board”) of Compellent
Technologies, Inc. (the “Company”) declared a dividend of one preferred share purchase right
(a “Right”) for each outstanding share of common stock, par value $0.001 per share (the “Common
Shares”), of the Company. The dividend is effective as of December 27, 2010 (the “Record Date”)
with respect to the stockholders of record on that date. The Rights will also attach to new Common
Shares issued after the Record Date. Each Right entitles the registered holder to purchase from
the Company one one-hundredth of a share of Series A Junior Participating Preferred Stock, par
value $0.001 per share (the “Preferred Shares”), of the Company at a price of $27.75 per one
one-hundredth of a Preferred Share (the “Purchase Price”), subject to adjustment. Each Preferred
Share is designed to be the economic equivalent of 100 Common Shares. The description and terms of
the Rights are set forth in a Rights Agreement dated as of December 15, 2010 (the “Rights
Agreement”), between the Company and Wells Fargo Bank, N.A. (the “Rights Agent”).

Detachment and Transfer of Rights

     Initially, the Rights will be evidenced by the stock certificates representing Common Shares
then outstanding, and no separate Right Certificates will be distributed. Until the earlier to
occur of (i) ten calendar days after a public announcement that a person or group of affiliated or
associated persons, has become an “Acquiring Person” (as such term is defined in the Rights
Agreement) or (ii) 10 business days (or such later date as the Board may determine) following the
commencement of, or announcement of an intention to make, a tender offer or exchange offer which
would result in the beneficial ownership by an Acquiring Person of 15% or more of the outstanding
Common Shares (the earlier of such dates being called the “Distribution Date”), the Rights will be
evidenced, with respect to any of the Common Share certificates outstanding as of the Record Date,
by such Common Share certificate. In general and subject to certain exceptions, an “Acquiring
Person” is a person, the affiliates or associates of such person, or a group, which has acquired
beneficial ownership of 15% or more of the outstanding Common Shares. One such exception is that
neither Parent nor Merger Sub (or any of Parent or Merger Sub’s Affiliates or Associates) shall be
or become an “Acquiring Person” by reason of, and the term “Acquiring Person” shall not include
Parent or Merger Sub (or any Affiliates or Associates of Parent or Merger Sub) by reason of the
execution, delivery or approval of any the Merger Agreement or the consummation of the Merger or
any other transactions contemplated by the Merger Transaction Agreements (as defined in the Rights
Agreement). For purposes of the Rights Agreement, beneficial ownership of the Common Shares is
generally determined consistent with the provisions of Rule 13d-3 under the Securities Exchange Act
of 1934, which

B-1.

 

determines beneficial ownership of securities under the federal securities laws, except that
derivative interests in the Common Shares, such as swap arrangements that do not carry with them
the right to control voting or disposition of the underlying securities, are also considered
beneficial ownership of the underlying Common Shares for purposes of the Rights Agreement. The
Rights Agreement sets out one carve-out to the definition of “Beneficial Ownership”, namely that no
party to any of the Merger Transaction Agreements shall be deemed to be the Beneficial Owner of any
Common Shares held by any other party to any such Merger Transaction Agreement solely by virtue of
the execution and delivery of any such Merger Transaction Agreement or any amendment thereof or the
performance of such party’s rights and obligations under any such Merger Transaction Agreement or
any such amendment.

     The Rights Agreement provides that, until the Distribution Date (or earlier redemption or
expiration of the Rights), the Rights will be transferable with and only with the Common Shares.
Until the Distribution Date (or earlier redemption or expiration of the Rights), new Common Share
certificates issued after the Record Date upon transfer or new issuance of Common Shares will
contain a notation incorporating the Rights Agreement by reference. Until the Distribution Date
(or earlier redemption or expiration of the Rights) the surrender or transfer of any certificates
for Common Shares outstanding as of the Record Date, even without such notation or a copy of this
Summary of Rights being attached thereto, will also constitute the transfer of the Rights
associated with the Common Shares represented by such certificate. As soon as practicable
following the Distribution Date, separate certificates evidencing the Rights (“Right Certificates”)
will be mailed to holders of record of the Common Shares as of the close of business on the
Distribution Date and such separate Right Certificates alone will evidence the Rights.

Exercisability of Rights

     The Rights are not exercisable until the Distribution Date. The Rights will expire on
December 27, 2011 (the “Final Expiration Date”), unless amended, unless the Final Expiration Date
is extended or unless the Rights are earlier redeemed or exchanged by the Company, in each case as
described below. Until a Right is exercised, the holder thereof, as such, will have no rights as a
stockholder of the Company, including, without limitation, the right to vote or to receive
dividends.

     The Purchase Price payable, and the number of Preferred Shares or other securities or property
issuable or payable, upon exercise of the Rights are subject to anti-dilution adjustments from time
to time. The number of outstanding Rights and the number of one one-hundredths of a Preferred
Share issuable upon exercise of each Right are also subject to adjustment in the event of a stock
split of the Common Shares or a stock dividend on the Common Shares payable in Common Shares, or
subdivisions, consolidations or combinations of the Common Shares occurring, in any such case,
prior to the Distribution Date. With certain exceptions, no adjustment in the Purchase Price will
be required until cumulative adjustments require an adjustment of at least 1% in such Purchase
Price. No fractional Preferred Shares will be issued (other than fractions which are integral
multiples of one one-hundredth of a Preferred Share, which may, at the election of the Company, be
evidenced by depositary receipts) and in lieu thereof, an adjustment in cash will be made based on
the market price of the Preferred Shares on the last trading day prior to the date of exercise.

B-2.

 

Terms of Preferred Shares

     Preferred Shares purchasable upon exercise of the Rights will not be redeemable. Each
Preferred Share will be entitled to a minimum preferential quarterly dividend payment of $l.00 per
share but will be entitled to an aggregate dividend of 100 times the dividend declared per Common
Share. In the event of liquidation, the holders of the Preferred Shares will be entitled to a
minimum preferential liquidation payment of $100.00 per share but will be entitled to an aggregate
payment of 100 times the payment made per Common Share. Each Preferred Share will have 100 votes,
voting together with the Common Shares. In the event of any merger, consolidation or other
transaction in which Common Shares are exchanged, each Preferred Share will be entitled to receive
100 times the amount received per Common Share. These rights are protected by customary
anti-dilution provisions. Because of the nature of the Preferred Shares’ dividend, liquidation and
voting rights, the value of the one one-hundredth interest in a Preferred Share purchasable upon
exercise of each Right should approximate the value of one Common Share. The Preferred Shares
would rank junior to any other series of the Company’s preferred stock.

Trigger of Flip-In and Flip-Over Rights

     In the event that any person or group of affiliated or associated persons becomes an Acquiring
Person, proper provision shall be made so that each holder of a Right, other than Rights
beneficially owned by the Acquiring Person or any affiliate or associate thereof (which will
thereafter be void), will thereafter have the right to receive upon exercise thereof at the then
current exercise price of the Right that number of Common Shares having a market value of two times
the exercise price of the Right. This right will commence at the time that a person has become an
Acquiring Person (or the effective date of a registration statement relating to distribution of the
rights, if later), but in any event no earlier than the Distribution Date.

     In the event that the Company is acquired in a merger or other business combination
transaction or 50% or more of its consolidated assets or earning power are sold to an Acquiring
Person, its affiliates or associates or certain other persons in which such persons have an
interest, proper provision will be made so that each such holder of a Right will thereafter have
the right to receive, upon the exercise thereof at the then current exercise price of the Right,
that number of shares of common stock of the acquiring company which at the time of such
transaction will have a market value of two times the exercise price of the Right.

Redemption and Exchange of Rights

     At any time prior to the earliest of (i) the time a person becomes an Acquiring Person, or
(ii) the Final Expiration Date, the Board may redeem the Rights in whole, but not in part, at a
price of $0.001 per Right (the “Redemption Price”). In general, the redemption of the Rights may
be made effective at such time on such basis with such conditions as the Board in its sole
discretion may establish. Immediately upon any redemption of the Rights, the right to exercise the
Rights will terminate and the only right of the holders of Rights will be to receive the Redemption
Price.

B-3.

 

     At any time after any person becomes an Acquiring Person and prior to the acquisition by any
person or group of affiliated persons of 50% or more of the outstanding Common Shares, the Board
may exchange the Rights (other than Rights owned by an Acquiring Person or its affiliate or
associates that will have become void), in whole or in part, at an exchange ratio of one Common
Share, or, under circumstances set forth in the Rights Agreement, cash, property or other
securities of the Company, including fractions of a Preferred Share (or of a share of another class
or series of the Company’s preferred stock), per Right (with a value equal to such Common Shares).

Amendment of Rights

     The Rights Agreement and the terms of the Rights generally may be amended by the Board without
the consent of the holders of the Rights, except that from and after such time as any person or
group of affiliated or associated persons becomes an Acquiring Person, no such amendment may
adversely affect the interests of the holders of the Rights (excluding the interest of any
Acquiring Person or its affiliates or associates).

Additional Information

     A copy of the Rights Agreement has been filed with the Securities and Exchange Commission as an
Exhibit to a Current Report on Form 8-K dated December 16, 2010. A copy of the Rights Agreement is
available from the Company by writing to: Compellent Technologies, Inc., 7625 Smetana Lane, Eden
Prairie MN, 55344. This summary description of the Rights is not intended to be complete and is
qualified in its entirety by reference to the Rights Agreement, which is hereby incorporated herein
by reference.

B-4.

 

Table Of Contents

	 	 	 	 	 	 	 
	 	 	 	 	Page
	 	 	 	 	 	 	 
	SECTION 1.

	 	Certain Definitions
	 	1
	SECTION 2.

	 	Appointment of Rights Agent
	 	7
	SECTION 3.

	 	Issue of Right Certificates
	 	7
	SECTION 4.

	 	Form of Right Certificates
	 	9
	SECTION 5.

	 	Countersignature and Registration
	 	9

	SECTION 6.

	 	Transfer, Split Up, Combination and Exchange of Right Certificates;
Mutilated, Destroyed, Lost or Stolen Right Certificates

	 	10

	SECTION 7.

	 	Exercise of Rights; Purchase Price; Expiration Date of Rights
	 	11

	SECTION 8.

	 	Cancellation and Destruction of Right Certificates
	 	12

	SECTION 9.

	 	Availability of Preferred Shares
	 	12

	SECTION 10.

	 	Preferred Shares Record Date
	 	14

	SECTION 11.

	 	Adjustment of Purchase Price, Number of Shares or Number of Rights
	 	14

	SECTION 12.

	 	Certificate of Adjusted Purchase Price or Number of Shares
	 	20

	SECTION 13.

	 	Consolidation, Merger or Sale or Transfer of Assets or Earning Power
	 	21

	SECTION 14.

	 	Fractional Rights and Fractional Shares
	 	23

	SECTION 15.

	 	Rights of Action
	 	25

	SECTION 16.

	 	Agreement of Right Holders
	 	25

	SECTION 17.

	 	Right Certificate Holder Not Deemed a Stockholder
	 	26

	SECTION 18.

	 	Concerning the Rights Agent
	 	26

	SECTION 19.

	 	Merger or Consolidation or Change of Name of Rights Agent
	 	26

	SECTION 20.

	 	Duties of Rights Agent
	 	27

	SECTION 21.

	 	Change of Rights Agent
	 	29

	SECTION 22.

	 	Issuance of New Right Certificates
	 	30

	SECTION 23.

	 	Redemption
	 	30

	SECTION 24.

	 	Exchange
	 	31

	SECTION 25.

	 	Notice of Certain Events
	 	33

	SECTION 26.

	 	Notices
	 	34

	SECTION 27.

	 	Supplements and Amendments
	 	34

	SECTION 28.

	 	Determination and Actions by the Board of Directors, Etc.
	 	35

i.

 

Table Of Contents

(continued)

	 	 	 	 	 	 	 
	 	 	 	 	Page
	 	 	 	 	 	 	 
	SECTION 29.

	 	Successors
	 	35

	SECTION 30.

	 	Benefits of this Agreement
	 	35

	SECTION 31.

	 	Severability
	 	35

	SECTION 32.

	 	Governing Law
	 	35

	SECTION 33.

	 	Counterparts
	 	35

	SECTION 34.

	 	Descriptive Headings
	 	36

Exhibit A —  Form of Right Certificate

Exhibit B —  Summary of Rights to Purchase Preferred Shares

ii.

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