Document:

Exhibit 10.1

Exhibit 10.1

The9 Limited

AMENDED 2004 STOCK OPTION PLAN

	1.	 	Purposes of the Plan

	 
	 	 	The purposes of this Plan are:

	 	(a)	 	to attract and retain the best available personnel for positions of
substantial responsibility,

	 
	 	(b)	 	to provide additional incentive to Employees, Directors and Consultants, and

	 
	 	(c)	 	to motivate the participating personnel, promote their dedication, and
encourage them to devote themselves to the success of the Company’s business.

Stock Purchase Rights may also be granted under the Plan.

	2.	 	Definitions

	 	 	 
	“Administrative Committee”

	 	the Board or any of its Committees as shall be
designated to administer the Plan in accordance
with Section 4 below.

	 
	 	 
	“Applicable Laws”

	 	the requirements relating to the administration
of stock option plans under any stock exchange
or quotation system on which the Ordinary
Shares are listed or quoted and the laws of any
country or jurisdiction which apply to the
grant of Options or Stock Purchase Rights under
the Plan.

	 
	 	 
	“Board”

	 	the Board of Directors of the Company.

	 
	 	 
	“Committee”

	 	a committee of Directors appointed by the Board.

	 
	 	 
	“Company”

	 	The9 Limited, a company incorporated under the
laws of Cayman Islands.

	 
	 	 
	“Consultant”

	 	any person who renders or has rendered
consulting or advisory services to the Company
or any Subsidiary.

 

 

 

	 	 	 
	“Director”

	 	a member of the Board.

	 
	 	 
	“Disability”

	 	any total and permanent disability which
prevents a Service Provider from performing his
duties under the relevant contract of
employment, engagement, appointment or service
(as the case may be) or otherwise from
continuing in such capacity.

	 
	 	 
	“Employee”

	 	any person employed by the Company or any
Subsidiary of the Company, including but not
limited to the directors of such Subsidiary. A
person shall not cease to be an Employee in the
case of:

	 
	 	 
	 

	 	(i)   any leave of absence approved by the
Company; or

	 
	 	 
	 

	 	(ii)  any transfers or secondment between any
locations of the Company or between the Company
and any Subsidiary.

	 
	 	 
	“Fair Market Value”

	 	as of any date, the value of Ordinary Shares as
determined in the following manners:

	 
	 	 
	 

	 	(i)   if the Ordinary Shares are listed or
publicly traded on any established stock
exchange or a national market system, its Fair
Market Value shall be the closing sales price
for such stock (or the closing bid, if no sales
were reported) as quoted on such exchange or
system on the date of determination or on the
last market trading day prior to the date of
determination (if the date of determination is
not a market trading day), as reported in The
Wall Street Journal or such other sources as
the Administrative Committee deems reliable;

 

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	 	(ii)  if the Ordinary Shares are regularly
quoted by a principal recognized securities
dealer but selling prices are not reported, its
Fair Market Value shall be the average between
the high bid and low asked prices for the
Ordinary Shares on the date of determination or
on the last market trading day prior to the
date of determination (if the date of
determination is not a market trading day); or

	 
	 	 
	 

	 	(iii) in the absence of an established market
for the Ordinary Shares, its Fair Market Value
shall be determined in good faith by the
Administrative Committee after consultation
with legal and accounting experts as the
Administrative Committee may deem advisable.

	 
	 	 
	“Option”

	 	a stock option granted pursuant to the Plan
which confers the holder a right to purchase a
specified amount of Ordinary Shares from the
Company on and subject to the pre-determined
terms and conditions stipulated in the Option
Agreement.

	 
	 	 
	“Option Agreement”

	 	a written or electronic agreement between the
Company and an Optionee evidencing the terms
and conditions of an individual Option grant.
The Option Agreement is subject to the terms
and conditions of the Plan.

	 
	 	 
	“Optioned Stock”

	 	the Ordinary Shares subject to an Option or a
Stock Purchase Right, as adjusted in accordance
with Section 12 below.

	 
	 	 
	“Optionee”

	 	the holder of an outstanding Option or Stock
Purchase Right granted under the Plan.

	 
	 	 
	“Ordinary Shares”

	 	the ordinary shares of the Company, par value
US$0.01 per share.

	 
	 	 
	“Plan”

	 	this 2004 Stock Option Plan.

	 
	 	 
	“Restricted Stock”

	 	Ordinary Shares acquired by an Optionee upon
exercise of the Stock Purchase Right, which is
granted pursuant to Section 10 below.

 

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	“Restricted Stock
Purchase Agreement”

	 	a written or electronic agreement between the
Company and an Optionee evidencing the terms
and conditions of an individual grant of Stock
Purchase Right. The Restricted Stock Purchase
Agreement is subject to the terms and
conditions of the Plan.

	 
	 	 
	“Securities Act”

	 	the securities exchange legislation of any
applicable jurisdiction as amended from time to
time.

	 
	 	 
	“Service Provider”

	 	an Employee, a Director or a Consultant.

	 
	 	 
	“Stock Purchase Right”

	 	a right to purchase Ordinary Shares pursuant to
Section 10 below.

	 
	 	 
	“Subsidiary”

	 	any entity in which the Company holds directly
or indirectly fifty point one percent (50.1%)
or more of the voting equity.

	 
	 	 
	“Tax Law”

	 	the relevant tax law of the applicable
jurisdiction, as amended from time to time.

Except where otherwise indicated by the context herein, references to the
masculine gender shall also include the feminine gender and the neuter and vice
versa, and references to the singular shall also include the plural and vice
versa.

	3.	 	Stock Subject to the Plan

Subject to the provisions of Section 12 of the Plan, the maximum aggregate number of
Ordinary Shares which may be subject to Option or Stock Purchase Right and sold under the
Plan is 6,449,614 Ordinary Shares. At all times during the term of the Plan and while any
Option(s) or Stock Purchase Right(s) are outstanding, the Company shall retain as
authorized and unissued stock, or as treasury stock, at least the number of Ordinary Shares
from time to time required under the provisions of the Plan for such outstanding Option(s)
and Stock Purchase Right(s), or otherwise assure itself of its ability to perform its
obligations hereunder.

 

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If an Option or Stock Purchase Right expires or terminates for any reason or becomes
unexercisable without having been exercised in full, or is
surrendered, the unacquired or unpurchased Ordinary Shares which were subject thereto shall
become available for future grant or sale under the Plan (unless the Plan has terminated).
However, Ordinary Shares that have actually been issued under the Plan, upon exercise of
either an Option or Stock Purchase Right, shall not be reverted to the Plan and shall not
become available for future distribution under the Plan, except that if Restricted Stock
are repurchased by the Company at their original purchase price and cancelled pursuant to
Section 10, the Ordinary Shares so repurchased (which will then be authorized but unissued
Ordinary Shares) shall become available for future grant under the Plan.

	4.	 	Administration of the Plan

	 	(a)	 	Administrative Committee

	 
	 	 	 	The Plan shall be administered by the Board or a Committee appointed by the Board
(the “Administrative Committee”), which Administrative Committee shall be
constituted to comply with the Applicable Laws. Unless it is prohibited by the
Applicable Laws, in which event the Plan shall be administered by the Board, the
Administrative Committee, if appointed, shall comprise two directors of the Company
nominated by each of Jun ZHU and Bosma Limited.

	 
	 	(b)	 	Powers of the Administrative Committee

	 
	 	 	 	Subject to the provisions of the Plan and, in the case of an Administrative
Committee, the specific duties delegated by the Board to such Administrative
Committee, and subject to the approval of any relevant authorities, the
Administrative Committee shall have, in addition to its other authority provided
herein, the authority at its sole discretion:

	 	(i)	 	to determine the Fair Market Value in the manners as set out
in the definition of Fair Market Value under Section 2 above;

	 
	 	(ii)	 	to select from time to time the Service Providers (excluding
the Directors, Option or Stock Purchase Right grants to whom shall be
determined by the compensation committee of the Board, or before the
appointment of compensation committee, by the Board) to whom Options and Stock
Purchase Rights may be granted hereunder;

 

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	 	(iii)	 	to determine the number of Ordinary Shares to be covered by
each grant of Option or Stock Purchase Right hereunder to the Service
Providers (excluding the Directors, Option or
Stock Purchase Right grants to whom shall be determined by the
compensation committee of the Board, or before the appointment of
compensation committee, by the Board);

	 
	 	(iv)	 	to approve forms of agreement for use under the Plan;

	 
	 	(v)	 	to determine the terms and conditions, of any Option or Stock
Purchase Right granted hereunder. Such terms and conditions include, but are
not limited to, the exercise price, the time or times when Option or Stock
Purchase Rights may be exercised (which may be based on performance criteria
or a pre-determined vesting period), any forfeiture restrictions, any vesting
acceleration or waiver of forfeiture restrictions, and any restriction or
limitation regarding any Option or Stock Purchase Right or the Ordinary Shares
relating thereto, based in each case on such factors as the Administrative
Committee, at its sole discretion, shall determine;

	 
	 	(vi)	 	to determine whether and under what circumstances an Option
may be settled in cash under subsection 9(e) below instead of Ordinary Shares;

	 
	 	(vii)	 	to reduce the exercise price of any Option or Stock Purchase
Right to the then current Fair Market Value if the Fair Market Value of the
Ordinary Shares covered by such Option or Stock Purchase Right has declined
since the date the Option or Stock Purchase Right was granted;

	 
	 	(vii)	 	to prescribe, amend and rescind rules and regulations
relating to the Plan (but not the Plan per se), including rules and
regulations relating to sub-plans established for the purpose of qualifying
for preferred tax treatment under foreign tax law;

	 
	 	(ix)	 	to allow Optionees to satisfy withholding tax obligations by
electing to have the Company withhold from the Ordinary Shares to be issued
upon exercise of an Option or Stock Purchase Right that number of Ordinary
Shares having a Fair Market Value equal to the amount required to be withheld.
The Fair Market Value of the Ordinary Shares to be withheld shall be
determined on the date that the amount of tax to be withheld is to be
determined or the tax liability arises or the tax is due to be paid, or any
other date as the Administrative Committee may deem appropriate. All
elections by Optionees to have Ordinary Shares withheld for
this purpose shall be made in such form and under such conditions as the
Administrative Committee may deem necessary or advisable;

 

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	 	(x)	 	to construe and interpret the terms of the Plan and awards
granted pursuant to the Plan; and

	 
	 	(xi)	 	to take any other actions as the Administrative Committee
shall consider appropriate for the proper administration of the Plan.

	 	(c)	 	Effect of Administrative Committee’s Decision

	 
	 	 	 	All decisions, determinations and interpretations of the Administrative Committee
pursuant to the provisions of the Plan shall be final conclusive and binding on all
Optionees.

	5.	 	Eligibility

	 	(a)	 	Options and Stock Purchase Rights may be granted to Service Providers.

	 	(b)	 	Neither the Plan nor any Option or Stock Purchase Right shall confer upon any
Optionee any right with respect to continuing the Optionee’s relationship as a Service
Provider with the Company, nor shall it interfere in any way with his or her right or
the Company’s right to terminate such relationship at any time, with or without cause.

	6.	 	Term of Plan

The Plan shall become effective upon its adoption by the Board. It shall continue in
effect for a term of twenty (20) years unless sooner terminated under Section 14 below.

	7.	 	Term of Option

The term of each Option shall be stated in the Option Agreement; provided, however, that
the term shall be no more than five (5) years from the date of grant thereof.

	8.	 	Option Exercise Price and Consideration

	 	(a)	 	The per share exercise price for the Ordinary Shares to be issued upon
exercise of an Option shall be such price as is determined by the Administrative
Committee.

 

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	 	(b)	 	The terms, conditions and restrictions for the issuance of the Ordinary
Shares upon exercise of an Option, including the method of payment, shall be
determined by the Administrative Committee. The Administrative Committee may at its
sole discretion authorize or accept payment in one or more of the following manners:

	 	(i)	 	cash,

	 
	 	(ii)	 	check payable to the order of the Company,

	 
	 	(iii)	 	promissory note,

	 
	 	(iv)	 	surrender to the Company of other Ordinary Shares which (x)
in the case of Ordinary Shares acquired upon exercise of an Option, have been
owned by the Optionee for more than six (6) months on the date of surrender,
and (y) have a Fair Market Value on the date of surrender equal to the
aggregate exercise price of the Ordinary Shares as to which such Option shall
be exercised,

	 
	 	(v)	 	consideration received by the Company under a cashless
exercise program implemented by the Company in connection with the Plan, or

	 
	 	(vi)	 	any combination of the foregoing methods of payment.

In making its determination as to the above, the Administrative Committee shall consider
the best interest of and advantage to the Company.

	9.	 	Exercise of Option

	 	(a)	 	Procedure for Exercise; Rights as a Shareholder

Any Option granted hereunder shall be exercisable according to the terms hereof at
such times and under such conditions as determined by the Administrative Committee
and set forth in the Option Agreement. Except in the case of Options granted to
the Directors and Consultants, Options shall become exercisable at a rate of no
more than one third (1/3rd) per year or one thirty-sixth (1/36th) per month over
three (3) years from the date the Options are granted. Unless the Administrative
Committee provides otherwise, vesting of Options granted hereunder to Directors
shall be tolled during any unpaid leave of absence. An Option may not be exercised
for a fraction of an Ordinary Share.

 

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An Option shall be deemed exercised when the Company receives:

	 	(i)	 	written or electronic notice of exercise (in accordance with
the Option Agreement) from the person entitled to exercise the Option, and

	 
	 	(ii)	 	full payment for the Ordinary Shares with respect to which
the Option is exercised.

Full payment may consist of any consideration and method of payment authorized by
the Administrative Committee and permitted by the Option Agreement and the Plan.
After the Option is exercised, the Company shall promptly issue (or cause to be
issued) such number of Ordinary Shares as covered by such Option. Ordinary Shares
issued upon exercise of an Option shall be issued in the name of the Optionee or,
if requested by the Optionee, in the joint name of the Optionee and his or her
spouse. Until the Ordinary Shares are issued (as evidenced by the appropriate
entry on the books of the Company or of a duly authorized transfer agent of the
Company), no right to attend general meeting of the Company, vote or receive
dividends or other distributions or any other rights as a shareholder shall exist
with respect to the Ordinary Shares, notwithstanding the exercise of the Option.
No adjustment will be made for a dividend or other right for which the record date
is prior to the date the Ordinary Shares are issued, except as provided in Section
12 below.

Exercise of an Option in any manner shall result in a decrease in the number of
Ordinary Shares thereafter available, both for purposes of the Plan and for sale
under the Option, by the number of Ordinary Shares as to which the Option is
exercised.

	 	(b)	 	Termination of Relationship as Service Provider

If an Optionee ceases to be a Service Provider (save and except due to the
Optionee’s Disability, in which event subsection 9(c) below shall apply or due to
the Optionee’s death, in which event subsection 9(d) below shall apply), such
Optionee may exercise his or her Option within such period of time as is specified
in the Option Agreement (of at least thirty (30) days but in no event later than
the expiration of the term of the Option as set forth in the Option Agreement) to
the extent that the Option is vested on the date of such cessation . In the
absence of a specified time in the Option Agreement, the Option shall remain
exercisable for three (3) months following the Optionee’s cessation as aforesaid
(but in no event later than the expiration of the term of the

 

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Option
as set forth in the Option Agreement). If, on the date of cessation, the Optionee is not vested
as to his or her entire Option, the Ordinary Shares covered by the unvested portion
of the Option shall revert to the Plan. If, after the cessation, the Optionee does
not exercise his or her Option to the fullest extent vested within the time
specified in the Option Agreement or stipulated herein as the case may be, the
Option shall lapse automatically, and the Ordinary Shares covered by such
unexercised portion of the Option shall revert to the Plan and the Optionee shall
have no claim for compensation or otherwise against the Company whatsoever.

	 	(c)	 	Disability of Optionee

If an Optionee ceases to be a Service Provider as a result of the Optionee’s
Disability, the Optionee may exercise his or her Option within such period of time
as is specified in the Option Agreement (of at least six (6) months but in no event
later than the expiration of the term of such Option as set forth in the Option
Agreement) to the extent the Option is vested on the date of such cessation. In
the absence of a specified time in the Option Agreement, the Option shall remain
exercisable for twelve (12) months following the Optionee’s cessation as aforesaid
(but in no event later than the expiration of the term of such Option as set forth
in the Option Agreement). If, on the date of cessation, the Optionee is not vested
as to his or her entire Option, the Ordinary Shares covered by the unvested portion
of the Option shall revert to the Plan. If, after the cessation, the Optionee does
not exercise his or her Option to the fullest extent vested within the time
specified in the Option Agreement or stipulated herein as the case may be, the
Option shall lapse automatically, and the Ordinary Shares covered by such
unexercised portion of the Option shall revert to the Plan and the Optionee shall
have no claim for compensation or otherwise against the Company whatsoever.

	 	(d)	 	Death of Optionee

If an Optionee dies while being a Service Provider, the Option may be exercised
within such period of time as is specified in the Option Agreement (of at least six
(6) months but in no event later than the expiration of the term of such Option as
set forth in the Option Agreement) to the extent that the Option is vested on the
date of death by the Optionee’s estate or by a person who acquires the right to
exercise the Option by bequest or inheritance (collectively, the “Optionee’s
Representative”). In the absence of a specified time in the Option Agreement, the
Option shall remain exercisable for twelve (12) months following the Optionee’s
death (but in no event later than

 

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the expiration of the term of such Option as set forth in the
Option Agreement). If, at the time of death, the Optionee is not vested as to the
entire Option, the Ordinary Shares covered by the unvested portion of the Option
shall immediately revert to the Plan. If the Option is not exercised by the
Optionee’s Representative to the fullest extent vested within the time specified in
the Option Agreement or stipulated herein as the case may be, the Option shall
lapse automatically, and the Ordinary Shares covered by such unexercised portion of
the Option shall revert to the Plan and the Optionee’s estate and the Optionee’s
Representative shall have no claim for compensation or otherwise against the
Company whatsoever.

	 	(e)	 	Buyout Provisions

The Administrative Committee may at any time offer to buy out an Option previously
granted for a payment in cash or Ordinary Shares, based on such fair and reasonable
terms and conditions as the Administrative Committee shall establish and
communicate to the Optionee at the time that such offer is made or as set forth in
the Option Agreement.

	10.	 	Stock Purchase Rights

	 	(a)	 	Rights to Purchase

Stock Purchase Rights may be issued in favour of the Optionees either alone, in
addition to, or in tandem with other awards granted under the Plan and/or cash
awards made by the Company outside of the Plan. After the Administrative Committee
determines that it will offer Stock Purchase Rights under the Plan, it shall advise
the offeree in writing or electronically of the terms, conditions and restrictions
related to the offer, including the number of Ordinary Shares that such person
shall be entitled to purchase, the price to be paid, the forfeiture restrictions,
the time limit for the exercise of the Stock Purchase Rights and the time within
which such person must accept such offer.

	 	(b)	 	Repurchase Option

Unless the Administrative Committee determines otherwise, the Restricted Stock
Purchase Agreement shall grant the Company a repurchase option exercisable upon the
voluntary or involuntary termination of the Optionee as a Service Provider for any
reason (including death or Disability). The purchase price for Ordinary Shares
repurchased pursuant to the Restricted Stock Purchase
Agreement shall be the original price paid by the Optionee and may be paid by
cancellation of any indebtedness of the Optionee to the Company. The repurchase
option shall lapse at such rate as the Administrative Committee may determine at
its sole discretion. Except with respect to Ordinary Shares purchased by the
Directors and Consultants, the repurchase option shall in no case lapse at a rate
of less than 25% per year over four (4) years from the date of purchase.

 

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	 	(c)	 	Other Provisions

The Restricted Stock Purchase Agreement shall contain such other terms, provisions
and conditions not inconsistent with the Plan as may be determined by the
Administrative Committee at its sole discretion.

	 	(d)	 	Rights as a Shareholder

Once the Stock Purchase Right is exercised, the purchaser shall have rights
equivalent to those of a shareholder and shall be a shareholder when his or her
purchase and personal particulars are entered upon the records of the Company or of
the duly authorized transfer agent of the Company. No adjustment shall be made for
a dividend or other right for which the record date is prior to the date the Stock
Purchase Right is exercised, except as provided in Section 12 below.

	11.	 	Non-Transferability of Options and Stock Purchase Rights

The Option and Stock Purchase Rights may not be sold, pledged, assigned, hypothecated,
transferred, or disposed of in any manner other than by will or by the laws of succession
and may be exercised, during the lifetime of the Optionee, only by the Optionee except as
provided in subsection 9(d) above.

	12.	 	Adjustments Upon Changes in Capitalization, Merger or Asset Sale

	 	(a)	 	(i) Changes in Capitalization

Subject to any action of the shareholders of the Company as necessitated by the
Applicable Laws, the number of Ordinary Shares covered by each outstanding Option
or Stock Purchase Right, and the number of Ordinary Shares which have been
authorized for issuance under the Plan but as to which no Options or Stock Purchase
Rights have yet been granted or which have been reverted to the Plan upon
cancellation or expiration of an

 

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Option or
Stock Purchase Right, as well as the price per Ordinary Share covered by
each such outstanding Option or Stock Purchase Right, shall be proportionately
adjusted for any increase or decrease in the number of issued Ordinary Shares
effected without receipt of consideration by the Company. The conversion of any
convertible securities of the Company shall not be deemed to have been “effected
without receipt of consideration”. Such adjustment shall be made by the Board,
whose determination in that respect shall be final, binding and conclusive. Except
as expressly provided herein, no issuance by the Company of shares of stock of any
class, or securities convertible into shares of stock of any class, shall affect,
and no adjustment by reason thereof shall be made with respect to, the number or
price of Ordinary Shares subject to an Option or Stock Purchase Right.

	 	(ii)	 	Adjustments for Stock Split, Stock Dividend, Etc.

If the Company shall at any time increase or decrease the number of its outstanding
Ordinary Shares, or change in any way the rights and privileges of its outstanding
Ordinary Shares, by means of the payment of a stock dividend or any other
distribution upon such Ordinary Shares, or through a stock split, subdivision,
consolidation, combination, reclassification or recapitalization involving such
Ordinary Shares, then in relation to the Ordinary Shares that are covered by the
Options or Stock Purchase Rights granted or available under the Plan and are
affected by one or more of the above events, the numbers, rights and privileges of
the following shall be increased, decreased or changed in like manner as if such
Ordinary Shares had been issued and outstanding, fully paid and non-assessable at
the time of such occurrence.

	 	(b)	 	Dissolution or Liquidation

In the event of the proposed dissolution or liquidation of the Company, the
Administrative Committee shall notify each Optionee as soon as practicable prior to
the effective date of such proposed dissolution or liquidation. The Administrative
Committee may at its sole discretion provide for an Optionee to have the right to
exercise his or her Option or Stock Purchase Right at any time until fifteen (15)
days prior to the commencement of such proposed dissolution or liquidation. In
addition, the Administrative Committee may at its sole discretion provide that any
repurchase option of the Company applicable to any Restricted Stock and/or any
right of the Company to buy out outstanding Options under subsection 9(e) shall
lapse upon dissolution or liquidation of the Company, provided the
proposed dissolution or liquidation takes place at the time and in the manner
contemplated.

 

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	 	(c)	 	Merger or Asset Sale

In the event of a merger of the Company with or into another corporation, or the
sale of substantially all of the assets of the Company, each outstanding Option and
Stock Purchase Right shall be assumed or an equivalent option or right substituted
by the successor corporation or its holding company (meaning any entity which holds
directly or indirectly at least fifty point one percent of the voting equity of the
successor corporation) or subsidiary (meaning any entity in which the successor
corporation holds directly or indirectly fifty point one percent or more of the
voting equity). In the event that the successor corporation or its holding company
or subsidiary refuses to assume or substitute for the Option or Stock Purchase
Right, the Optionee shall fully vest in and have the right to exercise the Option
or Stock Purchase Right as to all of the Optioned Stock, including such part of the
Optioned Stock as to which it would not otherwise be vested or exercisable and the
repurchase option of the Company applicable to any Restricted Stock and/or any
right of the Company to buy out outstanding Options under subsection 9(e) shall
lapse upon consummation of such merger or sale of assets. If an Option or Stock
Purchase Right becomes fully vested and exercisable in lieu of assumption or
substitution in the event of a merger or sale of assets, the Administrative
Committee shall accordingly notify the Optionee in writing or electronically in
which event the Option or Stock Purchase Right shall be fully exercisable for a
period of fifteen (15) days from the date of such notice, and the Option or Stock
Purchase Right shall terminate upon the expiration of such fifteen (15) day period.
For the purposes of this paragraph, the Option or Stock Purchase Right shall be
considered assumed if, following the merger or sale of assets, the outstanding
Option or Stock Purchase Right confers the right to purchase or receive
proportionately the consideration (whether stock, cash, or other securities or
property) received by holders of Ordinary Shares in the merger or sale of assets;
provided, however, that if such consideration received in the merger or sale of
assets is not solely common stock of the successor corporation or its holding
company or subsidiary, the Administrative Committee may, with the consent of the
successor corporation, provide for the consideration to be received upon the
exercise of the Option or Stock Purchase Right to be solely common stock of the
successor corporation or its holding company or subsidiary equal in fair market
value to the per share consideration received by holders of Ordinary Shares in the
merger
or sale of assets, such fair market value to be conclusively determined by the
Administrative Committee.

 

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	 	(d)	 	General Adjustment Rules

If any adjustment or substitution provided for in this Section 12 shall result in
the creation of a fractional Ordinary Share under any Option, the Company shall, in
lieu of issuing such fractional Ordinary Share, pay to the Optionee a cash sum in
the amount equal to the product of such fraction multiplied by the Fair Market
Value of an Ordinary Share on the date the fractional Ordinary Share otherwise
would have been issued.

	 	(e)	 	Determination by Administrative Committee

Adjustments under this Section 12 shall be made by the Administrative Committee
whose determinations with regard thereto shall be final, conclusive and binding
upon all parties.

	13.	 	Time of Granting Options and Stock Purchase Rights

The date of grant of an Option or Stock Purchase Right shall, for all purposes, be the date
on which the Administrative Committee makes the determination granting such Option or Stock
Purchase Right, or such other date as determined by the Administrative Committee. Notice
of the determination shall be given to each Service Provider to whom an Option or Stock
Purchase Right is so granted within a reasonable time after the date of such grant.

	14.	 	Amendment and Termination of the Plan

	 	(a)	 	Amendment and Termination

Subject to Subsection 14(b) below, the Board may at any time amend, alter, suspend
or terminate the Plan.

	 	(b)	 	Shareholder Approval

The Board shall obtain shareholder approval of any amendment to the Plan to the
extent necessary and desirable to comply with Applicable Laws.

	 	(c)	 	Effect of Amendment or Termination

No amendment, alteration, suspension or termination of the Plan shall impair the
rights of any Optionee, unless mutually agreed
otherwise between the Optionee and the Administrative Committee. Termination of
the Plan shall not affect the Administrative Committee’s ability to exercise the
powers granted to it hereunder with respect to Options granted under the Plan prior
to the date of such termination.

 

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	15.	 	Conditions Upon Issuance of Shares

	 	(a)	 	Legal Compliance

Ordinary Shares shall not be issued pursuant to the exercise of an Option or Stock
Purchase Right unless the exercise of such Option or Stock Purchase Right and the
issuance and delivery of such Ordinary Shares shall comply with Applicable Laws and
shall be further subject to the approval of legal counsel for the Company with
respect to such compliance.

	 	(b)	 	Cash Payment

The payment of cash pursuant to the Plan shall be subject to all Applicable Laws.

	 	(c)	 	Investment Representations

The Company may require any person to whom an Option or a Stock Purchase Right is
granted, as a condition of exercising such Option or Stock Purchase Right or
receiving Ordinary Shares pursuant to the Plan, to give written assurances, in the
substance and form satisfactory to the Company and its legal counsel, to the effect
that such person is acquiring the Ordinary Shares subject to the Option or Stock
Purchase Right for his own account for investment and not with any present
intention of selling or otherwise distributing the same, and to such other effects
as the Company deems necessary or appropriate in order to comply with applicable
securities laws.

	 	(d)	 	Restrictions

The Administrative Committee may provide that Ordinary Shares issuable upon the
exercise of an Option or Stock Purchase Right shall, under certain conditions, be
subject to restrictions whereby the Company has a right of first refusal with
respect to such Ordinary Shares, which restrictions may survive an Optionee’s term
of employment, engagement, appointment or service with the Company.

 

Page 16

 

	16.	 	Inability to Obtain Regulatory Approval

The inability of the Company to obtain approval from any regulatory body having
jurisdiction over the Company with respect to issuance of Ordinary Shares pursuant to this
Plan shall relieve the Company of any liability in respect of the failure to issue such
Ordinary Shares as to which such requisite approval shall not have been obtained.

	17.	 	Shareholder Approval

The Plan shall be subject to approval by the shareholders of the Company within twelve (12)
months after the date the Plan is adopted by the Board. Such shareholder approval shall be
obtained in the degree and manner required under Applicable Laws.

	18.	 	Information to Optionees and Purchasers

The Company shall provide to each Optionee and to each individual who acquires Ordinary
Shares pursuant to the Plan, not less frequently than annually during the period such
Optionee or purchaser has one or more Options or Stock Purchase Rights outstanding, and, in
the case of an individual who acquires Ordinary Shares pursuant to the Plan, during the
period such individual owns such Ordinary Shares, copies of annual financial statements.
The Company shall not be required to provide such statements to key employees whose duties
in connection with the Company assure their access to equivalent information.

	19.	 	Withholding

The Company’s obligations to deliver Ordinary Shares upon the exercise of an Option or
Stock Purchase Right shall be subject to the Optionee’s satisfaction of all Applicable Laws
related to tax withholding as a result of such exercise.

	20.	 	Non-exclusivity of the Plan

Neither the adoption of the Plan by the Board nor the submission of the Plan to
shareholders of the Company for approval shall be construed as creating any limitations on
the power or authority of the Board to adopt such other or additional incentive or other
compensation arrangements of whatever nature as the Board may deem necessary or desirable
or preclude or limit the continuation of any other plan, practice or arrangement for the
payment of compensation or fringe benefits to employees generally, or to any class or group
of employees, which the Company or any Subsidiary now has lawfully put into effect,
including, without limitation, any retirement, pension, savings and stock purchase
plan, insurance, death and disability benefits and executive short-term incentive plans.

 

Page 17

 

	21.	 	No Transfer or Assignment

The Option or Stock Purchase Right granted hereunder shall not be transferred or assigned
without the approval in writing of the Administrative Committee.

	22.	 	Governing Law

The terms and conditions of this Plan shall be governed by and construed in accordance with
the laws of the Cayman Islands.

- E N D -

 

Page 18exv10w1

    Exhibit 10.1

 

    CONFIDENTIAL
    TREATMENT REQUESTED

 

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

 

    EXECUTION COPY

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE AGREEMENT

    between

    NATIONAL MEDICAL CARE, INC.

    as Seller

    and

    NMC FUNDING CORPORATION

    as Purchaser

    Dated as of October 16, 2008

 

    TABLE OF
    CONTENTS

 

	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
    Page

	 

	
    Article I

    

    DEFINITIONS

	

    Section 1.1.
    

	
 
	
    Certain Defined Terms
	
 
	 
	
    1
	 

	

    Section 1.2.
    

	
 
	
    Other Terms
	
 
	 
	
    7
	 

	

    Section 1.3.
    

	
 
	
    Computation of Time Periods
	
 
	 
	
    7
	 

	
 

	
    Article II

    

    PURCHASE AND SETTLEMENTS

	

    Section 2.1.
    

	
 
	
    Purchases of Receivables; Agreement to Purchase
	
 
	 
	
    7
	 

	

    Section 2.2.
    

	
 
	
    Payment for the Purchases
	
 
	 
	
    8
	 

	

    Section 2.3.
    

	
 
	
    Purchase Price Credit Adjustments
	
 
	 
	
    9
	 

	

    Section 2.4.
    

	
 
	
    Payments and Computations, Etc
	
 
	 
	
    9
	 

	

    Section 2.5.
    

	
 
	
    Transfer of Records to Purchaser
	
 
	 
	
    9
	 

	

    Section 2.6.
    

	
 
	
    Protection of Ownership Interest of the Purchaser
	
 
	 
	
    10
	 

	

    Section 2.7.
    

	
 
	
    Additional Transferring Affiliates
	
 
	 
	
    10
	 

	
 

	
    Article III

    

    REPRESENTATIONS AND WARRANTIES

	

    Section 3.1.
    

	
 
	
    Representations and Warranties of the Seller
	
 
	 
	
    11
	 

	

    Section 3.2.
    

	
 
	
    Reaffirmation of Representations and Warranties by the Seller
	
 
	 
	
    13
	 

	
 

	
    Article IV

    

    CONDITIONS PRECEDENT

	

    Section 4.1.
    

	
 
	
    Conditions Precedent to Closing
	
 
	 
	
    14
	 

	

    Section 4.2.
    

	
 
	
    Conditions Precedent to Purchases
	
 
	 
	
    14
	 

	
 

	
    Article V

    

    COVENANTS

	

    Section 5.1.
    

	
 
	
    Affirmative Covenants of Seller
	
 
	 
	
    14
	 

	

    Section 5.2.
    

	
 
	
    Negative Covenants of the Seller
	
 
	 
	
    18
	 

	
 

	
    Article VI

    

    ADMINISTRATION AND COLLECTION

	

    Section 6.1.
    

	
 
	
    Collection of Receivables
	
 
	 
	
    19
	 

	

    Section 6.2.
    

	
 
	
    Rights of Purchaser
	
 
	 
	
    19
	 

	

    Section 6.3.
    

	
 
	
    Special Accounts
	
 
	 
	
    20
	 

	

    Section 6.4.
    

	
 
	
    Responsibilities of the Seller
	
 
	 
	
    20
	 

	

    Section 6.5.
    

	
 
	
    Reports
	
 
	 
	
    20
	 

	
 

	
    Article VII

    

    SELLER DEFAULTS

	

    Section 7.1.
    

	
 
	
    Seller Defaults
	
 
	 
	
    21
	 

	

    Section 7.2.
    

	
 
	
    Remedies
	
 
	 
	
    22
	 

	
 

	
    Article VIII

    

    INDEMNIFICATION; EXPENSES

	

    Section 8.1.
    

	
 
	
    Indemnities by the Seller
	
 
	 
	
    22
	 

	

    Section 8.2.
    

	
 
	
    Other Costs and Expenses
	
 
	 
	
    24
	 

    

    i

 

	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
    Page

	 

	
    Article IX

    

    MISCELLANEOUS

	

    Section 9.1.
    

	
 
	
    Term of Agreement
	
 
	 
	
    24
	 

	

    Section 9.2.
    

	
 
	
    Waivers; Amendments
	
 
	 
	
    24
	 

	

    Section 9.3.
    

	
 
	
    Notices
	
 
	 
	
    24
	 

	

    Section 9.4.
    

	
 
	
    Governing Law; Submission to Jurisdiction; Integration.
	
 
	 
	
    25
	 

	

    Section 9.5.
    

	
 
	
    Severability; Counterparts
	
 
	 
	
    25
	 

	

    Section 9.6.
    

	
 
	
    Successors and Assigns
	
 
	 
	
    26
	 

	

    Section 9.7.
    

	
 
	
    Waiver of Confidentiality
	
 
	 
	
    26
	 

	

    Section 9.8.
    

	
 
	
    Confidentiality Agreement
	
 
	 
	
    26
	 

	

    Section 9.9.
    

	
 
	
    Bankruptcy Petitions
	
 
	 
	
    26
	 

	

    Section 9.10.
    

	
 
	
    Purchase Termination
	
 
	 
	
    26
	 

	

    Section 9.11.
    

	
 
	
    Subordination
	
 
	 
	
    26
	 

	

    Section 9.12.
    

	
 
	
    Characterization of the Transactions Contemplated by the
    Agreement
	
 
	 
	
    27
	 

 

    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 and Designated Account Agents
	
 
	 
	
    C-1
	 

	

    EXHIBIT D

	
 
	
    Form of Special Account Letter
	
 
	 
	
    D-1
	 

	

    EXHIBIT E

	
 
	
    Form of Subordinated Note
	
 
	 
	
    E-1
	 

	

    EXHIBIT F

	
 
	
    List of Actions and Suits
	
 
	 
	
    F-1
	 

	

    EXHIBIT G

	
 
	
    Location of Records
	
 
	 
	
    G-1
	 

	

    EXHIBIT H

	
 
	
    List of Seller’s Subsidiaries, Divisions and Tradenames
	
 
	 
	
    H-1
	 

	

    EXHIBIT I

	
 
	
    Form of Transferring Affiliate Letter
	
 
	 
	
    I-1
	 

	

    EXHIBIT J

	
 
	
    List of Transferring Affiliates, Chief Executive Offices of
    Transferring Affiliates and Tradenames
	
 
	 
	
    J-1
	 

	

    EXHIBIT K

	
 
	
    Form of Account Agent Agreement
	
 
	 
	
    K-1
	 

    

    ii

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE AGREEMENT

 

    This AMENDED AND RESTATED RECEIVABLES PURCHASE AGREEMENT (this
    “Agreement”) dated as of October 16, 2008,
    is entered into by and between NATIONAL MEDICAL CARE, INC., a
    Delaware corporation, as seller (the “Seller”),
    and NMC FUNDING CORPORATION, a Delaware corporation, as
    purchaser (the “Purchaser”).

 

    PRELIMINARY
    STATEMENTS

 

    WHEREAS, the Seller and the Purchaser are parties to that
    certain Receivables Purchase Agreement dated as of
    August 28, 1997 (as amended prior to the date hereof, the
    “Existing Receivables Purchase
    Agreement”); and

 

    WHEREAS, the parties hereto desire to amend and restate the
    Existing Receivables Purchase Agreement in its entirety.

 

    NOW, THEREFORE, the parties hereby agree as follows:

 

    ARTICLE I

    

 

    DEFINITIONS
    

 

    Section 1.1. Certain
    Defined Terms. Capitalized terms used and not otherwise
    defined herein have the meanings assigned to such terms in the
    TAA. 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 K hereto.

 

    “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).

 

    “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.

 

    “Aggregate Unpaids” has the meaning specified
    in the TAA.

 

    “Agreement” has the meaning specified in the
    Preamble hereto.

 

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

 

    “Base Rate” has the meaning specified in the
    TAA.

 

    “Benefit Plan” means any employee benefit plan
    as defined in Section 3(3) of ERISA in respect of which the
    Seller or any ERISA Affiliate of 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 of even date herewith 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.

 

    “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.

 

    “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.

 

    “Closing Date” means October 16, 2008.

 

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

 

    “Collection Account” has the meaning specified
    in the TAA.

 

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

 

    “Collection Date” means the date on which the
    TAA shall be terminated in accordance with its terms and all of
    the Aggregate Unpaids thereunder paid in full.

 

    “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”.

 

    “Concentration Account” has the meaning
    specified in the TAA.

 

    “Concentration Account Agreement” has the
    meaning specified in the TAA.

 

    “Concentration Account Bank” has the meaning
    specified in the TAA.

 

    “Concentration Account Notice” has the meaning
    specified in the TAA.

 

    “Confidential Information” has 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 the Purchaser,
    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 the Purchaser.

 

    “Credit and Collection Policy” shall mean the
    Seller’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).

 

    “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 Purchaser an Account Agent Agreement.

 

    “Eligible Receivable” has the meaning set forth
    in the TAA, except that, for purposes of this Agreement
    (a) the criteria listed in clause (ii) of the
    definition of Eligible Receivable in the TAA shall not be
    applicable and (b) references in clauses (iii),
    (iv) and (v) of such definition in the TAA to
    “the time of the initial creation of an interest therein
    hereunder” shall instead be deemed to mean and refer to
    “the time such Receivable was sold or transferred by the
    Seller to the Purchaser hereunder.”

    

    2

 

    “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.

 

    “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).

 

    “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” shall have the
    meaning specified in the TAA.

 

    “FMCH” means Fresenius National 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.

 

    “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.

 

    “HCFA” means the Health Care Financing
    Administration, an agency of the HHS charged with administering
    and regulating, among other things, certain aspects of Medicaid
    and Medicare.

 

    “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.

 

    “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.

    

    3

 

    “Intermediate Concentration Account” has the
    meaning specified in the TAA.

 

    “Intermediate Concentration Account Agreement”
    has the meaning specified in the TAA.

 

    “Intermediate Concentration Account Bank” has
    the meaning specified in the TAA.

 

    “Intermediate Concentration Account Notice” has
    the meaning specified in the TAA.

 

    “Investor Report” has the meaning specified in
    the TAA.

 

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

 

    “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 Seller or any
    other Originating Entity to charge or collect a material portion
    of the Receivables or Related Security, (iii) the ability
    of (A) the Seller or any other 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 of any such
    provision or, if the Seller shall fail to do so, to perform or
    observe any such provision required to be performed or observed
    by the Seller under this Agreement or any other Transaction
    Document to which the Seller 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 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 of FME KGaA, FMCH, the Seller or the
    Transferor or (vi) the interests of the Purchaser
    and/or its
    assignees under the Transaction Documents.

 

    “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,
    HCFA, 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, HCFA, 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.

 

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

 

    “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 Seller or any ERISA Affiliate of the
    Seller on behalf of its employees.

 

    “Net Investment” has the meaning specified in
    the TAA.

 

    “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),

    

    4

 

    (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 by NMC Medical Products, Inc.
    of services or merchandise.

 

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

 

    (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, 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.

 

    “Parent Agreement” has the meaning specified in
    the TAA.

 

    “Parent Group” means, collectively, FME KGaA,
    FMCH, the Seller, the Originating Entities and their
    Subsidiaries and Affiliates (other than the Purchaser), and
    “Parent Group Member” means any such Person
    individually.

 

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

 

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

 

    “Proceeds” means “proceeds” as
    defined in
    Section 9-102
    of the UCC.

 

    “Purchase” means, on any Business Day, the
    sale, assignment, contribution, transfer
    and/or other
    conveyance of Receivables, together with the Related Assets with
    respect thereto, from the Seller to the Purchaser in accordance
    with the terms of Article II hereof.

 

    “Purchase Price” means, with respect to any
    Purchase on any date, the aggregate price to be paid to the
    Seller in connection therewith, which shall be an amount equal
    to (i) the Outstanding Balance of the Receivables that are
    the subject of such Purchase, minus any Contractual
    Adjustments in respect of such Receivables, multiplied by
    (ii) the Purchase Price Percentage then in effect.

 

    “Purchase Price Credit” means a credit in favor
    of the Purchaser against the Purchase Price otherwise due and
    payable by the Purchaser hereunder.

 

    “Purchase Price Percentage” means 97%, or such
    other percentage as may be agreed from time to time by the
    Purchaser and the Seller and which would provide the Purchaser
    with a reasonable return on its Purchases hereunder after taking
    into account (i) the time value of money based upon the
    anticipated dates of collection of such Receivables and the cost
    to the Purchaser of financing its investment in such Receivables
    during such period and (ii) the risk of nonpayment by the
    Obligors. The Seller and the Purchaser may agree from time to
    time to change the Purchase Price Percentage based on changes in
    the items described in clauses (i) and (ii) above,
    provided that any change to the Purchase Price Percentage
    shall apply only prospectively and shall

    

    5

 

    not affect the Purchase Price in respect of Purchases made prior
    to the date on which the Purchaser and the Seller agree to make
    such change.

 

    “Purchaser” means NMC Funding Corporation, and
    its successors and permitted assigns.

 

    “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(z).

 

    “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.

 

    “Related Assets” has the meaning specified in
    Section 2.1(a) hereof.

 

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

 

    (i) all of the Seller’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 Seller (A) under
    the Transferring Affiliate Letter, together with all financing
    statements filed in connection therewith against the
    Transferring Affiliates and (B) under the BMA Transfer
    Agreement, together with all financing statements filed in
    connection therewith against BMA; and

 

    (vi) all Proceeds of any of the foregoing.

 

    “Responsible Officer” means any of the Chief
    Executive Officer, the President, the Chief Financial Officer,
    the Controller, the Treasurer or an Assistant Treasurer of the
    Seller.

 

    “Revolving Loan” has the meaning specified in
    Section 2.2(c).

 

    “Seller” means National Medical Care, Inc., a
    Delaware corporation, and its successors and permitted assigns.

 

    “Seller Default” has the meaning specified in
    Section 7.1.

 

    “Settlement Date” means (i) the last
    Business Day of each calendar month with respect to the
    immediately preceding calendar month and (ii) any
    additional day designated by the Purchaser.

 

    “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.

    

    6

 

    “Special Account Letter” means a letter, in
    substantially the form of Exhibit D 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.

 

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

 

    “Subordinated Note” has the meaning specified
    in Section 2.2(d) hereof.

 

    “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.

 

    “TAA” means that certain Fourth Amended and
    Restated Transfer and Administration Agreement dated as of the
    Closing Date 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”, the
    Persons parties thereto as “Administrative Agents” and
    WestLB AG, New York Branch, as “Agent”, as the same
    has been or may hereafter be from time to time amended,
    restated, supplemented or otherwise modified.

 

    “Termination Date” means the date, occurring
    after the “Termination Date” under the TAA, which the
    parties hereto agree shall be the Termination Date for purposes
    of this Agreement.

 

    “Transaction Documents” has the meaning
    specified in the TAA.

 

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

 

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

 

    “US Government Obligor” means any Obligor that
    is the 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”.

 

    “Voting Stock” shall have the meaning specified
    in the TAA.

 

    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 Receivables Purchase
    Agreement in its entirety. This Agreement is not intended to
    constitute a novation of the Existing Receivables Purchase
    Agreement. Upon the effectiveness of this Agreement (the
    “Effective Date”), each reference to the
    Existing Receivables Purchase Agreement in any other document,
    instrument or agreement executed
    and/or
    delivered in connection therewith shall mean and be a reference
    to this Agreement.

 

    ARTICLE II

    

 

    PURCHASE AND
    SETTLEMENTS
    

 

    Section 2.1. Purchases
    of Receivables; Agreement to Purchase. (a) Subject to
    the terms and conditions hereinafter set forth, the Purchaser
    hereby purchases from the Seller, and the Seller hereby sells,
    transfers, assigns and otherwise conveys to the Purchaser, all
    of the Seller’s right, title and interest in and to each
    and every Receivable existing as of the Original Closing Date as
    well as each and every Receivable which may arise at any time
    thereafter until the Termination Date, together, in each case,
    with the Related Security, Collections and Proceeds with respect
    thereto (such Related Security, Collections and Proceeds,
    collectively, the “Related Assets”). All of the
    Seller’s right, title and interest in and to all
    Receivables and the Related Assets with respect thereto arising
    on each day prior to the Termination Date shall, without further
    action of any type being required on the part of the Purchaser
    or the Seller (and notwithstanding any delay in making payment
    of the Purchase Price therefor, or any delay in making any
    notation reflecting payment of such Purchase Price), be
    automatically transferred on such day to the Purchaser,
    whereupon the Purchaser shall have the obligation to pay the
    Purchase Price in respect thereof in the manner, at the

    

    7

 

    time and otherwise in accordance with the terms specified in
    this Agreement. Prior to paying the Purchase Price hereunder in
    respect of any Purchase, the Purchaser may request of the
    Seller, and the Seller shall deliver, such approvals, opinions,
    information, reports or documents as the Purchaser may
    reasonably request.

 

    (b) It is the intention of the parties hereto that each
    Purchase of Receivables made hereunder shall constitute a true
    sale of such Receivables and the Related Assets with respect
    thereto (including, in the case of Receivables, a “sale of
    accounts,” as such term is used in Article 9 of the
    UCC), which sales shall, in each case, be absolute and
    irrevocable and provide the Purchaser with the full benefits of
    ownership of such Receivables and Related Assets. Except for the
    Purchase Price Credits owed pursuant to Section 2.3 hereof,
    each sale of Receivables by the Seller to the Purchaser is made
    without recourse to the Seller; provided, however,
    that (i) the Seller shall be liable to the Purchaser for
    all representations, warranties and covenants made by the Seller
    pursuant to the terms of this Agreement or any other Transaction
    Document, and (ii) such sale does not constitute and is not
    intended to result in an assumption by the Purchaser of any
    obligation of the Seller, any Transferring Affiliate or any
    other Person arising under or in connection with the
    Receivables, the Related Assets
    and/or the
    related Contracts. In view of the intention of the parties
    hereto that the Purchases of Receivables made hereunder shall
    constitute sales of such Receivables rather than a loan secured
    by such Receivables, the Seller agrees on or prior to the date
    hereof to mark its master data processing records relating to
    the Receivables with a legend, acceptable to the Purchaser,
    evidencing that the Purchaser has purchased such Receivables as
    provided in this Agreement and to note in its financial
    statements that its Receivables have been sold to the Purchaser.

 

    (c) Notwithstanding any other provision of this Agreement
    to the contrary, no Purchases shall be made hereunder from and
    after the time of any Event of Bankruptcy with respect to the
    Seller or the Purchaser.

 

    Section 2.2. Payment
    for the Purchases. (a) The Purchase Price for the
    initial Purchase of Receivables hereunder shall be payable in
    full by the Purchaser to the Seller, and shall be paid to the
    Seller in the following manner on the date of such initial
    Purchase: (i) by the issuance of equity in the manner
    contemplated in that certain Stockholder and Subscription
    Agreement dated as of August 28, 1997 between the Seller
    and the Purchaser and having a value of not less than the
    greater of (A) $5,000,000 or (B) three percent (3.00%)
    of the Net Investment outstanding at such time under the TAA,
    after giving effect to such sale under the TAA, (ii) by
    delivery of immediately available funds, to the extent of funds
    made available to the Purchaser in connection with its
    subsequent sale of an interest in such Receivables to the Agent
    (on behalf of any Conduit Investor or the Bank Investors, as
    applicable) under the TAA and (iii) the balance, with the
    proceeds of a Revolving Loan. The Purchase Price for each
    Purchase after the initial Purchase shall be payable in full by
    the Purchaser to the Seller or its designee on the date of such
    Purchase, except that the Purchaser may, with respect to
    any such Purchase, offset against such Purchase Price any
    amounts owed by the Seller to the Purchaser hereunder and which
    have become due but remain unpaid.

 

    (b) If on any date the amount of cash available to the
    Purchaser to pay for the Purchases of Receivables to be made on
    such date is less the Purchase Price owing therefor, the
    Purchaser shall, with notice to the Seller, pay such remaining
    part of the Purchase Price by borrowing from the Seller a
    revolving loan (each a “Revolving Loan”), and
    the Seller, subject to the remaining provisions of this
    paragraph, irrevocably agrees to advance, and shall be deemed to
    have advanced, a Revolving Loan in the amount so specified by
    the Purchaser; provided, however, that no such
    Revolving Loan shall be made to the Purchaser, if, after giving
    effect thereto, either (i) the aggregate outstanding amount
    of the Revolving Loans would exceed the aggregate Outstanding
    Balance of the Eligible Receivables minus the aggregate
    Net Investment outstanding at such time under the TAA or
    (ii) the Purchaser’s net worth would be less than the
    greater of (A) $5,000,000 or (B) three percent (3.00%)
    of the aggregate Net Investment outstanding at such time under
    the TAA. The Revolving Loans shall be evidenced by, and shall be
    payable in accordance with the terms and provisions of, a
    promissory note in the form of Exhibit E hereto (the
    “Subordinated Note”) and shall be payable
    solely from funds which the Purchaser is not required under the
    TAA to set aside for the benefit of, or otherwise pay over to,
    the Agent, any Conduit Investor
    and/or the
    Bank Investors.

 

    (c) In the case of any Purchase subsequent to the initial
    Purchase, if the Purchaser has insufficient funds to pay in full
    the applicable Purchase Price therefor (after taking into
    account the proceeds received from any Transfers under the TAA
    and the proceeds of Revolving Loans made hereunder), then the
    Seller shall be deemed to have contributed to the capital of the
    Purchaser Receivables having a Purchase Price equal to the
    otherwise unpaid portion of the total Purchase Price owed on
    such day.

 

    (d) The respective Purchase Prices for the Purchases made
    during any calendar month shall be settled on a monthly basis on
    the Settlement Date occurring in the succeeding calendar month,
    such settlement to be made based on the information contained in
    the Investor Report in respect of such calendar month. With
    respect to any such settlement, each adjustment to the
    outstanding balance of the Subordinated Note made pursuant to
    this Article II and each capital contribution made by the
    Seller to the Purchaser pursuant to this Article II shall
    be deemed to have

    

    8

 

    occurred and shall be effective as of the last Business Day of
    the calendar month to which such settlement relates.
    Notwithstanding the foregoing, to the extent the Purchaser
    receives either Collections or proceeds from any Incremental
    Transfers, which, in either case, it is not required to hold in
    trust for, or remit to, the Agent, any Conduit Investor
    and/or any
    of the Bank Investors pursuant to the TAA, then the Purchaser
    shall remit such funds to the Seller (net of any funds needed to
    pay existing expenses of the Purchaser which are then accrued
    and unpaid) in the following order of application: first
    to pay the Purchase Price for any Receivables Purchased from the
    Seller; and second to pay amounts owed by the Purchaser
    to the Seller under the Subordinated Note; provided, that
    if on any Settlement Date it is determined that the aggregate
    amount of funds so remitted by the Purchaser to the Seller
    during any calendar month exceeded the aggregate of the amounts
    described in clauses first and second above due
    and payable by the Purchaser to the Seller during such calendar
    month, such excess funds shall be returned forthwith by the
    Seller to the Purchaser.

 

    Section 2.3. Purchase
    Price Credit Adjustments. (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,
    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 Purchaser shall be entitled to a
    Purchase Price Credit in an amount equal to the full amount of
    such reduction or cancellation. In addition, 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 thereof to the Purchaser 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” in the TAA, then, in any such
    case, the Purchaser shall be entitled to a Purchase Price Credit
    in an amount equal the Outstanding Balance of such Receivable.
    If any Purchase Price Credit to which the Purchaser is entitled
    pursuant to this Section 2.3 exceeds the Purchase
    Price of the Receivables to be sold hereunder on any date, then
    the Seller shall pay the remaining amount of such Purchase Price
    Credit to the Purchaser in cash on the next succeeding Business
    Day; provided that, if the Termination Date has not
    occurred, the Seller shall be allowed to deduct the remaining
    amount of such Purchase Price Credit from any indebtedness owed
    to it under the Subordinated Note.

 

    (b) Any payment by an Obligor in respect of any
    indebtedness owed by it to the Seller shall, except as otherwise
    specified by such Obligor or otherwise required by contract or
    law and unless otherwise instructed by the Purchaser, be applied
    as a Collection of any Receivable of such Obligor which was
    included in a Purchase hereunder (starting with the oldest such
    Receivable) before being applied to any other receivable or
    other indebtedness of such Obligor.

 

    Section 2.4. Payments
    and Computations, Etc. All amounts to be paid or deposited
    by the Seller hereunder shall be paid or deposited in accordance
    with the terms hereof no later than 11:00 a.m. (New York
    City time) on the day when due in immediately available funds.
    The Seller shall, to the extent permitted by law, pay to the
    Purchaser, upon demand, interest on all amounts not paid or
    deposited when due hereunder at a rate equal to 2% per annum
    plus the Base Rate. All computations of interest 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 the Purchaser of amounts payable by
    the Seller hereunder shall be binding upon the Seller absent
    manifest error.

 

    Section 2.5. Transfer
    of Records to Purchaser. (a) In connection with the
    Purchases of Receivables hereunder, the Seller hereby sells,
    transfers, assigns and otherwise conveys to the Purchaser all of
    the Seller’s right and title to and interest in the Records
    relating to all Receivables included in any Purchase hereunder,
    without the need for any further documentation in connection
    with any such Purchase. In connection with such transfer, the
    Seller hereby grants to each of the Purchaser and the Collection
    Agent (including, without limitation, any successor Collection
    Agent appointed in accordance with the TAA) an irrevocable,
    non-exclusive license to use, without royalty or payment of any
    kind, all software now or hereafter used by the Seller to
    account for the Receivables, to the extent necessary to
    administer the Receivables, whether such software is owned by
    the Seller or is owned by others and used by the Seller under
    license agreements with respect thereto (the
    “Software”). As of the date hereof, with respect to
    all Software now existing, either (i) no consent by any
    licensor of the Seller to such grant is required, (ii) if
    any such consent is required, such consent has been obtained, or
    (iii) the data administered and managed with the use of
    such Software is in a form such that other types of software
    that are generally available may be used to administer and
    manage such data in the same fashion as then being administered
    and managed with the applicable Software. If after the date
    hereof the consent by any licensor of the Seller to such grant
    shall be required, the Seller shall promptly obtain such
    consent. The license granted hereby shall be irrevocable, and
    shall not expire until the date on which this Agreement shall
    terminate in accordance with its terms.

    

    9

 

    (b) The Seller shall take such action requested by the
    Purchaser
    and/or the
    Agent, from time to time hereafter, that may be reasonably
    necessary or appropriate to ensure that the Purchaser (and its
    assignees) has (i) an enforceable ownership interest in the
    Records relating to the Receivables purchased from the Seller
    hereunder and (ii) an enforceable right (whether by license
    or sublicense or otherwise) to use all of the computer software
    used to account for the Receivables
    and/or to
    recreate such Records.

 

    Section 2.6. Protection
    of Ownership Interest of the Purchaser. (a) The Seller
    agrees that it will, and will cause each Transferring Affiliate
    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 Purchaser or the Agent may reasonably
    request in order to perfect or protect the ownership interest of
    the Purchaser in the Receivables and Related Assets with respect
    thereto or to enable the Purchaser to exercise or enforce any of
    its rights and remedies hereunder. Without limiting the
    foregoing, the Seller will, upon the request of the Purchaser or
    the Agent, 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 may
    be requested by the Purchaser or the Agent. The Seller shall,
    upon request of the Purchaser or the Agent, obtain such
    additional search reports as the Purchaser or the Agent shall
    request. To the fullest extent permitted by applicable law, each
    of the Purchaser and the Agent shall be permitted to sign and
    file continuation statements and amendments thereto and
    assignments thereof without the Seller’s signature. Carbon,
    photographic or other reproduction of this Agreement or any
    financing statement shall be sufficient as a financing
    statement. The Seller shall not, and shall not permit any
    Transferring Affiliate to, change its respective name, identity
    or corporate structure (within the meaning of
    Section 9-402(7)
    of the UCC as in effect in any applicable state) nor relocate
    its respective chief executive office or any office where
    Records are kept unless it shall have: (i) given each of
    the Purchaser and the Agent at least thirty (30) days prior
    notice thereof and (ii) prepared at Seller’s expense
    and delivered to each of the Purchaser and the Agent all
    financing statements, instruments and other documents necessary
    to preserve and protect the Purchaser’s ownership interest
    in the Receivables and the Related Assets with respect thereto
    or requested by the Purchaser or the Agent in connection with
    such change or relocation. Any filings under the UCC or
    otherwise that are occasioned by such change in name or location
    shall be made at the expense of the Seller.

 

    (b) In addition and without limiting the authority of the
    Purchaser or the Agent set forth in subsection (a) above,
    but subject to subsection (c) below, the Seller shall, and
    shall cause each Transferring Affiliate to (i) instruct any
    or all of the Special Account Banks (which instructions shall be
    maintained in full force and effect) 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
    Seller shall at any time determine, for any of the reasons
    described in subsection (c) below, that the Seller or any
    Transferring Affiliate shall be unable to comply fully with the
    requirements of this subsection (b), the Seller shall promptly
    so advise the Purchaser and the Agent, and the Purchaser, the
    Agent and the Seller shall commence discussions with a view
    toward implementing an alternative arrangement therefor
    satisfactory to the Purchaser and the Agent.

 

    (c) 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 2.7. Additional
    Transferring Affiliates. (a) If (i) one or more
    direct or indirect wholly-owned subsidiaries of the Seller
    (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 Seller and the Transferring
    Affiliates or (ii) the Seller 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 the
    Seller, any or all of the wholly-owned subsidiaries referred to
    in clauses (i) and (ii) may, with the prior written
    consent of the Purchaser and the Agent (which consent shall not
    be unreasonably withheld or delayed), become Transferring
    Affiliates under this Agreement upon delivery to the Purchaser
    and the Agent of (x) counterparts of the

    

    10

 

    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 either the Purchaser or the Agent
    may reasonably request in connection therewith.

 

    (b) Upon the addition of any wholly-owned subsidiary of the
    Seller as a Transferring Affiliate pursuant to
    subsection (a) above, the provisions of this Agreement,
    including Exhibit J, 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.

 

    ARTICLE III

    

 

    REPRESENTATIONS
    AND WARRANTIES
    

 

    Section 3.1. Representations
    and Warranties of the Seller. The Seller represents and
    warrants to the Purchaser that:

 

    (a) Corporate Existence and Power. The Seller 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 Seller 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 Seller of this Agreement and the other Transaction Documents
    to which the Seller is a party are within the Seller’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 2.6 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 By-laws of
    the Seller or of any agreement, judgment, injunction, order,
    writ, decree or other instrument binding upon the Seller or
    result in the creation or imposition of any Adverse Claim on the
    assets of the Seller or any of its Subsidiaries (except as
    contemplated by Section 2.6 hereof).

 

    (c) Binding Effect. Each of this Agreement and the
    other Transaction Documents to which the Seller is a party
    constitutes the legal, valid and binding obligation of the
    Seller, 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 Purchase
    hereunder, the Seller shall be the owner of all of the
    Receivables included in such Purchase, free and clear of all
    Adverse Claims. On or prior to each Purchase hereunder, all
    financing statements and other documents required to be recorded
    or filed, or notices to Obligors required to be given, in order
    to perfect and protect the ownership interest of the Purchaser
    against all creditors of and purchasers from the Seller will
    have been duly given to such Obligors or filed in each filing
    office necessary for such purpose, as applicable, 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 Seller (including, without
    limitation, each Investor Report (to the extent such Investor
    Report is prepared by the Seller or any other Parent Group
    Member or contains any information supplied by the Seller or any
    such Parent Group Member), any reports delivered pursuant to
    Section 6.5 and the Seller’s financial statements) to
    the Purchaser, any Conduit Investor, any Bank Investor, the
    Agent or any Administrative Agent for purposes of or in
    connection with this Agreement or any other Transaction Document
    or any transaction contemplated hereby or thereby is, and all
    such information hereafter furnished by the Seller to the
    Purchaser, any Conduit Investor, any Bank 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 Seller 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.

 

    (g) Action, Suits. Except as set forth in
    Exhibit F hereof, there are no actions, suits or
    proceedings pending, or to the knowledge of the Seller
    threatened, in or before any court, arbitrator or other body,
    against or

    

    11

 

    affecting (i) the Seller or any of its properties or
    (ii) any Affiliate of the Seller 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 Purchase
    will be used by the Seller 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 Seller are located at
    the address of the Seller indicated in Section 9.3 hereof
    and the offices where the Seller keeps substantially all its
    Records, are located at the address(es) described on
    Exhibit G or such other locations notified to the Purchaser
    and the Agent in accordance with Section 2.6 hereof in
    jurisdictions where all action required by Section 2.6
    hereof has been taken and completed. The principal place of
    business and chief executive office of each Transferring
    Affiliate are located at the address of such Transferring
    Affiliate indicated in Exhibit J hereof and the offices
    where the each Transferring Affiliate keeps substantially all
    its Records, are located at the address(es) specified on
    Exhibit J with respect to such Transferring Affiliate or
    such other locations notified to the Purchaser and the Agent in
    accordance with Section 2.6 hereof in jurisdictions where
    all action required by Section 2.6 hereof has been taken
    and completed.

 

    (j) Good Title. Upon each Purchase, the Purchaser
    shall acquire all legal and equitable title to, and a valid and
    perfected first priority ownership interest in, each Receivable
    that exists on the date of such Purchase and in the Related
    Security, Collections and other Proceeds with respect thereto
    free and clear of any Adverse Claim.

 

    (k) Tradenames, Etc. As of the date hereof:
    (i) the Seller’s chief executive office is located at
    the address for notices set forth in Section 9.3 hereof;
    (ii) the Seller has no subsidiaries or divisions other than
    those listed on Exhibit H hereto; (iii) the Seller
    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), except, in each
    case, as disclosed on Exhibit H hereto; and (iv) none
    of the Transferring Affiliates has, within the last five
    (5) years, operated under any tradename 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 disclosed on Exhibit J.

 

    (l) Nature of Receivables. Each Receivable purchased
    by, or otherwise transferred to, the Purchaser hereunder shall
    be an “eligible asset” as defined in
    Rule 3a-7
    under the Investment Company Act, of 1940, as amended,
    and, except as otherwise disclosed in writing on or prior to the
    date of such purchase or transfer, shall be an Eligible
    Receivable as of such date.

 

    (m) Amount of Receivables. As of August 31,
    2008, the aggregate Outstanding Balance of the Receivables in
    existence and the Net Receivable Balance (as defined in the TAA)
    were not less than the respective amounts certified as such in
    (i) the Investor Report dated as of September 30, 2008
    hereof and provided to the Agent or (ii) the Investor
    Report delivered after the date hereof in accordance with
    Section 4.2(a) of the TAA.

 

    (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 or any other Parent Group Member) to service and
    collect the Receivables.

 

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

 

    (q) Not an Investment Company. The Seller 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 Seller 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.

 

    (s) Special Account Banks and Intermediate Concentration
    Account Banks. The names and addresses of all the Special
    Account Banks (and, if applicable, the Designated Account Agents
    in respect thereof), the Intermediate Concentration Account
    Banks, if any, together with the account numbers of the Special
    Accounts

    

    12

 

    at such Special Account Banks and of the Intermediate
    Concentration Account Banks, are specified in Exhibit C
    hereto (or at such other Special Account Banks, with such other
    Special Accounts, Intermediate Concentration Accounts or with
    such other Designated Account Agents as have been notified to
    the Purchaser and the Agent in accordance with
    Section 5.2(e)). Neither the Seller nor any Transferring
    Affiliate has granted to any Person dominion and control over
    any Special Account or Intermediate Concentration Account, or
    the right to take dominion and control over any Special Account
    or Intermediate Concentration Account at a future time or upon
    the occurrence of a future event and each Special Account and
    each Intermediate Concentration Account is otherwise free and
    clear of any Adverse Claim.

 

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

 

    (u) Preference; Voidability (this Agreement). With
    respect to each Receivable transferred to the Purchaser under
    this Agreement, the Purchaser has given reasonably equivalent
    value to the Seller in consideration for such transfer of such
    Receivable and the Related Assets with respect thereto, no such
    transfer has been made for or on account of an antecedent debt
    owed by the Seller to the Purchaser and no such transfer is or
    may be voidable under any Section of the Bankruptcy Code.

 

    (v) 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 on the Original Closing Date, in the
    case of a Receivable outstanding such 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.

 

    (w) Preference; Voidability (Transferring
    Affiliates). The Seller shall have given reasonably
    equivalent value to each Transferring Affiliate in consideration
    for the transfer to the Seller of the Receivables and Related
    Security from such Transferring Affiliate, and each such
    transfer shall not have 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.

 

    (x) Ownership. FME KGaA owns, directly or
    indirectly, 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
    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 Purchaser is owned by
    the Seller, free and clear of any Adverse Claim.

 

    (y) Representations and Warranties of the Transferring
    Affiliates. Each of the representations and warranties of
    the Transferring Affiliates set forth in the Transferring
    Affiliate Letter and each of the representations and warranties
    of BMA set forth in the BMA Transfer Agreement are true and
    correct in all material respects and the Seller hereby remakes
    all such representations and warranties for the benefit of the
    Purchaser.

 

    Any document, instrument, certificate or notice delivered to the
    Purchaser (or any of its assignees) hereunder shall be deemed a
    representation and warranty by the Seller.

 

    Section 3.2. Reaffirmation
    of Representations and Warranties by the Seller. On each day
    that a Purchase is made hereunder, the Seller, by accepting the
    proceeds of such Purchase, 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.

    

    13

 

    ARTICLE IV

    

 

    CONDITIONS
    PRECEDENT
    

 

    Section 4.1. Conditions
    Precedent to Closing. The effectiveness of this Agreement is
    subject to the conditions precedent that (i) the Purchaser
    shall have received copies of each of the documents,
    instruments, certificates and opinions described in
    Section 4.1 of the TAA and (ii) each of the conditions
    precedent to the execution, delivery and effectiveness of the
    TAA shall have been satisfied
    and/or
    waived in accordance with the terms thereof.

 

    Section 4.2. Conditions
    Precedent to Purchases. The obligation of the Purchaser to
    make a Purchase on any Business Day is subject to the conditions
    precedent that:

 

    (a) the Seller shall have delivered to the Purchaser, in
    form and substance satisfactory to the Purchaser, all reports
    required to have been delivered by it pursuant to
    Section 6.5, together with such additional information as
    may be reasonably requested by the Purchaser; and

 

    (b) the representations and warranties set forth in
    Article III shall be true and correct on and as of the date
    of such Purchase as though made on and as of such date, both
    before and after giving effect to such Purchase and the
    application of the proceeds therefrom.

 

    By accepting the proceeds of any Purchase, the Seller shall be
    deemed to have represented and warranted that the foregoing
    conditions precedent are satisfied.

 

    Notwithstanding any failure or inability of the Seller to
    satisfy any of the foregoing conditions precedent on any date in
    respect of any Purchase, title to the Receivables and the
    Related Assets with respect thereto included in such Purchase
    shall vest in the Purchaser without any action required on the
    part of the Purchaser (but without impairment of its obligation
    to pay the Purchase Price in respect thereof in accordance with
    the terms of this Agreement), and the Purchaser (as owner of
    such Receivables) shall have a claim against the Seller arising
    in respect of the representations and warranties made by the
    Seller in connection with such Purchase.

 

    ARTICLE V

    

 

    COVENANTS
    

 

    Section 5.1. Affirmative
    Covenants of Seller. At all times from the date hereof to
    the Collection Date, unless each of the Purchaser and the Agent
    shall otherwise consent in writing:

 

    (a) Financial Reporting. The Seller will, and will
    cause 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 of the Purchaser and the Agent:

 

    (i) Annual Reporting. As soon as available and in
    any event within 105 days after the close of the fiscal
    year of FMCH, a company-prepared consolidated balance sheet of
    FMCH and its Subsidiaries as of the end of such fiscal year and
    the related company-prepared consolidated statements of income
    and retained earnings for such fiscal year.

 

    (ii) Quarterly Reporting. As soon as available and
    in any event within 50 days after the end of the second
    fiscal quarter of FMCH, a company-prepared consolidated balance
    sheet of FMCH 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.

 

    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 a Responsible Officer stating that
    (x) the attached financial statements have been prepared in
    accordance with GAAP and accurately reflect the financial
    condition of the applicable Person and (y) to the best of
    such Person’s knowledge, no Seller Default or Potential
    Seller Default exists, or if any Seller Default or Potential
    Seller Default exists, stating the nature and status thereof.

    

    14

 

    (iv) Notice of Seller Default or Potential Seller
    Default. 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 Seller
    Default or each Potential Seller Default, a statement of a
    Responsible Officer setting forth details of such Seller Default
    or Potential Seller Default and the action which the Seller
    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 any provision of 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
    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 Seller or any ERISA Affiliate of 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 Seller or any ERISA Affiliates of 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 Seller).

 

    (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 Agent’s
    execution of a confidentiality agreement in form and substance
    satisfactory to both the Seller and the Agent, as soon as
    possible and in any event (A) within five Business Days
    after any Originating Entity receives any subpoena, request for
    information, or any other document relating to any possible
    violation by any Originating Entity of, or failure by 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
    Purchaser or 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 the Purchaser or the 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 any Originating Entity.

 

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

 

    (b) Conduct of Business. The Seller (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 other Originating Entity to do each of
    the foregoing in respect of such Originating Entity.

 

    (c) Compliance with Laws. The Seller will, and will
    cause each other 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 Seller will, and will cause each other
    Originating Entity to, furnish to each of the Purchaser and the
    Agent from time to time such information with respect to the
    Receivables as the Purchaser or the Agent may reasonably
    request, including, without limitation, listings identifying the
    Obligor and the Outstanding Balance for each Receivable. The
    Seller will, and will cause each other Originating Entity to, at
    any time and from time to time during regular business hours
    permit the Purchaser, the Agent, or any of their respective
    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 Seller or such other

    

    15

 

    Originating Entity, as applicable, for the purpose of examining
    such Records, and to discuss matters relating to Receivables or
    the Seller’s or such other 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
    Seller or such other Originating Entity, as applicable, having
    knowledge of such matters; provided, however, that
    the Purchaser acknowledges that in exercising the rights and
    privileges conferred in this Section 5.1(d) 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
    Seller or another Originating Entity has a proprietary interest.
    The Purchaser 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 Seller 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 Seller; 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 5.1(d)),
    (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 Conduit
    Investor, any Bank Investor, any Credit Support Provider and any
    Liquidity Provider, subject to the terms of Section 5.1(d)
    of the TAA, (B) the Agent’s or any such Person’s
    legal counsel, auditors and other business advisors,
    (C) any such Person’s government regulators and
    (D) any Conduit Investor’s rating agencies,
    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 the Agent has agreed to keep confidential such Confidential
    Information as provided in clauses (x) and (y) above.

 

    (e) Keeping of Records and Books of Account. The
    Seller will, and will cause each other 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 Seller will, and will cause each
    other Originating Entity to, give each of the Purchaser and the
    Agent notice of any material change in the administrative and
    operating procedures of the Seller or such other Originating
    Entity, as applicable, referred to in the previous sentence.

 

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

 

    (g) Credit and Collection Policies. The Seller will,
    and will cause each other 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. The Seller shall, and shall
    cause each other Originating Entity to (i) 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
    all Obligors to cause all Collections to be deposited directly
    into a Special Account, (iii) 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, and (iv) instruct (or
    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 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, (v) 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

    

    16

 

    Banks and (vi) 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, the Seller shall,
    by not later than the date that occurs six months after the
    Original Closing Date, (i) close, or cause the applicable
    Originating Entity to close, such Special Account and
    (ii) instruct, and cause each other 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 Seller shall, and
    shall cause each other 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 of its
    receipt thereof (or, if such day is not a Business Day, the next
    Business Day following such receipt) to the Concentration
    Account, or Intermediate Concentration Account, as applicable,
    all Collections received from time to time by the Seller or such
    other Originating Entity, as the case may be.”

 

    (j) Sale Treatment. The Seller will not, and will
    not permit any Transferring Affiliate to, account for (including
    for accounting and tax purposes), or otherwise treat, the
    transactions contemplated by this Agreement, the Transferring
    Affiliate Letter or the BMA Transfer Agreement in any manner
    other than as a sale of Receivables by the Seller to the
    Purchaser or by the applicable Transferring Affiliate to the
    Seller, as applicable. In addition, the Seller shall, and shall
    cause each Transferring Affiliate 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 transactions contemplated hereby, by the TAA , by
    the Transferring Affiliate Letter and by the BMA Transfer
    Agreement, and the interest of the Purchaser in the Transferred
    Assets.

 

    (k) Separate Business. The Seller acknowledges that
    the Agent, the Conduit Investors and the Bank Investors are
    entering into the transactions contemplated in the TAA in
    reliance upon the Purchaser’s identity as a separate legal
    entity from the Seller. Therefore, from and after the Original
    Closing Date, the Seller shall take all actions reasonably
    required to maintain the Purchaser’s status as a separate
    legal entity and to make it manifest to third parties that the
    Purchaser is an entity with assets and liabilities distinct from
    those of the Seller or any other member of the Parent Group.
    Without limiting the generality of the foregoing, the Seller
    shall (i) not hold itself out to third parties as liable
    for the debts of the Purchaser nor purport to own the
    Receivables or any of the other assets acquired by the Purchaser
    hereunder, (ii) shall take all other actions necessary on
    its part to ensure that the Purchaser is at all times in
    compliance with the covenants set forth in Section 5.1(k)
    of the TAA and (iii) shall cause all tax liabilities
    arising in connection with the transactions contemplated herein
    or otherwise to be allocated between the Seller and the
    Purchaser on an arm’s-length basis.

 

    (l) Payment to the Transferring Affiliates. With
    respect to any Receivable purchased by the Seller from any
    Transferring Affiliate, the Seller 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.

 

    (m) Performance and Enforcement of the Transferring
    Affiliate Letter and BMA Transfer Agreement. The Seller
    shall timely perform the obligations required to be performed by
    the Seller, and shall vigorously enforce the rights and remedies
    accorded to the Seller, under each of the Transferring Affiliate
    Letter and the BMA Transfer Agreement. The Seller shall take all
    actions to perfect and enforce its rights and interests (and the
    rights and interests of the Purchaser, the Agent, the Conduit
    Investors and the Bank Investors, as assignees of the Seller)
    under the Transferring Affiliate Letter and\or the BMA Transfer
    Agreement as the Purchaser or the 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.

    

    17

 

    Section 5.2. Negative
    Covenants of the Seller. At all times from the date hereof
    to the Collection Date, unless the Agent shall otherwise consent
    in writing:

 

    (a) No Sales, Liens, Etc. Except as otherwise
    provided herein, the Seller will not, and will not permit any
    other 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 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 Seller
    will not, and will not permit any other 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 Seller will not, and will not permit any other
    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 Seller will not, and will
    not permit any other 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 if, but only
    if, each of the Purchaser and the Agent shall have received at
    least ten Business Days’ prior written notice of such
    merger or consolidation 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 Seller Default or Potential Seller Default
    would exist and (y) each of the Purchaser and the Agent
    shall have received a written agreement, in form and substance
    satisfactory to each of the Purchaser and the Agent, executed by
    the corporation resulting from such merger or consolidation,
    under which agreement such corporation shall become the Seller
    hereunder and the Collection Agent under the TAA, and shall
    assume the duties, obligations and liabilities of the Seller and
    the Collection Agent under this Agreement, the TAA, 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 of the TAA.

 

    (e) Change in Payment Instructions to Obligors, Special
    Account Banks and Designated Account Agents. The Seller will
    not, and will not permit any other 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 Seller may,
    and may permit any Originating Entity to, (A) add any bank
    as a Special Account Bank for purposes of this Agreement at any
    time following delivery to the Agent 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 Agent of written notice of such
    termination and evidence satisfactory to the Agent that the
    affected Obligors shall have been instructed to remit all
    subsequent Collections to another Special Account; or

 

    (ii) make any change in the instructions contained in any
    Special Account Letter; 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 Seller may, and may
    permit any Originating Entity to, (A) add 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 the Agent of written notice of such addition and an
    Account Agent Agreement duly executed by such Person, and
    (B) terminate any Designated Account Agent at any time
    following delivery to the Agent of written notice of such
    termination and evidence satisfactory to the 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.

    

    18

 

    (f) Deposits to Special Accounts, Intermediate
    Concentration Account and the Concentration Account. The
    Seller will not, and will not permit any of the other
    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 Seller will not, and
    will not permit any other Originating Entity to, change its
    name, identity or structure or the location of its chief
    executive office, unless at least 10 days prior to the
    effective date of any such change the Seller delivers to the
    Agent (i) such documents, instruments or agreements,
    executed by the Seller
    and/or the
    affected Originating Entities, as are necessary to reflect such
    change and to continue the perfection of the Purchaser’s
    ownership interests in the Affected Assets and (ii) new or
    revised Special Account Letters or Intermediate Concentration
    Account Letter executed by the Special Account Banks or the
    Intermediate Concentration Account Bank which reflect such
    change and enable the Agent to continue to exercise its rights
    contained in Section 2.8 of the TAA.

 

    (h) Amendment to Transferring Affiliate Letter,
    Etc.. The Seller will not, and will not permit any other
    Originating Entity to, (i) amend, modify, or supplement 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 Purchaser, the Agent and each Administrative
    Agent; nor shall the Seller take, or permit any other
    Originating Entity to take, any other action under any of the
    Initial Transfer Documents that shall have a material adverse
    affect on the Purchaser, the Agent, any Conduit Investor or any
    Bank Investor or which is inconsistent with the terms of this
    Agreement.

 

    (i) ERISA Matters. The Seller will not, and will not
    permit any other 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 Seller, 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 Seller, 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 Seller, in the aggregate, involve a payment of money
    or an incurrence of liability by the Seller, any Originating
    Entity or any ERISA Affiliate thereof, in an amount in excess of
    $500,000.

 

    ARTICLE VI

    

 

    ADMINISTRATION
    AND COLLECTION
    

 

    Section 6.1. Collection
    of Receivables. The servicing, administering and collection
    of the Receivables shall be conducted by the Collection Agent.
    For so long as the Person acting as Collection Agent is the
    Seller, the Seller shall perform its duties as Collection Agent
    under the TAA in accordance with the terms thereof, it being
    understood that it shall hold all Receivables, Related Assets,
    Records and Collections which it receives from time to time
    solely in its capacity as Collection Agent and shall not claim
    or retain any legal or beneficial title or interest therein. If
    at any time the Collection Agent is a Person other than the
    Seller, the Seller agrees promptly to provide all information
    requested by the Collection Agent in connection with the
    performance of its responsibilities under the TAA, and agrees to
    exert its best efforts to assist any successor Collection Agent
    in assuming and performing its duties as Collection Agent.

 

    Section 6.2. Rights
    of Purchaser. At any time:

 

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

    

    19

 

    (ii) The Seller shall, at the Purchaser’s request (or
    at the request of the Agent, as assignee of the Purchaser) and
    at the Seller’s expense, give notice of the
    Purchaser’s ownership of Receivables
    and/or the
    Agent’s interest in the Receivables to each Obligor and
    direct that payments be made directly to the Purchaser (or the
    Agent, as the case may be) or its designee.

 

    (iii) The Seller shall, at the Purchaser’s or the
    Agent’s request, (A) assemble all of the Records, and
    shall make the same available to the Purchaser, the Agent or its
    designee at a place selected by the Purchaser, 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
    Purchaser and 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.

 

    Notwithstanding the foregoing clauses (i), (ii) and (iii),
    neither the Purchaser nor any of its assigns shall at any time
    direct, or cause 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 such Originating Entity in respect of such Receivables or
    Related Security directly to either the Intermediate
    Concentration Account or the Concentration Account or to the
    Purchaser, the Purchaser’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.

 

    Section 6.3. Special
    Accounts. The Seller hereby transfers to the Purchaser, and
    shall cause each of the Transferring Affiliates to transfer to
    the Purchaser, effective concurrently with the initial Purchase
    hereunder, all right, title and interest of such Originating
    Entity in and to each Special Account, together with each
    lock-box related thereto and all agreements between such
    Originating Entity and the applicable Special Account Bank. The
    Seller hereby authorizes the Purchaser and its assigns to take,
    to the extent permitted by applicable law, any and all steps in
    the Seller’s or any other Originating Entity’s name
    (which power, in the case of each Transferring Affiliate, the
    Seller is authorized to grant pursuant to authority granted to
    the Seller under the Transferring Affiliate Letter) and on
    behalf of the Seller and such Originating Entity necessary or
    desirable, in the determination of the Purchaser or such assign,
    to collect all amounts due under any and all Receivables,
    including, without limitation, endorsing the Seller’s or
    such Originating Entity’s name on checks and other
    instruments representing Collections and enforcing such
    Receivables and the related Contracts; provided, however, that
    neither the Purchaser 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 payment of amounts due or to become due to the
    Seller or any Transferring Affiliate in respect of such
    Receivables or Related Security directly to either the
    Intermediate Concentration Account or the Concentration Account
    or to the Purchaser, the Purchaser’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.

 

    Section 6.4. Responsibilities
    of the Seller. Anything herein to the contrary
    notwithstanding, the Seller shall,
    and/or shall
    cause each other Originating Entity to, (i) perform all of
    such Person’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
    and/or the
    BMA Transfer Agreement, and the exercise by the Purchaser of its
    rights hereunder and under the Transferring Affiliate Letter and
    the BMA Transfer Agreement shall not relieve 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
    Purchaser nor any of its assignees 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.

 

    Section 6.5. Reports.
    On or prior to each Settlement Date, the Seller shall prepare
    and forward to the Purchaser a report setting forth the
    following with respect to the immediately preceding calendar
    month: (i) the aggregate Outstanding Balance of Receivables
    included in the Purchases occurring during such month,
    (ii) the aggregate Purchase Price payable to the Seller in
    respect of such Purchases, specifying the Purchase Price
    Percentage in effect for such month and the aggregate Purchase
    Price Credits deducted in calculating such aggregate Purchase
    Price, (iii) the aggregate amount of funds received by the
    Seller during such month which are to be applied toward the
    aggregate Purchase Price owing for such month pursuant to
    Section 2.2(d), (iv) the increase or decrease in the
    amount outstanding under the Subordinated Note as of the end of
    such month after giving effect to the application of funds
    toward the aggregate Purchase Price, (v) the amount of any
    capital contribution made by the Seller to the Purchaser as of
    the end of such month and (vi) such other information
    concerning the Receivables as the Purchaser may reasonably
    request. Promptly following any request therefor by the
    Purchaser, the Seller shall prepare and provide to the Purchaser
    a listing by Obligor of all Receivables together with an aging
    of such Receivables.

    

    20

 

    ARTICLE VII

    

 

    SELLER
    DEFAULTS
    

 

    Section 7.1. Seller
    Defaults. The occurrence of any one or more of the following
    events shall constitute a Seller Default:

 

    (a) the Seller shall fail to make any payment or deposit to
    be made by it hereunder when due; or

 

    (b) any representation, warranty, certification or
    statement made or deemed made by the Seller in this Agreement,
    by FME KGaA or FMCH under the Parent Agreement, or by the
    Seller, 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 Seller 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 Seller Default 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 Seller Default unless a senior officer of the
    Seller (including, the Treasurer, any Assistant Treasurer,
    General Counsel or any assistant or associate general counsel of
    the Seller) shall have known of the occurrence of such Potential
    Seller Default 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),
    5.2(a), 5.2(c), 5.2(d), 5.2(e), 5.2(f), 5.2(g), 5.2(h) or
    6.2; 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) failure of the Seller, FME KGaA, FMCH 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 $5,000,000 is governed; or the
    default by the Seller, FME KGaA, FMCH 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, FME KGaA,
    FMCH or any Transferring Affiliate greater than $5,000,000 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, FME
    KGaA, FMCH or any Transferring Affiliate greater than $5,000,000
    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
    Seller, any other Originating Entity, FME KGaA or FMCH;
    provided that, in the case of any Event of Bankruptcy
    relating to any Transferring Affiliate, such Event of Bankruptcy
    shall not constitute a Seller Default hereunder if at such time
    the “Percentage Factor” (as defined in the TAA) does
    not exceed the “Maximum Percentage Factor” (as defined
    in the TAA) after reducing the “Net Receivables
    Balance” (as defined in the TAA) by an amount equal to the
    aggregate Outstanding Balance of all Receivables otherwise
    included in the calculation of the 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) after giving effect to any Purchase hereunder, the
    Purchaser shall, for any reason, fail or cease to have all
    right, title and interest in and to all of the Receivables which
    are to be included in such Purchase, together with the Related
    Security and Collections with respect thereto, free and clear of
    any Adverse Claim, subject only to the interests therein of the
    Agent, on behalf of the Conduit Investors and the Bank
    Investors; or

 

    (g) the Transferring Affiliate Letter, the BMA Transfer
    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 Purchaser, the Agent, any Conduit
    Investor or any Bank Investor) shall fail to perform any
    material term,

    

    21

 

    provision or condition contained in any Transaction Document on
    its part to be performed or a default shall otherwise occur
    thereunder; or

 

    (h) either FMCH or the Seller shall enter into any
    transaction or merger whereby it is not the surviving
    entity; or

 

    (i) there shall have occurred any material adverse change
    in the operations of any of FMCH or the Seller since
    December 31, 1996 or any other Material Adverse Effect
    shall have occurred; or

 

    (j) 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

 

    (k) (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) or a Change
    of Control (as defined under the TAA).

 

    Section 7.2. Remedies.
    (a) Upon the occurrence of any Seller Default, the
    Purchaser 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.

 

    ARTICLE VIII

    

 

    INDEMNIFICATION;
    EXPENSES
    

 

    Section 8.1. Indemnities
    by the Seller. Without limiting any other rights which the
    Purchaser may have hereunder or under applicable law, the Seller
    hereby agrees to indemnify the Purchaser and any successors and
    permitted assigns (including, without limitation, the Conduit
    Investors, the Bank Investors, the Agent, the Administrative
    Agents, the Collateral Agents, the Liquidity Providers and the
    Credit Support Providers) 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 any Liquidity Provider, any Credit
    Support Provider, the Agent, any Administrative Agent, any
    Collateral Agent or the Purchaser, 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
    Seller 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 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
    Purchaser and its assigns of Receivables and Related Assets 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 Seller 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 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

    

    22

 

    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 to vest and maintain vested in the
    Purchaser a first priority ownership interest in the Affected
    Assets 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 (if a Parent Group
    Member or designee thereof) to perform its duties or obligations
    in accordance with the provisions of the TAA; 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 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;

 

    (xi) the commingling by the Seller, any other Originating
    Entity or the Collection Agent (if a Parent Group Member or
    designee thereof) of Collections of Receivables at any time with
    other funds;

 

    (xii) any investigation, litigation or proceeding related
    to this Agreement, any of the other Transaction Documents, the
    use of proceeds of Transfers by the Seller or any other
    Originating Entity, the ownership of any Receivable, Related
    Security or Contract or any interest therein;

 

    (xiii) the failure of any Special Account Bank or any
    Designated Account Agent 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 Seller, any Originating Entity or the
    Agent (to the extent such Person is entitled to give such
    instructions in accordance with the terms of the Transaction
    Documents) whether by reason of the exercise of set-off rights
    or otherwise;

 

    (xiv) 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 Seller
    to qualify to do business or file any notice of business
    activity report or any similar report;

 

    (xv) 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 or any transfer of any Receivable
    hereunder under statutory provisions or common law or equitable
    action, including, without limitation, any provision of the
    Bankruptcy Code;

 

    (xvi) any action taken by the Seller, any other 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 any applicable Liquidity Provider Agreement,
    Credit Support Agreement or the credit support furnished by any
    applicable Credit Support Provider to the Seller 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 Seller shall
    be solely liable for such Indemnified Amounts or if such
    Indemnified Amounts are

    

    23

 

    attributable to Other Transferors and not attributable to any
    Parent Group Member, such Other Transferors shall be solely
    liable for such Indemnified Amounts;

 

    (xvii) 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 Seller or any Parent
    Group Member; or

 

    (xviii) any failure by the Seller 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. Other
    Costs and Expenses. (a) The Seller agrees, upon receipt
    of a written invoice, to pay or cause to be paid, and to save
    the Purchaser harmless against liability for the payment of, all
    reasonable out-of-pocket expenses (including, without
    limitation, the out-of-pocket expenses payable by the Purchaser
    under Section 8.4 of the TAA) or intangible, documentary or
    recording taxes incurred by or on behalf of the Purchaser or any
    other Indemnified Party (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 Purchaser’s
    ownership of Receivables and Related Assets with respect
    thereto) 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
    the Purchaser’s enforcement or preservation of rights
    (including, without limitation, the perfection and protection of
    the transfers of Receivables and Related Assets 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.

 

    (b) If the Seller fails to perform any of its agreements or
    obligations under this Agreement, following expiration of any
    applicable cure period, the Purchaser (or any assignee thereof)
    may (but shall not be required to) perform, or cause performance
    of, such agreement or obligation, and the reasonable expenses of
    the Purchaser (or any such assignee) incurred in connection
    therewith shall be payable by the Seller upon the
    Purchaser’s (or any such assignee’s) written demand
    therefor.

 

    ARTICLE IX

    

 

    MISCELLANEOUS
    

 

    Section 9.1. Term
    of Agreement. This Agreement shall terminate on the date
    after the Collection Date on which (i) no further Purchases
    are to be made hereunder, (ii) the aggregate Outstanding
    Balance of Receivables conveyed to the Purchaser hereunder has
    been reduced to zero or written off in accordance with the
    Credit and Collection Policy and (iii) the Seller has paid
    the Purchaser all indemnities, adjustments and other amounts
    which may be owed to the Purchaser hereunder; provided,
    however, that (x) the rights and remedies of the
    Purchaser with respect to any representation and warranty made
    or deemed to be made by the Seller pursuant to this Agreement,
    (y) the indemnification and payment provisions of
    Article VII, and (z) the agreements set forth in
    Section 9.9 hereof, shall be continuing and shall survive
    any termination of this Agreement.

 

    Section 9.2. Waivers;
    Amendments. No failure or delay on the part of the Purchaser
    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. No provision of this Agreement or the
    Subordinated Note may be amended, supplemented, modified or
    waived except in writing by the Seller, the Purchaser, the Agent
    and each Administrative Agent. It is expressly understood and
    acknowledged that the prior written consent of the Agent shall
    be required in order for the Purchaser to grant a consent,
    authorization or approval requested by the Seller hereunder, or
    for the Purchaser to agree to any amendment, waiver or other
    modification to the terms or conditions of this Agreement.

 

    Section 9.3. 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 9.3 and confirmation is received, (ii) if
    given by mail 3 Business Days following such posting, postage
    prepaid, U.S. certified

    

    24

 

    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 9.3.

 

    If to the Purchaser:

 

    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 Seller:

 

    National Medical Care, Inc.

    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

 

    Section 9.4. 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 SELLER
    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. The
    Seller 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 9.4 shall affect the right of the
    Purchaser to bring any action or proceeding against the Seller
    or any of its 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 Seller hereby appoints 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 the
    Purchaser or any of its assignees.

 

    Section 9.5. 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.

    

    25

 

    Section 9.6. Successors
    and Assigns. This Agreement shall be binding on the parties
    hereto and their respective successors and assigns;
    provided, however, that the Seller may not 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 of the Purchaser
    and the Agent. The Purchaser 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 Seller. Without
    limiting the foregoing, the Seller acknowledges that the
    Purchaser, pursuant to the TAA, shall assign to the Agent, on
    behalf of the Conduit Investors or the Bank Investors, as the
    case may be, all of its rights, remedies, powers and privileges
    hereunder and that each of the Agent, the Conduit Investors and
    such Bank Investors may further assign such rights, remedies,
    powers and privileges to the extent permitted in the TAA. The
    Seller agrees that the Agent, as the assignee of the Purchaser,
    shall, subject to the terms of the TAA, have the right to
    enforce this Agreement and to exercise directly all of the
    Purchaser’s rights and remedies under this Agreement
    (including, without limitation, the right to give or withhold
    any consents or approvals of the Purchaser to be given or
    withheld hereunder) and the Seller agrees to cooperate fully
    with the Agent in the exercise of such rights and remedies. The
    Seller further agrees to give to the Agent copies of all
    notices, reports and other documents it is required to give to
    the Purchaser hereunder and to permit the Agent the rights of
    inspection and audit granted to the Purchaser hereunder. In
    addition, the Seller agrees that to the extent the Purchaser is
    herein permitted to take any action or to provide any
    information or report, the Agent may similarly so direct and
    require (with or without the concurrence of the Purchaser) the
    Seller to take such action or to provide such information or
    report.

 

    Section 9.7. Waiver
    of Confidentiality. The Seller hereby consents to the
    disclosure of any non-public information with respect to it
    received by the Purchaser, any Conduit Investor, the Agent, any
    Bank Investor or any Administrative Agent to any of the
    Purchaser, any Conduit Investor, the Agent, any nationally
    recognized rating agency rating any Conduit Investor’s
    Commercial Paper, 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 or the TAA.

 

    Section 9.8. Confidentiality
    Agreement. The Seller hereby agrees that it will not
    disclose, and will cause each Parent Group Member to refrain
    from disclosing, the contents of this Agreement or any other
    proprietary or confidential information of the Purchaser, any
    Conduit Investor, the Agent, any Administrative Agent, any
    Collateral Agent, any Liquidity Provider or any Bank Investor to
    any other Person except (i) 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 (ii) following notice thereof to the Agent,
    as otherwise required by applicable law (including the federal
    securities laws) or order of a court of competent jurisdiction.

 

    Section 9.9. Bankruptcy
    Petitions. (a) The Seller 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
    Seller will cause each Parent Group Member to not, institute
    against, or join any other Person in instituting against, any
    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.

 

    (b) The Seller hereby covenants and agrees that, prior to
    the date which is one year and one day after this Agreement
    shall have terminated in accordance with its terms, 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

 

    Section 9.10. Purchase
    Termination. The Seller’s obligation to sell, transfer,
    assigns and otherwise convey Receivables and Related Assets to
    the Purchaser hereunder may be terminated at any time by the
    Seller by giving written notice thereof to Purchaser and the
    Agent of the Seller’s election to discontinue Purchases
    hereunder, in which event the Purchase Termination Date (as
    defined in the TAA) shall thereafter occur on the date specified
    therefor by the Seller in such notice, but in any event not less
    than 60 days after the Agent’s receipt of such notice.

 

    Section 9.11. Subordination.
    The Seller agrees that any indebtedness, obligation or claim, it
    may from time to time hold or otherwise have (including, without
    limitation any obligation or claim arising in connection with
    the Revolving Loans) against the Purchaser or any assets or
    properties of the Purchaser, whether arising hereunder or
    otherwise existing, shall be subordinate in right of payment to
    the prior payment in full of any indebtedness or obligation of
    the Purchaser owing to the Agent, any Administrative Agent, any
    Conduit Investor or any Bank Investor under the TAA. The
    subordination provision contained herein is for the direct
    benefit of, and may be enforced by, the Agent, any
    Administrative Agent, any Conduit Investor, any Bank Investor
    and/or any
    of their respective assignees under the TAA.

    

    26

 

    Section 9.12. Characterization
    of the Transactions Contemplated by the Agreement. It is the
    intention of the parties that each Purchase hereunder 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
    hereby should be deemed a financing, the parties intend that the
    Seller shall be deemed to have granted to the Purchaser, and the
    Seller hereby grants 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 under
    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 Seller hereby assigns to the Purchaser all
    of its rights and remedies under 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]
    

    

    27

 

    IN WITNESS WHEREOF, the parties hereto have executed and
    delivered this Amended and Restated Receivables Purchase
    Agreement as of the date first written above.

 

    NMC FUNDING CORPORATION,

    as Purchaser

 

			
	 	    By: 
	
    /s/  Mark
    Fawcett

			
	 	      
	
    Name: Mark Fawcett

    Title: Vice President and Treasurer

 

    NATIONAL MEDICAL CARE, INC.,

    as Seller

 

			
	 	    By: 
	
    /s/  Mark
    Fawcett

			
	 	      
	
    Name: Mark Fawcett

    Title: Vice President and Treasurer

 

 

    Signature
    Page to Amended and Restated Receivables Purchase Agreement

    dated as of October 16, 2008

    

    28

 

 

    Exhibit 10.1

    EXECUTION COPY

 

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE AGREEMENT

    between

    NATIONAL MEDICAL CARE, INC.

    as Seller

    and

    NMC FUNDING CORPORATION

    as Purchaser

    Dated as of October 16, 2008

 

 

    Exhibit A

 

    EXHIBIT A

    to

    AMENDED AND RESTATED RECEIVABLES PURCHASE 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 within [*] 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 All 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 [*] 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

    

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE 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
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

    Financial Manual — Facility/Billing group
	
 
	
 
	
    PAGE
	
 
	
 
	
    12 of 19

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ©2007,
    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
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

    Financial Manual — Facility/Billing group
	
 
	
 
	
    PAGE
	
 
	
 
	
    13 of 19

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ©2007,
    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
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

    Financial Manual — Facility/Billing group
	
 
	
 
	
    PAGE
	
 
	
 
	
    13 of 19

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ©2007,
    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
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

    Financial Manual — Facility/Billing group
	
 
	
 
	
    PAGE
	
 
	
 
	
    15 of 19

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ©2007,
    Fresenius Medical Care Holdings, Inc. All Rights Reserved.

	 	 	 	 	 	 	 	 	 	 

 

 

			
	 	 	 
	
	 	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

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

    Financial Manual — Facility/Billing group
	
 
	
 
	
    PAGE
	
 
	
 
	
    16 of 19

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	

    ©2007,
    Fresenius Medical Care Holdings, Inc. All Rights Reserved.

	 	 	 	 	 	 	 	 	 	 

 

 

			
	 	 	 
	
	 	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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    PAGE
	
 
	
 
	
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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.

	 	 	 	 	 	 	 	 	 	 

 

 

			
	 	 	 
	
	 	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
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

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    PAGE
	
 
	
 
	
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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
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

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    PAGE
	
 
	
 
	
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    Fresenius Medical Care Holdings, Inc. All Rights Reserved.

	 	 	 	 	 	 	 	 	 	 

 

 

	 	 	 

	

	 	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
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group

	 	 	PAGE
	 	 	1 of 6	 
	 	©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
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group

	 	 	PAGE
	 	 	2 of 6	 
	 	©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
	 	 	[*]
	 	 	[*]	 
	 	Admissions and Readmissions

Financial Manual — Facility/Billing group

	 	 	PAGE
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Care Holdings, Inc. All
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
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
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    Admissions and Readmissions 

    Financial Manual — Facility/Billing group

	
 
	
 
	
    PAGE
	
 
	
 
	
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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
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

    Financial Manual — Facility/Billing group

	
 
	
 
	
    PAGE
	
 
	
 
	
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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

 

	 	 	 	 	 	 	 	 	 	 
	
    DOCUMENT
	
 
	
 
	
    DOCUMENT REVISION
	
 
	
 
	
    ISSUE DATE:
	
 
	
 
	
    EFFECTIVE DATE

	

    [*]

	
 
	
 
	
    XX
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Admissions and Readmissions 

    Financial Manual — Facility/Billing group

	
 
	
 
	
    PAGE
	
 
	
 
	
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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 [*].

1

 

	 	 	 

	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	 

2

 

	 	 	 

	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

3

 

	 	 	 

	FMCNA Financial Procedures Manual — Facility/Billing Group

	 	Rev. [*]
	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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	 	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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(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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	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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	 	[*]

	 	 	 

	 

	 	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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	 	 •     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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	 	[*]

	 	 	 

	 

	 	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

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	 	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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	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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	DESCRIPTION	 	PROCEDURE CODE
	EPOGEN <10,000 (admin. In-Center)

	 	[*]
	EPOGEN >10,000 (admin. In-Center)

	 	[*]

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	 	[*]

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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	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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	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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	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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	Home Program
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	 	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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	 	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
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	**	 	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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	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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	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
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	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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	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	 

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	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

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	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 [*]

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	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.

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	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 /

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	FMCNA Financial Procedures Manual — Facility / Billing Group
	 	Revised [*]
	Preparing and Processing Write-Offs and Recoveries
	 	[*]

	 	 	 	 	 
	Step	 	Who	 	Action
	 

	 	 	 	denial should take
place [*].

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	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
[*].

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	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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	 	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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	 	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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	 	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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	 	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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	 	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

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
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	 	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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	 	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

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	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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	 	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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	 	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

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	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

	

    [*]

	
 
	
 
	
    [*]
	
 
	
 
	
    [*]
	
 
	
 
	
    [*]

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
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	 	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

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	 	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	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
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	 	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	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
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	 	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	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
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	 	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

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	 	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	 
	 	[*]

	 	 	[*]
	 	 	[*]
	 	 	[*]	 
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	 	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

    AMENDED AND RESTATED

    RECEIVABLES PURCHASE 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 10.2

 

    Exhibit D

 

    EXHIBIT D

    

 

    to

    

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE AGREEMENT

    

 

    FORM OF
    SPECIAL ACCOUNT LETTER

 

 

    EXHIBIT D

 

    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 E

    

 

    to

    

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE AGREEMENT

    

 

    FORM OF
    SUBORDINATED NOTE

 

    Subordinated
    Revolving Note

 

		
	    Lexington,
    Massachusetts
    	    
    August 28, 1997
    

 

    1.  Note.  For value received, the
    undersigned, NMC Funding Corporation, a Delaware corporation
    (the Borrower), hereby unconditionally promises to pay to
    the order of National Medical Care, Inc., a Delaware corporation
    (the Lender), in lawful money of the United States of
    America and in immediately available funds, on the Collection
    Date (as defined below) the aggregate unpaid principal sum
    outstanding of all Revolving Loans made from time to time
    by the Lender to the Borrower pursuant to and in accordance with
    the terms of that certain Receivables Purchase Agreement dated
    as of August 28, 1997 between the Lender and the Borrower
    (as amended, restated, supplemented or otherwise modified from
    time to time, the Purchase Agreement). Reference to
    Section 2.2 of the Purchase Agreement is hereby made for a
    statement of the terms and conditions under which the loans
    evidenced hereby have been and will be made. The Collection
    Date shall be the later to occur of (i) the Termination
    Date under that certain Transfer and Administration Agreement
    dated as of even date herewith (as the same may be amended,
    restated, supplemented or otherwise modified from time to time,
    the TAA) among the Borrower, Enterprise Funding
    Corporation (the Company), certain Bank Investors from
    time to time party thereto (together with the Company, the
    Investors), National Medical Care, Inc. as Collection
    Agent and NationsBank, N.A., as Agent for the
    Investors, and (ii) the date all of the Aggregate
    Unpaids under the TAA shall have been repaid in full and all
    other obligations of the Borrower to the Investors and the Agent
    thereunder or in connection therewith shall have been
    indefeasibly satisfied in full (such Aggregate Unpaids and other
    obligations being the Senior Claim). All terms which are
    capitalized and used herein and which are not otherwise
    specifically defined herein shall have the meanings ascribed to
    such terms in the Purchase Agreement.

 

    2.  Interest.

 

    (a) The Borrower further promises to pay interest on the
    outstanding unpaid principal amount of any Revolving Loans from
    the date hereof until payment in full hereof at a rate per annum
    equal to the one-month LIBOR rate (as reported in the Bloomberg
    proprietary online service) plus 1.5% (the Interest
    Rate). The Interest Rate shall be re-set on the first
    Business Day of each month, based on the rate reported in
    Bloomberg on that date, and the rate shall be in effect during
    the month then beginning.

 

    (b) If the Borrower shall default in the payment of any
    principal hereof, the Borrower promises to, on demand, pay
    interest at the rate of the Interest Rate plus 1.0% on any such
    unpaid amounts, from the date such payment is due to the date of
    actual payment.

 

    (c) Interest shall be payable on the first calendar day of
    each month (or, if such day is not a Business Day, the next
    following Business Day) in arrears, provided, however, that the
    Borrower may elect, on the date any interest payment is due
    hereunder, to defer such payment and upon such election the
    amount of interest due but unpaid on such date shall constitute
    principal under this Subordinated Revolving Note.

 

    3.  Principal Payments.

 

    (a) The outstanding principal of any loan made under this
    Subordinated Revolving Note shall be due and payable on the
    Collection Date and may be repaid or prepaid at any time without
    premium or penalty.

 

    (b) The Lender is authorized and directed by the Borrower
    to enter in the Lender’s books and records the date and
    amount of each Revolving Loan made by it which is evidenced by
    this Subordinated Revolving Note and the amount of each payment
    of principal made by the Borrower, and absent manifest error,
    such entries shall constitute prima facie evidence of the
    accuracy of the information so entered; provided that neither
    the failure of the Lender to make any such entry or any error
    therein shall expand, limit or affect the obligations of the
    Borrower hereunder.

    

    1

 

    4.  Subordination.  The indebtedness
    evidenced by this Subordinated Revolving Note is subordinated to
    the prior payment in full of all of the Borrower’s
    obligations under the TAA. The subordination provisions
    contained herein are for the direct benefit of, and may be
    enforced by, the Agent and the Investors
    and/or any
    of their assignees (collectively, the Senior Claimants)
    under the TAA. Until the Collection Date, the Lender shall not
    demand, accelerate, sue for, take, receive or accept from the
    Borrower, directly or indirectly, in cash or other property or
    by set-off or any other manner (including, without limitation,
    from or by way of collateral) any payment or security of all or
    any of the indebtedness under this Subordinated Revolving Note
    or exercise any remedies or take any action or proceeding to
    enforce the same. The Lender hereby agrees that it will not
    institute against the Borrower any proceeding of the type
    constituting an Event of Bankruptcy unless and until the date
    that is one year and one day after the Collection Date has
    occurred. Nothing in this paragraph shall restrict the Borrower
    from paying, or the Lender from requesting, any payments under
    this Subordinated Revolving Note so long as (i) the
    Borrower is not required under the TAA to set aside the funds
    proposed to be used for such payments for the benefit of, or
    otherwise pay over such funds to any of the Senior Claimants,
    (ii) no Termination Event or Potential Termination Event
    shall have occurred and then be continuing under the TAA and no
    Collection Agent Default shall have occurred and then be
    continuing under the TAA and (iii) the making of such
    payment would not otherwise violate the terms and provisions of
    either the Purchase Agreement or the TAA. Should any payment,
    distribution or security or proceeds thereof be received by the
    Lender in violation of the immediately preceding sentence, the
    Lender agrees that such payment shall be segregated, received
    and held in trust for the benefit of, and deemed to be the
    property of, and shall be immediately paid over and delivered to
    the Agent for the benefit of the Senior Claimants.

 

    5.  Bankruptcy; Insolvency.  Upon the
    occurrence of any Event of Bankruptcy involving the Borrower as
    debtor, then and in any such event the Senior Claimants shall
    receive payment in full of all amounts due or to become due on
    or in respect of the Senior Claim (including Discount accruing
    under the TAA after the commencement of any such proceeding,
    whether or not any or all of such Discount is an allowable claim
    in any such proceeding) before the Lender shall be entitled to
    receive any payment on account of this Subordinated Revolving
    Note, and to that end, any payment or distribution of assets of
    the Borrower of any kind or character, whether in cash,
    securities or other property, in any applicable insolvency
    proceeding, which would otherwise be payable to or deliverable
    upon or with respect to any or all indebtedness under this
    Subordinated Revolving Note, is hereby assigned to and shall be
    paid or delivered by the Person making such payment or delivery
    (whether a trustee in bankruptcy, a receiver, custodian or
    liquidating trustee or otherwise) directly to the Agent for
    application to, or as collateral for the payment of, the Senior
    Claim until such Senior Claim shall have been paid in full and
    satisfied.

 

    6.  Amendments.  This Subordinated
    Revolving Note shall not be amended, modified or terminated
    except in accordance with Section 9.2 of the Purchase
    Agreement.

 

    7.  Governing Law.  This Subordinated
    Revolving Note shall be interpreted and the rights and
    liabilities of the parties hereto determined in accordance with
    the laws and decisions of the State of New York. Wherever
    possible each provision of this Subordinated Revolving Note
    shall be interpreted in such manner as to be effective and valid
    under applicable law, but if any provision of this Subordinated
    Revolving Note shall be prohibited by or invalid under
    applicable law, such provision shall be ineffective to the
    extent of such prohibition or invalidity, without invalidating
    the remainder of such provision or the remaining provisions of
    this Subordinated Revolving Note.

 

    8.  Waivers.  All parties hereto,
    whether as makers, endorsers, or otherwise, severally waive
    presentment for payment, demand, protest and notice of dishonor.
    The Lender additionally expressly waives all notice of the
    acceptance by any Senior Claimant of the subordination and other
    provisions of this Subordinated Revolving Note and expressly
    waives reliance by any Senior Claimant upon the subordination
    and other provisions herein provided.

 

    9.  Assignment.  This Subordinated
    Revolving Note may not be assigned, pledged or otherwise
    transferred to any party without the prior written consent of
    the Agent, and any such attempted transfer shall be void.

    

    2

 

    In witness whereof, the Borrower has executed this Subordinated
    Revolving Note on the date first written above.

 

    NMC Funding Corporation

 

			
	 	    By: 
	
    /s/  James
    V. Luther

    James V. Luther, President

    

    3

 

    EXHIBIT F

 

    To

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE 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
    personal injury claims. The agreement in principle and W.R.
    Grace & Co.’s related bankruptcy reorganization
    plan

    

    1

 

    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
    alternative technical solution. In view of the pending appeal
    against BPatG’s verdict and Fresenius Medical Care’s

    

    2

 

    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.

 

    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

    

    3

 

    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
    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

    

    4

 

    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 G

    

 

    to

    

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE 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
    

 

    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
    

 

    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,
    LP.

    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
    

 

    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
    

    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
    

 

 

 

    RTG

 

	 	 	 	 	 
	
    Fresenius USA, Inc
	
 
	
    Spectra East
	
 
	
    Erika de Reynosa S.A. de C.V.

	

2637 Shadelands Drive
Walnut Creek, CA 94590

920 Winter Street
Waltham, MA 02451

	
 
	

8 King Road
Rockleigh, NJ 07647

920 Winter Street
Waltham, MA 02451

	
 
	
    Brecha E-99 Sur Parque Ind. Reynosa

    Apartado Postal # 326

    Reynosa, Tamps.

    Mexico, CP 88780

	
 
	
 
	
 
	
 
	
 

	
    Fresenius USA Home Dialysis, Inc

    920 Winter Street

    Waltham, MA 02451
	
 
	
    Spectra Renal Research, LLC

    920 Winter Street

    Waltham, MA 02451
	
 
	
    Pharr Warehouse

    1100 E. Military Hwy. Ste. C

    Pharr, TX 78577

	
 
	
 
	
 
	
 
	
 

	

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

	
 
	

Fresenius USA Manufacturing
920 Winter Street
Waltham, MA 02451

Fresenius Medical Care Canada
45 Staples Suite 110
Richmond Hill, ON
L4B 4W6

	
 
	

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

	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
    Distributor D’Equipment Medicaux Haemotec, Inc

    383 Joseph Carrier

    Vaudreil-Dorion, QC

    J7V 5V5
	
 
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    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
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    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
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    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
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    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.
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Bio-Medical Applications of Fresno, Inc., PACIFIC NW BILLING
    GROUP, 4560 S. COACH DRIVE, SUITE 100, TUCSON,
    AZ, 85714
	
 
	
    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
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    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., 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
	
 
	
    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 & 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, 85202
	
 
	
    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
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    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., 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
	
 
	
    218 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
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    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 Rico, 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 & 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
	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE &

    OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	
    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
	
 
	
    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
	
 
	
    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.

    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
	
 
	
    PUERTO RICO BILLING GROUP
	
 
	
    ANTILLAS WAREHOUSE &

    OFFICE PARK
	
 
	
    461 FRANCIA ST., SUITE 1-401
	
 
	
    SAN JUAN
	
 
	
    PR
	
 
	
 
	
    00917
	
 

	
    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
	
 
	
    FAYETTEVILLE BILLING GROUP
	
 
	
    4200 MORGANTON ROAD
	
 
	
    SUITE 300
	
 
	
    FAYETTEVILLE
	
 
	
    NC
	
 
	
 
	
    28314
	
 

	
    Bio-Medical Applications of South Carolina, Inc.

    Bio-Medical Applications of South Carolina, Inc., FLORENCE
    BILLING GROUP, 218 N DOZIER BLVD., , FLORENCE, SC, 29501
	
 
	
    FLORENCE BILLING GROUP
	
 
	
    218 N. DOZIER BLVD.
	
 
	
 
	
 
	
    FLORENCE
	
 
	
    SC
	
 
	
 
	
    29501
	
 

	
    Bio-Medical Applications of South Carolina, Inc.

    Bio-Medical Applications of South Carolina, Inc., MACON
    BILLING GROUP, 1515 BASS ROAD, SUITE B, MACON, GA, 31210
	
 
	
    MACON BILLING GROUP
	
 
	
    1515 BASS ROAD
	
 
	
    SUITE B
	
 
	
    MACON
	
 
	
    GA
	
 
	
 
	
    31210
	
 

	
    Bio-Medical Applications of Southeast Washington, Inc,

    Bio-Medical Applications of Southeast Washington, Inc., STEEL
    CITY BILLING GROUP, BMA PITTSBURGH, 190 BILMAR DR.,
    SUITE 375, PITTSBURGH, PA, 15205
	
 
	
    STEEL CITY BILLING GROUP
	
 
	
    BMA PITTSBURGH
	
 
	
    190 BILMAR DR., SUITE 375
	
 
	
    PITTSBURGH
	
 
	
    PA
	
 
	
 
	
    15205
	
 

	
    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
	
 
	
    KNOXVILLE BILLING GROUP
	
 
	
    BILLING GROUP
	
 
	
    1512 COLEMAN ROAD, SUITE 308
	
 
	
    KNOXVILLE
	
 
	
    TN
	
 
	
 
	
    37919
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    Bio-Medical Applications of Tennessee, Inc.

    Bio-Medical Applications of Tennessee, Inc., OCALA BILLING
    GROUP, BMA OCALA, INC., 1308 SE 25TH LOOP, SUITE 102,
    OCALA, FL, 34471
	
 
	
    OCALA BILLING GROUP
	
 
	
    BMA OCALA, INC.
	
 
	
    1308 SE 25TH LOOP, SUITE 102
	
 
	
    OCALA
	
 
	
    FL
	
 
	
 
	
    34471
	
 

	
    Bio-Medical Applications of Tennessee, Inc.

    Bio-Medical Applications of Tennessee, Inc., ORLANDO BILLING
    GROUP, BMA ORLANDO, INC., 1155 W STATE ROAD 434, SUITE 125,
    LONGWOOD, FL, 32750
	
 
	
    ORLANDO BILLING GROUP
	
 
	
    BMA ORLANDO, INC.
	
 
	
    1155 W STATE ROAD 434,

    SUITE 125
	
 
	
    LONGWOOD
	
 
	
    FL
	
 
	
 
	
    32750
	
 

	
    Bio-Medical Applications of Texas, Inc. Bio-Medical Applications
    of Texas, Inc., ALBUQUERQUE BILLING GROUP, 909 VIRGINIA NE,
    SUITE 112, ALBUQUERQUE, NM, 87108
	
 
	
    ALBUQUERQUE BILLING GROUP
	
 
	
    909 VIRGINIA NE
	
 
	
    SUITE 112
	
 
	
    ALBUQUERQUE
	
 
	
    NM
	
 
	
 
	
    87108
	
 

	
    Bio-Medical Applications of Texas, Inc. Bio-Medical Applications
    of Texas, Inc., LUBBOCK BILLING GROUP, 4747 SOUTH LOOP 289.,
    SUITE 120., LUBBOCK, TX, 79424
	
 
	
    LUBBOCK BILLING GROUP
	
 
	
    4747 SOUTH LOOP 289,
	
 
	
    SUITE 120
	
 
	
    LUBBOCK
	
 
	
    TX
	
 
	
 
	
    79424
	
 

	
    Bio-Medical Applications of Texas, Inc. Bio-Medical Applications
    of Texas, Inc., NORTH TEXAS BILLING GROUP, 1485 RICHARDSON DRIVE
    #100, , RICHARDSON, TX, 75080
	
 
	
    NORTH TEXAS BILLING GROUP
	
 
	
    1485 RICHARDSON DRIVE #100
	
 
	
 
	
 
	
    RICHARDSON
	
 
	
    TX
	
 
	
 
	
    75080
	
 

	
    Bio-Medical Applications of Texas, Inc. Bio-Medical Applications
    of Texas, Inc., SAN ANTONIO BILLING GROUP, 6100 BANDERA ROAD,
    SUITE 601, SAN ANTONIO, TX, 78238
	
 
	
    SAN ANTONIO BILLING GROUP
	
 
	
    6100 BANDERA ROAD
	
 
	
    SUITE 601
	
 
	
    SAN ANTONIO
	
 
	
    TX
	
 
	
 
	
    78238
	
 

	
    Bio-Medical Applications of Texas, Inc. Bio-Medical Applications
    of Texas, Inc., TYLER BILLING, 3910 BROOKSIDE DRIVE,
    SUITE 100, TYLER, TX, 75701
	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	
    Bio-Medical Applications of Texas, Inc. Bio-Medical Applications
    of Texas, Inc., WACO BILLING GROUP, UPTOWN PLAZA, 1110 RICHLAND
    DR., #3, WACO, TX, 76710
	
 
	
    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 
	
 
	
    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
	
 
	
    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
	
 
	
    ROANOKE BILLING GROUP
	
 
	
    2830 KEAGY ROAD
	
 
	
 
	
 
	
    SALEM
	
 
	
    VA
	
 
	
 
	
    24153
	
 

	
    Bio-Medical Applications of West Virginia, Inc.

    Bio-Medical Applications of West Virginia, Inc., ROANOKE BILLING
    GROUP, 2830 KEAGY ROAD, , SALEM, VA, 24153
	
 
	
    ROANOKE BILLING GROUP
	
 
	
    2830 KEAGY ROAD
	
 
	
 
	
 
	
    SALEM
	
 
	
    VA
	
 
	
 
	
    24153
	
 

	
    Bio-Medical Applications of West Virginia, Inc.,

    Bio-Medical Applications of West Virginia, Inc., KENTUCKY
    BILLING GROUP, 6100 DUTCHMANS LANE, 12TH FLOOR, LOUISVILLE, KY,
    40205
	
 
	
    KENTUCKY BILLING GROUP
	
 
	
    6100 DUTCHMANS LANE
	
 
	
    12TH FLOOR
	
 
	
    LOUISVILLE
	
 
	
    KY
	
 
	
 
	
    40205
	
 

	
    Bio-Medical Applications of Wisconsin, Inc.

    Bio-Medical Applications of Wisconsin, Inc., UPPER MIDWEST
    BILLING GROUP, 9120 SPRINGBROOK DRIVE, , COON RAPIDS, MN, 55433
	
 
	
    UPPER MIDWEST BILLING GROUP
	
 
	
    9120 SPRINGBROOK DRIVE
	
 
	
 
	
 
	
    COON RAPIDS
	
 
	
    MN
	
 
	
 
	
    55433
	
 

	
    Bio-Medical Applications of Wisconsin, Inc.

    Bio-Medical Applications of Wisconsin, Inc., MICHIGAN BILLING
    GROUP, 3500 MASSILLON ROAD SUITE 230, , UNIONTOWN, OH, 44685
	
 
	
    MICHIGAN BILLING GROUP
	
 
	
    3500 MASSILLON ROAD

    SUITE 230
	
 
	
 
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    Brazoria Kidney Center, Inc.

    Brazoria Kidney Center, Inc., TYLER BILLING, 3910 BROOKSIDE
    DRIVE, SUITE 100, TYLER, TX, 75701
	
 
	
    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
	
 
	
    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
	
 
	
    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
	
 
	
    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

	
 
	
    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

	
 
	
    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
	
 
	
    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
	
 
	
    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
	
 
	
    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
	
 
	
    CHICAGO BILLING GROUP
	
 
	
    ONE WESTBROOK DRIVE
	
 
	
    TOWER 1, SUITE 1000
	
 
	
    WESTCHESTER
	
 
	
    IL
	
 
	
 
	
    60154
	
 

	
    Dialysis Centers of America — Illinois, Inc.

    Dialysis Centers of America — Illinois, Inc.,
    CLEVELAND BILLING, 25050 COUNTRY CLUB BOULEVARD, SUITE 250,
    NORTH OLMSTED, OH, 44070
	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	
    Dialysis Centers of America — Illinois, Inc.

    Dialysis Centers of America — Illinois, Inc.,
    INDIANAPOLIS BILLING, 10585 NORTH MERIDIAN STREET,
    SUITE 160, INDIANAPOLIS, IN, 46290
	
 
	
    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
	
 
	
    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
	
 
	
    NORTHERN OHIO BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 280
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	
    Dialysis Specialists of Topeka, Inc.

    Dialysis Specialists of Topeka, Inc., ARIZONA BILLING GROUP,
    2917 S. DOBSON, SUITE 101, MESA, AZ, 85202
	
 
	
    ARIZONA BILLING GROUP
	
 
	
    2917 S.  DOBSON
	
 
	
    SUITE 101
	
 
	
    MESA
	
 
	
    AZ
	
 
	
 
	
    85202
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    Dialysis Specialists of Tulsa, Inc.

    Dialysis Specialists of Tulsa, Inc., LUBBOCK BILLING GROUP, 4747
    SOUTH LOOP 289,, SUITE 120,, LUBBOCK, TX, 79424
	
 
	
    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
	
 
	
    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
	
 
	
    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
	
 
	
    KENTUCKY BILLING GROUP
	
 
	
    6100 DUTCHMANS LANE
	
 
	
    12TH FLOOR
	
 
	
    LOUISVILLE
	
 
	
    KY
	
 
	
 
	
    40205
	
 

	
    Everest Healthcare Indiana, Inc.

    Everest Healthcare Indiana, Inc., NORTHERN OHIO BILLING GROUP,
    3500 MASSILLON ROAD, SUITE 280, UNIONTOWN, OH, 44685
	
 
	
    NORTHERN OHIO BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 280
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	
    Everest Healthcare Indiana, Inc.

    Everest Healthcare Indiana, Inc., MICHIGAN BILLING GROUP, 3500
    MASSILLON ROAD SUITE 230, , UNIONTOWN, OH, 44685
	
 
	
    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
	
 
	
    NORTHERN OHIO BILLING GROUP
	
 
	
    3500 MASSILLON ROAD
	
 
	
    SUITE 280
	
 
	
    UNIONTOWN
	
 
	
    OH
	
 
	
 
	
    44685
	
 

	
    Everest Healthcare Rhode Island, Inc. 

    Everest Healthcare Rhode Island, Inc., NEW BEDFORD BILLING
    GROUP, 700 PLEASANT STREET, , NEW BEDFORD, MA, 2740
	
 
	
    NEW BEDFORD BILLING GROUP
	
 
	
    700 PLEASANT STREET
	
 
	
 
	
 
	
    NEW BEDFORD
	
 
	
    MA
	
 
	
 
	
    02740
	
 

	
    Everest Healthcare Texas, L.P.

    Everest Healthcare Texas, L.P., WACO BILLING GROUP, UPTOWN
    PLAZA, 1110 RICHLAND DR., #3, WACO, TX, 76710
	
 
	
    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
	
 
	
    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
	
 
	
    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
	
 
	
    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
	
 
	
    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
	
 
	
    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
	
 
	
    SAN ANTONIO BILLING GROUP
	
 
	
    6100 BANDERA ROAD
	
 
	
    SUITE 601
	
 
	
    SAN ANTONIO
	
 
	
    TX
	
 
	
 
	
    78238
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    Haemo-Stat, Inc.

    Haemo-Stat, Inc., SOUTHERN CALIFORNIA BILLING GROUP, 1337 EAST
    THOUSAND OAKS BLVD, SUITE 216, THOUSAND OAKS, CA, 91362
	
 
	
    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
	
 
	
    INDIANAPOLIS BILLING
	
 
	
    10585 NORTH MERIDIAN STREET
	
 
	
    SUITE 160
	
 
	
    INDIANAPOLIS
	
 
	
    IN
	
 
	
 
	
    46290
	
 

	
    Holton Dialysis Clinic, LLC

    Holton Dialysis Clinic, LLC, INDIANAPOLIS BILLING, 10585 NORTH
    MERIDIAN STREET, SUITE 160, INDIANAPOLIS, IN, 46290
	
 
	
    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
	
 
	
    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
	
 
	
    TYLER BILLING
	
 
	
    3910 BROOKSIDE DRIVE
	
 
	
    SUITE 100
	
 
	
    TYLER
	
 
	
    TX
	
 
	
 
	
    75701
	
 

	
    KDCO, Inc.

    KDCO, Inc., TYLER BILLING, 3910 BROOKSIDE DRIVE, SUITE 100,
    TYLER,

    TX, 75701
	
 
	
    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
	
 
	
    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
	
 
	
    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
	
 

	
    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
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    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., 1155W 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
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    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 Barnabas, L.L.C. 
	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	
    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. 
	
 
	
    CLEVELAND BILLING
	
 
	
    25050 COUNTRY CLUB BOULEVARD
	
 
	
    SUITE 250
	
 
	
    NORTH OLMSTED
	
 
	
    OH
	
 
	
 
	
    44070
	
 

	
    NNA-Saint Bamabas-Livingston, LLC., 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
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    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,
    46290
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    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
	
 

	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    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
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    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 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 Perm 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
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    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
	
 

	
    Renex Dialysis Clinic of University City, Inc., TYLER BILLING,
    3910 BROOKSIDE DRIVE, SUITE 100, TYLER, TX, 75701
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

	
    Renex Diarysis 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
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

	 	 	 	 	 	 	 	 	 	 	 	 	 	 	 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Billing

    
	
 
	
    Billing

    
	
 

	
    Location of Records-Exhibit I-Fresenius Medical Services

    
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
    Group

    
	
 
	
    Group

    
	
 

	
    2008 Transferring Affiliates
	
 
	
    FMS Billing Group
	
 
	
    Billing Group Address
	
 
	
    Billing Group Address 2
	
 
	
    Billing Group City
	
 
	
    State
	
 
	
    Zip
	
 

	 

	
    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
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 
	
 

 

 

    EXHIBIT H

 

    to

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE AGREEMENT

 

    LIST OF
    SELLER’S SUBSIDIARIES,

 

    DIVISIONS
    AND TRADENAMES

 

    SECTION 3.l(k)

 

    3.1(k)(ii) Seller’s subsidiaries and divisions:

 

    Wholly owned:

 

    Bio-Medical Applications Management Company, Inc.

    Bio-Medical Applications of Illinois, Inc.

    Dialysis America Alabama, LLC

    Fresenius Medical Care Dialysis Services — Oregon,
    LLC

    Fresenius Medical Care Ventures Holding Company, Inc.

    Fresenius Medical Care of Illinois, LLC

    Haemo-Stat, Inc.

    Home Intensive Care, Inc.

    Lifechem, Inc.

    NMC A, LLC

    NMC Funding Corporation

    NMC Homecare, Inc.

    NMC Services, Inc.

    Neomedica, Inc.

    QCI Holdings, Inc.

    Renal Scientific Service of Texas, Inc.

    Spectra Renal Research, LLC

    U.S. Vascular Access Holdings, LLC

 

    Partially owned (other member is another wholly owned entity):

 

    NMC-RRI Partnership (99%)

    QualiCenters Eugene-Springfield, Ltd. (49%)

    QualiCenters Inland Northwest L.L.C. (30%)

    QualiCenters Louisville LLC (20%)

    QualiCenters Salem LLC (40%)

    QualiCenters Sioux City, LLC (49%)

 

    3.1(k)(iii) Tradename: Fresenius Medical Care North America

 

    EXHIBIT I

    

 

    to

    

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE 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.

 

    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

    

    5

 

    to 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.

    

    6

 

    [Remainder
    of page intentionally left blank]
    

 

    

    7

 

    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.

    

    8

 

    BIO-MEDICAL APPLICATIONS OF MICHIGAN, INC.

    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

    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.

    

    9

 

    DIALYSIS MANAGEMENT CORPORATION

    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.

    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.

    RENAL CARE GROUP SOUTH NEW MEXICO, LLC

    RENAL CARE GROUP SOUTHWEST HOLDINGS, INC.

    RENAL CARE GROUP SOUTHWEST, L.P.

    RENAL CARE GROUP TEXAS, INC.

    

    10

 

    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 J

    

 

    to

    

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE AGREEMENT

    

 

    LIST OF
    TRANSFERRING AFFILIATES, CHIEF EXECUTIVE

    

 

    OFFICES
    OF TRANSFERRING AFFILIATES AND TRADENAMES

    

 

    SECTIONS 2.7(b),
    3.1(i) and 3.1(k)(iv)

 

    2.7(b) List of Transferring Affiliates:

 

    Angleton Dialysis, Inc.

    Bio-Medical Applications Home Dialysis Services, Inc.

    Bio-Medical Applications Management Company, Inc

    Bio-Medical Applications of Aguadilla, Inc.

    Bio-Medical Applications of Alabama, Inc.

    Bio-Medical Applications of Anacostia, 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 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 Hoboken, Inc.

    Bio-Medical Applications of Humacao, Inc.

    Bio-Medical Applications of Illinois, Inc. 

    Bio-Medical Applications of Indiana, 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.

    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 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 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 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.

    Conejo Valley Dialysis, Inc.

    Con-Med Supply Company, Inc.

    Diabetes Care Group, Inc.

    Dialysis America Alabama, LLC

    Dialysis America Georgia, LLC

    Dialysis Associates of Northern New Jersey, L.L.C.

    Dialysis Centers of America — Illinois, Inc.

    Dialysis Licensing Corp.

    Dialysis Management Corporation

    Dialysis Services of Atlanta, Inc.

    Dialysis Services of Cincinnati, Inc.

    Dialysis Services, Inc.

    Dialysis Specialists of Topeka, Inc.

    Dialysis Specialists of Tulsa, Inc.

    Du Page Dialysis, Ltd.

    Everest Healthcare Holdings, Inc.

    Everest Healthcare Indiana, Inc.

    

    2

 

    Everest Healthcare Ohio, Inc.

    Everest Healthcare Rhode Island, Inc.

    Everest Healthcare Texas Holding Corp

    Everest Healthcare Texas, L.P.

    Everest Management, Inc.

    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 Medical Care Dialysis Services — Oregon, LLC

    Fresenius Medical Care Dialysis Services Colorado LLC

    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.

    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.

    

    3

 

    NNA Transportation Services Corporation

    NNA-Saint Barnabas, L.L.C.

    NNA-Saint Barnabas-Livingston, L.L.C.

    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.

    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.

    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.

    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.

    

    4

 

    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, Inc.

    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.

 

    3.1(i) Place of Business:  For each Transferring
    Affiliate, the principal place of business, chief executive
    office, and the offices where each Transferring Affiliate keeps
    substantially all its Records is 920 Winter Street, Waltham, MA
    02451.

 

	 	 	 
	

    3.1k(iv) Tradenames:

	
 
	
    Fresenius Medical Care North America

    Spectra Renal Management

    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.

    

    5

 

    EXHIBIT K

 

    to

 

    AMENDED
    AND RESTATED RECEIVABLES PURCHASE 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

 

    “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) 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

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