Document:

Corporate Integrity Agreement dated May 19, 2008

 Exhibit 10.1 
 CORPORATE INTEGRITY AGREEMENT 
 BETWEEN THE 
 OFFICE OF INSPECTOR GENERAL 
 OF THE 
 DEPARTMENT OF HEALTH
AND HUMAN SERVICES 
 AND 
 ROTECH HEALTHCARE INC. 
  

	I.	PREAMBLE 

 Rotech Healthcare Inc. (Rotech) hereby enters into this Corporate Integrity Agreement (CIA) with the Office of Inspector General (OIG) of the United States Department of Health and Human Services (HHS) to promote
compliance with the statutes, regulations, and written directives of Medicare, Medicaid, and all other Federal health care programs (as defined in 42 U.S.C. § 1320a-7b(f)) (Federal health care program requirements). Contemporaneously with this
CIA, Rotech is entering into a Settlement Agreement with the United States. 
  

	II.	TERM AND SCOPE OF THE CIA 

 A. The period of the compliance obligations assumed by Rotech under this CIA shall be three years from the effective date of this CIA, unless otherwise
specified. The effective date shall be the date on which the final signatory of this CIA executes this CIA (Effective Date). Each one-year period, beginning with the one-year period following the Effective Date, shall be referred to as a
“Reporting Period.” 
 B. Sections VII, IX, X, and XI shall expire no later than 120 days after OIG’s receipt of:
(1) Rotech’s final annual report; or (2) any additional materials submitted by Rotech pursuant to OIG’s request, whichever is later. 
 C. The scope of this CIA shall be governed by the following definitions: 
 1. “Covered Persons”
includes: 
 a. all owners (other than shareholders who: (1) have an ownership interest of less than 5%; and (2) acquired the
ownership through public trading), officers, directors, and employees of Rotech; and 
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 b. all contractors, subcontractors, agents, and other persons who provide patient care items or services
or who perform billing or coding functions on behalf of Rotech. 
 Notwithstanding the above, this term does not include part-time or per diem
employees, contractors, subcontractors, agents, and other persons who are not reasonably expected to work more than 160 hours per year, except that any such individuals shall become “Covered Persons” at the point when they work more than
160 hours during the calendar year. 
 2. “Relevant Covered Persons” includes all Covered Persons who are: 
  

	 	a.	Involved in billing, coding, or claims submission functions on behalf of Rotech; 

  

	 	b.	Involved with preparation or completion of documentation to support claims submitted to Federal health care programs. 

  

	III.	CORPORATE INTEGRITY OBLIGATIONS  

 Rotech shall establish and maintain a Compliance Program that includes the following elements: 
 A. Compliance Management and Oversight. 
 1. Compliance Officer. Rotech shall continue to have an individual serve as its Compliance Officer and shall maintain a Compliance Officer for the term of the CIA. The Compliance Officer shall be responsible for developing and
implementing policies, procedures, and practices designed to ensure compliance with the requirements set forth in this CIA and with Federal health care program requirements. The Compliance Officer shall be a member of senior management of Rotech,
shall make periodic (at least quarterly) reports regarding compliance matters directly to the Board of Directors of Rotech, and shall be authorized to report on such matters to the Board of Directors at any time. The Compliance Officer shall not be
or be subordinate to the General Counsel or Chief Financial Officer. The Compliance Officer shall be responsible for monitoring the day-to-day compliance activities engaged in by Rotech as well as for any reporting obligations created under this
CIA. 
  

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 Rotech shall report to OIG, in writing, any changes in the identity or position description of the
Compliance Officer, or any actions or changes that would affect the Compliance Officer’s ability to perform the duties necessary to meet the obligations in this CIA, within 30 days after such a change. 
 2. Compliance Committee. Rotech shall continue to maintain a Compliance Committee. The Compliance Committee shall, at a minimum, include the
Compliance Officer and other members of senior management necessary to meet the requirements of this CIA (e.g., senior executives of relevant departments, such as billing, clinical, human resources, audit, and operations). The Compliance
Officer shall chair the Compliance Committee and the Committee shall support the Compliance Officer in fulfilling his/her responsibilities (e.g., shall assist in the analysis of the organization’s risk areas and shall oversee monitoring
of internal and external audits and investigations). 
 Rotech shall report to OIG, in writing, any changes in the composition of the
Compliance Committee, or any actions or changes that would affect the Compliance Committee’s ability to perform the duties necessary to meet the obligations in this CIA, within 30 days after such a change. 
 3. Board of Directors. The Rotech Board of Directors shall be responsible for the review and oversight of matters related to compliance with
Federal health care program requirements and the obligations of this CIA. The Board of Directors shall, at a minimum, be responsible for the following: 
  

	 	a.	The Board of Directors shall meet at least quarterly and shall review and oversee Rotech’s compliance program, including but not limited to the performance of the Compliance
Officer, the Compliance Committee, and the Compliance Department. 

  

	 	b.	For each Reporting Period of the CIA, the Board of Directors shall adopt a resolution, signed by each individual member of the Board, summarizing its review and oversight of
Rotech’s compliance with Federal health care program requirements and the obligations of the CIA. At a minimum, the resolution shall include the following language: 

 “The Board of Directors has made reasonable and due inquiry into the operations of Rotech’s compliance program, including 

  

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the performance of the Compliance Officer, the Compliance Committee, and the Compliance Department. As a result, the Board has concluded that, to the best of
its knowledge, Rotech has implemented an effective compliance program to meet Federal health care program requirements and the obligations of this CIA.” 
 If the Board is unable to provide such a conclusion in the resolution, the Board shall include in the resolution a written explanation of the reasons why it is unable to provide the conclusion and the steps it is
taking to implement an effective compliance program at Rotech. 
 Rotech shall report to OIG, in writing, any changes in the composition of the Board, or any
actions or changes that would affect the Board’s ability to perform the duties necessary to meet the obligations in this CIA, within 30 days after such a change. 
 B. Written Standards. 
 1. Code of Conduct. Rotech shall continue to develop, implement, and
distribute a written Code of Conduct to all Covered Persons. Rotech shall make the promotion of, and adherence to, the Code of Conduct an element in evaluating the performance of all employees. The Code of Conduct shall, at a minimum, set forth:

 a. Rotech’s commitment to full compliance with all Federal health care program requirements, including its commitment to prepare and
submit accurate claims consistent with such requirements; 
 b. Rotech’s requirement that all of its Covered Persons shall be expected
to comply with all Federal health care program requirements and with Rotech’s own Policies and Procedures as implemented pursuant to Section III.B (including the requirements of this CIA); 
 c. the requirement that all of Rotech’s Covered Persons shall be expected to report to the Compliance Officer, or other appropriate individual
designated by Rotech, suspected violations of any Federal health care program requirements or of Rotech’s own Policies and Procedures; 
  

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 d. the possible consequences to both Rotech and Covered Persons of failure to comply with Federal health
care program requirements and with Rotech’s own Policies and Procedures and the failure to report such noncompliance; and 
 e. the
right of all individuals to use the Disclosure Program described in Section III.E, and Rotech’s commitment to nonretaliation and to maintain, as appropriate, confidentiality and anonymity with respect to such disclosures. 
 Within 90 days after the Effective Date, each Covered Person shall certify, in writing or electronically, that he or she has received, read, understood,
and shall abide by Rotech’s Code of Conduct. New Covered Persons shall receive the Code of Conduct and shall complete the required certification within 60 days after becoming a Covered Person or within 120 days after the Effective Date,
whichever is later. 
 Rotech shall periodically review the Code of Conduct to determine if revisions are appropriate and shall make any
necessary revisions based on such review. Any revised Code of Conduct shall be distributed in writing or electronically within 60 days after any revisions are finalized. Each Covered Person shall certify, in writing or electronically, that he or she
has received, read, understood, and shall abide by the revised Code of Conduct within 60 days after the distribution of the revised Code of Conduct. 
 If, pursuant to Rotech’s Compliance Program, on or after February 1, 2008, Rotech distributed the Code of Conduct and obtained certifications from each Covered Person that he or she received, read,
understood and shall abide by Rotech’s Code of Conduct and the distribution and the certification satisfied the requirements set forth above in this Section, then the OIG shall credit that distribution as distribution and certification for
purposes of satisfying Rotech’s obligations under this Section for the first Reporting Period of this CIA. 
  

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 2. Policies and Procedures. Rotech shall continue to maintain and implement written Policies and Procedures
regarding the operation of Rotech’s compliance program and its compliance with Federal health care program requirements. Within 90 days of the Effective Date, Rotech shall review its existing policies and procedures, and amend them as
necessary, to ensure that they, at a minimum, shall address: 
 a. the subjects relating to the Code of Conduct identified in Section
III.B.1; 
 b. the applicable Federal health care program requirements governing coverage and reimbursement of oxygen; 
 c. the applicable Federal health care program requirements providing for proper completion of documentation necessary to support the submission and
reimbursement of claims; 
 d. the expectation that all Covered Persons shall comply with the Code of Conduct, the Policies and Procedures
required under this Section, and this CIA; 
 e. all risk areas under the Federal health care programs associated with the provision and
reimbursement of home oxygen and other durable medical equipment and supplies. 
 Within 60 days after the Effective Date, the relevant
portions of the Policies and Procedures shall be distributed in writing or electronically, which includes posting the Policies and Procedures to Rotech’s intranet, to all Covered Persons whose job functions relate to those Policies and
Procedures. Appropriate and knowledgeable staff shall be available to explain the Policies and Procedures. 
 At least annually (and more
frequently, if appropriate), Rotech shall assess and update, as necessary, the Policies and Procedures. Within 60 days after the effective date of any revisions, the relevant portions of any such revised Policies and Procedures shall be distributed
in writing or electronically, which includes posting the Policies and Procedures to Rotech’s intranet, to all Covered Persons whose job functions relate to those Policies and Procedures. 
  

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 C. Training and Education. 
 1. General Training. Within 90 days after the Effective Date, Rotech shall provide at least
one hour of General Training to each Covered Person. This training, at a minimum, shall explain Rotech’s: 
 a. CIA requirements; and

 b. Rotech’s Compliance Program (including the Code of Conduct and the Policies and Procedures as they pertain to general compliance
issues). 
 New Covered Persons shall receive the General Training described above within 60 days after becoming a Covered Person or within
90 days after the Effective Date, whichever is later. After receiving the initial General Training described above, each Covered Person shall receive at least one hour of General Training in each subsequent Reporting Period. 
 2. Specific Training. Within 90 days after the Effective Date, each Relevant Covered Person shall receive at least two hours of Specific Training
in addition to the General Training required above. This Specific Training shall include a discussion of: 
 a. the Federal health care
program requirements regarding the accurate coding and submission of claims; 
 b. applicable reimbursement statutes, regulations, and
program requirements and directives; 
 c. the Federal health care program requirements governing coverage and reimbursement of oxygen;

 d. the proper completion of documentation necessary to support the reimbursement of claims; 
 e. the personal obligation of each individual involved in the claims submission process to ensure that such claims are accurate; 
 f. the legal sanctions for violations of the Federal health care program requirements; and 
  

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 g. examples of proper and improper claims submission practices. 
 New Relevant Covered Persons shall receive this training within 60 days after the beginning of their employment or becoming Relevant Covered Persons, or
within 90 days after the Effective Date, whichever is later. A Rotech employee who has completed the Specific Training shall review a new Relevant Covered Person’s work, to the extent that the work relates to the delivery of patient care items
or services and/or the preparation or submission of claims for reimbursement from any Federal health care program, until such time as the new Relevant Covered Person completes his or her Specific Training. 
 After receiving the initial Specific Training described in this Section, each Relevant Covered Person shall receive at least two hours of Specific
Training in each subsequent Reporting Period. 
 3. Certification. Each individual who is required to attend training shall certify,
in writing, or in electronic form, if applicable, that he or she has received the required training. The certification shall specify the type of training received and the date received. The Compliance Officer (or designee) shall retain the
certifications, along with all course materials. These shall be made available to OIG, upon request. 
 4. Qualifications of Trainer.
Persons providing the training shall be knowledgeable about all relevant subject areas. 
 5. Update of Training. Rotech shall
review the training annually, and, where appropriate, update the training to reflect changes in Federal health care program requirements, any issues discovered during internal audits or the Claims Review, Unallowable Cost Review, and any other
relevant information. 
 6. Computer-based Training. Rotech may provide the training required under this CIA through appropriate
computer-based training approaches. If Rotech chooses to provide computer-based training, it shall make available appropriately qualified and knowledgeable staff or trainers to answer questions or provide additional information to the individuals
receiving such training. 
  

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 D. Review Procedures. 
 1. General Description. 
 a.
Engagement of Independent Review Organization. Within 90 days after the Effective Date, Rotech shall engage an entity (or entities), such as an accounting, auditing, or consulting firm (hereinafter “Independent Review Organization”
or “IRO”), to perform reviews to assist Rotech in assessing and evaluating its billing and coding practices and certain other obligations pursuant to this CIA and the Settlement Agreement. The applicable requirements relating to the IRO
are outlined in Appendix A to this CIA, which is incorporated by reference. 
 The IRO shall evaluate and analyze Rotech’s coding,
billing, and claims submission to the Medicare program and the reimbursement received (Claims Review), and shall analyze whether Rotech sought payment for certain unallowable costs (Unallowable Cost Review), if applicable. 
 b. Frequency of Claims Review. The Claims Review shall be performed annually and shall cover each of the Reporting Periods. The IRO(s) shall
perform all components of each annual Claims Review. 
 c. Frequency of Unallowable Cost Review. If applicable, the IRO shall perform
the Unallowable Cost Review for the first Reporting Period. 
 d. Retention of Records. The IRO and Rotech shall retain and make
available to OIG, upon request, all work papers, supporting documentation, correspondence, and draft reports (those exchanged between the IRO and Rotech) related to the reviews. 
 2. Claims Review. The Claims Review shall include a Discovery Sample of 50 Paid Claims selected for review, and, if the Error Rate for the
Discovery Sample is 5% or greater, a Full Sample and Systems Review. The applicable definitions, procedures, and reporting requirements are outlined in Appendix B to this CIA, which is incorporated by reference. 
  

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 3. Claims Review Report. The IRO shall prepare a report based upon the Claims Review performed
(Claims Review Report). Information to be included in the Claims Review Report is described in Appendix B. 
 4. Repayment of Identified
Overpayments. In accordance with Section III.H.1, Rotech shall repay within 30 days any Overpayment(s) identified in the Discovery Sample or the Full Sample (if applicable), regardless of the Error Rate, to the appropriate payor and in
accordance with payor refund policies. Rotech shall make available to OIG all documentation that reflects the refund of the Overpayment(s) to the payor. 
 5. Unallowable Cost Review. If applicable, the IRO shall conduct a review of Rotech’s compliance with the unallowable cost provisions of the Settlement Agreement. The IRO shall determine whether Rotech has
complied with its obligations not to charge to, or otherwise seek payment from, federal or state payors for unallowable costs (as defined in the Settlement Agreement) and its obligation to identify to applicable federal or state payors any
unallowable costs included in payments previously sought from the United States, or any state Medicaid program. This unallowable cost analysis shall include, but not be limited to, payments sought in any cost reports, cost statements, information
reports, or payment requests already submitted by Rotech or any affiliates. To the extent that such cost reports, cost statements, information reports, or payment requests, even if already settled, have been adjusted to account for the effect of the
inclusion of the unallowable costs, the IRO shall determine if such adjustments were proper. In making this determination, the IRO may need to review cost reports and/or financial statements from the year in which the Settlement Agreement was
executed, as well as from previous years. 
 6. Unallowable Cost Review Report. If applicable, the IRO shall prepare a report based
upon the Unallowable Cost Review performed. The Unallowable Cost Review Report shall include the IRO’s findings and supporting rationale regarding the Unallowable Costs Review and whether Rotech has complied with its obligation not to charge
to, or otherwise seek payment from, federal or state payors for unallowable costs (as defined in the Settlement Agreement) and its obligation to identify to applicable federal or state payors any unallowable costs included in payments previously
sought from such payor. 
 7. Validation Review. In the event OIG has reason to believe that: (a) Rotech’s Claims Review
and/or Unallowable Cost Review, if applicable, fails to conform 

  

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to the requirements of this CIA; or (b) the IRO’s findings or results of its Claims Review and/or Unallowable Cost Review are inaccurate, OIG may,
at its sole discretion, conduct its own review to determine whether the Claims Review and/or Unallowable Cost Review complied with the requirements of the CIA and/or the findings or results of the Claims Review and/or Unallowable Cost Review are
inaccurate (Validation Review). Rotech shall pay for the reasonable cost of any such review performed by OIG or any of its designated agents. Any Validation Review of Reports submitted as part of Rotech’s final Annual Report shall be initiated
no later than one year after Rotech’s final submission (as described in Section II) is received by OIG. 
 Prior to initiating a
Validation Review, OIG shall notify Rotech of its intent to do so and provide a written explanation of why OIG believes such a review is necessary. To resolve any concerns raised by OIG, Rotech may request a meeting with OIG to: (a) discuss the
results of any Claims Review and/or Unallowable Cost Review submissions or findings; (b) present any additional information to clarify the results of the Claims Review and/or Unallowable Cost Review or to correct the inaccuracy of the Claims
Review and/or Unallowable Cost Review; and/or (c) propose alternatives to the proposed Validation Review. Rotech agrees to provide any additional information as may be requested by OIG under this Section III.D.6 in an expedited manner. OIG will
attempt in good faith to resolve any Claims Review and/or Unallowable Cost Review issues with Rotech prior to conducting a Validation Review. However, the final determination as to whether or not to proceed with a Validation Review shall be made at
the sole discretion of OIG. 
 8. Independence and Objectivity Certification. The IRO shall include in its report(s) to
Rotech a certification or sworn affidavit that it has evaluated its professional independence and objectivity, as appropriate to the nature of the engagement, with regard to the Claims Review and/or Unallowable Cost Review and that it has concluded
that it is, in fact, independent and objective. 
 E. Disclosure Program. 
 Rotech shall continue to maintain a Disclosure Program that includes a mechanism (e.g., a toll-free compliance telephone line) to enable
individuals to disclose, to the Compliance Officer or some other person who is not in the disclosing individual’s chain of command, any identified issues or questions associated with Rotech’s policies, conduct, practices, or procedures
with respect to a Federal health care program believed by the individual to be a potential violation of criminal, civil, or administrative law. Rotech shall appropriately publicize the existence of the disclosure mechanism (e.g., via periodic
e-mails to employees or by posting the information in prominent common areas). 
  

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 The Disclosure Program shall emphasize a nonretribution, nonretaliation policy, and shall include a
reporting mechanism for anonymous communications for which appropriate confidentiality shall be maintained. Upon receipt of a disclosure, the Compliance Officer (or designee) shall gather all relevant information from the disclosing individual. The
Compliance Officer (or designee) shall make a preliminary, good faith inquiry into the allegations set forth in every disclosure to ensure that he or she has obtained all of the information necessary to determine whether a further review should be
conducted. For any disclosure that is sufficiently specific so that it reasonably: (1) permits a determination of the appropriateness of the alleged improper practice; and (2) provides an opportunity for taking corrective action, Rotech
shall conduct an internal review of the allegations set forth in the disclosure and ensure that proper follow-up is conducted. 
 The
Compliance Officer (or designee) shall maintain a disclosure log, which shall include a record and summary of each disclosure received (whether anonymous or not), the status of the respective internal reviews, and any corrective action taken in
response to the internal reviews. The disclosure log shall be made available to OIG upon request. 
 F. Ineligible Persons.

 1. Definitions. For purposes of this CIA: 
 a. an “Ineligible Person” shall include an individual or entity who: 
 i. is currently excluded,
debarred, suspended, or otherwise ineligible to participate in the Federal health care programs or in Federal procurement or nonprocurement programs; or 
 ii. has been convicted of a criminal offense that falls within the ambit of 42 U.S.C. § 1320a-7(a), but has not yet been excluded, debarred, suspended, or otherwise declared ineligible. 
 b. “Exclusion Lists” include: 
 i.
the HHS/OIG List of Excluded Individuals/Entities (available through the Internet at http://www.oig.hhs.gov); and 
  

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 ii. the General Services Administration’s List of Parties Excluded from Federal Programs (available
through the Internet at http://www.epls.gov). 
 c. “Screened Persons” include prospective and current owners (other than
shareholders who: (1) have an ownership interest of less than 5%; and (2) acquired the ownership through public trading), officers, directors, employees, contractors, and agents of Rotech. 
 2. Screening Requirements. Rotech shall ensure that all Screened Persons are not Ineligible Persons, by implementing the following screening
requirements. 
 a. Rotech shall screen all Screened Persons against the Exclusion Lists prior to engaging their services and, as part of the
hiring or contracting process, shall require such Screened Persons to disclose whether they are Ineligible Persons. 
 b. Rotech shall screen
all Screened Persons against the Exclusion Lists within 90 days after the Effective Date and on an annual basis thereafter. 
 c. Rotech
shall implement a policy requiring all Screened Persons to disclose immediately any debarment, exclusion, suspension, or other event that makes that person an Ineligible Person. 
 Nothing in this Section affects the responsibility of (or liability for) Rotech to refrain from billing Federal health care programs for items or
services furnished, ordered, or prescribed by an Ineligible Person. Rotech understands that items or services furnished by excluded persons are not payable by Federal health care programs and that Rotech may be liable for overpayments and/or
criminal, civil, and administrative sanctions for employing or contracting with an excluded person regardless of whether Rotech meets the requirements of Section III.F. 
 3. Removal Requirement. If Rotech has actual notice that a Screened Person has become an Ineligible Person, Rotech shall remove such Screened Person from 

  

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responsibility for, or involvement with, Rotech’s business operations related to the Federal health care programs and shall remove such Screened Person
from any position for which the Screened Person’s compensation or the items or services furnished, ordered, or prescribed by the Screened Person are paid in whole or part, directly or indirectly, by Federal health care programs or otherwise
with Federal funds at least until such time as the Screened Person is reinstated into participation in the Federal health care programs. 
 4. Pending Charges and Proposed Exclusions. If Rotech has actual notice that a Screened Person is charged with a criminal offense that falls within the ambit of 42 U.S.C. §§ 1320a-7(a), 1320a-7(b)(1)-(3), or is proposed for
exclusion during the Screened Person’s employment or contract term, Rotech shall take all appropriate actions to ensure that the responsibilities of that Screened Person have not and shall not adversely affect the quality of care rendered to
any beneficiary, patient, or resident, or any claims submitted to any Federal health care program. 
 G. Notification of Government
Investigation or Legal Proceedings. 
 Within 30 days after discovery, Rotech shall
notify OIG, in writing, of any ongoing investigation or legal proceeding known to Rotech conducted or brought by a governmental entity or its agents involving an allegation that Rotech has committed a crime or has engaged in fraudulent activities.
This notification shall include a description of the allegation, the identity of the investigating or prosecuting agency, and the status of such investigation or legal proceeding. Rotech shall also provide written notice to OIG within 30 days after
the resolution of the matter, and shall provide OIG with a description of the findings and/or results of the investigation or proceedings, if any. 
 H. Reporting. 
 1. Overpayments. 
 a. Definition of Overpayments. For purposes of this CIA, an “Overpayment” shall mean the amount of money Rotech has received in excess of the amount due and payable under any Federal health
care program requirements. 
 b. Reporting of Overpayments. If, at any time, Rotech identifies or learns of any Overpayment, Rotech
shall notify the payor (e.g., Durable Medical Equipment Medicare Administrative Contractors 

  

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(DME MAC), fiscal intermediary or carrier) within 30 days after identification of the Overpayment and take remedial steps within 60 days after identification
(or such additional time as may be agreed to by the payor) to correct the problem, including preventing the underlying problem and the Overpayment from recurring. Also, within 30 days after identification of the Overpayment, Rotech shall repay the
Overpayment to the appropriate payor to the extent such Overpayment has been quantified. If not yet quantified, within 30 days after identification, Rotech shall notify the payor of its efforts to quantify the Overpayment amount along with a
schedule of when such work is expected to be completed. Notification and repayment to the payor shall be done in accordance with the payor’s policies, and, for Medicare contractors, shall include the information contained on the Overpayment
Refund Form, provided as Appendix C to this CIA. Notwithstanding the above, notification and repayment of any Overpayment amount that routinely is reconciled or adjusted pursuant to policies and procedures established by the payor should be handled
in accordance with such policies and procedures. 
 2. Reportable Events. 
 a. Definition of Reportable Event. For purposes of this CIA, a “Reportable Event” means anything that involves: 
 i. a substantial Overpayment; 
 ii. a matter
that a reasonable person would consider a probable violation of criminal, civil, or administrative laws applicable to any Federal health care program for which penalties or exclusion may be authorized; or 
 iii. the filing of a bankruptcy petition by Rotech. 
 A Reportable Event may be the result of an isolated event or a series of occurrences. 
 b. Reporting of Reportable Events.
If Rotech determines (after a reasonable opportunity to conduct an appropriate review or 

  

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investigation of the allegations) through any means that there is a Reportable Event, Rotech shall notify OIG, in writing, within 30 days after making the
determination that the Reportable Event exists. The report to OIG shall include the following information: 
 i. If the Reportable Event
results in an Overpayment, the report to OIG shall be made at the same time as the notification to the payor required in Section III.H.1, and shall include all of the information on the Overpayment Refund Form, as well as: 
 (A) the payor’s name, address, and contact person to whom the Overpayment was sent; and 
 (B) the date of the check and identification number (or electronic transaction number) by which the Overpayment was repaid/refunded; 
 ii. a complete description of the Reportable Event, including the relevant facts, persons involved, and legal and Federal health care program authorities
implicated; 
 iii. a description of Rotech’s actions taken to correct the Reportable Event; and 
 iv. any further steps Rotech plans to take to address the Reportable Event and prevent it from recurring. 
 v. If the Reportable Event involves the filing of a bankruptcy petition, the report to the OIG shall include documentation of the filing and a
description of any Federal health care program authorities implicated. 
  

	IV.	CHANGES TO BUSINESS UNITS OR LOCATIONS

 A. Change or Closure of Unit or Location. In the event that, after the Effective Date, Rotech changes locations or
closes a business unit or location related to the furnishing of items or services that may be reimbursed by Federal health care programs, Rotech shall notify OIG of this fact as soon as possible, but no later than within 30 days after the date of
change or closure of the location. 
  

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 B. Purchase or Establishment of New Unit or Location. In the event that, after the Effective Date,
Rotech purchases or establishes a new business unit or location related to the furnishing of items or services that may be reimbursed by Federal health care programs, Rotech shall notify OIG as soon as possible, but no later than 15 days prior to
such purchase or the operation of the new business unit or location. This notification shall include the address of the new business unit or location, phone number, fax number, National Provider Identifier, Medicare Provider number,
provider identification number and/or supplier number, and the name and address of the contractor that issued each number. Each new business unit or location and all Covered Persons at each new business unit or location shall be subject to the
applicable requirements of this CIA. 
 C. Sale of Unit or Location. In the event that, after the Effective Date, Rotech proposes to
sell any or all of its business units or locations that are subject to this CIA, Rotech shall notify OIG of the proposed sale as soon as possible, but no later than 15 days prior to the sale of such business unit or location. This notification shall
include a description of the business unit or location to be sold, a brief description of the terms of the sale, and the name and contact information of the prospective purchaser. This CIA shall be binding on the purchaser of such business unit or
location, unless otherwise determined and agreed to in writing by the OIG. 
  

	V.	IMPLEMENTATION AND ANNUAL REPORTS 

 A. Implementation Report. Within 120 days after the Effective Date, Rotech shall submit a written report to OIG summarizing the status of its
implementation of the requirements of this CIA (Implementation Report). The Implementation Report shall, at a minimum, include: 
 1. the
name, address, phone number, and position description of the Compliance Officer required by Section III.A, and a summary of other noncompliance job responsibilities the Compliance Officer may have; 
 2. the names and positions of the members of the Compliance Committee required by Section III.A; 
 3. the names of the individuals serving on Rotech’s Board of Directors; 
  

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 4. a copy of Rotech’s Code of Conduct required by Section III.B.1; 
 5. a copy of all Policies and Procedures required by Section III.B.2; 
 6. the number of individuals required to complete the Code of Conduct certification required by Section III.B.1, the percentage of individuals who have completed such certification, and an explanation of any
exceptions (the documentation supporting this information shall be available to OIG, upon request); 
 7. the following information regarding
each type of training required by Section III.C: 
 a. a description of such training, including a summary of the topics covered, the length
of sessions, and a schedule of training sessions; 
 b. the number of individuals required to be trained, percentage of individuals actually
trained, and an explanation of any exceptions. 
 A copy of all training materials and the documentation supporting this information shall be available to
OIG, upon request. 
 8. a description of the Disclosure Program required by Section III.E; 
 9. the following information regarding the IRO(s): (a) identity, address, and phone number; (b) a copy of the engagement letter; and (c) a
summary and description of any and all current and prior engagements and agreements between Rotech and the IRO; 
 10. a certification from
the IRO regarding its professional independence and objectivity with respect to Rotech; 
 11. a description of the process by which Rotech
fulfills the requirements of Section III.F regarding Ineligible Persons; 
 12. the name, title, and responsibilities of any person who is
determined to be an Ineligible Person under Section III.F; the actions taken in response to the screening and removal obligations set forth in Section III.F; and the actions taken to identify, quantify, and repay any overpayments to Federal health
care programs relating to items or services furnished, ordered or prescribed by an Ineligible Person; 
  

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 13. a list of all of Rotech’s locations (including locations and mailing addresses); the
corresponding name under which each location is doing business; the corresponding phone numbers and fax numbers; each location’s National Provider Identifier, Medicare Provider number(s), provider identification number(s), and/or supplier
number(s); and the name and address of each Medicare contractor to which Rotech currently submits claims; 
 14. a description of
Rotech’s corporate structure, including identification of any parent and sister companies, subsidiaries, and their respective lines of business; and 
 15. the certifications required by Section V.C. 
 B. Annual Reports. Rotech shall submit to OIG
annually a report with respect to the status of, and findings regarding, Rotech’s compliance activities for each of the three Reporting Periods (Annual Report). 
 Each Annual Report shall include, at a minimum: 
 1. any change in the identity, position description, or
other noncompliance job responsibilities of the Compliance Officer, any change in the membership of the Compliance Committee, and any change in the membership of the Board of Directors described in Section III.A; 
 2. a copy of the Board of Directors’ resolution pursuant to Section III.A.3; 
 3. a summary of any significant changes or amendments to the Policies and Procedures required by Section III.B and the reasons for such changes
(e.g., change in contractor policy); 
 4. the number of individuals required to complete the Code of Conduct certification required
by Section III.B.1, the percentage of individuals who have completed such certification, and an explanation of any exceptions (the documentation supporting this information shall be available to OIG, upon request); 
 5. the following information regarding each type of training required by Section III.C: 
 a. a description of such training, including a summary of the topics covered, the length of sessions, and a schedule of training sessions; 
  

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 b. the number of individuals required to be trained, percentage of individuals actually trained, and an
explanation of any exceptions. 
 A copy of all training materials and the documentation supporting this information shall be available to OIG, upon request.

 6. a complete copy of all reports prepared pursuant to Section III.D, along with a copy of the IRO’s engagement letter; 

7. Rotech’s response and corrective action plan(s) related to any issues raised by the reports prepared pursuant to Section III.D; 
 8. a summary and description of any and all current and prior engagements and agreements between Rotech and the IRO, if different from what was submitted
as part of the Implementation Report; 
 9. a certification from the IRO regarding its professional independence and objectivity with respect
to Rotech; 
 10. a summary of Reportable Events (as defined in Section III.H) identified during the Reporting Period and the status of any
corrective and preventative action relating to all such Reportable Events; 
 11. a report of the aggregate Overpayments that have been
returned to the Federal health care programs. Overpayment amounts shall be broken down into the following categories: Medicare, Medicaid (report each applicable state separately, if applicable), and other Federal health care programs. Overpayment
amounts that are routinely reconciled or adjusted pursuant to policies and procedures established by the payor do not need to be included in this aggregate Overpayment report; 
 12. a summary of the disclosures in the disclosure log required by Section III.E that: (a) relate to Federal health care programs; or
(b) allege abuse or neglect of patients; 
 13. any changes to the process by which Rotech fulfills the requirements of Section III.F
regarding Ineligible Persons; 
  

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 14. the name, title, and responsibilities of any person who is determined to be an Ineligible Person
under Section III.F; the actions taken by Rotech in response to the screening and removal obligations set forth in Section III.F; and the actions taken to identify, quantify, and repay any overpayments to Federal health care programs relating to
items or services furnished, ordered or prescribed by an Ineligible Person; 
 15. a summary describing any ongoing investigation or legal
proceeding required to have been reported pursuant to Section III.G. The summary shall include a description of the allegation, the identity of the investigating or prosecuting agency, and the status of such investigation or legal proceeding;

 16. a description of all changes to the most recently provided list of Rotech’s locations (including addresses) as required by
Section V.A.12; the corresponding name under which each location is doing business; the corresponding phone numbers and fax numbers; each location’s National Provider Identifier, Medicare Provider number(s), provider identification number(s),
and/or supplier number(s); and the name and address of each Medicare contractor to which Rotech currently submits claims; and 
 17. the
certifications required by Section V.C. 
 The first Annual Report shall be received by OIG no later than 90 days after the end of the first
Reporting Period. Subsequent Annual Reports shall be received by OIG no later than the anniversary date of the due date of the first Annual Report. 
 C. Certifications. The Implementation Report and Annual Reports shall include a certification by the Compliance Officer that: 
 1. to the best of his or her knowledge, except as otherwise described in the applicable report, Rotech is in compliance with all of the requirements of this CIA; 
 2. he or she has reviewed the Report and has made reasonable inquiry regarding its content and believes that the information in the Report is accurate and truthful; and 
 3. to the best of his or her knowledge, Rotech has complied with its obligations under the Settlement Agreement: (a) not to resubmit to any Federal
health care program payors any previously denied claims related to the Covered Conduct 

  

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addressed in the Settlement Agreement, and not to appeal any such denials of claims; (b) not to charge to or otherwise seek payment from federal or
state payors for unallowable costs (as defined in the Settlement Agreement); and (c) to identify and adjust any past charges or claims for unallowable costs; 
 D. Designation of Information. Rotech shall clearly identify any portions of its submissions that it believes are trade secrets, or information that is commercial or financial and privileged or confidential,
and therefore potentially exempt from disclosure under the Freedom of Information Act (FOIA), 5 U.S.C. § 552. Rotech shall refrain from identifying any information as exempt from disclosure if that information does not meet the criteria for
exemption from disclosure under FOIA. 
  

	VI.	NOTIFICATIONS AND SUBMISSION OF REPORTS

 Unless otherwise stated in writing after the Effective Date, all notifications and reports required under this CIA shall be
submitted to the following entities: 
 OIG: 
 Administrative and Civil Remedies Branch 
 Office of Counsel to the Inspector General 
 Office of Inspector General 
 U.S. Department of Health and Human Services 
 Cohen Building, Room 5527 
 330 Independence Avenue, S.W. 
 Washington, DC 20201 
 Telephone: 202.619.2078 
 Facsimile: 202.205.0604 
 Rotech: 
 Robin Menchen 
 Chief Compliance Officer 
 Rotech Healthcare Inc. 
 2600 Technology Drive 
 Suite 300 
 Orlando, FL 32804 
 Phone: 407-822-4600 
 Fax: 407-297-8569 
  

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 Unless otherwise specified, all notifications and reports required by this CIA may be made by certified mail, overnight
mail, hand delivery, or other means, provided that there is proof that such notification was received. For purposes of this requirement, internal facsimile confirmation sheets do not constitute proof of receipt. Upon request by OIG, Rotech may be
required to provide OIG with an electronic copy of each notification or report required by this CIA in searchable portable document format (pdf), either instead of or in addition to, a paper copy. 
  

	VII.	OIG INSPECTION, AUDIT, AND REVIEW RIGHTS

 In addition to any other rights OIG may have by statute, regulation, or contract, OIG or its duly authorized
representative(s) may examine or request copies of Rotech’s books, records, and other documents and supporting materials and/or conduct on-site reviews of any of Rotech’s locations for the purpose of verifying and evaluating:
(a) Rotech’s compliance with the terms of this CIA; and (b) Rotech’s compliance with the requirements of the Federal health care programs in which it participates. The documentation described above shall be made available by
Rotech to OIG or its duly authorized representative(s) at all reasonable times for inspection, audit, or reproduction. Furthermore, for purposes of this provision, OIG or its duly authorized representative(s) may interview any of Rotech’s
employees, contractors, or agents who consent to be interviewed at the individual’s place of business during normal business hours or at such other place and time as may be mutually agreed upon between the individual and OIG. Rotech shall
assist OIG or its duly authorized representative(s) in contacting and arranging interviews with such individuals upon OIG’s request. Rotech’s employees may elect to be interviewed with or without a representative of Rotech present.

  

	VIII.	 DOCUMENT AND RECORD RETENTION 

 Rotech shall maintain for inspection all documents and records relating to reimbursement from the Federal health care programs, or to compliance with this
CIA, for six years (or longer if otherwise required by law) from the Effective Date. 
  

	IX.	DISCLOSURES  

 Consistent with
HHS’s FOIA procedures, set forth in 45 C.F.R. Part 5, OIG shall make a reasonable effort to notify Rotech prior to any release by OIG of information submitted by Rotech pursuant to its obligations under this CIA and identified upon submission
by Rotech as trade secrets, or information that is commercial or financial and privileged or confidential, under the FOIA rules. With respect to such releases, Rotech shall have the rights set forth at 45 C.F.R. § 5.65(d). 
  

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	X.	BREACH AND DEFAULT PROVISIONS 

 Rotech is expected to fully and timely comply with all of its CIA obligations. 
 A. Stipulated Penalties for Failure to Comply with Certain Obligations. As a contractual remedy, Rotech and OIG hereby agree that failure to
comply with certain obligations as set forth in this CIA may lead to the imposition of the following monetary penalties (hereinafter referred to as “Stipulated Penalties”) in accordance with the following provisions. 
 1. A Stipulated Penalty of $2,500 (which shall begin to accrue on the day after the date the obligation became due) for each day Rotech fails to
establish and implement any of the following obligations as described in Section III: 
 a. a Compliance Officer; 
 b. a Compliance Committee; 
 c. a written
Code of Conduct; 
 d. written Policies and Procedures; 
 e. the training of Covered Persons; 
 f. a Disclosure Program; 
 g. Ineligible Persons screening and removal requirements; and 
 h. notification of Government investigations or legal proceedings. 
 2. A Stipulated Penalty of $2,500
(which shall begin to accrue on the day after the date the obligation became due) for each day Rotech fails to engage an IRO, as required in Section III.D and Appendix A. 
  

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 3. A Stipulated Penalty of $2,500 (which shall begin to accrue on the day after the date the obligation
became due) for each day Rotech fails to submit the Implementation Report or any Annual Reports to OIG in accordance with the requirements of Section V by the deadlines for submission. 
 4. A Stipulated Penalty of $2,500 (which shall begin to accrue on the day after the date the obligation became due) for each day Rotech fails to submit
the annual Claims Review Report in accordance with the requirements of Section III.D and Appendix B. 
 5. A Stipulated Penalty of $1,500 for
each day Rotech fails to grant access as required in Section VII. (This Stipulated Penalty shall begin to accrue on the date Rotech fails to grant access.) 
 6. A Stipulated Penalty of $20,000 for each false certification submitted by or on behalf of Rotech as part of its Implementation Report, Annual Report, additional documentation to a report (as requested by the OIG),
or otherwise required by this CIA. 
 7. A Stipulated Penalty of $2,500 for each day Rotech fails to comply with the Board of Directors
resolution obligations as required by Section III.A.3; 
 8. A Stipulated Penalty of $1,000 for each day Rotech fails to comply fully and
adequately with any obligation of this CIA. OIG shall provide notice to Rotech stating the specific grounds for its determination that Rotech has failed to comply fully and adequately with the CIA obligation(s) at issue and steps Rotech shall take
to comply with the CIA. (This Stipulated Penalty shall begin to accrue 10 days after Rotech receives this notice from OIG of the failure to comply.) A Stipulated Penalty as described in this Subsection shall not be demanded for any violation for
which OIG has sought a Stipulated Penalty under Subsections 1-6 of this Section. 
 B. Timely Written Requests for Extensions. Rotech
may, in advance of the due date, submit a timely written request for an extension of time to perform any act or file any notification or report required by this CIA. Notwithstanding any other provision in this Section, if OIG grants the timely
written request with respect to an act, notification, or report, Stipulated Penalties for failure to perform the act or file the notification or report shall not begin to accrue until one day after Rotech fails to meet the revised deadline set by
OIG. Notwithstanding any other provision in this Section, if OIG denies such a timely written request, Stipulated Penalties for failure to perform the act or file the notification or report shall not begin to accrue until three business days after
Rotech 

  

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receives OIG’s written denial of such request or the original due date, whichever is later. A “timely written request” is defined as a request
in writing received by OIG at least five business days prior to the date by which any act is due to be performed or any notification or report is due to be filed. 
 C. Payment of Stipulated Penalties. 
 1. Demand Letter. Upon a finding that Rotech has failed
to comply with any of the obligations described in Section X.A and after determining that Stipulated Penalties are appropriate, OIG shall notify Rotech of: (a) Rotech’s failure to comply; and (b) OIG’s exercise of its contractual
right to demand payment of the Stipulated Penalties (this notification is referred to as the “Demand Letter”). 
 2. Response to
Demand Letter. Within 10 days after the receipt of the Demand Letter, Rotech shall either: (a) cure the breach to OIG’s satisfaction and pay the applicable Stipulated Penalties or (b) request a hearing before an HHS administrative
law judge (ALJ) to dispute OIG’s determination of noncompliance, pursuant to the agreed upon provisions set forth below in Section X.E. In the event Rotech elects to request an ALJ hearing, the Stipulated Penalties shall continue to accrue
until Rotech cures, to OIG’s satisfaction, the alleged breach in dispute. Failure to respond to the Demand Letter in one of these two manners within the allowed time period shall be considered a material breach of this CIA and shall be grounds
for exclusion under Section X.D. 
 3. Form of Payment. Payment of the Stipulated Penalties shall be made by certified or
cashier’s check, payable to: “Secretary of the Department of Health and Human Services,” and submitted to OIG at the address set forth in Section VI. 
 4. Independence from Material Breach Determination. Except as set forth in Section X.D.1.c, these provisions for payment of Stipulated Penalties shall not affect or otherwise set a standard for OIG’s
decision that Rotech has materially breached this CIA, which decision shall be made at OIG’s discretion and shall be governed by the provisions in Section X.D, below. 
 D. Exclusion for Material Breach of this CIA. 
 1. Definition of Material Breach. A material breach of this CIA means: 
 a. a failure by Rotech to report a Reportable
Event, take corrective action, and make the appropriate refunds, as required in Section III.H; 
  

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 b. a repeated or flagrant violation of the obligations under this CIA, including, but not limited to,
the obligations addressed in Section X.A; 
 c. a failure to respond to a Demand Letter concerning the payment of Stipulated Penalties in
accordance with Section X.C; or 
 d. a failure to engage and use an IRO in accordance with Section III.D. 
 2. Notice of Material Breach and Intent to Exclude. The parties agree that a material breach of this CIA by Rotech constitutes an independent
basis for Rotech’s exclusion from participation in the Federal health care programs. Upon a determination by OIG that Rotech has materially breached this CIA and that exclusion is the appropriate remedy, OIG shall notify Rotech of:
(a) Rotech’s material breach; and (b) OIG’s intent to exercise its contractual right to impose exclusion (this notification is hereinafter referred to as the “Notice of Material Breach and Intent to Exclude”).

 3. Opportunity to Cure. Rotech shall have 30 days from the date of receipt of the Notice of Material Breach and Intent to Exclude
to demonstrate to OIG’s satisfaction that: 
 a. Rotech is in compliance with the obligations of the CIA cited by OIG as being the basis
for the material breach; 
 b. the alleged material breach has been cured; or 
 c. the alleged material breach cannot be cured within the 30-day period, but that: (i) Rotech has begun to take action to cure the material breach;
(ii) Rotech is pursuing such action with due diligence; and (iii) Rotech has provided to OIG a reasonable timetable for curing the material breach. 
  

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 4. Exclusion Letter. If, at the conclusion of the 30-day period, Rotech fails to satisfy the
requirements of Section X.D.3, OIG may exclude Rotech from participation in the Federal health care programs. OIG shall notify Rotech in writing of its determination to exclude Rotech (this letter shall be referred to hereinafter as the
“Exclusion Letter”). Subject to the Dispute Resolution provisions in Section X.E, below, the exclusion shall go into effect 30 days after the date of Rotech’s receipt of the Exclusion Letter. The exclusion shall have national effect
and shall also apply to all other Federal procurement and nonprocurement programs. Reinstatement to program participation is not automatic. After the end of the period of exclusion, Rotech may apply for reinstatement by submitting a written request
for reinstatement in accordance with the provisions at 42 C.F.R. §§ 1001.3001-.3004. 
 E. Dispute Resolution 
 1. Review Rights. Upon OIG’s delivery to Rotech of its Demand Letter or of its Exclusion Letter, and as an agreed-upon contractual remedy for
the resolution of disputes arising under this CIA, Rotech shall be afforded certain review rights comparable to the ones that are provided in 42 U.S.C. § 1320a-7(f) and 42 C.F.R. Part 1005 as if they applied to the Stipulated Penalties or
exclusion sought pursuant to this CIA. Specifically, OIG’s determination to demand payment of Stipulated Penalties or to seek exclusion shall be subject to review by an HHS ALJ and, in the event of an appeal, the HHS Departmental Appeals Board
(DAB), in a manner consistent with the provisions in 42 C.F.R. § 1005.2-1005.21. Notwithstanding the language in 42 C.F.R. § 1005.2(c), the request for a hearing involving Stipulated Penalties shall be made within 10 days after receipt of
the Demand Letter and the request for a hearing involving exclusion shall be made within 25 days after receipt of the Exclusion Letter. 
 2.
Stipulated Penalties Review. Notwithstanding any provision of Title 42 of the United States Code or Title 42 of the Code of Federal Regulations, the only issues in a proceeding for Stipulated Penalties under this CIA shall be:
(a) whether Rotech was in full and timely compliance with the obligations of this CIA for which OIG demands payment; and (b) the period of noncompliance. Rotech shall have the burden of proving its full and timely compliance and the steps
taken to cure the noncompliance, if any. OIG shall not have the right to appeal to the DAB an adverse ALJ decision related to Stipulated Penalties. If the ALJ agrees with OIG with regard to a finding of a breach of this CIA and orders Rotech to pay
Stipulated Penalties, such Stipulated Penalties shall become due and payable 20 days after the ALJ issues such a decision unless Rotech requests review of the ALJ decision by the DAB. If the ALJ decision is properly appealed to the DAB and the DAB
upholds the determination of OIG, the Stipulated Penalties shall become due and payable 20 days after the DAB issues its decision. 
  

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 3. Exclusion Review. Notwithstanding any provision of Title 42 of the United States Code or Title
42 of the Code of Federal Regulations, the only issues in a proceeding for exclusion based on a material breach of this CIA shall be: 
 a.
whether Rotech was in material breach of this CIA; 
 b. whether such breach was continuing on the date of the Exclusion Letter; and

 c. whether the alleged material breach could not have been cured within the 30-day period, but that: (i) Rotech had begun to take
action to cure the material breach within that period; (ii) Rotech has pursued and is pursuing such action with due diligence; and (iii) Rotech provided to OIG within that period a reasonable timetable for curing the material breach and
Rotech has followed the timetable. 
 For purposes of the exclusion herein, exclusion shall take effect only after an ALJ decision favorable
to OIG, or, if the ALJ rules for Rotech, only after a DAB decision in favor of OIG. Rotech’s election of its contractual right to appeal to the DAB shall not abrogate OIG’s authority to exclude Rotech upon the issuance of an ALJ’s
decision in favor of OIG. If the ALJ sustains the determination of OIG and determines that exclusion is authorized, such exclusion shall take effect 20 days after the ALJ issues such a decision, notwithstanding that Rotech may request review of the
ALJ decision by the DAB. If the DAB finds in favor of OIG after an ALJ decision adverse to OIG, the exclusion shall take effect 20 days after the DAB decision. Rotech shall waive its right to any notice of such an exclusion if a decision upholding
the exclusion is rendered by the ALJ or DAB. If the DAB finds in favor of Rotech, Rotech shall be reinstated effective on the date of the original exclusion. 
 4. Finality of Decision. The review by an ALJ or DAB provided for above shall not be considered to be an appeal right arising under any statutes or regulations. Consequently, the parties to this CIA agree that
the DAB’s decision (or the ALJ’s decision if not appealed) shall be considered final for all purposes under this CIA. 
  

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	XI.	EFFECTIVE AND BINDING AGREEMENT 

 Rotech and OIG agree as follows: 
 A. This CIA
shall be binding on the successors, assigns, and transferees of Rotech; 
 B. This CIA shall become final and binding on the date the final
signature is obtained on the CIA; 
 C. This CIA constitutes the complete agreement between the parties and may not be amended except by
written consent of the parties to this CIA; 
 D. OIG may agree to a suspension of Rotech’s obligations under the CIA in the event of
Rotech’s cessation of participation in Federal health care programs. If Rotech withdraws from participation in Federal health care programs and is relieved of its CIA obligations by OIG, Rotech shall notify OIG at least 30 days in advance of
Rotech’s intent to reapply as a participating provider or supplier with any Federal health care program. Upon receipt of such notification, OIG shall evaluate whether the CIA should be reactivated or modified. 
 E. The undersigned Rotech signatories represent and warrant that they are authorized to execute this CIA. The undersigned OIG signatory represents that
he is signing this CIA in his official capacity and that he is authorized to execute this CIA. 
 F. This CIA may be executed in
counterparts, each of which constitutes an original and all of which constitute one and the same CIA. Facsimiles of signatures shall constitute acceptable, binding signatures for purposes of this CIA. 
  

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 ON BEHALF OF ROTECH
HEALTHCARE INC. 
  

					
	  
	 	 	 	  

	Philip L. Carter	 	 	 	DATE
	President and Chief Executive Officer	 		 	
	Rotech Healthcare Inc.	 		 	
			
	  
	 		 	  

	Robin Menchen	 		 	DATE
	Chief Compliance Officer	 		 	
	Rotech Healthcare Inc.	 		 	
			
	  
	 		 	  

	Roger Goldman, Esq.	 		 	DATE
	Latham & Watkins LLP	 		 	
	Counsel for Rotech Healthcare Inc.	 		 	

  

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 ON BEHALF OF THE OFFICE
OF INSPECTOR GENERAL 
 OF THE DEPARTMENT
OF HEALTH AND HUMAN SERVICES 
  

					
	  
	 	 	 	  

	Gregory E. Demske	 	 	 	DATE
	Assistant Inspector General for Legal Affairs	 		 	
	Office of Inspector General	 		 	
	U. S. Department of Health and Human Services	 		 	

  

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 APPENDIX A 
 INDEPENDENT REVIEW ORGANIZATION 
 This Appendix contains the requirements relating to the Independent Review
Organization (IRO) required by Section III.D of the CIA. 
  

	A.	IRO Engagement. 

 Rotech shall engage an IRO that
possesses the qualifications set forth in Paragraph B, below, to perform the responsibilities in Paragraph C, below. The IRO shall conduct the review in a professionally independent and objective fashion, as set forth in Paragraph D. Within 30 days
after OIG receives written notice of the identity of the selected IRO, OIG will notify Rotech if the IRO is unacceptable. Absent notification from OIG that the IRO is unacceptable, Rotech may continue to engage the IRO. 
 If Rotech engages a new IRO during the term of the CIA, this IRO shall also meet the requirements of this Appendix. If a new IRO is engaged, Rotech shall
submit the information identified in Section V.A.8 of the CIA to OIG within 30 days of engagement of the IRO. Within 30 days after OIG receives written notice of the identity of the selected IRO, OIG will notify Rotech if the IRO is unacceptable.
Absent notification from OIG that the IRO is unacceptable, Rotech may continue to engage the IRO. 
  

	B.	IRO Qualifications. 

 The IRO shall: 
 1. assign individuals to conduct the Claims Review engagement and, if applicable, the Unallowable Cost Review engagement, who have expertise in the
applicable laws and regulations relating to billing, coding, reporting and other requirements governing coverage and reimbursement for oxygen, and in the general requirements of the Federal health care program(s) from which Rotech seeks
reimbursement; 
 2. assign individuals to design and select the Claims Review sample who are knowledgeable about the appropriate statistical
sampling techniques; 
 3. assign individuals to conduct the coding review portions of the Claims Review who have a nationally recognized
coding certification (e.g., CCA, CCS, CCS-P, CPC, RRA, etc.) and who have maintained this certification (e.g., completed applicable continuing education requirements); and 
 Rotech Healthcare Inc. - CIA Appendix A 
  

 1 

 4. have sufficient staff and resources to conduct the reviews required by the CIA on a timely basis.

  

	C.	IRO Responsibilities. 

 The IRO shall: 
 1. perform each Claim Review in accordance with the specific requirements of the CIA; 
 2. follow all applicable Medicare, Medicaid or other Federal health care program rules and reimbursement guidelines in making assessments in the Claims
Review; 
 3. if in doubt of the application of a particular Medicare, Medicaid or Federal health care program policy or regulation, request
clarification from the appropriate authority (e.g., fiscal intermediary or carrier); 
 4. respond to all OIG inquires in a prompt,
objective, and factual manner; and 
 5. prepare timely, clear, well-written reports that include all the information required by Appendix B
to the CIA. 
  

	D.	IRO Independence and Objectivity. 

 The IRO must perform the Claims
Review in a professionally independent and objective fashion, as appropriate to the nature of the engagement, taking into account any other business relationships or engagements that may exist between the IRO and Rotech. 
  

	E.	IRO Removal/Termination. 

 1. Provider. If
Rotech terminates its IRO during the course of the engagement, Rotech must submit a notice explaining its reasons to OIG no later than 30 days after termination. Rotech must engage a new IRO in accordance with Paragraph A of this Appendix.

 2. OIG Removal of IRO. In the event OIG has reason to believe that the IRO does not possess the qualifications described in
Paragraph B, is not independent a objective as set forth in Paragraph D, or has failed to carry out its responsibilities as described in Paragraph C, OIG may, at its sole discretion, require Rotech to engage a new IRO in accordance with Paragraph A
of this Appendix. 
 Rotech Healthcare Inc. - CIA Appendix A 
  

 2 

 Prior to requiring Rotech to engage a new IRO, OIG shall notify Rotech of its intent to do so and provide
a written explanation of why OIG believes such a step is necessary. To resolve any concerns raised by OIG, Rotech may request a meeting with OIG to discuss any aspect of the IRO’s qualifications, independence or performance of its
responsibilities and to present additional information regarding these matters. Rotech shall provide any additional information as may be requested by OIG under this Paragraph in an expedited manner. OIG will attempt in good faith to resolve any
differences regarding the IRO with Rotech prior to requiring Rotech to terminate the IRO. However, the final determination as to whether or not to require Rotech to engage a new IRO shall be made at the sole discretion of OIG. 
 Rotech Healthcare Inc. - CIA Appendix A 
  

 3 

 APPENDIX B 
 CLAIMS REVIEW 
  

	A.	Claims Review. 

 1. Definitions. For the
purposes of the Claims Review, the following definitions shall be used: 
 a. Overpayment: The amount of money Rotech has received in
excess of the amount due and payable under Medicare. 
 b. Item: Any discrete unit that can be sampled (e.g., code, line item,
beneficiary, patient encounter, etc.). 
 c. Paid Claim: A code or line item submitted by Rotech and for which Rotech has received
reimbursement from Medicare. 
 d. Population: For the first Reporting Period, the Population shall be defined as all Items for which a
code or line item has been submitted by or on behalf of Rotech and for which Rotech has received reimbursement from Medicare (i.e., Paid Claim) during the 12-month period covered by the first Claims Review. 
 For the remaining Reporting Periods, the Population shall be defined as all Items for which Rotech has received reimbursement from Medicare (i.e.,
Paid Claim) during the 12-month period covered by the Claims Review. 
 To be included in the Population, an Item must have resulted in at
least one Paid Claim. 
 e. Error Rate: The Error Rate shall be the percentage of net Overpayments identified in the sample. The net
Overpayments shall be calculated by subtracting all underpayments identified in the sample from all gross Overpayments identified in the sample. (Note: Any potential cost settlements or other supplemental payments should not be included in the net
Overpayment calculation. Rather, only underpayments identified as part of the Discovery Sample shall be included as part of the net Overpayment calculation.) 
 The Error Rate is calculated by dividing the net Overpayment identified in the sample by the total dollar amount associated with the Items in the sample. 
 2. Discovery Sample. Within 15 days after the end of each Reporting Period, Rotech will provide the OIG with a list of Rotech Billing
Centers, including the total amount of claims billed to Medicare from those Billing Centers. OIG shall select 10% of 
 Rotech Healthcare Inc. - CIA Appendix
B 
  

 1 

 
Rotech Billing Centers at which the Claims Review shall be conducted. The IRO shall randomly select and review a sample of 50 Paid Claims submitted by or on
behalf of Rotech (Discovery Sample). The Paid Claims shall be reviewed based on the supporting documentation available at Rotech’s Billing Centers or under Rotech’s control, and all applicable billing and coding regulations and guidance to
determine whether the claim was correctly coded, submitted, and reimbursed. 
 If the Error Rate (as defined above) for the Discovery Sample
is less than 5%, no additional sampling is required, nor is the Systems Review required. (Note: The guidelines listed above do not imply that this is an acceptable error rate. Accordingly, Rotech should, as appropriate, further analyze any errors
identified in the Discovery Sample. Rotech recognizes that OIG or other HHS component, in its discretion and as authorized by statute, regulation, or other appropriate authority may also analyze or review Paid Claims included, or errors identified,
in the Discovery Sample or any other segment of the universe.) 
 3. Full Sample. If the Discovery Sample indicates that the
Error Rate is 5% or greater, the IRO shall select an additional sample of Paid Claims (Full Sample) using commonly accepted sampling methods. The Full Sample shall be designed to: (1) estimate the actual Overpayment in the population with a 90%
confidence level and with a maximum relative precision of 25% of the point estimate; and (2) conform with the Centers for Medicare and Medicaid Services’ statistical sampling for overpayment estimation guidelines. The Paid Claims selected
for the Full Sample shall be reviewed based on supporting documentation available at Rotech or under Rotech’s control and applicable billing and coding regulations and guidance to determine whether the claim was correctly coded, submitted, and
reimbursed. For purposes of calculating the size of the Full Sample, the Discovery Sample may serve as the probe sample, if statistically appropriate. Additionally, the IRO may use the Items sampled as part of the Discovery Sample, and the
corresponding findings for those 50 Items, as part of its Full Sample, if: (1) statistically appropriate and (2) the IRO selects the Full Sample Items using the seed number generated by the Discovery Sample. OIG, in its sole discretion,
may refer the findings of the Full Sample (and any related workpapers) received from Rotech to the appropriate Federal health care program payor, including the Medicare contractor (e.g., Durable Medical Equipment Medicare Administrative
Contractors (DME MAC), carrier or fiscal intermediary), for appropriate follow-up by that payor.  
 4. Systems Review. If
Rotech’s Discovery Sample identifies an Error Rate of 5% or greater, Rotech’s IRO shall also conduct a Systems Review. Specifically, for each claim in the Discovery Sample and Full Sample that resulted in an Overpayment, the IRO shall
perform a “walk through” of the system(s) and process(es), that generated the claim to identify any problems or weaknesses that may have resulted in the identified Overpayments. The IRO shall provide its observations and recommendations on
suggested improvements to the system(s) and the process(es) that generated the claim. 
 Rotech Healthcare Inc. - CIA Appendix B 
  

 2 

 5. Other Requirements. 
 a. Paid Claims without Supporting Documentation. For the purpose of appraising Items included in the Claims Review, any Paid Claim for which Rotech
cannot produce documentation sufficient to support the Paid Claim shall be considered an error and the total reimbursement received by Rotech for such Paid Claim shall be deemed an Overpayment. Replacement sampling for Paid Claims with missing
documentation is not permitted. 
 b. Replacement Sampling. Considering the Population shall consist only of Paid Claims and that Items
with missing documentation cannot be replaced, there is no need to utilize alternate or replacement sampling units. 
 c. Use of First
Samples Drawn. For the purposes of all samples (Discovery Sample(s) and Full Sample(s)) discussed in this Appendix, the Paid Claims associated with the Items selected in each first sample (or first sample for each strata, if applicable) shall be
used (i.e., it is not permissible to generate more than one list of random samples and then select one for use with the Discovery Sample or Full Sample). 
  

	B.	Claims Review Report. The following information shall be included in the Claims Review Report for each Discovery Sample and Full Sample (if applicable).

 1. Claims Review Methodology. 
 a. Sampling Unit. A description of the Item as that term is utilized for the Claims Review. 
 b.
Claims Review Population. A description of the Population subject to the Claims Review. 
 c. Claims Review Objective. A
clear statement of the objective intended to be achieved by the Claims Review. 
 d. Sampling Frame. A description of the sampling
frame, which is the totality of Items from which the Discovery Sample and, if any, Full Sample has been selected and an explanation of the methodology used to identify the sampling frame. In most circumstances, the sampling frame will be identical
to the Population. 
 Rotech Healthcare Inc. - CIA Appendix B 
  

 3 

 e. Source of Data. A description of the specific documentation relied upon by the IRO when
performing the Claims Review (e.g., medical records, physician orders, certificates of medical necessity, requisition forms, local medical review policies (including title and policy number), CMS program memoranda (including title and
issuance number), Medicare carrier or intermediary manual or bulletins (including issue and date), other policies, regulations, or directives). 
 f. Review Protocol. A narrative description of how the Claims Review was conducted and what was evaluated. 
 2.
Statistical Sampling Documentation. 
 a. The number of Items appraised in the Discovery Sample and, if applicable, in the Full Sample.

 b. A copy of the printout of the random numbers generated by the “Random Numbers” function of the statistical sampling software
used by the IRO. 
 c. A copy of the statistical software printout(s) estimating how many Items are to be included in the Full Sample, if
applicable. 
 d. A description or identification of the statistical sampling software package used to select the sample and determine the
Full Sample size, if applicable. 
 3. Claims Review Findings. 
 a. Narrative Results. 
 i. A
description of Rotech’s billing and coding system(s), including the identification, by position description, of the personnel involved in coding and billing. 
 ii. A narrative explanation of the IRO’s findings and supporting rationale (including reasons for errors, patterns noted, etc.) regarding the Claims Review, including the results of the Discovery Sample, and the
results of the Full Sample (if any). 
 Rotech Healthcare Inc. - CIA Appendix B 
  

 4 

 b. Quantitative Results. 
 i. Total number and percentage of instances in which the IRO determined that the Paid Claims submitted by Rotech (Claim Submitted) differed from what
should have been the correct claim (Correct Claim), regardless of the effect on the payment. 
 ii. Total number and percentage of instances
in which the Claim Submitted differed from the Correct Claim and in which such difference resulted in an Overpayment to Rotech. 
 iii. Total
dollar amount of all Overpayments in the sample. 
 iv. Total dollar amount of paid Items included in the sample and the net Overpayment
associated with the sample. 
 v. Error Rate in the sample. 
 vi. A spreadsheet of the Claims Review results that includes the following information for each Paid Claim appraised: Federal health care program billed, beneficiary health insurance claim number, date of service,
procedure code submitted, procedure code reimbursed, allowed amount reimbursed by payor, correct procedure code (as determined by the IRO), correct allowed amount (as determined by the IRO), dollar difference between allowed amount reimbursed by
payor and the correct allowed amount. (See Attachment 1 to this Appendix.) 
 4. Systems Review. Observations, findings, and
recommendations on possible improvements to the system(s) and process(es) that generated the Overpayment(s). 
 5. Credentials. The
names and credentials of the individuals who: (1) designed the statistical sampling procedures and the review methodology utilized for the Claims Review; and (2) performed the Claims Review. 
 Rotech Healthcare Inc. - CIA Appendix B 
  

 5 

 Attachment 1 
 Claim Review Results 
  

																	
	 Federal
 Health Care
Program

 Billed
	  	 Bene
 HIC
 #
	  	 Date of
Service
	  	 Procedure
Code
Submitted
	  	 Procedure
Code
 Reimbursed
	  	 Allowed
Amount
Reimbursed
	  	 Correct
Procedure
Code (IRO
determined)
	  	 Correct
Allowed Amt
Reimbursed
 (IRO
determined)
	  	 Dollar Difference
between Amt
Reimbursed and
Correct Allowed Amt

		  		  		  		  		  		  		  		  	
		  		  		  		  		  		  		  		  	
		  		  		  		  		  		  		  		  	

 APPENDIX C 
 OVERPAYMENT REFUND 
 TO BE COMPLETED BY MEDICARE CONTRACTOR 
 Date:                                     

Contractor Deposit Control
#                             Date of Deposit:
                                 
 Contractor Contact
Name:                                       
                         Phone
#                                        
         
 Contractor
Address:                                      
                                        
                                        
                   
 Contractor
Fax:                                       
                                        
                                        
                          
  
  
 TO BE COMPLETED BY
PROVIDER/PHYSICIAN/SUPPLIER 
 Please complete and forward to Medicare Contractor. This form, or a similar document containing the following
information, should accompany every voluntary refund so that receipt of check is properly recorded and applied. 
 PROVIDER/PHYSICIAN/SUPPLIERNAME                               
                                        
                          
 ADDRESS                                   
                                        
                                        
                                      
 PROVIDER/PHYSICIAN/SUPPLIER
#                            CHECK
NUMBER#                                       
      
 CONTACT
PERSON:                                       
                     PHONE
#                                        
                       AMOUNT OF CHECK 
 $                            CHECK
DATE                             
 REFUND INFORMATION 
 For each Claim, provide the
following: 
 Patient
Name                                       
                                        
                 HIC
#                                        
                         
 Medicare Claim
Number                                      
      Claim Amount Refunded
$                                 
 Reason Code for Claim Adjustment:            (Select reason code from list below. Use one reason per
claim) 
 (Please list all claim numbers involved. Attach separate sheet, if necessary)  
  

	Note:	If Specific Patient/HIC/Claim #/Claim Amount data not available for all claims due to Statistical Sampling, please indicate methodology and formula used to determine amount and
reason for
overpayment:                                      
                               

 For Institutional Facilities Only: 
 Cost Report Year(s)
                                        

 (If multiple cost report years are involved, provide a breakdown by amount and corresponding cost report year.) 
 For OIG Reporting Requirements: 
 Do you have a Corporate
Integrity Agreement with OIG?                     Yes
                    No 
 Reason Codes: 

					
	Billing/Clerical Error	  	MSP/Other Payer Involvement	  	Miscellaneous
	01 - Corrected Date of Service	  	08 - MSP Group Health Plan Insurance	  	13 - Insufficient Documentation
	02 - Duplicate	  	09 - MSP No Fault Insurance	  	14 - Patient Enrolled in an HMO
	03 - Corrected CPT Code	  	10 - MSP Liability Insurance	  	15 - Services Not Rendered
	04 - Not Our Patient(s)	  	11 - MSP, Workers Comp.(Including	  	16 - Medical Necessity
	05 - Modifier Added/Removed	  	        Black Lung	  	17 - Other (Please Specify)
	06 - Billed in Error	  	12 - Veterans Administration	  	
	07 - Corrected CPT CodeAmended and Restated Non-Employee Directors Stock Plan

 Exhibit 10.1 
 

 
 AMENDED AND RESTATED 
 NON-EMPLOYEE DIRECTORS STOCK PLAN 
 ***** 
 PLAN DOCUMENT 
 As amended through
May 21, 2008 

 First Midwest Bancorp, Inc. 
 Non-Employee Directors Stock Plan 
 Plan Document 
 Table of Contents 
  

			
	 SECTION 1 – ESTABLISHMENT, PURPOSES AND EFFECTIVE DATE OF PLAN
	  	A-1
		
	 1.1 – Establishment
	  	A-1
	 1.2 – Purposes
	  	A-1
	 1.3 – Effective Date
	  	A-1
		
	 SECTION 2 – DEFINITIONS
	  	A-1
		
	 SECTION 3 – PARTICIPATION, ADMINISTRATION AND AWARD AGREEMENTS
	  	A-3
		
	 3.1 – Participation
	  	A-3
	 3.2 – Administration
	  	A-3
	 3.3 – Award Agreements
	  	A-3
		
	 SECTION 4 – COMMON STOCK AVAILABLE
	  	A-3
		
	 4.1 – Number
	  	A-3
	 4.1 – Unused Stock
	  	A-3
	 4.3 – Adjustment in Capitalization
	  	A-3
		
	 SECTION 5 – Awards
	  	A-4
		
	 5.1 – Grant of Options
	  	A-4
	 5.2 – Grant of Stock Appreciation Rights
	  	A-4
	 5.3 – Grant of Restricted Stock or Restricted Stock Units
	  	A-4
	 5.4 – Grant of Other Awards
	  	A-4
		
	 SECTION 6 – COORDINATION WITH OMNIBUS STOCK AND INCENTIVE PLAN
	  	A-5
		
	 6.1 – Change-in-Control
	  	A-5
	 6.2 – Limited Transferability of Options Beneficiary Designations
	  	A-5
		
	 SECTION 7 – AMENDMENT AND TERMINATION
	  	A-5
		
	 7.1 – Amendment, Modification or Termination of the Plan
	  	A-5
	 7.2 – Amendment or Modification of Awards
	  	A-5
		
	 SECTION 8 – MISCELLANEOUS
	  	A-5
		
	 8.1 – Rights of Directors
	  	A-5
	 8.2 – Indemnification
	  	A-6
	 8.3 – Requirements of Law
	  	A-6
	 8.4 – Governing Law
	  	A-6

 FIRST MIDWEST BANCORP, INC. 
 AMENDED AND RESTATED 
 NON-EMPLOYEE DIRECTORS STOCK PLAN 
 Plan Document 
 Section 1.
    Establishment, Purposes and Effective Date 
 1.1 Establishment. First Midwest Bancorp,
Inc., a Delaware corporation (the “Company” or “FMBI”), hereby amends and restates the “FIRST MIDWEST BANCORP, INC. AMENDED AND RESTATED NON-EMPLOYEE DIRECTORS’ STOCK OPTION PLAN” (as last amended on May 20,
2003) as the “FIRST MIDWEST BANCORP, INC. AMENDED AND RESTATED NON-EMPLOYEE DIRECTORS STOCK PLAN”. 
 1.2
Purposes. The purpose of the Plan is to advance the interests of the Company and its stockholders by enabling the Company to provide a Non-Employee Director compensation program that attracts and retains the services of sophisticated and
qualified independent directors whose judgment, initiative, leadership, and efforts are important to the success of the Company, as well as by aligning the interest of the Company’s Non-Employee Directors with those of the Company’s
stockholders. 
 1.3 Effective Date. The Plan, as amended and restated, shall become effective immediately upon
receipt of approval by the Company’s stockholders on May 21, 2008. 
 Section 2.     Definitions 
 As used herein, the following terms shall have the meanings hereinafter set forth: 
 (a) “Award” means any Stock Option, Stock Appreciation Right, Restricted Stock, Restricted Stock Unit or
Other Award granted under this Plan. 
 (b) “Award Agreement” means the agreement that sets
forth the terms, conditions and limitations applicable to an Award. 
 (c) “Board” means the
Board of Directors of the Company. 
 (d) “Code” means the Internal Revenue Code of 1986, as
amended. 
 (e) “Committee” means the Compensation Committee of the Board or such other
committee appointed from time to time by the Board to administer the Plan. The Committee shall consist of two or more members, each of whom shall qualify as a “non-employee director,” as the term (or similar or successor term) is defined
by Rule 16b-3. 
 (f) “Common Stock” means the common stock, par value $.01 per share, of
the Company or such other class of shares or other securities as may be applicable pursuant to the provisions of Subsection 4.3. 
 (g) “Effective Date” means May 21, 2008, the date on which the Plan is approved by the Company’s stockholders. 
 (h) “Exchange Act” means the Securities Exchange Act of 1934, as amended. 
 (i) “Fair Market Value” shall have the meaning set forth in the Omnibus Plan. 
  

 A-1 

 (j) “Gain Deferral Plan” means the “FIRST MIDWEST
BANCORP, INC. STOCK OPTION GAIN DEFERRAL PLAN” as such plan may be amended from time to time and which is only available to certain non-employee directors who were participants in such plan prior to January 1, 2005. 
 (k) “Non-Employee Director” means any person who is a member of the Board and who is not, as of the
applicable Award grant date, an employee of the Company or any of its subsidiaries. A Non-Employee Director who, with the approval of the Board, enters into a “Continuing Participant Agreement” with the Company effective upon such person
ceasing to be a member of the Board shall continue to be deemed to be a Non-Employee Director for purposes of the Plan and shall not be deemed to incur a cessation of directorship during the term of such “Continuing Participant Agreement”.

 (l) “Omnibus Plan” means the “FIRST MIDWEST BANCORP, INC. OMNIBUS STOCK AND
INCENTIVE PLAN”, as such plan may be amended from time to time. 
 (m) “Option” means
the right to purchase shares of Common Stock at a stated price for a specified period of time. For purposes of the Plan, an Option is a “Nonstatutory (Nonqualified) Stock Option,” or “NSO” as defined by Code Section 422.

 (n) “Other Award” means an Award, other than a Stock Option, Stock Appreciation Right,
Restricted Stock or Restricted Stock Unit granted under this Plan, including the right to receive shares of Common Stock or a fixed or variable share denominated unit granted under this Plan or any deferred compensation plan established from time to
time by the Company. 
 (o) “Plan” means the “FIRST MIDWEST BANCORP, INC. AMENDED AND RESTATED
NON-EMPLOYEE DIRECTORS STOCK PLAN” as set forth herein and any amendments hereto. 
 (p)
“Restricted Stock” means shares of Common Stock granted to a Non-Employee Director pursuant to Subsection 5.3 of the Plan. 
 (q) “Restricted Stock Unit” means a right to receive a payment equal to the value of a share of Common Stock, pursuant to Subsection 5.3 of the Plan. 
 (r) “Retirement” means termination of the Non-Employee Director’s Board membership upon the
expiration of the Non-Employee Director’s term of office (unless such Non-Employee Director is then elected for another term of office), or upon such other circumstances as the Board may in its discretion determine to constitute
“Retirement”. 
 (s) “Rule 16b-3” means Rule 16b-3 or any successor or comparable
rule or rules applicable to Awards granted under the Plan promulgated by the Securities and Exchange Commission under Section 16(b) of the Securities Exchange Act of 1934, as amended. 
 (t) “Stock Appreciation Right” and “SAR” mean the right to receive a payment from the Company
equal to the excess of the Fair Market Value of a share of Common Stock at the date of exercise over a specified price fixed by the Committee, which shall not be less than 100% of the Fair Market Value of the Stock on the date of grant. In the case
of a Stock Appreciation Right which is granted in conjunction with an Option, the specified price shall be the Option exercise price. 
  

 A-2 

 Except when otherwise indicated by the context, words in the masculine gender when used in the Plan shall
include the feminine gender, the singular shall include the plural, and the plural shall include the singular. 
 Section 3.
    Participation, Administration and Award Agreements 
 3.1 Participation. Each Non-Employee
Director as of the Effective Date and each person who becomes a Non-Employee Director after the Effective Date shall be eligible to participate in the Plan. 
 3.2 Administration. The Committee shall be responsible for the administration of the Plan. The Committee, by majority action thereof (whether taken during a meeting or by written consent),
shall determine the type or types of Awards to be made under the Plan. The Committee is authorized to interpret the Plan, to prescribe, amend, and rescind rules and regulations relating to the Plan, to provide for conditions and assurances deemed
necessary or advisable to protect the interests of the Company, and to make all other determinations necessary or advisable for the administration of the Plan, but only to the extent not contrary to the express provisions of the Plan.
Determinations, interpretations, or other actions made or taken by the Committee pursuant to the provisions of the Plan shall be final and binding and conclusive for all purposes and upon all persons whomsoever. To the extent deemed necessary or
advisable for purposes of Rule 16b-3 or otherwise, the Board may act as the Committee hereunder. 
 3.3 Award
Agreements. Each Award shall be embodied in an Award Agreement, which shall contain such terms, conditions and limitations as shall be determined by the Committee. 
 Section 4.     Common Stock Available 
 4.1 Number.
The total number of shares of Common Stock subject to issuance under this Plan, and subject to adjustment upon occurrence of any of the events indicated in Subsection 4.3, may not exceed 200,000 plus the number of shares of Common Stock
subject to Awards outstanding as of the Effective Date. The Common Stock to be delivered under the Plan may consist, in whole or in part, of authorized but unissued stock or treasury stock not reserved for any other purpose. 
 4.2 Unused Stock. In the event an Option expires or terminates for any reason without having been exercised in full (including,
without limitation, cancellation and re-grant), or in the event that an Option is exercised or settled in a manner such that some or all of the shares of Common Stock related to the Option are not issued (including as the result of a share-for-share
exercise or the use of shares for withholding taxes, if any), the shares of Common Stock subject thereto which have not become outstanding shall (unless the Plan shall have terminated) remain available for issuance under the Plan. In the event an
Award is forfeited for any reason, or settled in cash in lieu of Common Stock or in a manner such that some or all of the shares of Common Stock related to the Award are not issued (including as a result of the use of shares for tax withholding),
such shares of Common Stock shall (unless the Plan shall have terminated) remain available for issuance under the Plan. 
 4.3 Adjustment in Capitalization. In the event of any change in the outstanding shares of Common Stock by reason of a stock dividend or split, recapitalization, merger, consolidation, combination, exchange of shares, or other similar
corporate change, the aggregate number of shares of Common Stock subject to an Award to be granted or outstanding pursuant to the Plan, and/or the stated exercise price (if applicable), shall be appropriately adjusted by the Committee, whose
determination shall be conclusive; provided, however, that fractional shares shall be rounded to the nearest whole share. 
  

 A-3 

 Section 5.     Awards 
 5.1 Grant of Options. Subject to the provisions of Sections 4 and 6, Options may be granted to Non-Employee
Directors at any time and from time to time as shall be determined by the Committee. The Committee shall have complete discretion in determining the number of Options granted to each Non-Employee Director. 
 (a) No Option granted pursuant to the Plan shall have an exercise price that is less than the Fair Market Value of the
Common Stock on the date the Option is granted. 
 (b) Options awarded under the Plan shall be exercisable at
such times and be subject to such restrictions and conditions as the Committee shall approve, either at the time of grant of such Options or pursuant to a general determination, and which need not be the same for all participants. 
 (c) Options may be exercised in the manner set forth in the Omnibus Plan. The exercise price payable upon the exercise of
an Option by a Non-Employee Director who has a deferral election in effect under the Gain Deferral Plan shall be made solely by tendering previously-acquired shares of Common Stock. 
 (d) Each Option shall vest and become exercisable as determined by the Committee, including vesting terms upon
termination of service to the Board due to death, disability or retirement. Once vested, Options shall expire upon the date which is three years following termination of the Non-Employee Director’s service to the Board for any reason;
provided, however, in no event may any Option be exercised beyond the tenth anniversary of its date of grant, or such shorter period which may be set forth in the Award Agreement. 
 5.2 Grant of Stock Appreciation Rights. Subject to the provisions of Sections 4 and 6, Stock Appreciation
Rights (“SARs”) may be granted to Non-Employee Directors at any time and from time to time as shall be determined by the Committee. An SAR may be granted at the discretion of the Committee in any of the following forms in connection
with previously awarded Options: (a) in lieu of Options; (b) in addition to Options; (c) upon lapse of Options and; (d) independent of Options. The terms, conditions and material provisions of an Award of SARs issued to a
Non-Employee Director shall be made in accordance with and subject to the provisions relating to SARs set forth in the Omnibus Plan. 
 5.3 Grant of Restricted Stock or Restricted Stock Units. Subject to the provisions of Sections 4 and 6, the Committee, at any time and from time to time, may grant shares of Restricted Stock
or Restricted Stock Units under the Plan to Non-Employee Directors and in such amounts as it shall determine. Each grant of Restricted Stock or Restricted Stock Units shall be in writing. The Committee, in its discretion, may permit a Non-Employee
Director to defer receipt of any Restricted Stock Units beyond the expiration of any applicable period of restriction. The terms, conditions and material provisions of an Award of shares of Restricted Stock or Restricted Stock Units issued to a
Non-Employee Director shall be made in accordance with and subject to the provisions relating to shares of Restricted Stock or Restricted Stock Units set forth in the Omnibus Plan. 
 5.4 Grant of Other Awards. Subject to the provisions of Sections 4 and 6, Other Awards may be granted to
Non-Employee Directors at any time and from time to time as shall be determined by the Committee. The terms, conditions and material provisions of an Other Award issued to a 

  

 A-4 

 
Non-Employee Director shall be made in accordance with and subject to the provisions relating to Other Awards set forth in the Omnibus Plan. 
 Section 6.     Coordination with Omnibus Stock and Incentive Plan 
 The following provisions of the Omnibus Plan, shall be applicable to the Director Options as if such provisions were set forth in this
Plan in full: 
 6.1 Change-in-Control. For purposes of this Plan, a “Change-in-Control” shall be deemed to
have occurred on the date a Change-in-Control occurs under the Omnibus Plan. In the event of a Change-in-Control of the Company, all Awards under the Plan shall vest 100%, whereupon all Options shall become exercisable in full, the restrictions
applicable to Restricted Stock shall terminate and all Other Awards shall be paid out based on the terms thereof. 
 6.2
Limited Transferability of Awards; Beneficiary Designations. No Award granted under this Plan may be sold, transferred, pledged, assigned or otherwise alienated or hypothecated, otherwise than by will or the laws of descent and distribution.
Notwithstanding the foregoing, the Board may, in its discretion, authorize all or a portion of an Award to be on terms which permit the transfer by the Non-Employee Director to the extent the Committee under the Omnibus Plan may permit such
transfers. Non-Employee Directors may designate beneficiaries with respect to Awards granted hereunder on the same basis as applicable to awards under the Omnibus Plan. 
 Section 7.     Amendment and Termination 
 7.1 Amendment,
Modification or Termination of the Plan. The Committee, or any committee to the extent authorized by the Board, may make such modifications to, or may terminate, the Plan as it shall deem advisable; provided, however, that except as contemplated
by Subsection 4.3, no modification that increases the number of shares of Common Stock subject to issuance under the Plan or that amends the provisions of Subsection 7.2 to remove the prohibition regarding Award re-pricing shall be
made without approval of the Company’s shareholders; and provided, further, that no modification or termination shall adversely affect the rights under any Award then outstanding without the written consent of the holder. 
 7.2 Amendment or Modification of Awards. The Committee, or any committee to the extent authorized by the Board, may amend or
modify any outstanding Awards in any manner to the extent that the Committee would have had the authority under the Plan initially to make such Award as so modified or amended, including without limitation, to change the date or dates as of which
Awards may be exercised, to remove the restrictions on Awards, or to modify the manner in which Awards are determined and paid. Notwithstanding the foregoing or any other provision of this Plan, except in circumstances described in Subsection
4.3, the terms and outstanding Awards may not be amended to reduce the exercise price of outstanding Options or SARs, or exchange for cash, other Awards or Options or SARs with an exercise price that is less than the exercise price of the
original Options or SARs, without shareholder approval. 
 Section 8.     Miscellaneous 
 8.1 Rights of Directors. Neither the Plan nor any action taken hereunder shall be construed as giving any Non-Employee Director
any right to continue to serve as a member of the Board or otherwise to be retained in the service of the Company. 
  

 A-5 

 8.2 Indemnification. To the extent permitted by law, each person who is or shall
have been a member of the Board shall be indemnified and held harmless by the Company against and from any loss, cost, liability or expense that may be imposed upon or reasonably incurred by him in connection with or resulting from any claim,
action, suit or proceeding to which he may be a party or in which he may be involved by reason of any action taken or failure to act under the Plan and against and from any and all amounts paid by him in settlement thereof, with the Company’s
approval, or paid by him in satisfaction of any judgment in any such action, suit or proceeding against such member, provided such member shall give the Company an opportunity, at its expense, to handle and defend the same before he undertakes to
handle and defend it on his own behalf. The foregoing right of indemnification shall not be exclusive of any other rights of indemnification to which such persons may be entitled under the Company’s Certificate of Incorporation or Bylaws, as a
matter of law or otherwise, or any power that the Company may have to indemnify them or hold them harmless. 
 8.3
Requirements of Law. The granting of Awards and the issuance of Common Stock with respect to an Award, shall be subject to all applicable laws, rules and regulations, and to such approvals by any governmental agencies or national securities
exchanges as may be required. 
 8.4 Governing Law. The Plan, and all agreements hereunder, shall be construed in
accordance with and governed by the laws of the State of Delaware. 
  

 A-6

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