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B. MISCELLANEOUS PROVISIONS 1, Company will not make a!'ly addltlonal payment for fecllity or process ional seNlces based upo!'I a ru1'11 1 health care desl gnatlon under 1h13 Medlnare program, l"cludfng any designation $l:ICh as a Cr Ucal Access Hospital (CAH), Physician Scarc;lty A~ (PSA) or any other des gnaUon . unless Iha res u!llng paymenl l!i agreed to by Company n advan ce and In writing . 2. Provl,d~r ag(ees 1010,ok sole ly to Company for compensalion for ·Cavered Services provided to Members . Ptovlder agrees to collect directly from Member any outpatient co-payment whic h may be establlsl]ed from time to lime by Company ror !3J!,Ch office cell and for eaeh ·home visit. The co• pay ment st1all , be a cred!l against the amount di.le from Oorn p-any for Covered Serv ces rendered lo a Me rTJper, without regard to whether the ProvidBr has actually collocted any co.-pavme nt . 3. for purposes of prompt payment of clJilms under this MA Addendum only , claimg for Covered Servi ces prov ided to MA Members under this Addend um shall l.'1 · ! be aUbjectto any late fees, inte rest, or other penallies as established by the Agreement o r by stale law. See 42 CFR § 422,520(b). 4. Cons,slenl with all other MA Member Agreements offered by Company , Compnnvwill follow CMS's standards Ir, determining Medrcal Necessity , lnclu dJng , without limlla tlot;1 1,Medlcare 's national co ve rage t;1ec1slons ·(N CDs) and-appHca.ble local medic.al review polic ies (LMRPs), 5. This Addendum shall continue , unless terminated acc01dlng to 11\e process set forth in the ·Agreemenl Ellhef party may terminate this AddendL(m without teffl'I na.ting the remainder of the Agreement However , Ir:, the event either party 1ermlnates the Agreemi,n lhis Addendum terminates as well. Ar1y term not defined herein shall hav& the meaning set forth in the Agreemen t. The l~rms or this Addendum shall become a part of, and shall be. speoiflcally i ncorporated ln'to, the terms of, the Ag1eemenl In the e vept of tiny c:onRlct or lnc011sistency b~en the term& of th is Addendum and the terms of the Ag r.eeme nt, the terms of this Addendum &hall apply. This Addendum supersedes and repl aces In Ifs entirety any prior MA Addenda between the parties. MA PPO Profeasional Reimbursement Addendum Asuri• 1 A18818854AA Page 2 or 2