SETTLEMENT AGREEMENT I. Recitals 1. Parties. The Parties to this Settlement Agreement(Agreement)are the Office ofInspector General(OIG} of the United States Department of Health and Human Services(HHS)and Sprin~eld Hospital in Springfield, Vermont(Respondent). 2. The Hospital is a Participating Provider. Respondenfi is a participating hospital that has entered into a provider agreement under section 185b ofthe Social Security Act(Act} and has an emergency department. 3. Description of Section 18b7 ofthe Act. The Emergency Medical Treatment and Labor Act(EMTALA)requires that a participating hospital with an emergency department must provide, upon request, an appropriate medical screening examination, within the capability ofthe hospital's emergency department, to determine whether an emergency medical condition exists, as defined in section 1867(e)(1) ofthe Act. 42 U.S.C.§ 1395dd If an individual has an emergency medical condition, fine hospital must provide, within the capabilities of the staff and facilities available at the hospital, treatment to stabilize the condition, unless a physician certifies that the individual should be transferred because the benefits of medical treatment elsewhere outweigh the risks associated with transfer. 4. Description ofCivil Monetary Penalty. Section 1857(d)(1)(A)of the Act provides that "ja] participating hospital that negligently violates a requirement of this section is subject to a civil money penalty of not more than $50,000 or not more than $25,000 in the case ofa hospital with less than 100 beds for each such violation." S. Covered Conduct. The OIG conducted an investigation regarding allegations that Respondent had violated section 1867 ofthe Act. Based on its investigation, the OIG concluded that Respondent violated the requirements ofsection 1$b7 ofthe Act on March 4,2013, when Respondent failed to provide treatment to stabilize the emergency psychiatric condition for P.T. before having him criminally charged and transferred to jail. OIG also alleges that Respondent violated EMTALA requirements an March 13,2013, when Respondent failed to provide an appropriate medical screening examination to A.K. before having him criminally charged and sent to jail. In each case a court later ordered each parient to be returned for further needed psychiatric care at Respondent's E.D., and Respondent then provided the needed psychiatric care including treatment ofP.T. for pneumonia and exacerbated bipolar disorder and treatment of A.K. for an acute schizophrenic episode. (Covered Conduct). `This Agreement resolves the OIG's investigation pertaining to these violations. No Admission or Concession. This Agreement is neither an admission of 6. liability by Respondent nor a concession by the OIG that its claims are not well founded. Intent ofParties to Effect Settlement. In order to avoid the uncertainty and 7. expense oflitigation, the Parties agree to resolve this matter according to the terms and conditions delineated below. II. Terms and Conditions P._a n~nent. Respondent agrees to pay to the OIG $50,000 which includes 8. applicable interest($48,750 Settlement Amount plus $1,250 interest at the current 2.5% Medicaze trust fund rate). The first payment of$25,000 shall be made via wire transfer to the United States Department ofHealth and Human.Services according to written instructions provided by OIG. Respondent shall make the first payment no later than five days after the Effective Date. A second remainder payment of$25,000 shall be made via wire transfer by September 1, 2015. Release by OIG. 1n consideration ofthe obligations ofRespondent under 9. this Agreement and conditioned upon Respondent's full payment ofthe Settlement Amount,the DIG releases Respondent from any and all clainns ox causes of action against Respondent for civil monetary penalties or other action under section 1867(d)(1} of the Act,42 U.S.C. § 1395dd(d)(1), for the Covered Conduct. The OIG and HHS do not agree to waive any rights, obligations, or causes of action other than those specifically referred to in this Paragraph. This release is applicable only to Respondent and is not applicable in any manner to any other individual, person, partnership, operation, or entity. 10. Release by Respondent. Respondent shall not contest the Settlement Amount under this Agreement and any other remedy agreed to under this A~eement. Respondent waives all procedural rights granted under the Civil Monetary Penalties Law or EMTALA(42 U.S.C. §§ 1320a-7a and 1395dd), related regulations(42 C.F.R. Part l OQ3), and the HHS claim collections regulations(45 C.F.R. Part 30}, including but not limited to notice, hearing, and appeal with respect to the Settlement Amount. 11. Reservation of Claims. Notwithstanding any term of this Agreement, specifically reserved and excluded from the scope and terms ofthis Agreement as to any entity or person (including Respondent) are the following: a. Any criminal, civil, ox administrative clauns arising under Title 26 U.S. Code (Internal Revenue Code); b. Any criminal liability; 2 c. Except as explicitly stated in this Agreement, any administrative liability, including mandatory and permissive exclusion from Federal health care programs; and d. Any liability to the United States(or its agencies} for any conduct other than the Covered Conduct. 12. Binding on Successors. This Agreement shall be binding on Respondent and the heirs, successors, assigns, and transferees of Respondent. 13. Costs. Each Party to this Agreement shall bear its own legal and other costs incurred in connection with this matter, including the preparation and performance ofthis Agreement. 14. No Additional Releases. This Agreement is intended to be for the benefit ofthe Parties only, and by this instrument the Parties do not release any claims against any other person or entity. 15. Effect of Agreement. This Agreement constitutes the complete agreement between the Parties. All material representations, understandings, and promises ofthe Parties are contained in the Agreement. Any modifications to this Agreement shall be set forth in writing and signed by all Parties. Respondent represents that this Agreement is entered into with the advice of counsel and knowledge ofthe events described herein. Respondent further represents that this Agreement is voluntarily entered into in order to avoid litigation, without any degree of duress or compulsion. 1 ~. Effect:le Date. T't~~ effective Date ofthis Agreement sha?1 He the date of signing by the last signatory. 17. Disclosure. Respondent consents to OIG's disclosure of this Agreement, and information about this Agreement,to the public. 18, Execution in Countezparts. This Agreement maybe executed in counterparts, each of which constitutes an original, and all of which shall constitute ane and the saane agreement. 19. Authorizations. The individuals signing this Agreement on behalf of the Respondent represent and warrant that they are authorized by Respondent to execute this Agreement. The individuals signing this Agreement on behalf ofthe OIG represent and warrant that they are signing this Agreement in their official capacities and that they are authorized to execute this Agreement. RESPONDENT ~y'/ n.~ 3 b Timothy Fold President anal CEO Springfield Hospital Date ~,Z~~`t Date Shireen Hart Counsel for Respondent .Primmer,Piper, Eggleston, &Cramer,PC 4 OFFICE OF INSPECTOR GENERAL Da e Robert K. DeConti Assistant Inspector General for Legal Affairs Office of Counsel to the Inspector General Office of Inspector General U.S. Department of Health and Human Services _`, Lb — ~ — / Date ' 1 ger i ten Sc Senior Counsel Office of Counsel to the Inspector General Office of Inspector General U.S. Department of Health and Human Services