SETTLEMENT AGREEMENT
This Settlement Agreement (“Agreement”) is entered into among and through the
authorized representatives of: (1) the United States of America, acting through the United States
Department of Justice and on behalf of the Office of Inspector General (OIG-HHS) of the
Department of Health and Human Services (HHS); the Defense Health Agency (DHA), acting on
behalf of the TRICARE program; the Office of Personnel Management (OPM), which
administers the Federal Employees Health Benefits Program (FEHBP); and the Office of
Workers’ Compensation Programs of the United States Department of Labor (DOL-OWCP)
(collectively, the “United States”); (2) Emil DiIorio M.D. (Dr. DiIorio); and (3) and Coordinated
Health Holding Company, LLC, together with its direct and indirect subsidiaries, including but
not limited to CHS Professional Practice, P.C. and CH Hospital of Allentown, LLC (collectively
“Coordinated Health”). The United States, Dr. DiIorio, and Coordinated Health are hereafter
collectively referred to as “the Parties.”
RECITALS
A.

Coordinated Health is a for-profit hospital and health system based in the Lehigh

Valley region of Pennsylvania that employs approximately 100 physicians, approximately 30 of
whom are board-certified orthopedic surgeons.
B.

Dr. DiIorio, a board-certified orthopedic surgeon, is the founder, principal owner,

and Chief Executive Officer of Coordinated Health.
C.

At material times, Coordinated Health and Dr. DiIorio submitted or caused to be

submitted claims for payment to: the Medicare Program, 42 U.S.C. §§ 1395-1395kkk-1
(“Medicare”); the Medicaid Program, 42 U.S.C. §§ 1396-1396w-5 (“Medicaid”); the TRICARE
Program, 10 U.S.C. §§ 1071-1110b (“TRICARE”); the FEHBP, 5 U.S.C. §§ 8901-8914; and the

 DOL-OWC Program, the Federal Employees’ Compensation Act 5 U.S.C. § 8101 et seq.
(“FECA”) (collectively “Federal Healthcare Programs”).
D.

The United States contends that it has certain civil claims against Coordinated

Health arising from Coordinated Health’s requests for payment from Federal Healthcare
Programs. Specifically, the United States contends that:
1.

Medical providers in the United States use American Medical

Association-defined Current Procedural Terminology (CPT) codes when requesting
reimbursement from Federal Healthcare Programs for rendered services and performed
procedures.
2.

Many orthopedic surgical procedures have a designated “global” CPT

code that encompasses reimbursement for the entire surgery, including all of its
component surgical steps. In those cases, a provider should request reimbursement for
the global code and not request nor receive reimbursement for components of the surgery
that overlap with and are included within the global code.
3.

HHS’s Centers for Medicaid and Medicare Services (CMS) implemented

National Correct Coding Initiative (NCCI) edits to automatically block reimbursement
for codes that should not be billed together for the same procedure (e.g., the global
surgery code plus a code seeking additional reimbursement for a component of the
surgery). The NCCI edits were in place from January 1, 2007 through May 31, 2014.
4.

If a provider performs separate and distinct procedures on the same patient

on the same day, the provider can bill the second procedure with a billing code, Modifier
59, to indicate that it was a “distinct procedural service” and therefore separately
reimbursable and not subject to NCCI edits.

2

 5.

A provider improperly “unbundles” a reimbursement claim when the

provider uses Modifier 59 to bypass an NCCI edit in order to obtain reimbursement for
overlapping services that should have been included in a global surgery claim.
6.

From January 1, 2007 through May 31, 2014, Coordinated Health used

Modifier 59 to submit thousands of improperly unbundled claims for orthopedic surgeries
to Federal Health Care Programs. Coordinated Health thereby received (and then
retained) millions of dollars in overpayments from Federal Health Care Programs.
7.

In 2011, Coordinated Health retained a third-party consultant (Auditor A)

to audit a small sample (9 patients) of the company’s surgery coding for Dr. DiIorio and
one other of its orthopedic surgeons.
8.

In March 2011, Auditor A conducted a coding audit of 18 patient records

(77 claim lines) comprised of surgeries performed by Dr. DiIorio (9 patients) and another
Coordinated Health orthopedic surgeon (9 patients). Auditor A’s report listed
“Unbundling of Procedures” as its first finding and explained that “Several CPT Codes
were reported separately but were integral to the more comprehensive code.” The report
provided information regarding NCCI bundling edits and a link to NCCI information on a
CMS website. On March 31, 2011, the Director of Coordinated Health’s Central Billing
Office forwarded the report by email to Coordinated Health’s President, Chief Financial
Officer, and Director of Orthopedics. The email stated, among other things, that Auditor
A found “Routine unbundling of codes…particularly evident”, that “this should not be
considered a revenue opportunity”, and that “under an audit it is likely we could have
paybacks and penalties for routine unbundling particularly when the documentation does
not support it.” However, Coordinated Health: (a) continued to improperly use Modifier
59 to unbundle orthopedic surgery claims and (b) retained resulting overpayments.

3

 9.

In 2013, Coordinated Health retained a different third-party consultant

(Auditor B) to perform a coding audit of its orthopedic surgery coding. Auditor B
reviewed medical records for over 800 orthopedic surgery claim lines.
10.

In October 2013, Auditor B issued a report stating, under a “major

findings” heading, that “Professional and technical claims contain codes for services
rendered that would be considered unbundled and not pass Correct Coding Initiative
(“CCI”) edits.” The report recommended, among other things, that Coordinated Health
conduct further chart reviews, ascertain the scope of the problem, and self-report and readjudicate improperly unbundled claims to Medicare and other federal healthcare
programs.
11.

By email on November 4, 2013, Coordinated Health’s Chief Financial

Officer, Revenue Manager, Reimbursement Manager, and multiple Coordinated Health
coders received a copy of Auditor B’s report.
12.

On November 6, 2013, Auditor B provided on-site training to Coordinated

Health coders on orthopedic surgery coding topics. As part of this training, Auditor B
instructed Coordinated Health coders on the correct use of Modifier 59. However,
Coordinated Health continued to routinely unbundle orthopedic surgery procedures by
using Modifier 59 through May 31, 2014.
13.

Coordinated Health never repaid Federal Healthcare Programs for the

overpayments resulting from its improper unbundling with Modifier 59.
14.

Coordinated Health violated the False Claims Act by using Modifier 59 to

submit false and improper claims to Federal Healthcare Programs, and by improperly
retaining resulting overpayments. 31 U.S.C. § 3729(a)(1)(A), (G).

4

 E.

The United States further contends that it has certain civil claims against Dr.

DiIorio arising from his billing for orthopedic surgeries. Specifically, the United States contends
that:
1.

Beginning on April 1, 2009, and continuing until Dr. DiIorio stopped

performing surgeries in 2012, Coordinated Health used Modifier 59 to improperly
unbundle claims connected to orthopedic surgeries performed by Dr. DiIorio, including
joint replacement surgeries and arthroscopic shoulder surgeries.
2.

As Coordinated Health’s Chief Executive Officer, Dr. DiIorio knew, or

should have known, that Coordinated Health was using Modifier 59 to improperly
unbundle orthopedic surgery claims, including his own. Dr. DiIorio failed to stop
Coordinated Health’s improper unbundling.
3.

Beginning on April 1, 2009, Dr. DiIorio took steps to enable those under

his supervision to improperly unbundle billings for his surgeries, and therefore
improperly increased his reimbursements.
4.

For example, Dr. DiIorio increased unbundling for his surgeries by

materially changing how he described his total knee replacement surgeries in operative
reports.
5.

A “lateral retinacular release” procedure is intended to improve patellar

tracking through an incision of connective tissue in the knee called the lateral
retinaculum. Although this can be a stand-alone procedure, it can also, if necessary, be
indicated during a knee replacement to address patellar maltracking over the prosthetic
knee. When performed as part of a knee replacement, the lateral retinacular release is
included in the global CPT reimbursement code for the knee replacement and may not be
billed separately through use of Modifier 59 or otherwise.

5

 6.

Before April 1, 2009, Dr. DiIorio rarely listed patellar maltracking as a

diagnosis in his knee replacement operative reports.
7.

Before April 1, 2009, Dr. DiIorio stated, in the vast majority of his total

knee replacement operative reports, that the patient’s patella tracked well over the
prosthetic knee without a lateral retinacular release.
8.

After April 1, 2009, Dr. DiIorio listed patellar maltracking as a diagnosis

in the vast majority of his knee replacement operative reports.
9.

After April 1, 2009, Dr. DiIorio stated that he performed a lateral

retinacular release in the vast majority of his total knee replacement operative reports.
10.

In each case where Dr. DiIorio stated that he performed a lateral release,

Coordinated Health improperly used Modifier 59 to submit two separate claims – one for
a total knee replacement, and another for a lateral retinacular release – and thereby
misrepresented to Federal Healthcare Programs that the claims were distinct.
11.

Dr. DiIorio violated the False Claims Act by causing false claims to be

submitted to Federal Healthcare Programs with Modifier 59. 31 U.S.C. § 3729(a)(1)(A).
F.

The term “Coordinated Health Covered Conduct,” as it is used in this agreement,

shall mean Coordinated Health’s submission of orthopedic surgery claim lines with Modifier 59
to Federal Healthcare Programs from January 1, 2007 through May 31, 2014.
G.

The phrase “orthopedic surgery claim lines,” as it is used in this agreement, shall

mean claim lines seeking reimbursement for CPT codes 20000 through 29999.
H.

The term “DiIorio Covered Conduct,” as it is used in this agreement, shall mean

orthopedic surgery claim lines submitted with Modifier 59 to Federal Healthcare Programs from
April 1, 2009 through December 31, 2012 for orthopedic surgeries performed by Dr. DiIorio.

6

 I.

This Agreement is made in compromise of disputed claims. Coordinated Health

and Dr. DiIorio expressly deny the allegations of the United States and deny that they engaged in
any wrongful conduct in connection with the Covered Conduct. This Agreement is not an
admission of facts or liability by Coordinated Health or Dr. DiIorio, nor a concession by the
United States that its claims are not well-founded.
To avoid the delay, uncertainty, inconvenience, and expense of protracted litigation of the
above claims, and in consideration of the mutual promises and obligations of this Settlement
Agreement, the Parties agree and covenant as follows:
TERMS AND CONDITIONS
1.

Coordinated Health shall pay to the United States ELEVEN MILLION TWO

HUNDRED FIFTY THOUSAND DOLLARS ($11,250,000) (“Coordinated Health Settlement
Amount”), of which FIVE MILLION DOLLARS ($5,000,000) is restitution, and interest on the
Coordinated Health Settlement Amount at a rate of 2.875% annually from July 25, 2018, no later
than SIXTY (60) days after the Effective Date of this Agreement by electronic funds transfer
pursuant to written instructions to be provided by the Office of the United States Attorney for the
Eastern District of Pennsylvania.
2.

Dr. DiIorio shall pay to the United States ONE MILLION TWO HUNDRED

FIFTY THOUSAND DOLLARS ($1,250,000) (“DiIorio Settlement Amount”), of which FIVE
HUNDRED FIFTY THOUSAND DOLLARS ($550,000) is restitution, and interest on the Dr.
DiIorio Settlement Amount at a rate of 2.875% annually from July 25, 2018, no later than
SIXTY (60) days after the Effective Date of this Agreement by electronic funds transfer pursuant
to written instructions to be provided by the Office of the United States Attorney for the Eastern
District of Pennsylvania.

7

 3.

Subject to the exceptions in Paragraph 9 (concerning excluded claims) below, and

conditioned upon Coordinated Health’s full payment of the Coordinated Health Settlement
Amount, the United States releases Coordinated Health, together with its current and former
parent corporations; direct and indirect subsidiaries; brother or sister corporations; divisions and
affiliates; and its predecessors, successors, transferees and assigns of any of them, from any civil
or administrative monetary claim the United States has for the Coordinated Health Covered
Conduct under the False Claims Act, 31 U.S.C. §§ 3729-3733; the Civil Monetary Penalties
Law, 42 U.S.C. §1320a-7a; the Program Fraud Civil Remedies Act, 31 U.S.C. §§3801-3812; any
statutory provision creating a cause of action for civil damages or civil penalties which the Civil
Division of the Department of Justice has actual or present authority to assert and compromise
pursuant to 28 C.F.R. Pt. 0, Subpart I, 0.45(d); and the common law theories of payment by
mistake, unjust enrichment and fraud.
4.

Subject to the exceptions in Paragraph 9 (concerning excluded claims) below, and

conditioned upon Dr. DiIorio’s full payment of the DiIorio Settlement Amount, the United States
releases Dr. DiIorio from any civil or administrative monetary claim the United States has for the
DiIorio Covered Conduct under the False Claims Act, 31 U.S.C. §§ 3729-3733; the Civil
Monetary Penalties Law, 42 U.S.C. §1320a-7a; the Program Fraud Civil Remedies Act, 31
U.S.C. §§3801-3812; any statutory provision creating a cause of action for civil damages or civil
penalties which the Civil Division of the Department of Justice has actual or present authority to
assert and compromise pursuant to 28 C.F.R. Pt. 0, Subpart I, 0.45(d); and the common law
theories of payment by mistake, unjust enrichment, disgorgement, and fraud.
5.

In consideration of the obligations of Coordinated Health in this Agreement and

the Corporate Integrity Agreement (CIA), entered into between OIG-HHS and Coordinated
Health, and conditioned upon Coordinated Health’s full payment of the Coordinated Health

8

 Settlement Amount, the OIG-HHS agrees to release and refrain from instituting, directing, or
maintaining any administrative action seeking exclusion from Medicare, Medicaid, and other
Federal health care programs (as defined in 42 U.S.C. § 1320a-7b(f)) against Coordinated Health
under 42 U.S.C. § 1320a-7a (Civil Monetary Penalties Law) or 42 U.S.C. § 1320a-7(b)(7)
(permissive exclusion for fraud, kickbacks, and other prohibited activities) for the Coordinated
Health Covered Conduct, except as reserved in this Paragraph and in Paragraph 9 (concerning
excluded claims), below. The OIG-HHS expressly reserves all rights to comply with any
statutory obligations to exclude Coordinated Health from Medicare, Medicaid, and other Federal
health care programs under 42 U.S.C. § 1320a-7(a) (mandatory exclusion) based upon the
Coordinated Health Covered Conduct. Nothing in this Paragraph precludes the OIG-HHS from
taking action against entities or persons, or for conduct and practices, for which claims have been
reserved in Paragraph 9, below.
6.

In consideration of the obligations of Coordinated Health in this Agreement, and

conditioned upon Coordinated Health’s full payment of the Coordinated Health Settlement
Amount, OPM agrees to release and refrain from instituting, directing, or maintaining any
administrative action seeking exclusion from the FEHBP against Coordinated Health under 5
U.S.C. § 8902a or 5 C.F.R. Part 890 Subpart J or Part 919 for the Coordinated Health Covered
Conduct, except as reserved in this Paragraph and in Paragraph 9 (concerning excluded claims),
below, and except if excluded by the OIG-HHS pursuant to 42 U.S.C. § 1320a-7(a). OPM
expressly reserves all rights to comply with any statutory obligation to debar Coordinated Health
from the FEHBP under 5 U.S.C. § 8902a(b) (mandatory exclusion) based upon the Coordinated
Health Covered Conduct. Nothing in this Paragraph precludes OPM from taking action against
entities or persons, or for conduct and practices, for which claims have been reserved in
Paragraph 9, below.

9

 7.

In consideration of the obligations of Coordinated Health set forth in this

Agreement, and conditioned upon Coordinated Health’s full payment of the Coordinated Health
Settlement Amount, DHA agrees to release and refrain from instituting, directing, or maintaining
any administrative action seeking exclusion from the TRICARE Program against Coordinated
Health under 32 C.F.R. § 199.9 for the Coordinated Health Covered Conduct, except as reserved
in this Paragraph and in Paragraph 9 (concerning excluded claims), below. DHA expressly
reserves authority to exclude Coordinated Health from the TRICARE Program under 32 C.F.R.
§§ 199.9 (f)(1)(i)(A), (f)(1)(i)(B), and (f)(1)(iii) (mandatory exclusion), based upon the
Coordinated Health Covered Conduct. Nothing in this Paragraph precludes DHA or the
TRICARE Program from taking action against entities or persons, or for conduct and practices,
for which claims have been reserved in Paragraph 9, below.
8.

In consideration of the obligations of Coordinated Health in this Agreement, and

conditioned upon Coordinated Health’s full payment of the Coordinated Health Settlement
Amount, DOL-OWCP agrees to release and refrain from instituting, directing, or maintaining
any administrative action seeking exclusion and debarment from the FECA program against
Coordinated Health under 20 C.F.R. §§ 10.815 for the Coordinated Health Covered Conduct,
except as reserved in Paragraph 9 (concerning excluded claims), below, and except if excluded
by the OIG-HHS pursuant to 42 U.S.C. § 1320a 7(a). Nothing in this Paragraph precludes the
DOL-OWCP from taking action against entities or persons, or for conduct and practices, for
which claims have been reserved in Paragraph 9, below.
9.

Notwithstanding the releases given in paragraphs 3 and 4 of this Agreement, or

any other term of this Agreement, the following claims of the United States are specifically
reserved and are not released:
a.

Any liability arising under Title 26, U.S. Code (Internal Revenue Code);

10

 b.

Any criminal liability;

c.

Except as explicitly stated in this Agreement, any administrative liability,
including mandatory or permissive exclusion from Federal health care
programs;

d.

Any liability to the United States (or its agencies) for any conduct other
than the Coordinated Health Covered Conduct or the DiIorio Covered
Conduct;

e.

Any liability based upon obligations created by this Agreement;

f.

Any liability of individuals other than the release specifically provided in
this agreement for the DiIorio Covered Conduct;

g.

Any liability for express or implied warranty claims or other claims for
defective or deficient products or services, including quality of goods and
services;

h.

Any liability for failure to deliver goods or services due; and

i.

Any liability for personal injury or property damage or for other
consequential damages arising from the Covered Conduct.

10.

Coordinated Health and Dr. DiIorio each waives and shall not assert any defenses

each may have to any criminal prosecution or administrative action relating to the Coordinated
Health Covered Conduct and/or the DiIorio Covered Conduct that may be based in whole or in
part on a contention that, under the Double Jeopardy Clause in the Fifth Amendment of the
Constitution, or under the Excessive Fines Clause in the Eighth Amendment of the Constitution,
this Agreement bars a remedy sought in such criminal prosecution or administrative action.
11.

Coordinated Health and Dr. DiIorio both fully and finally release the United

States, its agencies, officers, agents, employees, and servants, from any claims (including

11

 attorney’s fees, costs, and expenses of every kind and however denominated) that Coordinated
Health and/or Dr. DiIorio have asserted, could have asserted, or may assert in the future against
the United States, and its agencies, officers, agents, employees, and servants related to the
Coordinated Health Covered Conduct and/or the DiIorio Covered Conduct and the United States’
investigation and prosecution thereof.
12.

The Settlement Amount shall not be decreased as a result of the denial of claims

for payment now being withheld from payment by any Medicare contractor (e.g., Medicare
Administrative Contractor, fiscal intermediary, carrier), Tricare, FEHBP, or any state payer,
related to the Coordinated Health Covered Conduct or DiIorio Covered Conduct; and
Coordinated Health agrees not to resubmit to any Medicare contractor, Tricare, FEHBP, or any
state payer any previously denied claims related to the Coordinated Health Covered Conduct,
agrees not to appeal any such denials of claims, and agrees to withdraw any such pending
appeals.
13.

Coordinated Health and Dr. DiIorio agree to the following:
a.

Unallowable Costs Defined: All costs (as defined in the Federal

Acquisition Regulation, 48 C.F.R. § 31.205-47; and in Titles XVIII and XIX of the Social
Security Act, 42 U.S.C. §§ 1395-1395kkk-1 and 1396-1396w-5; and the regulations and official
program directives promulgated thereunder) incurred by or on behalf of Dr. DiIorio and/or
Coordinated Health, its present or former officers, directors, employees, shareholders, and agents
in connection with:
(1)

the matters covered by this Agreement;

(2)

the United States’ audit(s) and civil investigation(s) of the matters covered
by this Agreement;

12

 (3)

Dr. DiIorio’s investigation, defense, and corrective actions undertaken in
response to the United States’ audit(s) and civil and any criminal
investigation(s) in connection with the matters covered by this Agreement
(including attorney’s fees);

(4)

Coordinated Health’s investigation, defense, and corrective actions
undertaken in response to the United States’ audit(s) and civil and any
criminal investigation(s) in connection with the matters covered by this
Agreement (including attorney’s fees);

(5)

the negotiation and performance of this Agreement;

(6)

the payments Dr. DiIorio and Coordinated Health make to the United
States pursuant to this Agreement; and

(7)

the negotiation of, and obligations undertaken pursuant to the CIA to: (i)
retain an independent review organization to perform annual reviews as
described in Section III of the CIA; and (ii) prepare and submit reports to
the OIG-HHS,

are unallowable costs for government contracting purposes and under the Medicare Program,
Medicaid Program, TRICARE Program, and Federal Employees Health Benefits Program
(FEHBP) (hereinafter referred to as Unallowable Costs). However, nothing in paragraph 12.a.(7)
that may apply to the obligations undertaken pursuant to the CIA affects the status of costs that
are not allowable based on any other authority applicable to Coordinated Health or Dr. DiIorio.
b.

Future Treatment of Unallowable Costs: Unallowable Costs shall be

separately determined and accounted for in nonreimbursable cost centers by Coordinated Health,
and Coordinated Health shall not charge such Unallowable Costs directly or indirectly to any
contracts with the United States or any State Medicaid program, or seek payment for such

13

 Unallowable Costs through any cost report, cost statement, information statement, or payment
request submitted by Coordinated Health or any of its subsidiaries or affiliates to the Medicare,
Medicaid, TRICARE, or FEHBP Programs.
c.

Treatment of Unallowable Costs Previously Submitted for Payment:

Coordinated Health further agrees that within 90 days of the Effective Date of this Agreement it
shall identify to applicable Medicare and TRICARE fiscal intermediaries, carriers, and/or
contractors, and Medicaid and FEHBP fiscal agents, any Unallowable Costs (as defined in this
Paragraph) included in payments previously sought from the United States, or any State
Medicaid program, including, but not limited to, payments sought in any cost reports, cost
statements, information reports, or payment requests already submitted by Coordinated Health or
any of its subsidiaries or affiliates, and shall request, and agree, that such cost reports, cost
statements, information reports, or payment requests, even if already settled, be adjusted to
account for the effect of the inclusion of the unallowable costs. Coordinated Health agrees that
the United States, at a minimum, shall be entitled to recoup from Coordinated Health any
overpayment plus applicable interest and penalties as a result of the inclusion of such
Unallowable Costs on previously-submitted cost reports, information reports, cost statements, or
requests for payment.
Any payments due after the adjustments have been made shall be paid to the United
States pursuant to the direction of the Department of Justice and/or the affected agencies. The
United States reserves its rights to disagree with any calculations submitted by Coordinated
Health or any of its subsidiaries or affiliates on the effect of inclusion of Unallowable Costs (as
defined in this Paragraph) on Coordinated Health or any of its subsidiaries or affiliates’ cost
reports, cost statements, or information reports.

14

 d.

Nothing in this Agreement shall constitute a waiver of the rights of the

United States to audit, examine, or re-examine Coordinated Health’s books and records to
determine that no Unallowable Costs have been claimed in accordance with the provisions of this
Paragraph.
14.

This Agreement is intended to be for the benefit of the Parties only. The Parties

do not release any claims against any other person or entity, except to the extent provided for in
Paragraph 15 (waiver for beneficiaries paragraph), below.
15.

Coordinated Health and Dr. DiIorio agree that they waive and shall not seek

payment for any of the health care billings covered by this Agreement from any health care
beneficiaries or their parents, sponsors, legally responsible individuals, or third party payors
based upon the claims defined as Coordinated Health Covered Conduct and DiIorio Covered
Conduct.
16.

Each Party shall bear its own legal and other costs incurred in connection with

this matter, including the preparation and performance of this Agreement.
17.

Each party and signatory to this Agreement represents that it freely and

voluntarily enters in to this Agreement without any degree of duress or compulsion.
18.

This Agreement is governed by the laws of the United States. The exclusive

jurisdiction and venue for any dispute relating to this Agreement is the United States District
Court for the Eastern District of Pennsylvania. For purposes of construing this Agreement, this
Agreement shall be deemed to have been drafted by all Parties to this Agreement and shall not,
therefore, be construed against any Party for that reason in any subsequent dispute.
19.

This Agreement constitutes the complete agreement between the Parties. This

Agreement may not be amended except by written consent of the Parties.

15

 20.

The undersigned counsel represent and warrant that they are fully authorized to

execute this Agreement on behalf of the persons and entities indicated below.
21.

This Agreement may be executed in counterparts, each of which constitutes an

original and all of which constitute one and the same Agreement.
22.

This Agreement is binding on Coordinated Health’s successors, transferees, heirs,

and assigns.
23.

This Agreement is binding on Dr. DiIorio’s successors, transferees, heirs, and

assigns.
24.

All parties consent to the United States’ disclosure of this Agreement, and

information about this Agreement, to the public.
25.

This Agreement is effective on the date of signature of the last signatory to the

Agreement (Effective Date of this Agreement). Facsimiles and electronic transmissions of
signatures shall constitute acceptable, binding signatures for purposes of this Agreement.

16

 THE UNITED STATES OF AMERICA

DATED:

I :2./, 1,/;
, J-

BY:

1,J ~ # l ~
WILLIAM M. McSWAIN
United States Attorney

c- ~

, -

,D

~~~

Assist nt U · ed States Attorney
Depu
1ef, Civil Division

ei& ~

T. CRUTCHLOW
:slant United States Attorney

BY:

Q; 8afal /(.Q
LISA M. RE
Assistant Inspector General for Legal Affairs
Office of Counsel to the Inspector General
Office of Inspector General
United States Department of Health and Human Services

DATED: _ __

BY:
LEIGH A. BRADLEY
General Counsel
Defense Health Agency
United States Department of Defense

DATED: _ _ __

BY:
EDWARD M. DEHARDE
Assistant Director of Federal Employee
Insurance Operations
Healthcare and Insurance
United States Office of Personnel Management

DATED: - - - -

BY:
PAUL N. ST. HILLAIRE
Acting Assistant Inspector General for Legal Affairs
United States Office of Personnel Management

17

 THE UNITED STATES OF AMERICA
DATED: _ _ __

BY:
WILLIAM M. McSWAIN
United States Attorney

GREGORY B. DAVID
Assistant United States Attorney
Chief, Civil Division
·

CHARLENE KELLER FULLMER
Assistant United States Attorney
Deputy Chief, Civil Division

JOHN T. CRUTCHLOW
Assistant United States Attorney
DATED: _ _ __

BY:
LISA M.RE
Assistant Inspector General for Legal Affairs
Office of Counsel to the Inspector General
Office oflnspcctor General
United States Department of Health and Human Services

DATED: 11/30/2018

BY:

BLEY•PAUL ' NICHOLAS
• 1099873821

_

Digitallysignedby
BLEY.PAUL.NICHOLAS.1099873821
Date:2018.1 13017:37:37-05'00'

LEIGH A. BRADLEY
General Counsel
Defense Health Agency
United States Department of Defense

for

BY:

DATED :

EDWARD M. DEHARDE
Assistant Director of Federal Employee
Insurance Operations
Healthcare and Insurance
United Stales Office of Personnel Management
DATED: _ __

_

BY:
PAUL N. ST. HILLAIRE
Acting Assistant Inspector General for Legal A ffairs
United States Office of Personnel Management

17

 THE UNITED STATES OF AMERICA
DA1ED: _ _ __

BY:

WILLIAM M. McSWAIN
United States Attorney
GREGORY B. DAVID
Assistant United States Attorney
Chief, Civil Division

CHARLENE KELLER FULLMER
Assistant United States Attorney
Deputy Chief, Civil Division
JOHN T. CRUTCHLOW
Assistant United States Attorney
DATED: _ __ _

BY:

LISAM.RE
Assistant Inspector General for Legal Affairs
Office of Counsel to the Inspector General
Office of Inspector General
United States Department of Health and Human Services
DATED: _ __

BY:

LEIGH A. BRADLEY

EDWARD M. DEHARDE
Assistant Director of Federal Employee
Insurance Operations
Healthcare and Insurance
United States Office of Personnel Management
DATED: _ _ __

BY:

PAUL N. ST. HILLAIRE
Acting Assistant Inspector General for Legal Affairs
United States Office of Personnel Management

17

 THE UNITED STATES O:D' AMERICA
DATED: _ _ __

BY:
WILLIAM M. McSWAIN
United States Attomey
GREGORY B. DAVID
Assistant United States Attorney
Chief, Civil Division ·
CHARLENE KELLER FULLMER
Assistant United States Attomoy
Deputy Chief, Civil Division
JORN T. CRUTCHLOW
Assistant United States Attorney

DATED: _ _ __

BY:
LISAM.RE

Assistant Inspector General for Legal Affairs
Office of Counsel to the rnspector General
Office of Inspector General
United States Department of Health and Human Services
DATED: _ _ _ _

BY:
LEIGH A. BRADLEY
General Counsel
Defense Health Agency
United States Department of Defense

DATED: _ _ __

DATED:#

BY:
EDWARD M. DEHARDE
Assistant Director of Federal Employee
Insurance Operations
Healthcare and Insurance
ffice of P
United
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Acting Assistant Inspector General for Legal Affairs
United States Office of Personnel Management

17

 DATED:

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BY·

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Deputy Director for Program Integrity
Office of Workers' Compensation Programs
Division of Federal Employees' Compensation
United Stat.es Department of Labor

DATED: _ _ __

BY:
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Presid and Chief Operating Officer
CoordinatodHealth Holding Company. LLC
CHS Professional Practice, P.C.
CH Hospital of Allentown, LLC
BY:

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psteltt Becker Green. P. C:

Counsel for Coordinated Health Holding Company. LLC

11/28/2018
DATED: _ _ __

orio,M.D.
11/28/2018

DATED:----.

BY:

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Wick Sollers
Dan Sale
King & Spalding, LLP
Collllsel for Emil Diiorio, M.D.

18