Summit Compliance Training Acknowledgment

Thank you for completing the compliance training.
Please review the items below and provide your acknowledgment.

By signing below, the undersigned certifies on behalf of their organization and its employees that they have read and understand:

✓ My obligations under Summit's compliance program and identified risk areas

✓ How to report compliance issues through multiple channels (confidential hotline and anonymous online form) and retaliation protections

✓ Federal False Claims Act (31 U.S.C. §§ 3729-3733) and penalties up to $27,894 per claim plus treble damages

✓ New York State False Claims Act (State Finance Law §§ 187-194) and civil penalties

✓ New York State criminal laws related to Medicaid fraud (Penal Law Articles 155, 175, 176, 177)

✓ Whistleblower protections under federal and state law (FCA § 3730(h), NYS Labor Law §§ 740, 741)

✓ Consequences of non-compliance including termination of services and legal action

✓ Partnership termination clause: Summit may terminate services for cause including exclusion from healthcare programs, failure to comply with laws, or violation of compliance policies

✓ Neither the organization nor any of its employees or agents providing services to Summit are currently excluded, debarred, or ineligible from federal/state healthcare programs

✓ As a participant in the Medicaid supply chain, the organization may be subject to review by federal and state regulatory authorities including OMIG, MFCU, and HHS-OIG

✓ Summit's written compliance policies and procedures are available upon request

✓ No language or accessibility accommodations are required at this time

If you require accommodations (language assistance, accessibility needs, etc.):

The undersigned agrees to all of the above on behalf of their organization *

Full Name of Signatory *

Role / Title / Position *

Company/Organization *

Electronic Signature (type your full name) *

By clicking "Submit Acknowledgment" below, the undersigned certifies on behalf of their organization that:
• The annual compliance training materials have been read and understood
• This electronic signature is legally binding and equivalent to a handwritten signature
• All information provided is true and accurate
• The organization and its employees understand their obligations, the partnership termination clause, and the consequences of non-compliance
• This acknowledgment becomes part of the organization's partnership agreement with Summit Home Health Care