Summit Compliance Training Acknowledgment

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

I certify that I 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

✓ I am NOT currently excluded, debarred, or ineligible from federal/state healthcare programs

✓ I am subject to audit and investigation by Summit, OMIG, MFCU, and other regulatory authorities

✓ I have access to Summit's written compliance policies and procedures upon request

✓ I do not require language or accessibility accommodations at this time

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

I agree to all of the above *

Your Full Name *

Role / Title / Position *

Company/Organization *

Electronic Signature (type your full name) *

By clicking "Submit Acknowledgment" below, I certify that:
• I have read and completed the compliance training dated December 22, 2025
• This electronic signature is legally binding and equivalent to my handwritten signature
• All information provided is true and accurate
• I understand my obligations, the partnership termination clause, and the consequences of non-compliance
• This acknowledgment becomes part of my partnership agreement with Summit Home Health Care