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CONFIDENTIAL AND PROPRIETARY Client Indian Rivt!r County Arnenditicrit Number P201710013626 SCHEDULE IA SCOPE OF SERVICES-SUPPLEMENTAL PAYMENT RECOVERY ASSISTANCE SERVICES The Terms and Conditions or the Agreement and this Schedule apply to all services rendered by PST under this Schedule. 1. TERM 1.1 Initial Term ol'Schedule. The initial term or this Schedule is three years (the "Schedule Term-) beginning December 1.2016(the-Commencement Date'*). 1.2 Automatic Renewal, This Schedule will automatically renew for one year terms unless (i) either puny delivers to the other written notice of termination at least 90 days prior to the expiration of the then-current term.or(ii)as otherwise set lbrth in the Agreement. 1.3 No Cause Termination. Either party may terminate this Schedule IA at any time and lbr any reason or no reason upon 90 days prior written notice to the other party, 2 SCOPE OF SERVICES 2.1 S..pM. PST will provide supplemental payment assistant services as specified below based on intormation provided by Client for professional ambulance services rendered by Client in accordance with the terms of the Agreement and this Schedule. 2.2 Responsibilities Each party agrees to perform its respective responsibilities identified below in a timely and diligent manner. Client acknowledges and agrees that PST's performance or the Services described herein is dependent upon Client's performance of its responsibilities as set forth in this SchLdulc. 2.2.1 PST Rg§nonsibi I i ties. As part of the PST's Supplemental Payment Assistance Services, PST's responsibilities under this Schedule will include. (a) Advising and assisting Client with enrolling in the rloridu Ambulance Supplemental Payment Program: (b) Assisting Client with enrolling in the Florida Ambulance Supplemental Payment Program (C) Managing the program applications and required cost reports lbr Client in accordance with the ASPP: (d) Managing the ASPP pre-Lost report submittal process for Client. which may also include: • Developing and submitting the Provider Approval materials to the Florida Agency ror Health Cart: Administration ("Al-ICA-) agency on behalf of Client: • Developing and submitting the Cost Allocation Model and Report to ARCA on behall'orClient for rekie%% as pan ol'thc ASPP; • Changing and finalizing the Cost Allocation Model during AHCA's rc%ic"ol' the Cost Allocation Model and Report. to meet AHCA*s requirements to move forward with the cost report submittal. (e) Assisting Client in developing cost models for LNIS transports for submission to ASPP; (i) Assisting Client with submitting other annual reports as my required by the ASPP; (g) Ensuring that cost report preparer(s)engaged on behalf ol'Client by PST are ccrti fied in accordance with all applicable rules.laws and regulations:and (h) Ensuring that it utilizes separate stall for all billing and cost report preparation services provided to Client. 2.2.2 Client Responsibilities. Client acknowledges and understands that inaccurate or false data submissions, even advertent ones, can lead to a false claim charge or Medicaid program exclusion. Therefore.Client agrees that it will use best ell'orts to: ,v;r 2 4 3