R96-20 AUTHORIZING EXECUTION OF AGREEMENT

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AUTHORIZATION FOR DISCLOSURE OF INFORMATION WHEREAS, representatives of the Blue Cross and Blue Shield Association (BCBSA") acting on behalf of its Member Plans including Blue Cross and Blue Shield of Illinois (`BCBSP') and representatives of the Health Care Financing Administration ("HCFA") and the Department of Justice ("DOJ") have engaged in negotiations and have reached a settlement resolving disputes concerning Medicare Secondary Payer("MSP") Laws and Regulations effective October 15, 1995: and WHEREAS, the Settlement Agreement provides, among other things, a Release from the Federal Government to BCBSI and its wholly-owned subsidiary HMO Illinois (collectively hereinafter referred to as "BCBSI") for MSP claims related to services and supplies provided on or before July 17, 1995 to individuals covered under Employer Group Health Plans ("EGHPs") underwritten or administered by BCBSI (excluding IRS or criminal matters or actions to enforce the Settlement Agreement); and WHEREAS,the Release extends to BCBSI's group accounts to the extent and during the period of the group's association with BCBSI provided such group account cooperates in the Data Match required under the settlement Agreement and provided further that such group account does not seek a refund from Medicare for payments made pursuant to MSP Demand Letters from HCFA, otherwise released under the settlement A�reement: and WHEREAS, the Data Match involves a commitment on behalf of BCBSI to use its best efforts to collect, maintain and provide to HCFA on a periodic basis, membership data regarding individuals who are enrolled in EGHPs as employees, or who are beneficiaries of coverage through employees enrolled in EGHPs, which BCBSI insures or administers and who are also Medicare-eligible; and WHEREAS, the Settlement Agreement also requires BCBSI among other things, to assist HCFA in identifying duplicate primary payments to providers, physicians and other suppliers ("Providers") by a one-time search through current paid claim files to identify those claims for which BCBSI made a primary payment relating to Medicare beneficiaries. NOW, THEREFORE, the Group identified below("Group") hereby agrees as follows: I. The Group hereby authorizes and directs BCBSI to disclose to HCFA periodically, as required by HCFA, the information contained on Exhibit I of this Authorization pertaining to Medicare-eligible individuals covered under the EGHP(s) of the Group administered by BCBSL The Group further agrees to cooperate, and to require and facilitate its employees' cooperation, in supplying to BCBSI the information contained in Attachment I.