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Provider, and by vhich Carle Clinic rill compensate Provider for <br /> De�onstration Services rendered to Patiente. <br /> NOW THEREFORE, in consideration of the promises hereinafter set <br /> forth, the above-stated recitals, rhich ere incorporated herein by this <br /> reference, and other veluable coneideretion, the adequacy and receipt of <br /> �hich ie hereby acknorledged, Carle Clinic and Provider agree as follors: <br /> SECTION I - GEHERAL PURPOSE <br /> 1. 1 The intent of thie Agreement is to establish a har�onious <br /> relationship betMeen the Partfes in regard to arranging for and paying for <br /> the provision of Demonstration Services and treat�ent of Patients rho elect <br /> to receive such Demonstration Services from Provider. <br /> SECTIOH II - ELIGIBILITY REDUIREHENTS <br /> 2. 1 The Patient �ust be entitled to both Part A and Part B of <br /> Medicere or to Medicaid. <br /> 2.2 The Patient �uet have e pri�ary diagnosis of Alzheimer'B <br /> disease or related disorder ■ade by e physician. <br /> 2.3 The Petient muet reside Mithin the Demonstration site's <br /> catchment area end muat not be inetitutionalized. <br /> 2.4 The Patient �uet require case �anagement and services for <br /> functional dieabilities or cognitive impairments. <br /> 2.5 The Patient and/or their representative must agree to <br /> participate in the Demonstration and have a signed informed consent <br /> statenent on record. <br /> 2.6 The Patient and/or their representative wust egree to a 20X <br /> co-pay�ent for Demonstration Services. <br /> -2- <br />