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EXHIBIT A <br /> RE: NC Breast and Cervical Cancer Program <br /> This letter outlines the reimbursement terms and conditions whereby UNC <br /> Faculty Physicians (UNC FP) will provide services associated with the NC Breast <br /> and Cervical Cancer Program as outlined on the "North Carolina Breast and <br /> Cervical Cancer Control Program 2013-14 Fee Schedule" (Fee Schedule), <br /> attached hereto as Attachment 1. Patients will be referred by the Orange County <br /> Health Department (OCHD). Services shall be performed at UNC's clinics <br /> located at 101 Manning Drive, Chapel Hill, North Carolina, 27514. All UNC FP <br /> physicians performing services under this Agreement shall be Board Eligible or <br /> Board Certified OB-GYNs. UNC FP shall comply with State regulations and local <br /> medical standards. This letter will cover services provided on dates of service <br /> between July 1, 2013 and June 30, 2014. For these services, UNC FP agrees to <br /> accept as payment in full reimbursement rates as outlined on the attached Fee <br /> Schedule. Hospital charges, if any, are excluded from this agreement, as are any <br /> services provided by UNC FP that are not listed on the Fee Schedule. UNC FP <br /> further agrees to seek payment only from the OCHD and will not seek payment <br /> from individual patients for services covered under this agreement. <br /> UNC FP represents that it is in compliance with all applicable Federal, State, and <br /> local laws,regulations or orders, as amended or supplemented. The <br /> implementation of this contract will be carried out in strict compliance with all <br /> Federal, State, or local laws. If applicable, UNC FP shall comply with HIPAA <br /> Privacy rules effective April 2003 and HIPAA Security regulations and guidelines <br /> effective February 2005. <br /> OCHD will notify Lisa Johnson and Jeff Arscott of patients being referred <br /> to UNC as part of this program. Identification will occur preferably by <br /> email, or otherwise by fax or phone, to: <br /> Jeff Arscott, Ambulatory Program Director <br /> (919) 966-2687 (phone) <br /> (919) 966-6049 (fax) <br /> jascott@unch.unc.edu <br /> Lisa Johnson, Revenue Cycle Director <br /> ' (919) 966-8583 (phone) <br /> (919) 966-5790 (fax) <br /> Lisa_G_Johnson @unchealthcare.org <br />