WHEREAS, Lake Region Healthcare Corporati on, along with other Minnesota health

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1 STATE OF MNNESOTA COUNTY OF RAMSEY DSTRCT COURT SECO D JUDCAL DSTRCT Court Fle No. C n the matter of Lake Regon Healthcare Corporaton AGREEMENT WHEREAS, Lake Regon Healthcare Corporat on, along wth other Mnnesota health systems, entered nto an agreement wth the Mnnesota Attorney General's Offce ("AGO") n 2005 relatng to ts patent bllng and medcal debt collecton practces (the "Hosptal Agreement''); WHEREAS, Lake Regon Healthcare Corporaton and the AGO renewed the Hosptal Agreement n 2007 and 2012 and now desre to renew the Hosptal Agreement; NOW, THEREFORE, Lake Regon Healthcare Corporaton and the AGO agree as follows: The Hosptal Agreement approved by the Ramsey County Dstrct Court on September 12, 2012, Court F le o. C , a copy ofwhch s attached hereto as Exhbt A, shall contnue n effect untl July 1, Dated: _ 5=-- _.._ t-/ _-...:..._ /7_ LOR SWANSON Attorney General State of Mnnesota Dated: o/z?j/;7 Assstant Attorney General Lake Regon Healthcare Corporaton ~ ChefExecutve Offcer

2 STATE OF M NNESOTA COUNTY OF RAMSEY SEP lky-j=-~ DSTRCT COURT SECOND JUDCAL DSTRCT Court Fle No. CS n the Matter of Lake Regon Heallhcare Corporat on AGREEMENT WHEREAS, the Hosptals and Holdng Companes named n ths Agreement beleve that a hosptal bll should never get n the way of a Mnnesotan recevng essental health servces; and WHEREAS, the Hosptals and Holdng Companes named n ths Agreement beleve that fnancal ad polces should be clear, understandable, and communcated n a dgnfed manner and should be consstent wth the msson and values of the hosptal, takng nto account each ndvdual's ablty to contrbute to the cost of hs or her care and the hosptal's fnancal ablty to provde the care; and WHEREAS, the Hosptals and Holdng Companes named n ths Agreement beleve t11at debt collecton polces - by both hosptal staff and external collecton agences - should reoect the msson and values of the hosptal; and WHEREAS, to convey ths message to patents and the communtes they serve, the Hosptals and Holdng Companes named n ths Agreement entered mo an Agreement n 2005 and 2007 for purposes of memor alzng ther desre to reform practces relatng to collecton of medcal debt and patent bllng; and WHEREAS, the Holdng Companes and Hosptals set forth n ths Agreement wsh to contnue these polces and practces; and EXHBT A

3 NOW, THJt;REfORE, e Holdng Companes and Hosptals named n ths Agreement srpula<e and agree to ~e entry f the followng Agreement DEFNTONS A. Thel tert "Char y Care'' means the provson of free or dscounte care ro a patent pursuant to r na ca! ass tance polces approved by the Hosptal Board of D ectors. B. Thej ten "Hold g Company" means the fo llowng parent organza ons whch are sgnatores to t~ s greemen : Lake Regon Healthcare Corporaton and nclu es any free standng physcan Jcln,cs opera ed by those Holdng Companes or ther subsdare durng the term of th s Agree~en, as well as all hosptals operated by those Holdng Compan es. Un less otherwse ndcated, fo purpose of ths Agreement, the term "Hosptal" s synonym term "Holdng Co 1~pan "and s all nclude all of the sgnatores to ths Agreement. C. The jte "Hosp Board of Drectors" shall mean the Board of Dre tors of the partcular Holdng Co 1 LTGATON PRACT CES,. TheHot tal shall not gve an y debt collecton agency or attorney ny blanket authorzaton to ta~e ltgal act n aganst ts patents for the collecton of medca debt. The Hosptal shall not rk tny laws t aganst any pancular patent to collect medcal ebt untl a.. Hosptal employee \wtj the app oprate level of authorty authorzes the ltgaton aft r verfyng that: 1! a. Ther s a rea onable bass to bel eve that the patent owes the debt b. Al l nown th1rd -party payors have been properly blled by the Ho p tal. such 1at any remanng debt s the fnancal responsblty of the patenl and.., '('! \J-, ~") -. v a_:.,.:j:.j,,_:.,\do.l.l\1 6 ~ =GJ :"J 0 Z ~;W Z!~Z

4 provded that the Hosptal shall not b ll a patent for any amount that an nsurance company s oblgated to pay; c. Where the patent has ndcated nab lty to pay the full amount of the debt n one payment, the Hosptal has offered the patent a reasonable payment plan, provded that the Hosptal may requre the patent to provde reasonable verf caton of the nablty to pay the full amount of the debt n one payment: d. The patent has been gven a reasonable opportunty to submt an applcaton for Charty Care, f the facts and crcumstances suggest that the patent may be elgble for Charty Care, ncludng, for example, f the patent s unnsured or s on MnnesotaCare, Medcal Assstance, or other relef based on need; and e. ln the case of a default judgment proceedng, verfyng: that there s not a reasonable bass to beleve: () that the patent may already consder that he or she has adequately answered the complant by callng or wrtng to the Hosptal, ts debt collecton agency, or ts attorney; ( ) that the patent s sck, d sabled. n f nn or so elderly so as to poten tally render the patent unable to answer the complant; or () the patent may not have rece ved servce of the complant. 2. The Hosptal shall set forth n the polcy developed pursuant to Paragraph 36(b) of ths Agreement the level of employee (.e. supervsor, manager, Chef F nancal Oftcer, etc.) who s authorzed to make the determnatons requred n the pror paragraph, whch level may vary based upon the amou nt of the debt. 3

5 3. On rt 1 ast an a nual ba ss, the Hosptal 's Chef Executve Off cer hall revew and determ ne w~thj or not to ssue to or renew any contract wth any th rd party debt collecton attorney! 1 detenn ng whether to ssue or renew an y such contract, the Hosptal shall consder wh. herl the deb collecton anorney has acted n a manner consstept wlh th s Agreement and wth th Hospt 's msson and polces and applcable laws. 4. The jho pta! sha enter nto a wntten contract drectly wlh any atto ey or law f nn utlzed by tl to ollect d bt from ts patents and shall not subcontract or elegate the electon of any thrd t collecton attorney or law f rm to ts debt collect on agency. l Any contract be t w ~en e Hasp tal and the debt collecton attorney or law frm shall requre lhe attorney or law fmh to act n ac ordance wth the terms of ths Agreemenr, applcab e laws, and the polces descrbbd 1 paragra h The! Ho pta! s not pay any debt collecton attorney or a frm any performance bonus, coqtngenc bonus, or other Smlar payment whch s calculated n the bass not prohbt the Hpsp a! from payng an attorney a percentage of the debt col ted from a partcular patent, ~ ro\j d ed tha the Hosptal shall estab lsh adequate contractual controls to ensure that the attr rnt msson. acts m a manner consstent wnh ths Agreement and th Hosptal's 6. The Ho pta!' General Counsel's Offce or, f none exsts, a Hospt employee w1th sutable experen e and a thorty shall oversee the conduct of any thrd p l y attorney retaned by the H ~s p t l to col ect med cal debt from ts patents and shal l over. ee all debt collecton ltgatorl. 4

6 7. The Hosptal shall requre that ts thrd party debt collecton attorneys take the followng actons wth respect to the collecton of medcal debt from patents: a. F le any lawsuts brought aganst the Hosptal's patent for the collecton of medcal debt wth the applcable court no later than seven (7) days after the lawsut has been served upon the patent; b. Sgn and date all pleadngs, ncludng but not lmted to all summonses and complants and garnshment summonses and related documents; c. Ensure that all affdavts of servce whch purport to documem the servce of any pleadng or legal papers state the followng () f the pleadng s served by ma l, the affdavt of servce shall state the address to whch t was maled; and () f the pleadng s served personally. the affdavt of servce shall state the name of the person to whom the pleadng was del vered. Generalzed statements, such as that the pleadng was delvered to 'a person of sutable age," shall not suffce for purpose of ths paragraph. d. Serve along wth any summons and complant the form attached as Exhbt A, or such other form approved n advance by the Anorney General's Offce. e. Lst n the case capton of all pleadngs the county where the lawsut s or wll be venued: and f. The Hosptal shall nstruct ts attorneys not to petton any court to have any debtor arrested, or any arrest warrant or body attachment ssued, or ro cause such an acton, as a resu lt of the debtor's falure to appear n court. to 5

7 rm~ l ete pa rwork, or to otherwse respond to any request or at ton by the r-ost tal n c nnecton wth ts efforts to collect medcal debt from the patent. 8. f le H~s pta l h s knowledge of the dentty of an attorney represent g a patent n connecton w1 tht debt collecton efforts. t shall not fy ts thrd pany debt collecton auomeyl la frm, nd agency of the dentty of any attorney who re resents the patent. Nether t1e osptal. or any debt collecton agency or attorney retaned by t, shall drectly contact ant pa.ent kno n to be represented by attorney wth regard to the llecton of that debt wthout ~e pt msson of the patent's attorney. GARNSHMENTS 9. The Ho pta! sh not gve any debt collecton agency or attorney ny blanket author zaton to pu~sue the gam shment of patents' wages or bank accounts. The H sptal shall not authorze ts 1ebt collecto agences or attorneys to proceed wth the garns ment of a partcular patent's ranj account or wages untl a Hosptal employee w th the appropr ate level of authorty authorzek th garnsh ent for that partcular patent after verfyng that: a. f hc Hosptal has no reasonable bass to beleve that the patent s wages or ~ n+ at a f ancal nsttuton are lkely to be exempt from g rnshment. pucl nfonn ton may nclude. but s not lmted to. such factors as whether ~h e!patent s on Soc1al Securty, :'vedcal Assstance, or other rel f based on h ee~; b. ~he~e s a rej'onable bass to beleve that the patent owes the deb : c. f.,.tl ~now n thrd-party payors ha ve been properly blled by the H sptal, such that any re amwg debt S the f nancal respon s blty of the atent and 6 '

8 provded that the Hosptal shall not bll a patent for any amount that an nsurance company s oblgated to pa y; d. Where the patent has ndcated an nablty to pay the full amount of the debt n one payment, the Hosptal has offered the patent a reasonable payment plan, provded that the Hosptal may requre the patent to provde reasonable verfcaton of the nablty to pay the full amount of the debt n one payment; and e. The patent has been gven a reasonable opportunty to submt an appl caton for Charty Care, f the facts and crcumstances suggest that the patent may be elgble for Charty Care, ncludng, for example, f the patent s unnsured or s on MnnesotaCare, Medcal Assstance, or other relef based on need. 10. The Hosptal shall set forth n the polcy developed pursuant to Paragraph 36 of ths Agreement the level of employee (.e. supervsor, manager, Chef F nancal Off cer, etc.) who s authorzed to make the detennnatons requred n the pror paragraph, whch le vel may vary based upon the amount of the debt.. The Hosptal shall not garnsh the wages or bank account of any patent unless t has frst obtaned a judgment aganst the patent n court for rhc amount of the debt. 12. The Hosptal shall nclude wth the ntal notce t sends ro any patent of a garnshment the form attached as Exhbt B, or such other form approved, n advance, by the Attorney General 's Offce. 13. f a patent submts a wrtten clam that the patent's account or wages are exempt from garnshment, the Hosptal's thrd party debt collecton attorney sha ll not obj ect to the clam of exempton wthout recevng the specfc, case-by-case approval of the Hosptal's General 7

9 counsel 's Offce o~. f hone ex ts, a Hosptal employee wth sutable experence an8 authorty. to,grant su h approval n a partcular case. the General Counsel's Offce or n decdng w h et h ~ r Hosptal employed sh reve ' all nformaton submned by the patent n support of the patent's clam or ekem ton. COLLECTON AGENCES, and 14. On ft l ~st an a nu al bass, the Hosptal's Chef Executve Offcer determne whb the~ or not to ssue to or renew any contract wth any thrd all revew party debt collecton agenc y.!n d term n g whether to ssue or renew any such contract. the H sptal shall consder whether the debt co lecton agency has acted n a manner conssten wth ths Agreement and wl)j th Hospt 's msson and polces and applcable laws. S The!Ho ta! sha enter nto a wr tten contract wth any collecton age cy utlzed by t to collect de~ fr m ts pa ents. The contract shall requre the collecton agcn y to act m accordance wth t~e t rm of s Agreement, applcabl e Jaws, and the polces escnbed n paragraph The,Ho1ptal sha not refer any patent's account to a thrd party de t collecton agency unless the ~os~ta l has c nfrmed that:! a. r he1e s a re onable bas s to beleve that the patent owes the deb ; b. All ~nown th rd-party payors have been properly blled by the H spttal, such ~at any re anng debt s the fnancal responsblty of the patent and c rro1ded tha the Ho ptal shall not bll a patent for any amo~t that an. lnsutance co pany s oblgated to pay ; Wh re the pa ent has ndca ted an nablty to pay the fu ll amounl of the debt n ope payment, the Hosptal has offered the pallent a re asona~ l e payment 8

10 plan, provded that the Hosptal may requre the patent to provde reasonable verfcaton of the nabl ty to pay the full amount of the debt n one paymem; and d. The patent has been gven a reasonable opportun ty to submt an applcaton for Charty Care, f the facts and crcumstances suggest that the patent may be elgble for Charty Care, ncludng, for example, f the patent s unnsured or s on MnnesotaCare, Medcal Assstance, or other relef based on need. 17. The Hosptal shall set forth n lhe polcy developed pursuant to Paragraph 36 of ths Agreement the process for satsfyng the crtera requred n lhe pror paragraph and the person(s) accoun table for complance wth ths agreement. 18. The Hosptal shall not refer any medcal debt to a thrd party debt collecton agency or artorney f the patent has made payments on that debt n accordance wth the terms of a payment plan prevously agreed to by the Hosptal. 19. rf a patent has submaed an applcaton for Charty Care after an account has been referred for collecton actvty, the Hosptal shall suspend all collecton actvty untl the patent's Charty Care applcaton has been processed by the Hospta l and the Hosptal has notfed the pat ent of ts decson. 20. The Hosptal shall not pay any debt collecton agency any performance bonus, contngency bonus. or other smlar paymenr whch s calculated on the bass of the amount or percentage of debt collected from two or more patents. Ths paragraph shall not prohbt the Hosptal from payng a collecton agency a percentage of the debt collected from a pa.rlcular patent, provded that the Hosp tal shall establsh adequate contractual comrols to ensure that the collecton agency acts n a manner consstent wth ths Agreement and the Hosptal's msson. 9

11 2. The Hojptal sh requre any th rd pany debt collecton agency a d attorney utlzed by t to ke~p a og of al oral and wrtten complants receved by any patent concernng! the conduct of the ~ge~cy. urposes of ths paragraph, a "complant" s any co muncaton 1 from a patent or + e t's repres ntat'e n whch they express concerns about the cotduct of the debt collecton ag~ncy The H sptal shall obtan a complete copy of the log at lfast sx (6) tmes per year. Th~ H the agency to log ~ nd oncract wth the debt collecton agency shall state th t fa lure by rovde patent complants n the manner requred by th paragraph may result n tenn ratdm of the osptal's contract w th the agency. 22. The! Hotptal sh requ re any thrd party debt collecton agency a d attorney utlzed by t to ket p a record 0 the date, tme, and purpose of all communcatons t or from ts patents.! / 23. f a l pat ~n t asks any th rd party debt co llecton agency or attorney fo the contact nformalon for th ~ Htspta1, the Hosptal shall nstruct the agency or attorney to provde lhe ' patent wth the paone[ number and address descrbed n Paragraph 28. The Hosp al shall not 1 1 refuse to supply n om)aton to r speak wth any of ts patents on the bass that the account has been placed wtth a th r~ party d bt collecton agency or attorney for collectons. 24. Th ~ Hofp tal sh tran ts outsde debt collecton agences and au rneys about the Hosptal's Chdrty care po ~y and how a patent may obtan more nformat n about the Hosptal's Charty Ca e polcy or submt an appl caton for Charty Care. The requre ts debt cpl le ton age 1ces and attorneys to refer patents who may be elgble for Charty Care to th1 Ho pta!. 10

12 25. The Hosptal shall nclude the fol lown g language on all collecton notces sent to patents by t or ts thrd party debt collecton agences or attorneys, and on all cover letrers servng all lawsuts and garnshment papers: f you feel that your concerns have not been addressed, please contact f rst and all ow us the opportunty to try and address your concerns. f you contnue to have concerns that have not been addressed, you may contact the Mnnesota Attorney General's Offce at or l The Hosptal shall prnt ths language wth the promnence requred for notces under the federal Far Debt Collecton Practces Act. 26. Nether the Hosptal nor ts debt collecton agences or attorneys shall report any patent to a cred t reportng agency as a result of that patent 's falure to pay a medcal bll. CENTRAL BLLNG OFFCE 27. The Hosptal shall develop and mplement polces and procedures to ensure the tmely and accurate submsson of clams to thrd part y payors. f the Hosptal tmely receved from a patent nformaton about the patent's thrd party payor but does not tmely submt a clam to the thrd party payor, the Hosptal shall not bll the patent for any amount n excess of that for whch the patent would have been responsble had the thrd party payor pad the clam. The Hosptal shall not refer any bl l to a thrd party collecton agency or attorney for collecton actvty wh le a cla m for payment of the bll s pendng wth a thrd party payor wth whch the Hosptal has a contract. The Hosptal may refer a bll to a thrd party collecton agency or attorney fo ll owng an n tal den al of the clam by the thrd part y pa yor. The Hosptal shall not refer any b ll to a thrd party collecton agency or auorney for collecton actv ty when a clam s dened by a thrd party payor due to the Hosptal's error. and such error results n the patent becom ng lable for tl1e debt when they would not otherwse be lable. The partes recognze that. n order fo r the Hosptal to properly b ll a patent 's nsurance company. the Hosp tal may

13 need the patent's 4oop raton a d that the Hosptal may not be able to properly bll ~he patent's ' nsu rance compan~ w+out the atent's cooperaton. n the event that the Hosptal Beleves that 0 has mproperl y delayed or dened payment of a clam, ~e Hosptal may fle a comp.ant wrh th Mnnesota Attorney General's Offce, whch a prvate thrd parjy p ~yor al or ts atent n attemptng to get the clam pad. 28. Thel Ho pta! sh develop a streamlned process for patents to ueston or assstance to the H ~s p dspute blls, n clu~ ng a toll-fr e phone number patents may call and an address to whch they may wrte. The 1hon numbe and address shall be lsted on all patent blls an collecton notces sent by th Ho ptal.!e Hosptal shall return telephone calls made by pa ents to ths number as promp~ly receved. The H o~p t ten ( 0) days. 29. f J.. a patent a possbl, but n no event later than one busness day afte the call s shall r spond to correspondence sent to ths address by pat ems wth n the Hosptal, ts debt collecton agency. or y attorney utlzed by the H~pt that: ) the patent does not owe all or part of a bll, b) thrd party! payor should pay tpe b ll. or c) e patent needs documentaton concernng the bll, t e Hosptal. the collecton age1cy, rnd ts a tomey must cease funhe< collecton effons Untl the Hosptal 0' the agency provdr t1e paten wth documentaton establshng that, as appl cable the patent owes the debt or tjat t, e applc ble thrd party payor has already pad all amounts f whtch n s oblgated. The Hpsp al or th collecton agency shall provde such documentato n wrt ng wthn ten (10) djys nd shall nor pursue fu rther collecton actvty for a perod o thrty (30) days after provd!)g p oof that he debt s ov..-ed, so as to gve the patent further o portuncy to pay the bll or to ~a ll nge the ocumentaton suppled by the Hosptal. f the Hosptal provdes l the requred documenthton and the patent does not respond wthn thrty (30) days, the Hospttal 1! 2

14 may resume collect on actvty. Ths secton should not be construed as preventng the Hosptal from addressng patent b llng nqu res orally when approprate. 30. The Hosptal shall develop a system to record and log all patent complants receved by ts b llng offces, nclud ng at the locatons dentfed n paragraph 28, regard ng the co llecton of medcal debt by the Hosptal or ts thrd party debt col lecton attorneys or agences. The Hosptal may mantan such records at more than one locaton. BLLNG TO THE UNNSURED J l. f the Hosptal demands that an unnsured patent pay a medcal bll, upon request by the unnsured patent, the Hosptal shall provde to that patent a detaled, temzed bll. 32. The term "most favored nsurer" means the nongovernmental thrd party payor that provded the most revenue to the provder durng the prevous calendar yea r. The Hosptal shall not charge a patent whose annual household ncome s less than $125,000 for any unnsured treatment n an amou nt greater than the amount whch the provder would be rembursed for that servce or treatment from ts most favored nsurer. The total charge for unnsured treatment shall not be more than the provder would be rembursed drectly from ts most favored nsurer and from that nsurer' s polcyholder under any applcable and allowable copayments, deductbles, or consurance. The Hospnal shall apply the same percentage dscount to ts charge descrpton master for unnsured treatme nt that t would apply to charges ncurred by a polcyholder of ts most favored nsurer. Begnnng on the date of ths Agreement. each year the osptal and the Attorney General may agree n advance, by a confdent al letter agreement, on the percentage dscount from the charge descrpton master that the Hosptal provdes to ts most favored nsurer and whch the Hosptal shall provde for unnsu red treatment under th s paragraph. The Hosptal shall provde ro the Attorney General, pursuant to paragraph 13

15 41, any nformaton r The Hosptal shal ut lze lhe the Attorney General for purposes of calculaung t1s dscount. same ntal charge descrpton master prces fo ~ treatment that t ut1~ze for trea ent provded to a polcyholder of ts most favored nsurer. unnsured The term "~ nn ured tre trnent" means any treatment or servces whch are hot covered by a plan, contrac t ~ or ol cy w ch provdes coverage to the patent through or s ssued to the patent by: () a "1ealt (2) a self-funded e~ pl yee bene pany," as that term s defned n Mnn. Stat. 62Q.Pl, subd. 4: t plan; (3) any governmental program, ncludng buq not lmted to MnnesotaCare, the Mnnes ta Comprehensve Health AssocatOn. Med1care, Medcad, or TrCarc; (4) any o er ype of h alth nsurance, health mantenance, or health plan c verage, (5) any other type of 11surrce cov rage, ncludng but not lm ted to no-fault automob e coverage, workers' compen ~ ato 1 cover ge, or lablty coverage. l.n the event that tl e Hosp tal! madvertentl y send a ll to a aten t n excess of that whch s allowed by ths p ragraph 32 because the Hosptal not aw re that the treatment or servce consttutes unnsure treatment. and the Hosptal tere fter lear s that the treatment or servce consttutes un nsure treatment, the Hosptal hall qro paragraph 32. and 1 he ~osptal Th1 parag tly adju t ts charge so as not to exceed the amount allowable under ths 1 aphtshall on all promptly notfy the patent of the new amount o the bll. apply to charges by or ncurred at a faclty dcfn d n Mnn. Stat. 1-l-UO. subd. (2010) or Mnn. Stat subd. 2 (2010). m<.:ludn those of a '. provder who s e'npl yed by he Hosptal when provdng servces to a patent t a fac lty defned m Mnn. Stat subd. 2 (20 0) and Mnn. Stat , subd. 2 (10 10). Ths paragraph shall o ly pply to procedures wthout an d.. me 1cal necessny. edcally necessary health care treatment and not o cosmerc 14

16 33. n recognton that some patents express ther fnancal concerns drectly to ther u earment prov ders (.e. doctors, nurses, etc.), the Hosptal shall tra n ts staff responsble for adm ssons, bllng, and provdng drect patent treatment, about the exstence of the Hosp tal's Charty Care polcy and how a patent may obtan more nformaton about the Hosptal's Charty Care polcy or submt an applcaton for Charty Care. MSCELLANEOUS PROVSONS 34. n the event that the Hosptal concludes that any requrement of ths Agreement s no longer feasble, that the publc may be better served by a modfcaton of th s Agreement, or that t has evdence that the terms of ths Agreement have caused those who can afford health nsurance coverage to vol untarly choose to go wthout t, the Hosptal may request that the Attorney General consent to a modf caton of the terms of ths Agreemenr. The Attorney General shall make a good fath evaluaton of the then-exstng crcu mstances and, after collectng nformaton the Attorney General deems necessary, make a decson wth n thrty (30) days as to whether to consent to a modfcaton of ths Agreement. 35. The Hosptal and ts age nts shall not state or mply, drectly or ndrect ly. that the State of Mnnesota or the Attorney General's Offce has approved of, condones, or agrees wth any lawsu t, garnshment, or other attempt by the Hosptal to collect debt from a patent. 36. The Hosptal's Board of Drectors shall adopt the followng polces, whch shall not be nconsstent wth ths Agreement: a. A zero tolerance polcy fo r abusve, harass ng, oppressve, fal se, deceptve, or msleadng language or collectons conduct by ts debt collecton attorney and agency, and ther agents and employees, and Hosptal employees responstble for collectng medcal debt from patems; 15

17 " b. d bt collec on l t gaton polcy. whch shall nclude a pol cy permtlng the ~arryshmcnt f patent wages or accounts only after entry of a Judgment; c. ~ p~ J cy est blshng the procedures to be utlzed by the Hos tal'- th rd arty debt co lecton agences; d. ~ polcy e ablshng the procedures to be utlzed by the emp~oyees w 0 partc pate n the collecton of medcal debt; and e. l Jarty C re polcy whch takes nto consde.raton the fnanc ~he vatent talpay a medcal bll. Hosptal's ablty of 37. The Ho ptal's Board of Drectors shall revew. at least one tme p r year. the Hosptal's practce n e fo llowng areas: a. rrlle fl ng of debt collecton ltgaton aganst Hosptal patents, T eludng the f patent wages or accounts subsequent to entry f a default b. The, debt col~ec t o n actvty of ts thrd party debt collecton agcnc cs; c. jthe,debt col ecton actvtes of ts nternal debt collectors; d.!the Hosptal's complance wth ths Agreement and the polces lescr bed n Par graph 3 : e.!the results of the revews requred by the Chef Executve Oftce: m 1Par*graphs 3 and 14 of ths Agreement: f. The1 results o the revews requred by Paragraph 38 of th s Agree ent; and g. Th~ Hospta 's Charty Care practces. / 38 The Ho pta! sh annually revew rhe practce of rs thrd parry de 1 collecton agency and debt collecton attorney, and ts nternal medcal debt collecton pracr~ces, at least l6

18 one () tme per year. The pufljose s to revew complance wth ths Agreement and the Hosptal's pol ces. 39. Ths Agreemenr s not ntended to assert, nor shall t be construed as, or deemed to be, an adm sson or concesson or evdence of any lab lty or wrongdong whatsoever on the part of Hosptal. 40. Th s Agreement shall reman n effect for fve years after the entry of ths Agreement by the Cou rt. 41. The Hosptal shall cooperate w th, respond to nqures o f, and provde nformaton to the Attomey General n a tmely manner as necessary for the enforcement of th s Agreemen t. 42. The Court shall rerajo jursdcton to enforce the provsons of ths Agreement. 43. The Hosptal shall compl y wth all applcable state and federal laws relatng 10 bll ng and debt collecton. Dated: O'& lllo ( (.. Lake Regon Healtbcare Cofl)oraton By~lrs: CEO 17

19 STATE OF MNNESOTA Offce of Attorney general Dated: LOR SWANSON Accomey General State of Mnnesota 445 Mnnesota Street, Sute 1200 St. Paul, Mnnesota (65 1) (Vo ce) (65 ) (TTY) ATTORNEYS FOR STATE OF M ESOTA Dated: Based upo9 the above St pulaton, T [S SO ORDERED: \./ BY THE COURT:! 18 :

20 EXHBT A [HOSPTAL NAME] Lawsut nformaton Sheet You are rece vng ths nformaton sheer because you have been served wth a Summons and Complant (lawsut) by [HOSPTAL NAME) (" "). [HOSPTAL NAME) cannot gve you legal advce. Therefore, ths document only provdes basc nformaton, and you should mmedately dscuss ths matter wth an attorney. Start of the Lawsut. To start a lawsur aganst you, [HOSPTAL NAME] has served a Summons and Complant on you ether: (a) by delverng t to you personally or leavng t at your home; or (b) by mal, f you agree n wrtng to accept servce" of the Summons and Complant by mal and sgn a form that so ndcates. The Summons nfonns you that you must provde aformal, wrtten Legal "answer" lo the complant wthn 20 days after you receve the legal documents. The Complant explans why fhosptal NAME] s sung you and asks a court to make you pay money. The Summons and Complant may not nclude a court fle number. They are, however, the lega l documents that beg n the lawsu t. t s very mportant that yo u do not gnore the documents, or you wll be n "defaul t." No court hearng s requred for a default judgment to be entered aganst you f you do not respond to the Complant. Answerng a Complant. The "Answer" s the fonnal legal name for your response to the Complant. The Answer must meet certan requrements of the Mnnesota Rules of Cvl Procedure. Contactng [HOSPTAL NAME] or ts attorney by telephone or wrtten correspondence s not ((answerng" the Comp/ont. Whle [HOSPTAL NAME] encourages you to call f you have questons regardng the bll that was sent to collectons, do ng so s nor a formal "Answer." Some court clerks have form ''Answers" whch may be of assstance to you. You must serve a copy of your An wcr on [HOSPTAL NAME]'s attorney by majj. fax, or hand delvery and complete an Affdavt of Servce that explans who was served, how, and on what date. The Affdavt of Servce form mu st be sgned n front of a notary publc or a court clerk. [f you want a judge ro hear the dspute, you should f le the orgnal Answer and Affdavt of Servce wth the coun n the county n whch you are beng sued after you have served your Answer on [HOSPTAL NAME]. You wll be req ured to pay a court flng fee. (f you meet certan fnancal gudelnes, however, you may not be requ red to pay the court fl ng fee. You may obtan more nformaton regardng a waver of the fee by contactng the clerk of coutt.) Falure to Ans wer. f you do not answer" the Complant, [HOSPTAL NAME] may get a "default" judgment entered aganst you requ rng you to pay money. By gettng a default judgment. [HOSPTAL NAMEl may be able to nuatc a separate garnshment acton aganst you.

21 [H~S PTA. NAME] Garnshment nformaton Sheet You are redev g ths nformaton sheet because [HOSPTAL NAME] ("_1--_") has started a proce s tq get money from you by sendng a garnshment summons" to a arnshee -- typcall y you r baqk o emp l o~e r. These proceedngs are called "garn shmen t" roceedngs. [HOSPTAL NA~E] cannot rovde you wth legal advce. Therefore, th s do ument only provdes basc nffn1a on. Yo should mmedately dscuss ths matter wllh an alto ey. Takng M ne) From our Wages. f [HOSPTAL NAME] s tryng to from your wages y u shoul rece ve notce before your wages are garnshe or taken. Generally, [HOSUT L NAM ] cannot garnsh more than 25% of your net wage, or any of your net wages f tpe~re less an $206 per week. Lf you have receved publc ass tance based on need, [HOSPTA NAME cannot take any of your wages for 6 months after ou receved the assstance, f yt u s bmt th proper paperwork on tme. To cl am that wages can ot be taken (.e.. are exempt", y must p omptly return to [HOSPTAL NAME)'s attorney e "Debtor' s Exem pton Clam!Not ce" that came wth the "Garnshment Exempton Notce an Notce of ntent to Garnsh ~am n gs." allng [HOSPTAL NAME] s not suffcent. f [ OSPTAL NAME]'s attomex do s not re eve ths exempton notce wthn 10 days, [Hospta Name] can seek co get mond fro your mployer. f [HOSPTA L NAME) d oes not agrc Lhat your wages are exempt, t an stll eek to get money from your employer, and you wll have to ask the court to d cdr that y r wages cannot be taken., ' Takng Mp n e~ From our Bank Accounts. f [HOSPTAL NAME] s yng to take money from your p a n ~ account the bank wll "freeze" enough money n your accou t to pay off your debt to [HO~ P'l'AL NA E]. You wll not receve notce of the bank gam hment untl ajrer your funds qre [ready ozen. You wll not have access to your f unds w le they are frozen. Your chec~s m~y "bour ce," ~ n d you may ncur overdraft charges durng thts tme. You may want to conta t y~ u r bank mmedately. f you depost qual'fe publc ssstance checks (or wages f you are on or have rec~ ved publ c assstance wthn he ast 6 m nths) n a bank account, [HOSPTAL NA MEl ca not garnsh your account for 0 d ys, f Y<?U tmely fll out the proper paperwork. To clam t at funds n your bank accoun~ ca ot be taken (.e.. are exempt"). you must s1m and return w h n 14 days to the bank (and rtj,o.. PTAL ~AM E]' s attorney) the "Exempton Notce" (the for your bank sen! co you when lt r ceved Garnshment Summons from [HOSPJTAL NAM!j:)). Callng [HOSPTAL NA~E s not uffcent. You may want to nclude copes of dodumcnts (.e. benef t letters, bank st tements, etc.) to show why your funds are exempt. f you do ' t clam an exempton wthn 14 days fr the date the bank maled the exempton notc to you. the bank may turn ove your ozen funds to [HOSPTAL NAME]. f you o clam an exempton on tme, th bank w "unfreeze'' your funds and release them to you 1n days unless [HOSPTAL :"~M ] "obj ts" to your "exempton cla m." f [HOSPT L NA 1E] "objects." t musq se d you a wrtten ObJecton to your exempt on clam, along vth a fo rm enttled ' A Requdst f r Hcar o and Notce of Hearng." f [HOSPTAL NAM ~ ] sends you ths form, you must 1ll out a d fle wth the court the " Request for Hearng : form wthn 10 days of reccyng the obj cton, or the bank can release your money to [f10sptal NAME]. 1 '!!