Milwaukee Preforma Layout

Equipment leases Lab Management Services

BALTIMORE LAB GROUP ENTITY RELATIONSHIPS

High-Sensitivity & High-Speed Scanning at 30,000 u/sec Simultaneous Quantitative and Qualitative Analysis Simultaneous High-Speed Screening of 12 Toxicological Drugs Just One Minute per Analysis Screen Sample $59 (Analyzer) Confirmation Sample $180 200 Samples Per Day

LCMS-8050

KJ Singh, MD

Specialties •President • Boa Vida Healthcare, LLC May 2017 – Present

LocationCrown Point, IN • Synergy Network, LLC 2015 – Present •Owner • Elite Diagnostics Jan 2012 – Present • Singh Investments LLC Jun 2007 – Present •Surgeon • KJ Singh, MD PC (Indiana Medical Group) Aug 2002 – Present Private Practice, Orthopedic Spine Surgery, Addiction Medicine Education • The University of Texas Medical Branch at Galveston 1992 – 1996 • The University of Texas at Austin BA Field Of Study Economics 1990 – 1992 • Indiana University School of Medicine Orthopedic Surgery, IU Med Center, Indianapolis, IN

•New York University School of Medicine Spine Fellowship NYU/HJD New York, NY

•Owner/Manager Monroe Regional Hospital Aberdeen, MS •Owner/President Labnet, LLC • Lab Management • Equipment Leasing

•Urine Screen – Immunoassay • AU 480 • Indigo • LCMS •Urine Confirmation- LCMS • Schimadzu 8050

Congratulations •••••••••••••••

UMADAOP Lima, Inc “ Families First! “

Stark law In Office Ancillary Exception (1) They are furnished personally by one of the following individuals: An individual who is supervised by the group practice.

(2) They are furnished in one of the following locations: (i) The same building

(ii) A centralized building that is used by the group practice for the provision of some or all of the group practice’s clinical lab services

(3) They are billed by one of the following: (i) The group practice

(ii) An entity that is wholly owned by the group practice under the entity’s own billing number or under a billing number assigned to the group practice (Subsidiary of group practice) (iii) An independent third party billing company acting as an agent of group practice or entityw

Each Clinic bills for their own samples

Model 1: Single Group 1. SINGLE LEGAL ENTITY. A group practice that is otherwise a single legal entity may itself own subsidiary entities. 2. PHYSICIANS. The group practice must have at least two physicians who are members of the group (whether employees or direct or indirect owners) 3. RANGE OF CARE. 4. SERVICES furnished by group practice members (substantially all) 5. DISTRIBUTION of expenses and income. 6. UNIFIED BUSINESS. (1) The group practice must be a unified business having at least the following features: (i) Centralized decision-making by a body representative of the group practice that maintains effective control over the group’s assets and liabilities and; (ii) Consolidated billing, accounting, and financial reporting (2) Location and specialty-based compensation practices are permitted with respect to revenues derived from services that are not DHS and may be permitted with respect to revenues derived from DHS 7. VOLUME or value of referrals. 8. PHYSICIAN-PATIENT encounters. 9. SPECIAL RULE for productivity bonuses and profit shares.

Model 1: Single Group

Agency 1

Agency 2

Agency 3

Parent Company

Agency 4

• Parent Company • Board

•Management Company • Employ All Providers from Agencies 1-4 •All monies flow from Agencies to Parent then pay expenses •Unified decision making •Unified Marketing (for example Federation with affiliated local Agencies) •Unified Policies and Procedures • Subsidiary Companies (Agencies 1-4) •May have a contract to manage local operations

•May bill for services of local Agencies •May use different EMRs for local services

Model 2: Multiple Group • Single Lab location, but each Agency has its own CLIA certificate • Each Agency: • is assigned specific days of the week to run their patient samples • bills for its own patient samples with its own CLIA certificate • will have CLIA/COLA fees • will have a lab director cost • will have separate lab policies and procedures (included in management fee) • Total additional costs => $20,000 annually • All Agencies would share the remainder of the expenses

AGENCY 1

AGENCY 2

One Lab Location

AGENCY 3

AGENCY 4

Shared Lab

Monday Agency 1 • CLIA 1

tuesday

Agency 2 • CLIA 2

wednesday Agency 1 • CLIA 1

thursday Agency 2 • CLIA 2

friday Agency 3 • CLIA 3

LABORATORY REQUIREMENTS

•Staffing • Lab Director (PhD or MD) • Lab Manager (provided by Labnet, LLC) • Lab techs- 2 •Requirements • Space 1000 sq feet • Equipment (depends on volume, assume 2000 samples) • Sample prep- tables, computers, scanners, agitators, pipettes, refrigerator, freezer, water bath, hood. • LCMS- Schimadzu 8050 (fast positive and negative injections) nitrogen generator, UPS, generator, Software • Data Analysis- LIS

•Regulatory • CLIA or COLA • High Complexity • SOPs and Proficiency Testing • Validation Protocols • QA/QC protocols

•Timeline • Contracting 1mos • Ordering and Validating LCMS- 3 mos • Method Development and Validation- 1 mos • Training and Troubleshooting- 1 mos •Total 6 mos

Five Easy Steps

1.

2.

3.

SITE DETERMINATION

ORDERING EQUIPMENT

HIRE EMPLOYEES

3 MONTH TIMELINE

4.

5.

VALIDATE METHODS/CLIA APPROVALS

BEGIN TESTING

MILWAUKEE LAB GROUP ENTITY RELATIONSHIPS

• Clinics 1-4

• Patient Volume • Equipment and Management Agreements • Guarantees Building Lease • Each Clinic Bills for their own samples

• Labnet/BVH

• Equipment Leases • Lab Management (Manager of Newco Lab, LLC) • Billing and Collecting via Boa Vida Healthcare, LLC • The Influence • Referrals • Marketing • Printing • Magazines, Brochures, Business Cards, etc. • Graphic Design • Logos, Letterhead, Web, etc. • Website Development

LABNET, LLC

BOA VIDA HEALTHCARE LLC

THE INFLUENCE

CLINICS 1-4

Urine Confirmation Testing PERFORMA Clinics 1-4

1000 Samples

2000 Samples

$233,576.00

$467,152.00

Total Revenue

$131,257.28

$243,264.56

Total Expenses

$102,318.72

$223,887.44

Operating Profit ANNUAL PROFIT

$1,227,824.64

$2,686,649.28

LABNET, LLC

BOA VIDA HEALTHCARE LLC

THE INFLUENCE

CLINICS 1-4

3000 Samples

5000 Samples

10,000 Samples

$700,728.00

$1,167,880.00

$2,335,760.00

$367,171.84

$602,586.40

$1,194,922.80

$333,556.16

$565,293.60

$1,140,837.20

$4,002,673.92

$13,690,046.40

$6,783,523.20

LABNET, LLC

BOA VIDA HEALTHCARE LLC

THE INFLUENCE

CLINICS 1-4

Full Scale, In-House Marketing Production and Printing Services

Custom Magazines

Flyers

CI TYWIDE Behavioral Health

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