Risk Factors Update Summary

• Addition of detailed federal civil False Claims Act implications, including penalties and exclusions for false claims.
• Detailed changes in penalties for False Claims Act violations, with an increase from $5,946 to $13,894 per false claim.
• History of losses and future profitability uncertainty raised substantial doubt regarding the ability to continue as a going concern.
• Mention of the federal Criminal False Claims Act and penalties for making fraudulent claims to the government.
• Detailed state law provisions added, extending beyond federal laws, potentially impacting commercial insurers and private pay patients.
• Increased net losses from $240.3 million in 2022 to $377 million in 2023.
• Inclusion of the federal Civil Monetary Penalties Law and penalties for activities like presenting false claims.
• Disclosure of penalties for violating Stark Law and state laws, including physician licensure sanctions and fines.
• Outstanding indebtedness increased from $240.3 million to $377 million in 2023.
• Expansion on the federal Physician Self-Referral Law (Stark Law) and its prohibitions on referrals.
• The number of MIPS-eligible clinicians increased from 13 to 16 for the 2024 performance period.
• Revenue derived from fixed fees under risk-based agreements with health plans increased from 92% to more than 95%.
• Potential Medicare payment reduction of up to 4% under the American Rescue Plan Act.
• Uncertainty over MA enrollment and payment rates, with predicted increases of 8.50% in 2023 and 3.32% in 2024.