Produced by the National Council on Aging (NCOA), this resource is a sample MOU between a community-based organization (CBO) and a hospital. It details the expectations, protections, and limitations of a hypothetical agreement in which the CBO would be providing evidence-based self-management education programs to the hospital’s patients/former patients. The MOU contemplates that the CBO has already submitted the necessary paperwork to obtain its own Medicare provider number, but simply hasn’t received it yet.
**NOTE: this document can only serve as a sample to give you ideas about what you might want to negotiate with your chosen partner. You cannot simply copy this MOU and use it as-is. It is intended to be as used as a guide, not a template.