1 GIPSON HOFFMAN & PANCIONE A Professional Corporation 2 DANIEL R. PALUCH (SBN 287231) [email protected] 3 DANIEL B. LIFSCHITZ (SBN 285068) [email protected] 4 1901 Avenue of the Stars, Suite 1100 Los Angeles, California 90067-6002 5 Telephone: (310) 556-4660 Facsimile: (310) 556-8945 6 Attorneys for Plaintiff and Relator 7 INTEGRA MED ANALYTICS LLC

8 UNITED STATES DISTRICT COURT 9 CENTRAL DISTRICT OF CALIFORNIA 10 11 UNITED STATES OF AMERICA and Case No.: 2:21-cv-05265-JFW-RAOx THE STATE OF CALIFORNIA, ex rel, 12 INTEGRA MED ANALYTICS LLC, [PROPOSED] PROTECTIVE ORDER GOVERNING THE 13 Plaintiff, DISCLOSURE OF HEALTH INFORMATION AND 14 v. CONFIDENTIAL INFORMATION

15 WILLIAM NELSON, an individual; [Stipulation submitted concurrently] VICKI ROLLINS, an individual; 16 TORRANCE CARE CENTER WEST, INC.; GLENDORA GRAND, INC.; 17 CENTINELA GRAND, INC.; LONG BEACH CARE CENTER, INC.; 18 PACIFIC VILLA, INC.; FLOWER VILLA, INC.; CENTURY VILLA, 19 INC.; VILLA DEL RIO WINTER, INC.; VILLA DEL RIO CENTER, 20 INC.: WEST COVINA MEDICAL CENTER, INC.; L.A. DOWNTOWN 21 MEDICAL CENTER, INC.,

22 Defendants.

23

24 25

26 27 28 1 1. A. PURPOSES AND LIMITATIONS 2 Discovery in this action is likely to involve production of confidential, 3 proprietary, or private information for which special protection from public 4 disclosure and from use for any purpose other than prosecuting this litigation may 5 be warranted. Accordingly, the parties hereby stipulate to and petition the Court to 6 enter the following Stipulated Protective Order. The parties acknowledge that this 7 Order does not confer blanket protections on all disclosures or responses to 8 discovery and that the protection it affords from public disclosure and use extends 9 only to the limited information or items that are entitled to confidential treatment 10 under the applicable legal principles. 11 B. GOOD CAUSE STATEMENT 12 This FCA action alleges a “patient recycling scheme” by Defendants, 13 implicating sensitive materials. Plaintiff’s claims rely on statistical models, 14 government communications, patient-level data, financial records, communications 15 with current and former employees of Defendants, and internal analyses. 16 Unrestricted disclosure of this information is critical to Defendants’ ability to 17 challenge the allegations, and to Plaintiff’s ability to prove up its claims. Both 18 Plaintiff’s and Defendants’ production will include protected health information as 19 defined in

and individually identifiable information that may 20 be subject to the provisions of the Privacy Act, 5 U.S.C. § 552a, or the provisions of 21

(“Protected Health Information” or “PHI”), claims data, 22 operational policies, and internal leadership communications, the public release of 23 which could harm patient privacy, competitive standing, and litigation claims or 24 defenses. A protective order is justified under FRCP 26(c) to expedite discovery, 25 resolve confidentiality disputes, ensure production of entitled information, protect 26 entitled information, and permit reasonable use in preparation for and conduct of 27 trial, while ensuring designations are made in good faith and not for tactical delay or 28 obstruction of discovery. 1 C. ACKNOWLEDGEMENT OF PROCEDURE FOR FILING UNDER 2 SEAL 3 The parties further acknowledge, as set forth in Section 12.3, below, that this 4 Stipulated Protective Order does not entitle them to file confidential information 5 under seal; Local Civil Rule 79-5 sets forth the procedures that must be followed 6 and the standards that will be applied when a party seeks permission from the court 7 to file material under seal. 8 There is a strong presumption that the public has a right of access to judicial 9 proceedings and records in civil cases. In connection with non-dispositive motions, 10 good cause must be shown to support a filing under seal. See Kamakana v. City and 11 County of Honolulu,

(9th Cir. 2006); Phillips v. Gen. Motors 12 Corp.,

, 1210-11 (9th Cir. 2002); Makar-Welbon v. Sony Electrics, 13 Inc.,

(E.D. Wis. 1999) (even stipulated protective orders require 14 good cause showing), and a specific showing of good cause or compelling reasons 15 with proper evidentiary support and legal justification, must be made with respect to 16 Protected Material that a party seeks to file under seal. The parties’ mere designation 17 of Disclosure or Discovery Material as CONFIDENTIAL does not—without the 18 submission of competent evidence by declaration, establishing that the material 19 sought to be filed under seal qualifies as confidential, privileged, or otherwise 20 protectable—constitute good cause. 21 Further, if a party requests sealing related to a dispositive motion or trial, 22 then compelling reasons, not only good cause, for the sealing must be shown, and 23 the relief sought shall be narrowly tailored to serve the specific interest to be 24 protected. See Pintos v. Pacific Creditors Ass’n,

(9th Cir. 25 2010). For each item or type of information, document, or thing sought to be filed 26 or introduced under seal in connection with a dispositive motion or trial, the party 27 seeking protection must articulate compelling reasons, supported by specific facts 28 and legal justification, for the requested sealing order. Again, competent evidence 1 supporting the application to file documents under seal must be provided by 2 declaration. 3 Any document that is not confidential, privileged, or otherwise protectable 4 in its entirety will not be filed under seal if the confidential portions can be 5 redacted. If documents can be redacted, then a redacted version for public 6 viewing, omitting only the confidential, privileged, or otherwise protectable 7 portions of the document shall be filed. Any application that seeks to file 8 documents under seal in their entirety should include an explanation of why 9 redaction is not feasible. 10 2. DEFINITIONS 11 2.1 Action: This pending federal lawsuit, Case No. 2:21-cv-05265-JFW- 12 RAOx. 13 2.2 Challenging Party: A Party or Non-Party challenging a designation 14 under this Order. 15 2.3 “CONFIDENTIAL” Information or Items: Information (regardless of 16 how it is generated, stored, or maintained) or tangible things that qualify for 17 protection under Federal Rule of Civil Procedure 26(c), including PHI (e.g., patient 18 records, identifiers), proprietary or financial information (e.g., trade secrets, 19 statistical models, algorithms, government communications, financial records, 20 claims data, operational policies, internal leadership communications, raw data sets), 21 where the Designating Party reasonably believes public disclosure would cause 22 specific, identifiable harm. This excludes information foundational to claims or 23 defenses (e.g., statistical analyses or patient data subsets identified in pleadings or 24 discovery responses) unless specific justification is provided at designation. 25 2.4 Counsel: Outside Counsel of Record and House Counsel (as well as 26 their support staff). 27 28 1 2.5 Designating Party: a Party or Non-Party that designates information or 2 items that it produces in disclosures or in responses to discovery as 3 “CONFIDENTIAL.” 4 2.6 Disclosure or Discovery Material: all items or information, regardless 5 of the medium or manner in which it is generated, stored, or maintained (including, 6 among other things, testimony, transcripts, and tangible things) that are produced or 7 generated in disclosures or responses to discovery in this matter. 8 2.7 Expert: a person with specialized knowledge or experience in a matter 9 pertinent to the litigation who has been retained by a Party or its counsel to serve as 10 an expert witness or as a consultant in this Action. 11 2.8 House Counsel: attorneys who are employees of a party to this Action. 12 House Counsel does not include Outside Counsel of Record or any other outside 13 counsel. 14 2.9 Non-Party: any natural person, partnership, corporation, association or 15 other legal entity not named as a Party to this action. 16 2.10 Outside Counsel of Record: attorneys who are not employees of a party 17 to this Action but are retained to represent or advise a party to this Action and have 18 appeared in this Action on behalf of that party or are affiliated with a law firm that 19 has appeared on behalf of that party, and includes support staff. 20 2.11 Party: any party to this Action, including all of its officers, directors, 21 employees, consultants, retained experts, and Outside Counsel of Record (and their 22 support staffs). 23 2.12 Producing Party: a Party or Non-Party that produces Disclosure or 24 Discovery Material in this Action. 25 2.13 Professional Vendors: persons or entities that provide litigation support 26 services (e.g., photocopying, videotaping, translating, preparing exhibits or 27 demonstrations, and organizing, storing, or retrieving data in any form or medium) 28 and their employees and subcontractors. 1 2.14 Protected Material: Disclosure or Discovery Material designated as 2 “CONFIDENTIAL.” 3 2.15 Receiving Party: a Party that receives Disclosure or Discovery Material 4 from a Producing Party. 5 2.16 “Unredacted Complaint” means the unredacted version of the original 6 complaint filed by Relator on June 29, 2021, containing personally identifiable 7 information and/or PHI, which is to be maintained as confidential pursuant to the 8 Joint Stipulation to Maintain Confidentiality of Pleadings Filed Under Seal (ECF 9 No. 45) and this Protective Order. 10 3. SCOPE 11 The protections conferred by this Stipulation and Order cover not only 12 Protected Material (as defined above), but also (1) any information copied or 13 extracted from Protected Material; (2) all copies, excerpts, summaries, or 14 compilations of Protected Material; and (3) any testimony, conversations, or 15 presentations by Parties or their Counsel that might reveal Protected Material. 16 Any use of Protected Material at trial shall be governed by the orders of the 17 trial judge. This Order does not govern the use of Protected Material at trial. 18 This Order applies to all materials responsive to pending discovery requests, 19 including those previously withheld pending its entry, which must be produced 20 within fourteen (14) days of this Order’s entry unless objected to on non- 21 confidentiality grounds, with failure to comply subject to sanctions absent good 22 cause. 23 For the avoidance of doubt, this Protective Order applies to the Unredacted 24 Complaint. The Unredacted Complaint shall be deemed “CONFIDENTIAL” under 25 this Order and treated in accordance with all provisions applicable to Protected 26 Material. 27 // 28 // 1 4. DURATION 2 Once a case proceeds to trial, information that was designated as 3 CONFIDENTIAL or maintained pursuant to this protective order used or introduced 4 as an exhibit at trial becomes public and will be presumptively available to all 5 members of the public, including the press, unless compelling reasons supported by 6 specific factual findings to proceed otherwise are made to the trial judge in advance 7 of the trial. See Kamakana,

(distinguishing “good cause” 8 showing for sealing documents produced in discovery from “compelling reasons” 9 standard when merits-related documents are part of court record). Accordingly, the 10 terms of this protective order do not extend beyond the commencement of the trial. 11 5. DESIGNATING PROTECTED MATERIAL 12 5.1 Exercise of Restraint and Care in Designating Material for Protection. 13 Each Party or Non-Party that designates information or items for protection 14 under this Order must take care to limit any such designation to specific material 15 that qualifies under the appropriate standards. The Designating Party must designate 16 for protection only those parts of material, documents, items, or oral or written 17 communications that qualify so that other portions for which protection is not 18 warranted are not swept unjustifiably within the ambit of this Order. For materials 19 foundational to a party’s claims or defenses, such as statistical data, analytical 20 methodologies, or witness statements identified in pleadings or discovery responses, 21 the Designating Party must provide a brief written justification for the designation 22 at the time of production. 23 Mass, indiscriminate, tactical, or routinized designations are prohibited. 24 Designations that are shown to be clearly unjustified or made for an improper 25 purpose (e.g., to unnecessarily encumber the case development process or impose 26 unnecessary expenses and burdens on other parties) may expose the Designating 27 Party to sanctions. Sanctions apply for frivolous designations or failure to justify 28 foundational material designations. 1 If a Designating Party learns that designated information does not qualify for 2 protection, it must promptly notify all other Parties and withdraw the designation. 3 5.2 Manner and Timing of Designations. 4 Except as otherwise provided in this Order or stipulated, Disclosure or 5 Discovery Material that qualifies for protection must be clearly designated before 6 disclosure or production. Designation requires: 7 (a) For documentary information, the Producing Party must affix 8 “CONFIDENTIAL” to each page containing protected material. If only a portion 9 qualifies, the protected portion(s) must be clearly identified (e.g., by margin 10 markings). For materials produced in native format (e.g., Excel, PowerPoint), the 11 Producing Party must include a written notice identifying specific protected portions 12 with production. Within seven (7) business days of production, the Producing Party 13 must provide a log (e.g., privilege log or confidentiality index) listing each 14 designated document (by Bates number) and the specific basis for designation (e.g., 15 trade secret, PHI, competitive harm). Failure to comply waives the designation 16 unless good cause is shown. 17 (b) For deposition testimony, the Designating Party must identify protected 18 testimony on the record before the deposition closes. 19 (c) For other tangible items, the Producing Party must affix the 20 “CONFIDENTIAL” legend on the container or identify protected portions to the 21 extent practicable. 22 A Party or Non-Party making original documents available for inspection 23 need not designate them until after the inspecting Party selects documents for 24 copying. During inspection, all materials are deemed “CONFIDENTIAL.” After 25 selection, the Producing Party must designate qualifying documents before 26 production. 27 \\ 28 \\ 1 5.3 Inadvertent Failures to Designate. 2 If timely corrected, within 10 days of discovery, an inadvertent failure to 3 designate qualified information or items does not, standing alone, waive the 4 Designating Party’s right to secure protection under this Order for such material. 5 Upon timely correction of a designation, the Receiving Party must make reasonable 6 efforts to assure that the material is treated in accordance with the provisions of this 7 Order. 8 6. CHALLENGING CONFIDENTIALITY DESIGNATIONS 9 6.1 Timing of Challenges 10 Any Party or Non-Party may challenge a confidentiality designation at any 11 time consistent with the Court’s Scheduling Order. 12 6.2 Meet and Confer 13 The Challenging Party shall initiate the dispute resolution process under Local 14 Rule 37.1 et seq. The Designating Party must respond in writing within seven (7) 15 business days, justifying the designation with particularity. Parties are encouraged 16 to pursue Judge Oliver’s informal discovery dispute resolution process (joint email 17 to [email protected] before filing a motion), per her procedures. 18 6.3 Burden and Resolution 19 The burden of persuasion in any challenge proceeding rests on the 20 Designating Party proving confidentiality via declaration within fourteen (14) days 21 of challenge notice, detailing specific harm (e.g., competitive injury, privacy breach) 22 per FRCP 26(c). Frivolous challenges or those made for improper purposes may 23 expose the Challenging Party to sanctions. Unless the Designating Party has waived 24 or withdrawn the designation, all parties shall treat the material as CONFIDENTIAL 25 until the Court rules. If the parties cannot resolve the dispute within fourteen (14) 26 business days of the initial challenge notice, either party may file a motion under 27 Local Rule 37, provided disputes are raised at least four (4) weeks before the 28 discovery cutoff per the District Judge’s scheduling order. For foundational 1 materials (e.g., statistical data or methodologies underlying claims), the Court may 2 expedite review to ensure timely access. 3 7. ACCESS TO AND USE OF PROTECTED MATERIAL 4 7.1 Basic Principles 5 A Receiving Party may use Protected Material only for prosecuting, 6 defending, or settling this Action. Such material may be disclosed only to authorized 7 persons under this Order and must be stored securely. 8 7.2 Disclosure of “CONFIDENTIAL” Information or Items 9 Unless otherwise ordered or permitted by the Designating Party, a Receiving 10 Party may disclose “CONFIDENTIAL” information only to: 11 (a) the Receiving Party’s Outside Counsel of Record in this Action, as 12 well as employees of said Outside Counsel of Record to whom it is reasonably 13 necessary to disclose the information for this Action; 14 (b) the officers, directors, and employees (including House Counsel) 15 of the Receiving Party to whom disclosure is reasonably necessary for this Action; 16 (c) Experts (as defined in this Order) of the Receiving Party to whom 17 disclosure is reasonably necessary for this Action and who have signed the 18 “Acknowledgment and Agreement to Be Bound” (Exhibit A); 19 (d) the court and its personnel; 20 (e) court reporters and their staff; 21 (f) professional jury or trial consultants, mock jurors, and Professional 22 Vendors to whom disclosure is reasonably necessary for this Action and who have 23 signed the “Acknowledgment and Agreement to Be Bound” (Exhibit A); 24 (g) the author or recipient of a document containing the information or 25 a custodian or other person who otherwise possessed or knew the information; 26 (h) during their depositions, witnesses, and attorneys for witnesses, in 27 the Action to whom disclosure is reasonably necessary provided: (1) the deposing 28 party requests that the witness sign the form attached as Exhibit A hereto; and (2) 1 they will not be permitted to keep any confidential information unless they sign the 2 “Acknowledgment and Agreement to Be Bound” (Exhibit A), unless otherwise 3 agreed by the Designating Party or ordered by the court. Pages of transcribed 4 deposition testimony or exhibits to depositions that reveal Protected Material may 5 be separately bound by the court reporter and may not be disclosed to anyone except 6 as permitted under this Stipulated Protective Order; and 7 (i) any mediator or settlement officer, and their supporting personnel, 8 mutually agreed upon by any of the parties engaged in settlement discussions. 9 (j) For foundational materials underlying a party’s claims or defenses 10 (e.g., statistical data, patient data subsets, or analytical methodologies identified in 11 discovery responses), the Receiving Party may disclose redacted or de-identified 12 versions to additional persons as reasonably necessary for litigation (e.g., experts or 13 counsel staff), provided PHI is protected per HIPAA and trade secrets are 14 safeguarded; Plaintiff’s personnel must sign Exhibit A to access Defendants’ 15 foundational materials, and Defendants’ personnel may access Plaintiff’s 16 foundational materials without signing Exhibit A if previously known to them. To 17 the extent there is any inconsistency between Exhibit A to the Joint Stipulation to 18 Maintain Confidentiality of Pleadings Filed Under Seal and Exhibit A to this 19 Protective Order, the terms of this Protective Order shall control, and Exhibit A 20 hereto shall govern acknowledgments going forward. 21 8. PROTECTED MATERIAL SUBPOENAED OR ORDERED 22 PRODUCED IN OTHER LITIGATION 23 If a Party is served with a subpoena or a court order issued in other litigation 24 that compels disclosure of any information or items designated in this Action as 25 “CONFIDENTIAL,” that Party bears the burden of seeking protection and must: 26 (a) promptly notify in writing the Designating Party. Such notification 27 shall include a copy of the subpoena or court order; 28 1 (b) promptly notify in writing the party who caused the subpoena or 2 order to issue in the other litigation that some or all of the material covered by the 3 subpoena or order is subject to this Protective Order. Such notification shall include 4 a copy of this Stipulated Protective Order; and 5 (c) cooperate with respect to all reasonable procedures sought to be 6 pursued by the Designating Party whose Protected Material may be affected. 7 (d) If a Party seeks to obtain financial information about another Party 8 from a third party in this Action via subpoena under FRCP 45, the subpoenaing Party 9 must notify the affected Party within five (5) business days of issuance, providing a 10 copy of the subpoena. The affected Party may object within seven (7) days, 11 triggering a meet-and-confer under Local Rule 37.1 and, if unresolved, Judge 12 Oliver’s informal dispute resolution process (joint email to 13 [email protected]). Such subpoenas must demonstrate specific 14 relevance to claims or defenses (e.g., funding of statistical analyses for Plaintiff or 15 operational practices for Defendants), and the affected Party may move to quash 16 under FRCP 45(d)(3) if unduly burdensome or unrelated to FCA allegations. Any 17 third-party material produced shall be designated ‘CONFIDENTIAL’ and subject to 18 this Order unless the Court rules otherwise. 19 If the Designating Party timely seeks a protective order, the Party served with 20 the subpoena or court order shall not produce any information designated in this 21 action as “CONFIDENTIAL” before a determination by the court from which the 22 subpoena or order issued, unless the Party has obtained the Designating Party’s 23 permission. The Designating Party shall bear the burden and expense of seeking 24 protection in that court of its confidential material and nothing in these provisions 25 should be construed as authorizing or encouraging a Receiving Party in this Action 26 to disobey a lawful directive from another court. 27 \\ 28 \\ 1 9. A NON-PARTY’S PROTECTED MATERIAL SOUGHT TO BE 2 PRODUCED IN THIS LITIGATION 3 (a) The terms of this Order are applicable to information produced by 4 a Non-Party in this Action and designated as “CONFIDENTIAL.” Such information 5 produced by Non-Parties in connection with this litigation is protected by the 6 remedies and relief provided by this Order. Defendants may seek third-party 7 discovery of Plaintiff’s financial information relevant to claims or defenses, with 8 Non-Parties encouraged to produce under this Order’s protections. Nothing in these 9 provisions should be construed as prohibiting a Non-Party from seeking additional 10 protections. 11 (b) In the event that a Party is required, by a valid discovery request, 12 to produce a Non-Party’s confidential information in its possession, and the Party is 13 subject to an agreement with the Non-Party not to produce the Non-Party’s 14 confidential information, then the Party shall: 15 (1) promptly notify within five (5) days of discovery requests in 16 writing the Requesting Party and the Non-Party that some or all of the information 17 requested is subject to a confidentiality agreement with a Non-Party; 18 (2) promptly provide the Non-Party with a copy of the Stipulated 19 Protective Order in this Action, the relevant discovery request(s), and a reasonably 20 specific description of the information requested; and 21 (3) make the information requested available for inspection by 22 the Non-Party, if requested. 23 (c) If the Non-Party fails to seek a protective order from this court 24 within fourteen (14) days of receiving the notice and accompanying information, the 25 Receiving Party may produce the Non-Party’s confidential information responsive 26 to the discovery request. If the Non-Party timely seeks a protective order, the 27 Receiving Party shall not produce any information in its possession or control that 28 is subject to the confidentiality agreement with the Non-Party before a determination 1 by the court. Absent a court order to the contrary, the Non-Party shall bear the 2 burden and expense of seeking protection in this court of its Protected Material. 3 10. TERMS SPECIFIC TO PROTECTED HEALTH INFORMATION 4 10.1 This Order is a Qualified Protective Order under

164.512(e). 6 10.2 PHI use is restricted to this litigation, including all appellate 7 proceedings or the expiration of time to commence such appellate proceedings 8 (“Litigation”). Covered entities as defined in

(“Covered 9 Entities”) may disclose PHI responsive to discovery to authorized persons, including 10 de-identified data sets where feasible. 11 10.3 Pursuant to

(e)(1) and for purposes of compliance 12 with the Health Insurance Portability and Accountability Act (“HIPAA”), the parties 13 and the parties’ legal counsel in this case, the employees and agents of each party 14 and each party’s legal counsel in this case, and all non-party Covered Entities are 15 expressly and specifically prohibited from using or disclosing PHI in accordance 16 with this order for any purpose other than the Litigation. 17 10.4 Pursuant to

(e)(1) and for purposes of HIPAA 18 compliance, each deponent noticed for deposition in this case, including but not 19 limited to a party, a fact witness, a records custodian, an expert, or a Covered Entity 20 of any type, is expressly and specifically authorized to use or to disclose to the 21 parties’ legal counsel in this case and the employees and agents of each party and 22 each party’s legal counsel in this case, the PHI that is responsive to deposition 23 questions or a valid subpoena duces tecum. 24 10.5 Pursuant to

(e)(1) and for purposes of HIPAA 25 compliance, any person or entity authorized or ordered above to use or disclose PHI 26 is expressly and specifically authorized to do so with, to, or before any court reporter 27 service, videographer service, translation service, photocopy service, document 28 management service, records management service, graphics service, or other such 1 litigation service provider (“service providers”), engaged by a party or a party’s legal 2 counsel in this case. The protections and requirements of Paragraphs 4 and 9 of this 3 Protective Order apply to such service providers. Each party or the party’s legal 4 counsel is charged with obtaining advance consent of such service provider to 5 comply with this paragraph. Upon such consent, the service provider will be deemed 6 to have voluntarily submitted to this court’s jurisdiction during the pendency of this 7 case for purposes of enforcement of this paragraph, including but not limited to the 8 imposition of such sanctions as may be appropriate for any non- compliance. 9 10.6 Service providers must sign Exhibit A and comply. 10 10.7 Except for business associate agreements (as defined by HIPAA) 11 entered into by a party or a party’s legal counsel for purposes of satisfying the 12 requirements of Paragraph 11 above, the uses and disclosures of PHI authorized 13 under this Protective Order are separate from, and not to be deemed subject to, any 14 business associate agreement that has been or will be executed by any party, any 15 party’s legal counsel, or any disclosing person or entity. No use or disclosure made 16 pursuant to this Protective Order shall be deemed to require the execution of a 17 business associate agreement (as defined by HIPAA). The intent of this Protective 18 Order is that such business associate agreements, including any requirement for such 19 agreements under the HIPAA regulations, should be construed as inapplicable to 20 uses and disclosures under this Protective Order and as limited only to uses and 21 disclosures of PHI outside of this Protective Order. 22 11. TERMS SPECIFIC TO PROPRIETARY INFORMATION 23 11.1 Production does not waive confidentiality rights. 24 11.2 Objections to designations must be raised within fourteen (14) days, 25 followed by meet-and-confer. The Designating Party must justify via motion with a 26 declaration within fourteen (14) days thereafter, or protection lapses. Failure to 27 produce responsive documents after designation lapses incurs sanctions unless good 28 1 cause is shown. Parties are encouraged to use Judge Oliver’s informal resolution 2 process before motion practice. 3 12. UNAUTHORIZED DISCLOSURE OF PROTECTED MATERIAL 4 If a Receiving Party learns that, by inadvertence or otherwise, it has disclosed 5 Protected Material to any person or in any circumstance not authorized under this 6 Stipulated Protective Order, the Receiving Party must immediately (a) notify in 7 writing the Designating Party of the unauthorized disclosures, (b) use its best efforts 8 to retrieve all unauthorized copies of the Protected Material, (c) inform the person 9 or persons to whom unauthorized disclosures were made of all the terms of this 10 Order, and (d) request such person or persons to execute the “Acknowledgment and 11 Agreement to Be Bound” that is attached hereto as Exhibit A. 12 The Unredacted Complaint shall not be filed publicly or attached to any filing 13 unless redacted or filed under seal pursuant to Local Rule 79-5. The parties agree 14 that the Unredacted Complaint qualifies as Protected Material under this Order and 15 that good cause exists to maintain its confidentiality. 16 13. INADVERTENT PRODUCTION OF PRIVILEGED OR OTHERWISE 17 PROTECTED MATERIAL 18 When a Producing Party gives notice to Receiving Parties that certain 19 inadvertently produced material is subject to a claim of privilege or other protection, 20 the obligations of the Receiving Parties are those set forth in Federal Rule of Civil 21 Procedure 26(b)(5)(B). This provision is not intended to modify whatever procedure 22 may be established in an e-discovery order that provides for production without prior 23 privilege review. Pursuant to Federal Rule of Evidence 502(d) and (e), insofar as 24 the parties reach an agreement on the effect of disclosure of a communication or 25 information covered by the attorney-client privilege or work product protection, the 26 parties may incorporate their agreement in the stipulated protective order submitted 27 to the court. 28 \\ 1 14. MISCELLANEOUS 2 14.1 Right to Further Relief 3 Nothing in this Order abridges the right of any person to seek modification by 4 the Court for good cause. 5 14.2 Right to Assert Other Objections 6 This Order does not affect a party’s right to object to discovery on other 7 grounds. 8 14.3 Filing Protected Material 9 Without Designating Party consent, Protected Material may not be filed 10 publicly. A party seeking to file Protected Material must follow Local Civil Rule 79- 11 5. For foundational materials, the filing party may propose redactions to avoid 12 sealing where practicable, subject to Court approval. 13 15. FINAL DISPOSITION 14 Within 60 days of the Action’s termination, each Receiving Party must return 15 or destroy all Protected Material, including copies, and provide written certification. 16 Defendants may retain copies of foundational materials necessary to defend against 17 subsequent claims or investigations arising from this litigation, provided such 18 materials remain subject to this Order. Counsel may retain archival copies of 19 pleadings, motions, transcripts, exhibits, legal memoranda, correspondence, drafts, 20 raw data, or work product containing Protected Material, subject to this Order’s 21 protections. 22 16. VIOLATION 23 Any violation of this Order may be punished by appropriate measures, 24 including contempt proceedings and/or monetary sanctions. 25 26 IT IS SO STIPULATED, THROUGH COUNSEL OF RECORD. 27 28 Dated: May 13, 2025 Respectfully submitted, 2 /s/ Daniel R. Paluch 3 GIPSON HOFFMAN & PANCIONE Daniel R. Paluch 4 Daniel B. Lifschitz 5 Attorneys for Plaintiff and Relator 61) Dated: May 13, 2025 7 /s/ Matthew Donald Umhofer 8 UMHOFER, MITCHELL & KING, LLP Matthew Donald Umhofer 9 Elizabeth A. Mitchell 10 Eugene Lim

4 Attorneys for Defendants 2. 2 FOR GOOD CAUSE SHOWN, IT IS SO ORDERED. < 13 ao 14 5 + ° 15 <2 Dated: 5/14/2025 Rayehis Qa. O42. eae zo (16 HONORABLE ROZELLA A. OLIVER 1932008073140, v4 UNITED STATES MAGISTRATE JUDGE Zo aa 18

19 20 21 22 23 24 25 26 27 28 18

1 EXHIBIT A 2 ACKNOWLEDGMENT AND AGREEMENT TO BE BOUND 3 4 I, _____________________________ [print or type full name], of 5 _________________ [print or type full address], declare under penalty of perjury 6 that I have read in its entirety and understand the Stipulated Protective Order that 7 was issued by the United States District Court for the Central District of California 8 on ___________ [date] in the case of United States of America and the State of 9 California, ex rel., Integra Med Analytics LLC, v. William Nelson, an individual, et 10 al., 2:21-cv-05265-JFW-RAOx. I agree to comply with and to be bound by all the 11 terms of this Stipulated Protective Order and I understand and acknowledge that 12 failure to so comply could expose me to sanctions and punishment in the nature of 13 contempt. I solemnly promise that I will not disclose in any manner any 14 information or item that is subject to this Stipulated Protective Order to any person 15 or entity except in strict compliance with the provisions of this Order. 16 I further agree to submit to the jurisdiction of the United States District Court 17 for the Central District of California for enforcing the terms of this Stipulated 18 Protective Order, even if such enforcement proceedings occur after termination of 19 this action. I hereby appoint __________________________ [print or type full 20 name] of _______________________________________ [print or type full address 21 and telephone number] as my California agent for service of process in connection 22 with this action or any proceedings related to enforcement of this Stipulated 23 Protective Order. 24 Date: ______________________________________ 25 City and State where sworn and signed: _________________________________ 26 Printed name: _______________________________ 27