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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>EACH REGULAR AND MEDICAL SERVICE PROVIDER ASSOCIATE MEMBER, COLLECTIVELY REFERRED TO AS "VOTING MEMBERS," SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE AT A MEETING OF THE MEMBERS, EXCEPT AS OTHERWISE PROVIDED BY THE PROVISIONS OF THE DELAWARE GENERAL CORPORATION LAW OR OTHER LAWS OF THE STATE OF DELAWARE, BY THE ARTICLES OF INCORPORATION OR BY OTHER PROVISIONS OF THESE BYLAWS. MEMBERS WHO ARE NOT VOTING MEMBERS (EDUCATIONAL AFFILIATES, LEGAL AFFILIATES, FINANCIAL AFFILIATES, AND HONORARY MEMBERS) SHALL NOT BE ENTITLED TO ANY VOTES. ONLY VOTING REPRESENTATIVES OF MEMBERS CURRENT ON THEIR DUES MAY VOTE. OFFICERS AND DIRECTORS SHALL BE ELECTED BY BALLOT OF THE VOTING MEMBERS OF THE ASSOCIATION DISTRIBUTED NOT LESS THAN FORTY-FIVE (45) DAYS PRIOR TO AN ANNUAL MEETING OF THE MEMBERSHIP, WHICH BALLOTS SHALL SPECIFY A DEADLINE FOR RETURN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>BYLAWS MAY BE ADOPTED, AMENDED, OR REPEALED BY TWO-THIRDS (2/3) OF THE AFFIRMATIVE VOTE OR BY THE WRITTEN CONSENT OF THE MAJORITY OF VOTING MEMBERS WHO RESPOND TO A BALLOT, EITHER PHYSICAL OR ELECTRONIC, CONDUCTED IN ACCORDANCE WITH PROVISIONS OF ARTICLE XI. THE ENTIRE BOARD OR ANY INDIVIDUAL DIRECTOR MAY BE REMOVED FROM OFFICE WITHOUT CAUSE BY AN AFFIRMATIVE MAJORITY VOTE OF THE VOTING MEMBERS ENTITLED TO VOTE ON SUCH REMOVAL, OR AS OTHERWISE PROVIDED IN THE GENERAL NOT FOR PROFIT CORPORATION ACT, AT A MEETING EXPRESSLY CALLED FOR THAT PURPOSE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FORM 990 IS REVIEWED IN DETAIL BY THE SECRETARY/TREASURER FOR ACCURACY AND COMPLETENESS BEFORE IT IS PRESENTED TO ALL OF THE DIRECTORS AND FILED WITH THE INTERNAL REVENUE SERVICE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE ORGANIZATION DID NOT MAKE ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC DURING THE TAX YEAR. THE ORGANIZATION DOES NOT HAVE A WRITTEN CONFLICT OF INTEREST POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>CONSULTING FEES 221,612.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
  </ReturnData>
</Return>