1 EXHIBIT 10.9 CONSULTING AGREEMENT THIS CONSULTING AGREEMENT ("Agreement") is made and entered into as of the 1st day of September, 1996, by and among BIRMAN MANAGED CARE, INC., a Tennessee corporation (the "Company"); RRCG, L.L.C., an Arizona limited liability company, ("Consultant") and RICHARD M. ROSS, an Arizona resident ("Principal"). W I T N E S S E T H: WHEREAS, Principal is as of the date hereof the legal and beneficial owner of the majority of the outstanding membership units of Consultant (including its economic interests); and is Consultant's sole employee devoted to the engagement described herein; and WHEREAS, the Company, Consultant and Principal mutually desire that Consultant be engaged in accordance with the terms and conditions hereof; NOW, THEREFORE, in consideration of the foregoing, the payment of $1.00 and other good and valuable consideration and the mutual covenants and agreements contained herein, the receipt and sufficiency whereof the parties hereby acknowledge, the parties hereto, intending to be legally bound, hereby agree as follows: 1. Engagement. The Company hereby engages Consultant and Consultant hereby accepts engagement from the Company as a consultant. Consultant shall perform services for the Company for the period and upon the terms and conditions set forth in this Agreement. The term "Company" as used herein shall mean the Company and its Affiliates. "Affiliate" means an entity or person that, directly, or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, the person specified, including the holder of five percent (5%) or more of the beneficial ownership of the Company. 2. Term. The term of this Agreement shall commence as of the date hereof and, unless terminated sooner as provided in Article 7 herein, shall continue up to and including August 31, 1997 (the "Initial Term"). Following the expiration of the Initial Term, this Agreement shall automatically be renewed for one or more (but not more than five (5)) successive one (1) years terms, unless this Agreement has been sooner terminated in accordance with Section 7. 3. Scope of Engagement. 3.01 Services. During the term of this Agreement, Consultant shall consult with and advise the Company as to business development; corporate strategies; opportunities for mergers and acquisitions and other ventures related to the Company's business, all as reasonably requested by the Board of Directors or the Chief Executive Officer from time to time. 2 3.02 Performance of Services. (A) Consultant and Principal shall serve the Company faithfully and to the best of its and his ability and devote such time, attention, skill and effort as is required to effectively discharge its and his duties hereunder, consistent with the standards of conduct and professionalism applicable to the health care industry. Principal shall make himself available to the Company during business hours on business days, and may be required to expend up to, but not in excess of, seventy-five (75) hours per month (non-cumulative) on Company matters. The manner, means and methods of conducting the Services are under the sole control of Consultant so long as they are lawful and consistent with the terms of this Agreement. (B) Neither Consultant nor Principal shall provide services on behalf of or with respect to any business which is competitive with any of the Company's plans, programs or products ("Competing Business"). Subject to the foregoing, and subject further to the provisions of Articles 5 and 6 hereof, Consultant may, with the consent of the Company (which shall not unreasonably be withheld), provide services to entities which engage in a Competing Business. Consultant shall receive reimbursement for travel and other business expenses of Principal in accordance with Section 4.02. The consent referred to above shall be deemed to have been given by the Company if the Company fails to respond in writing to a Notice of Proposed Services given by Ross within ten (10) days after receipt of such Notice by the Company. The term "Notice of Proposed Service" shall mean a writing signed by Ross and sent by certified mail, return receipt requested, to (i) the Company's Chief Executive Officer and (ii) the Company's Chief Financial Officer, describing in reasonable detail the entity for whom services will be performed, the nature of the services proposed, and the amount of time which Ross expects to expend. 3.03 Independent Contractor. The parties intend that an independent contractor relationship be created by this Agreement. None of the benefits provided by the Company to its employees will be provided to Consultant or Principal, except as specifically set forth in this Agreement. Neither Consultant nor Principal shall be deemed to be the employee of the Company, or as an agent of the Company except as otherwise specifically agreed upon by the parties. Consultant shall have no authority to bind the Company unless specifically authorized by an executive officer of the Company. 4. Compensation. 4.01 Fee. During the Initial Term and any Renewal Terms, the Company shall pay to Consultant as compensation for all services to be rendered by Consultant and Principal under this Agreement a consulting fee ("Fee") as follows: 2 3 One Hundred Eighty Six Thousand Dollars ($186,000), to be paid in monthly installments of $15,500.00, mid-month, with the first installment due on September 15, 1996 and with each subsequent installment due on the fifiteenth (15th) day of the month next following. 4.02 Expenses. The Company will pay or reimburse Consultant for all reasonable and necessary travel and other out-of-pocket expenses incurred by Principal in the performance of duties under this Agreement (except as provided in Section 4.03 below), subject to the presentment of appropriate vouchers in accordance with the Company's policies and procedures as adopted from time to time. Notwithstanding the foregoing, the Company must pre-approve any single expense which exceed $500.00 and any expenses in excess of an aggregate of $1500.00 per month. Payments will be made to Consultant within twenty (20) days after presentment of invoice. The Company will make all travel arrangements for Consultant for airline travel outside Maricopa County, Arizona on Company business. 4.03 Office Facilities. Consultant shall be responsible for its office facilities as well as such staff, equipment and materials as may Consultant may deem necessary for Consultant to fulfill its duties under this Agreement. 5. Confidentiality; Return of Materials. 5.01 Consequences of Entrustment. Consultant and Principal hereby acknowledge that (i) the services to the Company will be of a special, unique, extraordinary and intellectual character, (ii) Consultant's engagement by the Company will place Consultant and Principal in a position of confidence, responsibility and trust with respect to the operations of the Company, and (iii) in reliance on Consultant's and Principal's ethical responsibility and loyalty, the Company have entrusted and expect to entrust Consultant and Principal with highly sensitive, confidential, restricted and proprietary information involving Trade Secret Information (as hereinafter defined). Consultant and Principal acknowledge that Consultant and Principal are legally and ethically responsible for protecting and preserving the proprietary rights of the Company for use only for the benefit of the Company, and these responsibilities may impose limitations on Consultant's and Principal's ability to pursue some kinds of business opportunities that might interest Consultant after the termination of Consultant's and Principal's employment. 5.02 Definition of "Trade Secret Information". For purposes of this Agreement, "Trade Secret Information" means information, whether or not in written or tangible form, in the possession of the Company and considered by the Company to be proprietary, valuable and confidential, from which the Company derives economic value, actual or potential, by such information not being generally known to, and not being readily ascertainable by proper means by, other persons who can obtain economic value from its disclosure or use, and is the subject of efforts that are reasonable under the circumstances to maintain its secrecy. Trade Secret Information includes, without limitation, (a) any data or information acquired by Consultant and Principal during their engagement by the Company relating to the products, services, business methods, customer accounts or operations of the Company or any customer or business 3 4 partner of the Company, and (b) the techniques and business methods for (i) applying scientific literature to merge resources and clinical language used in defining medical payments for purposes of quality management and utilization review, (ii) developing and managing health care provide organizations and providing services thereto, (iii) developing reimbursement and at-risk systems under capitation, prepayment, indemnity and other forms of compensatory arrangements, and (iv) managing the delivery, reporting and financing of health care services in managed care and managed cost settings, including the systems, techniques, strategies and methods used to compete successfully in these lines of business and the managed care business of the Company generally. 5.03 Restrictions on Use and Disclosure of Trade Secret Information. Except as authorized by the Company, neither Principal or Consultant shall during the term of this Agreement and for so long after the termination of this Agreement as the information or data remains Trade Secret Information, directly or indirectly divulge, furnish or make accessible to anyone or use in any way (other than in the ordinary course of business of the Company) the Trade Secret Information. 5.04 Return of Materials. Upon the request of the Company and, in any event, upon the termination of Consultant's engagement, Consultant and Principal shall return to the Company and leave at the disposal of the Company all copies of memoranda, notes, records, drawings, manuals, computer programs, documentation, diskettes and other documents or media, in Consultant's or Principal's possession or control, pertaining in any way to the business, practices or techniques of the Company. 6. Restrictions on Competition. 6.01 Premises. The Company has invested prior to the date hereof and expects to continue to invest considerable time, effort and capital in developing the business of the Company and enhancing the value and desirability of the skills of its executives, technical personnel and consultants. This investment, together with the Fee, reflect the Company's expectation of receiving a considerable return from the exclusive use of Consultant's services and know-how in the future, free from any risk that the Company's competitors may attempt to induce Consultant or Principal to leave the Company and wrongfully gain the benefit of the Company's investment. The partial restraint set forth in Section 6.02 hereof does not, and cannot, provide complete protection for the Company's investment, but the Company, on the one hand, and Consultant and Principal, on the other hand, believe that, in combination with the other provisions of this Agreement, it is a fair and reasonable measure permitted under applicable law to protect the Company's interests, giving due regard to both the interests of Consultant and Principal and the interests of the Company. Consultant and Principal hereby (i) agree that the restrictions contained within Section 6 are reasonable and necessary for the protection of the goodwill of the business of the Company during the term of this Agreement and thereafter and that the limitations as to period of time and geographic area contained in Section 6.02 are reasonable and necessary for the protection of the Company's business; and (ii) acknowledge that the Company would not have entered into this Agreement but for these restrictions. 4 5 6.02 Covenant Not to Compete; Solicit. In consideration of Consultant's engagement hereunder, together with the Fee payable to Consultant, during the term of this Agreement and for a period equal to the two (2) years from the termination of this Agreement for any reason, neither Consultant nor Principal shall: (a) directly or indirectly, for itself, himself, as an owner, partner, principal, shareholder, officer, director, employee, or independent contractor engage in the development, management or operation of any Managed Care Plan within fifty (50) miles from any city or town where the Company has engaged in the development, management or operation of a Managed Care Plan; or (b) attempt, directly or indirectly, to solicit or entice (i) any employee or consultant of the Company to terminate his or her employment or consultancy with the Company or to become employed by or associated with any person, firm or corporation other than the Company, or approach any such employee or associate of any of the foregoing purposes or authorize or assist in the taking of any such action by any third party; (ii) any existing customer, business partner or client of the Company to terminate or reduce its relationship with the Company; or (iii) any prospective customer, business partner or client of the Company to refrain from doing business with the Company. (c) a "Managed Care Plan" shall be defined as independent practice associations ("IPAs"), physician-hospital organizations ("PHOs"), management services organizations ("MSOs"), preferred provide organizations ("PPOs"), integrated delivery systems ("IDS"), health maintenance organizations ("HMOs"), point of service ("POS") plans, long-term plans, third-party administrators ("TPAs") or other types of managed care organizations ("MCOs") that contract with commercial third-party payors, self-insured employers, health care purchasing cooperatives or Medicare fiscal intermediaries for the delivery of health care services, engage in the development, management or operation of any such IPAs, PHOs, MSOs, PPOs, IDS, HMOs, POS plans, long-term plans, TPAs or other MCOs; 6.03 Interpretation. If Consultant or Principal violates the restrictive covenant in Section 6.02 and the Company brings legal action for injunctive or other relief, the Company shall not, as a result of the time involved in obtaining the relief, be deprived of the benefit of the full period of the restrictive covenant. Accordingly, unless Consultant or Principal contests the alleged violation in a court of law and is the prevailing party in a nonappealable decision to the applicable court, the restrictive covenant shall be deemed to have the three-year post-employment duration specified in Section 6.02 hereof computed from the date the relief is granted but reduced by the period when the restriction began to run and the date of the first 5 6 violation by Consultant or Principal. Notwithstanding the foregoing, however, to the extent this provision is invalid or unenforceable under the laws of any applicable jurisdiction, the remainder of Section 6 shall be interpreted, status quo ante, as if Section 6.03 had never been included herein and was an absolute nullity. 6.04 No Adequate Remedy at Law. Consultant and Principal hereby acknowledge and agree that a violation of any of the provisions contained in Section 6.02 will cause irreparable damage to the Company, the exact amount of which may be impossible to ascertain and that, for such reason, among others, the Company shall be entitled to seek injunctive relief, both pendente lite and permanently, against Consultant and Principal to restrain any further violation of such provisions, and Consultant and Principal hereby consents to any initiation by the Company in a court of competent jurisdiction of any action to enjoin immediately any breach of this Agreement. This provision with respect to injunctive relief shall not, however, diminish the right of the Company to pursue any other rights and remedies the Company may have against Consultant, including, but not limited to, the recovery of damages. 6.05 Duration. The restrictions contained in this Section 6 shall insure to the benefit of the Company and shall survive the termination of this Agreement. 7. Termination of Engagement. This Agreement shall terminate prior to the expiration of its term upon the occurrence of any of the following events: (A) (i) A breach of Articles 5 or 6 of this Agreement which is not cured (to the extent curable) within three (3) business days after notice by the Company of such breach is received by Consultant or Principal; or (ii) a material breach of any other provision contained in this Agreement which is not cured within thirty (30) days after written notice by the Company of such breach is received by Consultant, provided that the Company shall not be required to give Consultant an opportunity to cure in the event Consultant or Principal breaches this Agreement in a material manner twice in any six (6) month period; (B) Principal's death; (C) by mutual agreement of the parties; or (D) upon ten (10) day's notice to the Company given by Consultant. In the event of a termination of this Agreement hereunder, unless otherwise agreed in writing, the Company will have no further obligation to Consultant or Principal, except the obligation to pay the prorated Fee due Consultant through the period ending as of the effective date of termination. Notwithstanding the foregoing, if Consultant's engagement is terminated as a result of Principal's death, the Company shall pay to Consultant the prorated Fee through the sixtieth (60th) day following the date on which Consultant's death occurs. 6 7 8 Miscellaneous. 8.01 Governing Law. This Agreement shall be deemed to have been executed in the State of Arizona and shall be governed and construed as to both substantive and procedural matters in accordance with the laws of the State of Arizona, but excepting (i) any State of Arizona rule which would result in the application of the law of a jurisdiction other than the State of Arizona. 8.02 Prior Agreements. This Agreement contains the entire agreement of the parties relating to the subject matter hereof and supersedes all prior agreements and understandings with respect to such subject matter, and the parties hereto have made no agreements, representations or warranties relating to the subject matter of this Agreement which are not set forth herein. 8.03 Amendment. This Agreement may not be amended, modified, superseded, canceled or terminated, and any of the matters, covenants, representations, warranties or conditions hereof may not be waived, except by written instrument executed by the parties hereto or, in the case of a waiver, by the party to be charged with such waiver. 8.04 Severability. To the extent any provision of this Agreement shall be invalid or unenforceable, it shall be considered deleted herefrom and the remainder of such provision and of this Agreement shall be unaffected and not in limitation of business activities covered by, any provision of this Agreement be in excess of that which is valid and enforceable under applicable law, then such provision shall be construed to cover only that duration, extent or activities which may validly and enforceably be covered. Consultant acknowledges the uncertainty of the law in this respect and expressly stipulates that this Agreement be given the construction which renders its provisions valid and enforceable to the maximum extent possible under applicable law. 8.05 Attorney's Fees. If either party hereto shall be required to retain the services of an attorney to enforce any of his or its rights hereunder, the prevailing party shall be entitled to receive from the other party all costs and expenses including, but not limited to, court costs and attorneys' or experts' fees (whether in a court of original jurisdiction or one or more courts of appellate jurisdiction) incurred by him or it in connection therewith. 8.06 Assignment. This Agreement shall not be assignable, in whole or in part, by either party without the written consent of the other party, except that the Company may, without the consent of Consultant or Principal, assign its rights and obligations under this Agreement to any corporation, firm or other business entity with or into which the Company may merge or consolidate, or to which the Company may sell or transfer all or substantially all of its assets, or of which fifty (50%) percent or more of the equity investment and of the voting control is owned, directly or indirectly, by, or is under common ownership with the Company; provided, however, that such corporation, firm or business entity has a financial net worth comparable to or greater than the Company as of the date of such transaction, and provided further, that the Company remains liable to Consultant for its obligations hereunder. 7 8 IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be duly executed as of the day and year first above written. The Company BIRMAN MANAGED CARE, INC., a Tennessee corporation By:/s/ David Birman, M.D. ------------------------------ David N. Birman, M.D. Chairman and Chief Executive Officer [signatures continued on following page] 8 9 PRINCIPAL ---------------------- (SEAL) Richard M. Ross CONSULTANT RRCG, L.L.C. By: ------------------------- Manager 9