An Excluded Payor is a Federal, state, or local government agency, a United States institution of higher education, an academic teaching hospital, a medical center, or a research institute that is affiliated with an institution of higher education. Note that foreign government agencies are not Excluded Payors. By way of example, the University, the University of Pennsylvania Health System, Children’s Hospital of Philadelphia, the Philadelphia Veterans Affairs Medical Center, the Howard Hughes Medical Institute, and Wistar Institute are Excluded Payors.