Medical group
Medical group means a partnership, association, corporation, or other group:
(1) That is composed of health professionals licensed to practice medicine or osteopathy and of such other licensed health professionals (including dentists, optometrists, and podiatrists) as are necessary for the provision of health services for which the group is responsible;
(2) A majority of the members of which are licensed to practice medicine or osteopathy; and
(3) The members of which:
(i) After the end of the 48 month period beginning after the month in which the HMO for which the group provides health services becomes a qualified HMO, as their principal professional activity (over 50 percent individually) engage in the coordinated practice of their profession and as a group responsibility have substantial responsibility (over 35 percent in the aggregate of their professional activity) for the delivery of health services to enrollees of an HMO;
(ii) Pool their income from practice as members of the group and distribute it among themselves according to a prearranged salary or drawing account or other similar plan unrelated to the provision of specific health services;
(iii) Share health (including medical) records and substantial portions of major equipment and of professional, technical, and administrative staff;
(iv) Establish an arrangement whereby an enrollee's enrollment status is not known to the health professional who provides health services to the enrollee.
Source
42 CFR § 417.1
Scoping language
As used in this part, unless the context indicates otherwise