provider-sponsored organization

(1) In general In this part, the term “provider-sponsored organization” means a public or private entity— (A) that is established or organized, and operated, by a health care provider, or group of affiliated health care providers, (B) that provides a substantial proportion (as defined by the Secretary in accordance with paragraph (2)) of the health care items and services under the contract under this part directly through the provider or affiliated group of providers, and (C) with respect to which the affiliated providers share, directly or indirectly, substantial financial risk with respect to the provision of such items and services and have at least a majority financial interest in the entity.


42 USC § 1395w-25(d)(1)

Scoping language

In this part
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