1. Formal permission obtained from legal authorities to execute specific professional activities that conform to state regulations or federal regulations and compliance standards. This certification is applicable to individuals and health care facilities. 2. In reference to a long-term facility, this means the facility has met certain standards set by a state or local government agency. 3. For a health maintenance organization (HMO), that it has met all regulatory requirements before it started to operate in a locale and that the state authority reviewed and approved its fiscal soundness, network capacity, and quality assurance. Also referred to as licensure .