Health maintenance organization that is an eligible organization with a contract under §1876 or a Medicare+Choice organization; a provider-sponsored organization, or any other private or public organization, that meets the requirements of §1902(w). These MCOs provide comprehensive services to commercial and/or Medicare enrollees, as well as Medicaid enrollees.

Assessment of an employee that results in the preparation of a narrative medical report prepared and performed by a qualified medical evaluator (QME) and agreed medical evaluator (AME), or the primary treating physician, to prove or disprove a contested workers’ compensation claim.

Facility providing services such as physician’s services related to administrative functions; physical therapy, occupational therapy, speech pathology services, and respiratory therapy; social and psychological services; and prosthetic and orthotic devices.