Managed Care organisations are entities that serve Medicare or Medicaid beneficiaries on a risk basis through a network of employed or affiliated providers.

Stands for Managed Care Organization. The term generally includes HMOs, PPOs, and Point of Service plans. In the Medicaid world, other organisations may set up managed care programmes to respond to Medicaid managed care. These organisations include Federally Qualified Health Centers, integrated delivery systems, and public health clinics.

Is a health maintenance organization, an eligible organisation with a contract under §1876 or a Medicare-Choice organization, a provider-sponsored organization, or any other private or public organization, which meets the requirements of §1902 (w) to provide comprehensive services.