Section 16J Definitions applicable to Secs. 16J to 16L - Massachusetts Statutes

Section 16J. As used in this section and in sections 16K and 16L, the following words shall, unless the context clearly requires otherwise, have the following meanings:—

“Clinician”, a health care professional licensed under chapter 112.

“Council”, the health care quality and cost council, established by section 16K.

“Facility”, a hospital, clinic or nursing home licensed under chapter 111 or a home health agency.

“Health care provider”, a clinician, a facility or a physician group practice.

“Insurer”, a carrier authorized to transact accident and health insurance under chapter 175, a nonprofit hospital service corporation licensed under chapter 176A, a nonprofit medical service corporation licensed under chapter 176B, a dental service corporation organized under chapter 176E, an optometric service corporation organized under chapter 176F and a health maintenance organization licensed under chapter 176G.

“Physician group practice”, 2 or more physicians who deliver patient care, make joint use of equipment and personnel and divide income by a prearranged formula.

“Third party administrator”, an entity that administers payments for health care services on behalf of a client plan in exchange for an administrative fee.