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What is an other health care entity?

A health care entity must provide health care services and follow a formal peer review process to further quality health care. The phrase "provides health care services" means the delivery of health care services through any of a broad array of coverage arrangements or other relationships with practitioners, either by employing them directly or through contractual or other arrangements. This definition specifically excludes indemnity insurers that have no contractual or other arrangement with physicians, dentists, or other health care practitioners.

A formal peer review process is the conduct of professional review activities through formally adopted written procedures that provide for adequate notice and an opportunity for a hearing.

Examples of Other Health Care Entities may include, but are not limited to:

  • Health Centers/Community Health Centers
  • Health Maintenance Organizations (HMOs)
  • Preferred provider organizations (PPOs)
  • Group practices
  • Ambulatory facilities
  • Nursing facilities
  • Rehabilitation centers
  • Hospices
  • Renal dialysis centers
  • Freestanding ambulatory care
  • Surgical service centers
  • Patient-centered medical homes (PCMHs)
  • Accountable care organizations (ACOs)
  • Other health care delivery models that meet the definition

Refer to the NPDB Guidebook for more information.

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