reimbursement: health
maintenance organization (HMO)
Any organization that, through an organized system of health care, provides or assures
the delivery of an agreed-upon set of comprehensive health maintenance and treatment
services for an enrolled group of persons under a prepaid
fixed sum. Services usually include primary care, emergency
care, acute hospital care, extended care, and rehabilitation. To be considered a "Federally Qualified Health Maintenance Organization,"
the HMO must meet the provisions of the HMO Act, P.L.
93-222, as amended in Title XIII of the Public Health Service Act.*
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