Definitions

1. "Commissioner" means the insurance commissioner of North Dakota. 2. "Department" means the North Dakota insurance department. 3. "Health care services" means the following medically necessary services: preventive care, emergency care, inpatient and outpatient hospital and physician care, diagnostic laboratory, and diagnostic and therapeutic radiological services. 4. "Medicare+choice program" means the criteria developed by the Balanced Budget Act of 1997 [Pub. L. 105-33; 111 Stat. 312; 42 U.S.C. 1345 et seq.], whereby risk-bearing organizations are permitted to offer health insurance or health benefits coverage to Medicare-eligible enrollees through a Medicare+choice plan. 5. "Provider" means any physician, hospital, or other person licensed or otherwise authorized to furnish health care services. 6. "Provider-sponsored organization" means a public or private entity that: a. Is established or organized, and operated, by a health care provider, or group of affiliated health care providers; b. Provides a substantial proportion of the health care items and services under the Medicare+choice program directly through the provider or affiliated group of providers; and c. With respect to which the affiliated providers share, directly or indirectly, substantial financial risk with respect to the provision of such items and services and have at least a majority financial interest in the entity.