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participating provider

Defined in 6 places across 4 titles of the United States Code.

The term "participating provider" means a broadband provider that—

(A) (i) is designated as an eligible telecommunications carrier; or

(ii) meets requirements established by the Commission for participation in the Affordable Connectivity Program and is approved by the Commission under subsection (d)(2); and

(B) elects to participate in the Affordable Connectivity Program.

Source

The term “participating provider” means—

(I) with respect to an individual described in subparagraph (A), a health care provider that has entered into a participation agreement with the State for the provision of services to individuals entitled to benefits under the State plan; or

(II) with respect to an individual described in subparagraph (B) who is enrolled in a Medicaid managed care organization, a health care provider that has entered into an arrangement for the provision of services to enrollees of the organization under this subchapter.

Source

The term "participating provider" means, with respect to an item or service and a group health plan, a physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable State law and who has a contractual relationship with the plan for furnishing such item or service under the plan.

Source

The term "participating provider" means, with respect to an item or service and a group health plan or group health insurance coverage offered by a health insurance issuer, a physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable State law and who has a contractual relationship with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.

Source

The term "participating provider" means, with respect to an item or service and a group health plan or group or individual health insurance coverage offered by a health insurance issuer, a physician or other health care provider who is acting within the scope of practice of that provider's license or certification under applicable State law and who has a contractual relationship with the plan or issuer, respectively, for furnishing such item or service under the plan or coverage, respectively.

Source

The terms “nonparticipating provider” and “participating provider” have the meanings given such terms, respectively, in subsection (a)(3) of section 300gg–111 of this title.

Source

  • 2020–present42 U.S.C. § 300gg-132The Public Health and Welfare · Balance billing in cases of non-emergency services performed by nonparticipating providers at certain participating facilities · in this section