Healthcare Glossary - PREFERRED PROVIDER ORGANIZATION | HealthPocket

Glossary

PREFERRED PROVIDER ORGANIZATION

An M+CO coordinated care plan that: (a) has a network of providers that have agreed to a contractually specified reimbursement for covered benefits with the organization offering the plan; (b) provides for reimbursement for all covered benefits regardless of whether the benefits are provided with the network of providers; and (c) is offered by an organization that is not licensed or organized under State law as an HMO. See Social Security Act Section 1852(e)(2)(D), 42 U.S.C. 139w-22(e)(2)(D).

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