qualifications of a health care practitioner, including, but not
limited to, an evaluation of licensure status, education,
training, experience, competence and professional judgment.
"Federally qualified health center." A federally qualified
health center as defined in section 1905(l)(2)(B) of the Social
Security Act (49 Stat. 620, 42 U.S.C. ยง 1396d(l)(2)(B)), or a
federally qualified health center look-alike that is a
participating provider with the Department of Human Services
under the act of June 13, 1967 (P.L.31, No.21), known as the
Human Services Code.
"Health care practitioner." As defined under section 103 of
the act of July 19, 1979 (P.L.130, No.48), known as the Health
Care Facilities Act. The term shall include a health care
practitioner at a federally qualified health center.
"Health insurer." As follows:
(1) An entity that contracts or offers to contract to
provide, deliver, arrange for, pay for or reimburse any of
the costs of health care services in exchange for a premium,
including, but not limited to, a Medicaid managed care
organization as defined in section 1903(m)(1)(a) of the
Social Security Act, and an entity licensed under any of the
following:
(i) The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921.
(ii) The act of December 29, 1972 (P.L.1701,
No.364), known as the Health Maintenance Organization
Act.
(iii) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations).
(iv) 40 Pa.C.S. Ch. 63 (relating to professional
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