42 C.F.R. § 475.1
For purposes of this part:
Case reviews means the different types of reviews that QIOs are authorized to perform. Such reviews include, but are not limited to-
Five percent or more owner means a person (including, where appropriate, a corporation) who:
Health care facility means an institution that directly provides or supplies health care services for which payment may be made in whole or in part under Title XVIII of the Act. A health care facility may be a hospital, skilled nursing facility, home health agency, free-standing ambulatory surgical center, or outpatient facility or any other entity which provides or supplies direct care to Medicare beneficiaries.
Managing employee means a general manager, business manager, administrator, director or other individual who exercises operational or managerial control over the entity or organization, or who, directly or indirectly, conducts the day-to-day operations of the entity or organization.
Payor organization means any organization, other than a self-insured employer, which makes payments directly or indirectly to health care practitioners or providers whose health care services are reviewed by the organization or would be reviewed by the organization if it entered into a QIO contract. "Payor organization" also means any organization which is affiliated with any entity which makes payments as described above, by virtue of the organization having two or more governing body members who are also either governing body members, officers, partners, 5 percent or more owners or managing employees in a health maintenance organization or competitive medical plan.
Physician means:
Practitioner has the same meaning as provided in § 476.1 of this chapter.
QIO area means the defined geographic area, such as the State(s), region(s), or community(ies), in which the CMS contract directs the QIO to perform.
Quality improvement initiative has the same meaning as provided in § 476.1 of this chapter.
42 C.F.R. §475.1