An Organized Delivery System (ODS) is a legal entity that contracts with a carrier for the purpose of providing or arranging for the provision of health care services to those persons covered under a carrier’s health benefits plan, but which is not a licensed health care facility or other health care provider.

Examples of the types of entities that are an ODS include preferred provider organizations (PPOs), Physician Hospital Organizations (PHOs) and Independent Practice Associations (IPAs). In order to contract with a carrier, an ODS must become licensed or certified. However, by law, an entity that only contracts to provide pharmaceutical services, or case management services, or employee assistance plan services does not have to become licensed or certified.

Certain additional entities that might otherwise appear to be an ODS also are exempt from obtaining certification or licensing. More details are set forth in regulations.