Any healthcare provider or group of medical service providers may apply to the director of the Department of Consumer and Business Services (DCBS) to become a certified MCO. Oregon law prohibits an organization that is formed, owned, or operated by an insurer or employer other than a healthcare provider to be certified as an MCO. This ensures an arm’s length relationship between the providers of medical services and insurers to avoid the company doctor syndrome, thereby striking a balance between quality care and cost effective care.