; (IV) includes any person described in subclause (I) who conducts business as a not-for-profit organization; (V) includes— (aa) an entity or person that contracts directly with a State, locality, Tribal government, or the Federal Government, to provide care (which may include items and services) through employees of such entity or person to individuals under the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq.), under a State Medicaid plan under title XIX of such Act ( 42 U.S.C. 1396 et seq.) or under a waiver of such plan, or under any other program established or administered by a State, locality, Tribal government, or the Federal Government; (bb) a subcontractor of an entity or person described in item (aa); (cc) an individual client (or a representative on behalf of an individual client), an entity, or a person, that employs an individual to provide care (which may include items and services) to the individual client under a self-directed service delivery model through a program established or administered by a State, locality, Tribal government, or the Federal Government; or (dd) an individual client (or a representative on behalf of an individual client) that, on their own accord, employs an individual to provide care (which may include items and services) to the individual client using the individual client's own finances; (VI) includes the United States Postal Service; (VII) includes a nonappropriated fund instrumentality under the jurisdiction of the Armed Forces