Title 42

PART 480 SUBPART B

Subpart B - Utilization and Quality Control Quality Improvement Organizations (QIOs) Source:50 FR 15359, Apr. 17, 1985, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.

42:4.0.1.4.20.2.191SUBJGRP 191
General Provisions
42:4.0.1.4.20.2.191.1SECTION 480.101
   480.101 Scope and definitions.
42:4.0.1.4.20.2.191.2SECTION 480.102
   480.102 Statutory bases for acquisition and maintenance of information.
42:4.0.1.4.20.2.191.3SECTION 480.103
   480.103 Statutory bases for disclosure of information.
42:4.0.1.4.20.2.191.4SECTION 480.104
   480.104 Procedures for disclosure by a QIO.
42:4.0.1.4.20.2.191.5SECTION 480.105
   480.105 Notice of disclosures made by a QIO.
42:4.0.1.4.20.2.191.6SECTION 480.106
   480.106 Exceptions to QIO notice requirements.
42:4.0.1.4.20.2.191.7SECTION 480.107
   480.107 Limitations on redisclosure.
42:4.0.1.4.20.2.191.8SECTION 480.108
   480.108 Penalties for unauthorized disclosure.
42:4.0.1.4.20.2.191.9SECTION 480.109
   480.109 Applicability of other statutes and regulations.
42:4.0.1.4.20.2.192SUBJGRP 192
QIO Access to Information
42:4.0.1.4.20.2.192.10SECTION 480.111
   480.111 QIO access to records and information of institutions and practitioners.
42:4.0.1.4.20.2.192.11SECTION 480.112
   480.112 QIO access to records and information of intermediaries and carriers.
42:4.0.1.4.20.2.192.12SECTION 480.113
   480.113 QIO access to information collected for QIO purposes.
42:4.0.1.4.20.2.192.13SECTION 480.114
   480.114 Limitation on data collection.
42:4.0.1.4.20.2.193SUBJGRP 193
QIO Responsibilities
42:4.0.1.4.20.2.193.14SECTION 480.115
   480.115 Requirements for maintaining confidentiality.
42:4.0.1.4.20.2.193.15SECTION 480.116
   480.116 Notice to individuals and institutions under review.
42:4.0.1.4.20.2.194SUBJGRP 194
Disclosure of Nonconfidential Information
42:4.0.1.4.20.2.194.16SECTION 480.120
   480.120 Information subject to disclosure.
42:4.0.1.4.20.2.194.17SECTION 480.121
   480.121 Optional disclosure of nonconfidential information.
42:4.0.1.4.20.2.195SUBJGRP 195
Disclosure of Confidential Information
42:4.0.1.4.20.2.195.18SECTION 480.130
   480.130 Disclosure to the Department.
42:4.0.1.4.20.2.195.19SECTION 480.131
   480.131 Access to medical records for the monitoring of QIOs.
42:4.0.1.4.20.2.195.20SECTION 480.132
   480.132 Disclosure of information about patients.
42:4.0.1.4.20.2.195.21SECTION 480.133
   480.133 Disclosure of information about practitioners, reviewers and institutions.
42:4.0.1.4.20.2.195.22SECTION 480.134
   480.134 Verification and amendment of QIO information.
42:4.0.1.4.20.2.195.23SECTION 480.135
   480.135 Disclosure necessary to perform review responsibilities.
42:4.0.1.4.20.2.195.24SECTION 480.136
   480.136 Disclosure to intermediaries and carriers.
42:4.0.1.4.20.2.195.25SECTION 480.137
   480.137 Disclosure to Federal and State enforcement agencies responsible for the investigation or identification of fraud or abuse of the Medicare or Medicaid programs.
42:4.0.1.4.20.2.195.26SECTION 480.138
   480.138 Disclosure for other specified purposes.
42:4.0.1.4.20.2.195.27SECTION 480.139
   480.139 Disclosure of QIO deliberations and decisions.
42:4.0.1.4.20.2.195.28SECTION 480.140
   480.140 Disclosure of quality review study information.
42:4.0.1.4.20.2.195.29SECTION 480.141
   480.141 Disclosure of QIO interpretations on the quality of health care.
42:4.0.1.4.20.2.195.30SECTION 480.142
   480.142 Disclosure of sanction reports.
42:4.0.1.4.20.2.195.31SECTION 480.143
   480.143 QIO involvement in shared health data systems.
42:4.0.1.4.20.2.195.32SECTION 480.144
   480.144 Access to QIO data and information.
42:4.0.1.4.20.2.195.33SECTION 480.145
   480.145 Beneficiary authorization of use of confidential information.