Title 42, Part 480 — Acquisition, Protection, and Disclosure of Quality Improvement Organization Information

Scope and definitions.

Statutory bases for acquisition and maintenance of information.

Statutory bases for disclosure of information.

Procedures for disclosure by a QIO.

Notice of disclosures made by a QIO.

Exceptions to QIO notice requirements.

Limitations on redisclosure.

Penalties for unauthorized disclosure.

Applicability of other statutes and regulations.

QIO access to records and information of institutions and practitioners.

QIO access to records and information of intermediaries and carriers.

QIO access to information collected for QIO purposes.

Limitation on data collection.

Requirements for maintaining confidentiality.

Notice to individuals and institutions under review.

Information subject to disclosure.

Optional disclosure of nonconfidential information.

Disclosure to the Department.

Access to medical records for the monitoring of QIOs.

Disclosure of information about patients.

Disclosure of information about practitioners, reviewers and institutions.

Verification and amendment of QIO information.

Disclosure necessary to perform review responsibilities.

Disclosure to intermediaries and carriers.

Disclosure to Federal and State enforcement agencies responsible for the investigation or identification of fraud or abuse of the Medicare or Medicaid programs.

Disclosure for other specified purposes.

Disclosure of QIO deliberations and decisions.

Disclosure of quality review study information.

Disclosure of QIO interpretations on the quality of health care.

Disclosure of sanction reports.

QIO involvement in shared health data systems.

Access to QIO data and information.

Beneficiary authorization of use of confidential information.