[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR1004.60]



[Page 1191-1192]

 

                         TITLE 42--PUBLIC HEALTH

 

      GENERAL--HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES

 

PART 1004_IMPOSITION OF SANCTIONS ON HEALTH CARE PRACTITIONERS AND 

 

                     Subpart C_QIO Responsibilities

 

Sec.  1004.60  QIO finding of a violation.



    (a) On the basis of any additional information received, the QIO 

will affirm or modify its finding. If the QIO affirms its finding, it 

may suggest in writing a method for correcting the situation and a time 

period for corrective action. This CAP could correspond with, or be a 

continuation of, a prior CAP or be a new proposal based on additional 

information received by the QIO. If the finding has been resolved to the 

QIO's satisfaction, the QIO may modify its initial finding or 

recommendation or close the case.

    (b) The QIO must give written notice to the practitioner or other 

person of any action it takes as a result of the additional information 

received, as specified in Sec.  1004.70.

    (c) At least one member of the QIO participating in the process 

which resulted in a recommendation to the OIG that a practitioner or 

other person be sanctioned should practice in a similar geographic area, 

e.g. urban or rural, and at least one member of the panel must be in the 

same medical specialty. Both requirements can be met by a single 

individual. In addition, no one at the QIO who is a participant in such 

a finding may be in direct economic competition with, or have a 

substantial bias for or against, that practitioner or



[[Page 1192]]



other person being recommended for sanction.