[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: 42CFR476.73]



[Page 468]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 476_UTILIZATION AND QUALITY CONTROL REVIEW--Table of Contents

 

  Subpart C_Review Responsibilities of Utilization and Quality Control 

                Quality Improvement Organizations (QIOs)

 

Sec.  476.73  Notification of QIO designation and implementation of 



review.



    (a) Notice of CMS's decision. CMS sends written notification of a 

QIO contract award to the State survey agency and Medicare fiscal 

intermediaries and carriers. The notification includes the effective 

dates of the QIO contract and specifies the area and types of health 

care facilities to be reviewed by the QIO. The QIO must make a similar 

notification when review responsibilities are subcontracted.

    (b) Notification to health care facilities and the public. As 

specified in its contract with CMS, the QIO must--

    (1) Provide, to each health care facility scheduled to come under 

review, a timely written notice that specifies the date and manner in 

which the QIO proposes to implement review, and the information to be 

furnished by the facility to each Medicare beneficiary upon admission as 

specified in Sec.  466.78(b)(3) of this part.

    (2) Publish, in at least one local newspaper of general circulation 

in the QIO area, a notice that states the date the QIO will assume 

review responsibilities and lists each area health care facility to be 

under review. The QIO must indicate that its plan for the review of 

health care services as approved in its contract with CMS is available 

for public inspection in the QIO's business office and give the address, 

telephone number and usual hours of business.



[50 FR 15330, Apr. 17, 1985. Redesignated at 52 FR 37457, Oct. 7, 1987, 

and further redesignated at 64 FR 66279, Nov. 24, 1999]