[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: 42CFR480.102]



[Page 484]

 

                         TITLE 42--PUBLIC HEALTH

 

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

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 480_ACQUISITION, PROTECTION, AND DISCLOSURE QUALITY IMPROVEMENT 

 

     Subpart B_Utilization and Quality Control Quality Improvement 

                          Organizations (QIOs)

 

Sec.  480.102  Statutory bases for acquisition and maintenance of 



information.



    (a) Section 1154(a)(7)(C) of the Act requires QIOs to the extent 

necessary and appropriate to examine the pertinent records of any 

practitioner or provider of health care services for which payment may 

be made under Title XVIII of the Act.

    (b) Section 1154(a)(9) of the Act requires QIOs to collect and 

maintain information necessary to carry out their responsibilities under 

the Act.

    (c) Section 1156(a)(3) of the Act requires health care practitioners 

and providers to maintain evidence of the medical necessity and quality 

of health care services they provide to Medicare patients as required by 

QIOs.