[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: 42CFR480.105]



[Page 485]

 

                         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.  480.105  Notice of disclosures made by a QIO.



    (a) Notification of the disclosure of nonconfidential information. 

Except as permitted under Sec.  480.106, at least 30 calender days 

before disclosure of nonconfidential information, the QIO must notify an 

identified institution of its intent to disclose information about the 

institution (other than reports routinely submitted to CMS or Medicare 

fiscal intermediaries, or to or from QIO subcontractors, or to or from 

the institution) and provide the institution with a copy of the 

information. The institution may submit comments to the QIO that must be 

attached to the information disclosed if received before disclosure, or 

forwarded separately if received after disclosure.

    (b) Notification of the disclosure of confidential information. (1) 

A QIO must notify the practitioner who has treated a patient, of a 

request for disclosure to the patient or patient representative in 

accordance with the requirements and exceptions to the requirements for 

disclosure specified under Sec.  480.132.

    (2) A QIO must notify a practitioner or institution of the QIO's 

intent to disclose information on the practitioner or institution to an 

investigative or licensing agency (Sec. Sec.  480.137 and 480.138) 

except for cases specified in Sec.  480.106 involving fraud or abuse or 

imminent danger to individuals or the public health. The practitioner or 

institution must be notified and provided a copy of the information to 

be disclosed at least 30 calendar days before the QIO discloses the 

identifying information. The QIO must forward with the information any 

comments submitted by the practitioner or institution in response to the 

QIO notice if received before disclosure, or forwarded separately if 

received after disclosure.



[50 FR 15359, Apr. 17, 1985; 50 FR 41886, Oct. 16, 1985. Redesignated at 

64 FR 66279, Nov. 24, 1999, as amended at 69 FR 49267, Aug. 11, 2004]