[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: 42CFR480.106]



[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.  480.106  Exceptions to QIO notice requirements.



    (a) Imminent danger to individuals or public health. When the QIO 

determines that requested information is necessary to protect against an 

imminent danger to individuals or the public health, the notification 

required in Sec.  480.105 may be sent simultaneously with the 

disclosure.

    (b) Fraud or Abuse. The notification requirement in Sec.  480.105 

does not apply if--

    (1) The disclosure is made in an investigation of fraud or abuse by 

the Office of the Inspector General or the General Accounting Office; or

    (2) The disclosure is made in an investigation of fraud or abuse by 

any other Federal or State fraud or abuse agency and the investigative 

agency specifies in writing that the information is related to a 

potentially prosecutable criminal offense.

    (c) Other. The notification requirements in Sec.  480.105(a) and 

(b)(2) do not apply if:

    (1) The institution or practitioner has requested, in writing, that 

the QIO make the disclosure;

    (2) The institution or practitioner has provided, in writing, 

consent for the disclosure; or

    (3) The information is public information as defined in Sec.  

480.101(b) and specified under Sec.  480.120.



[50 FR 15359, Apr. 17, 1985. Redesignated at 64 FR 66279, Nov. 24, 1999, 

as amended at 69 FR 49266, 49267, Aug. 11, 2004]