§475.101. Eligibility requirements for QIO contracts.
42 C.F.R. § 475.101
In order to be eligible for a QIO contract, an organization must meet the following requirements:
Have a governing body that includes at least one individual who is a representative of health care providers and at least one individual who is a representative of consumers.
Demonstrate the ability to perform the functions of a QIO, including—
The ability to meet the eligibility requirements and perform activities as set forth in the QIO Request for Proposal; and
The ability to—
Perform case reviews as described in § 475.102; and/or
Perform quality improvement initiatives as set forth in § 475.103.
Demonstrate the ability to actively engage beneficiaries, families, and consumers, as applicable, in case reviews as set forth in § 475.102, and/or quality improvement initiatives as set forth in § 475.103.
Demonstrate the ability to perform the functions of a QIO with objectivity and impartiality and in a fair and neutral manner.
Notes, amendments, and revision history
Source
Source: 78 FR 75198, Dec. 10, 2013, unless otherwise noted.
Authority
Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).