---
kind: "section"
citation: "42 C.F.R. § 475.101"
title: "42"
number: "475.101"
heading: "Eligibility requirements for QIO contracts."
url: "https://uscodex.org/cfr/42/475.101"
---

# §475.101. Eligibility requirements for QIO contracts.


In order to be eligible for a QIO contract, an organization must meet the following requirements:

- (a) 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.
- (b) **Demonstrate the ability to perform the functions of a QIO, including—**
  - (1) The ability to meet the eligibility requirements and perform activities as set forth in the QIO Request for Proposal; and
  - (2) **The ability to—**
    - (i) Perform case reviews as described in [§ 475.102](/cfr/42/475.102.md); and/or
    - (ii) Perform quality improvement initiatives as set forth in [§ 475.103](/cfr/42/475.103.md).
- (c) Demonstrate the ability to actively engage beneficiaries, families, and consumers, as applicable, in case reviews as set forth in [§ 475.102](/cfr/42/475.102.md), and/or quality improvement initiatives as set forth in [§ 475.103](/cfr/42/475.103.md).
- (d) Demonstrate the ability to perform the functions of a QIO with objectivity and impartiality and in a fair and neutral manner.

## Notes

### 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).