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Current as of January 02, 2025 | Updated by Findlaw Staff
(a)(1) A QIO must not disclose its deliberations except to—
(i) CMS; or
(ii) The Office of the Inspector General, and the Government Accountability Office as necessary to carry out statutory responsibilities.
(2) QIO deliberations are not disclosable, either in written form or through oral testimony, in connection with the administrative hearing or review of a beneficiary's claim.
(b) Reasons for QIO decisions.
(1) A QIO may disclose to those who have access to QIO information under other provisions of this subpart, the reasons for QIO decisions pertaining to that information provided that the opinions or judgements of a particular individual or practitioner cannot be identified.
(2) A QIO must disclose, if requested in connection with the administrative hearing or review of a beneficiary's claim, the reasons for QIO decisions. The QIO must include the detailed facts, findings and conclusions supporting the QIO's determination. The QIO must insure that the opinions or judgements of a particular individual or practitioner cannot be identified through the materials that are disclosed.
Cite this article: FindLaw.com - Code of Federal Regulations Title 42. Public Health § 42.480.139 Disclosure of QIO deliberations and decisions - last updated January 02, 2025 | https://codes.findlaw.com/cfr/title-42-public-health/cfr-sect-42-480-139/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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