GroundRules
42 CFR 480.106: Exceptions to QIO notice requirements.
Where this section sits in the code
- Title 42—Public Health
- CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
- SUBCHAPTER F—QUALITY IMPROVEMENT ORGANIZATIONS
- PART 480—ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION INFORMATION
- Subpart B—Utilization and Quality Control Quality Improvement Organizations (QIOs)
(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 § 480.105 may be sent simultaneously with the disclosure.
(b) Fraud or Abuse. The notification requirement in § 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 § 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 § 480.101(b) and specified under § 480.120.
Collected 2026-08-27T02:26:11Z. Source file · JSON