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42 CFR 480.102 : Public Health (Part 1 To Parts 1009-1099) — (§ 430.0 To Part 481) — Centers For Medicare & Medicaid Services, Department Of Health And Human Services (Continued) (§ 430.0 To Part 481) — Quality Improvement Organizations (§ 475.1 To Part 481) — Acquisition, Protection, And Disclosure Of Quality Improvement Organization Information (Subpart A To § 480.145) — Utilization And Quality Control Quality Improvement Organizations (Qios) (§ 480.101 To § 480.145) — General Provisions (§ 480.101 To § 480.109) — Statutory bases for acquisition and maintenance of information.

4 Aug 2016

(a) Section 1154(a)(7)(C) of the Act requires QIOs to the extent necessary and appropriate to examine the pertinent records of any practitioner or provider of health care services for which payment may be made under Title XVIII of the Act.

(b) Section 1154(a)(9) of the Act requires QIOs to collect and maintain information necessary to carry out their responsibilities under the Act.

(c) Section 1156(a)(3) of the Act requires health care practitioners and providers to maintain evidence of the medical necessity and quality of health care services they provide to Medicare patients as required by QIOs.

42 CFR 480.102