[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR475.103]



[Page 462]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 475_QUALITY IMPROVEMENT ORGANIZATIONS--Table of Contents

 

     Subpart C_Utilization and Quality Control Quality Improvement 

                              Organizations

 

Sec.  475.103  Eligibility of physician-access organizations.



    (a) In order to be eligible for designation as a physician-access 

QIO, an organization must meet the following conditions:

    (1) Have available to it, by arrangement or otherwise, the services 

of a sufficient number of licensed doctors of medicine or osteopathy 

practicing medicine or surgery in the review area to assure adequate 

peer review of the services provided by the various medical specialties 

and subspecialties.

    (2) Not be a health care facility, health care facility association, 

or health care facility affiliate, as specified in Sec.  462.105.

    (b) An organization meets the requirements of paragraph (a)(1) of 

this section if it demonstrates--

    (1) That it has available to it at least one physician in every 

generally recognized specialty; and

    (2) The existence of an arrangement or arrangements with physicians 

under which the physicians would conduct review for the organization.



[50 FR 15328, Apr. 17, 1985. Redesignated at 64 FR 66279, Nov. 24, 1999]



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