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Code of Federal Regulations (Last Updated: July 5, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter F - Quality Improvement Organizations |
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Part 476 - Quality Improvement Organization Review |
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Subpart B - XXX |
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General Provisions |
§ 476.105 - Notice of disclosures made by a PRO.
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(a)
Notification of the disclosure of nonconfidential information. Except as permitted under § 476.106, at least 30 calender days before disclosure of nonconfidential information, the PRO must notify an identified institution of its intent to disclose information about the institution (other than reports routinely submitted to HCFA or Medicare fiscal intermediaries, or to or from PRO subcontractors, or to or from the institution) and provide the institution with a copy of the information. The institution may submit comments to the PRO that must be attached to the information disclosed if received before disclosure, or forwarded separately if received after disclosure.(b)
Notification of the disclosure of confidential information. (1) A PRO must notify the practitioner who has treated a patient, of a request for disclosure to the patient or patient representative in accordance with the requirements and exceptions to the requirements for disclosure specified under § 476.132.(2) A PRO must notify a practitioner or institution of the PRO's intent to disclose information on the practitioner or institution to an investigative or licensing agency (§§ 476.137 and 476.138) except for cases specified in § 476.106 involving fraud or abuse or imminent danger to individuals or the public health. The practitioner or institution must be notified and provided a copy of the information to be disclosed at least 30 calendar days before the PRO discloses the identifying information. The PRO must forward with the information any comments submitted by the practitioner or institution in response to the PRO notice if received before disclosure, or forwarded separately if received after disclosure.