Current through October 31, 2024
Section 475.101 - Eligibility requirements for QIO contractsIn order to be eligible for a QIO contract, an organization must meet the following requirements:
(a) Have a governing body that includes at least one individual who is a representative of health care providers and at least one individual who is a representative of consumers.(b) Demonstrate the ability to perform the functions of a QIO, including-(1) The ability to meet the eligibility requirements and perform activities as set forth in the QIO Request for Proposal; and(2) The ability to-(i) Perform case reviews as described in § 475.102 ; and/or(ii) Perform quality improvement initiatives as set forth in § 475.103 .(c) Demonstrate the ability to actively engage beneficiaries, families, and consumers, as applicable, in case reviews as set forth in § 475.102 , and/or quality improvement initiatives as set forth in § 475.103 .(d) Demonstrate the ability to perform the functions of a QIO with objectivity and impartiality and in a fair and neutral manner.