42 C.F.R. § 475.103   Eligibility of physician-access organizations.


Title 42 - Public Health


Title 42: Public Health
PART 475—QUALITY IMPROVEMENT ORGANIZATIONS
Subpart C—Utilization and Quality Control Quality Improvement Organizations

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§ 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 §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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