Confidential Information

10030 - Confidential Information (Rev. 15, Issued: 06-30-06; Effective/Implementation Dates: 06-30-06) A. Definition of Confidential Information Confidential information is defined at 42 CFR 480.101(b). B. Disclosure of Confidential Information Disclose confidential information only as authorized under 42 CFR 480.130 through 480.143. For all information gathered or developed as part of a Quality Review Study (QRS), follow the requirements at 42 CFR 480.140 (All Health Care Quality Improvement activities are defined as QRSs). As specified at 42 CFR 480.135(a), the QIO is to disclose confidential information as necessary to fulfill its duties and functions under title XI of the Act. This includes any disclosures needed to properly complete the appeals process. As specified in 42 CFR 480.135(c)(1), disclose confidential information to another QIO when the material is related to patients, providers, or practitioners who are subject to review by the other QIO. This includes sanction information as well as any other pertinent information. Disclose practitioner-specific information about potential and confirmed quality concerns to the involved practitioner and to the facility where the services were furnished (See §§7200-7250). Each facility should designate specific officials to receive your notices and other confidential disclosures. C. Information About Interns and Residents Your disclosure of practitioner-specific information involving interns and residents is restricted in the same manner as other practitioner-specific information. Generally, you cannot disclose an intern's/resident's quality problems to program officials, attending physicians, or residency/intern program accrediting bodies without the consent of the affected individual. If the residency/intern program is operated by the involved hospital, however, quality review findings that you disclose to the hospital may be shared by the hospital with residency/intern program officials as internal communications, when appropriate. D. Disclosure of Confidential Information To Elected Officials See §5010B.1.