42 C.F.R. § 475.101

Eligibility requirements for QIO contracts.

Last amended: 2017Year: 2026Length: 158 wordsSubsections: 5Official source

Cite as 42 C.F.R. § 475.101 (2026)

In 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.
Cross-references to the CFR
475.102475.103.
42 C.F.R. § 475.101: Eligibility requirements for QIO contracts. | Justis AI