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42 C.F.R. § 476.102

Involvement of health care practitioners other than physicians.

§ 476.102 Involvement of health care practitioners other than physicians.

(a) Basic requirement. Except as provided in paragraph (b) of this section, a QIO must meet the following requirements:

(1) Consult with the peers of the practitioners who furnish the services under review if the QIO reviews care and services delivered by health care practitioners other than physicians.

(2) Assure that in determinations regarding medical necessity of services or the quality of the services they furnish, these practitioners are involved in—

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