Public Law 119-73 (01/23/2026)

42 U.S.C. § 1320c–1

Definition of quality improvement organization

The term “quality improvement organization” means an entity which—
(1)
is able, as determined by the Secretary, to perform its functions under this part in a manner consistent with the efficient and effective administration of this part and subchapter XVIII;
(2)
has at least one individual who is a representative of health care providers on its governing body; and
(3)
has at least one individual who is a representative of consumers on its governing body.

Aug. 14, 1935, ch. 531Pub. L. 97–248, title I, § 14396 Stat. 382Pub. L. 99–509, title IX, § 9353(b)(1)100 Stat. 2046Pub. L. 112–40, title II, § 261(a)(1)125 Stat. 423(, title XI, § 1152, as added , , ; amended , , ; , (2)(A), (C), , .)

Editorial Notes

Prior Provisions

act Aug. 14, 1935, ch. 531, title XI, § 1152Pub. L. 92–603, title II, § 249F(b)86 Stat. 1430Pub. L. 94–182, title I89 Stat. 1052Pub. L. 95–142, § 5(a)o91 Stat. 1183Pub. L. 96–499, title IX, § 92194 Stat. 2627Pub. L. 97–35, title XXI95 Stat. 793Pub. L. 97–248A prior section 1320c–1, , as added , , ; amended , , §§ 105, 108(a), , 1053; , , (d)(2)(A), (B), ()(1), , 1185, 1191; , , ; , , §§ 2112(a)(2)(A), (B), 2113(b), (c), , 794, related to the designation of Professional Standards Review Organizations, prior to the general revision of this part by .

Amendments

Pub. L. 112–40, § 261(a)(2)(A)2011—, (C), substituted “quality improvement” for “utilization and quality control peer review” in section catchline and introductory provisions.

Pub. L. 112–40, § 261(a)(1)Pars. (1), (2). , added pars. (1) and (2) and struck out former pars. (1) and (2) which read as follows:

section 1320c–2 of this title“(1)(A) is composed of a substantial number of the licensed doctors of medicine and osteopathy engaged in the practice of medicine or surgery in the area and who are representative of the practicing physicians in the area, designated by the Secretary under , with respect to which the entity shall perform services under this part, or (B) has available to it, by arrangement or otherwise, the services of a sufficient number of licensed doctors of medicine or osteopathy engaged in the practice of medicine or surgery in such area to assure that adequate peer review of the services provided by the various medical specialties and subspecialties can be assured;

section 1320c–3 of this title“(2) is able, in the judgment of the Secretary, to perform review functions required under in a manner consistent with the efficient and effective administration of this part and to perform reviews of the pattern of quality of care in an area of medical practice where actual performance is measured against objective criteria which define acceptable and adequate practice; and”.

Pub. L. 99–5091986—Par. (3). added par. (3).

Statutory Notes and Related Subsidiaries

Effective Date of 2011 Amendment

Pub. L. 112–40section 261(e) of Pub. L. 112–40section 1320c of this titleAmendment by applicable to contracts entered into or renewed on or after , see , set out as a note under .

Effective Date of 1986 Amendment

Pub. L. 99–509, title IX, § 9353(b)(2)100 Stat. 2046

“The amendment made by paragraph (1) [amending this section] shall apply to contracts entered into or renewed on or after .”
, , , provided that: