42 U.S.C. § 1320c: Purpose

The purpose of this part is to establish the contracting process which the Secretary must follow pursuant to the requirements of section 1395y(g) of this title , including the definition of the quality improvement organizations with which the Secretary shall contract, the functions such quality improvement organizations are to perform, the confidentiality of medical records, and related administrative matters to facilitate the carrying out of the purposes of this part. An overview of the program under such part. The duties of organizations with contracts with the Secretary under such part. The extent to which quality improvement organizations improve the quality of care for medicare beneficiaries. The extent to which other entities could perform such quality improvement functions as well as, or better than, quality improvement organizations. The effectiveness of reviews and other actions conducted by such organizations in carrying out those duties. The source and amount of funding for such organizations. The conduct of oversight of such organizations. Not later than June 1, 2006 , the Secretary shall submit to Congress a report on the results of the study described in paragraph (1), including any recommendations for legislation. If the Secretary finds based on the study conducted under paragraph (1) that other entities could improve quality in the medicare program as well as, or better than, the current quality improvement organizations, then the Secretary shall provide for such increased competition through the addition of new types of entities which may perform quality improvement functions.” the development of common utilization and medical review criteria; criteria for the targetting of reviews by peer review organizations and carriers; and improved methods for exchange of information among peer review organizations and carriers. Not later than January 1, 1992 , the Secretary shall submit to Congress a report on the development of the plan described under paragraph (1) and shall include in the report such recommendations for changes in legislation as may be appropriate.” The Secretary of Health and Human Services shall not terminate or fail to renew any agreement in effect with a professional standards review organization under part B of title XI of the Social Security Act [ 42 U.S.C. 1320c et seq.] on the earlier of the date of the enactment of this Act [ Sept. 3, 1982 ] or September 30, 1982 until such time as he enters into a contract with a utilization and quality control peer review organization under such part, as amended by this subtitle [subtitle C (§§ 141–150) of title I of Pub. L. 97–248 ], for the area served by such professional standards review organization. In complying with this subsection, the Secretary may renew any such agreement with a professional standards review organization for a period of less than 12 months. The provisions of part B of title XI of the Social Security Act [ 42 U.S.C. 1320c et seq.] as in effect prior to the amendments made by this subtitle [subtitle C (§§ 141–150) of title I of Pub. L. 97–248 ] shall remain in effect with respect to agreements with professional standards review organizations in effect on the earlier of the date of the enactment of this Act [ Sept. 3, 1982 ] or September 30, 1982 , until such time as such agreement is terminated or is not renewed, in accordance with subsection (a). Any matters awaiting a determination by a Statewide Professional Standards Review Council on the date of the enactment of this Act shall be transferred to the Secretary of Health and Human Services for a determination unless such determination is made by such Council within 30 days after the date of the enactment of this Act. No payments shall be made under part B of title XI of the Social Security Act to Statewide Professional Standards Review Councils for services performed under section 1162 of such Act [ 42 U.S.C. 1320c–11 ] after the end of such 30-day period.”