Page:United States Statutes at Large Volume 114 Part 5.djvu/580

 114 STAT. 2763A-540 PUBLIC LAW 106-554—APPENDIX F pertinent facts and applicable regulations applied in making such decision, and in the case of a determination of whether an item or service is reasonable and necessary for the diagnosis or treatment of illness or injury (under section 1862(a)(1)(A)) an explanation of the medical and scientific rationale for the decision. " (F) NOTICE REQUIREMENTS.— Whenever a qualified independent contractor makes a decision with respect to a reconsideration under this subsection, the qualified independent contractor shall promptly notify the entity responsible for the payment of claims under part A or part B of such decision. "(G) DISSEMINATION OF DECISIONS ON RECONSIDER- ATIONS. —Each qualified independent contractor shall make available all decisions with respect to reconsiderations of such qualified independent contractors to fiscal intermediaries (under section 1816), carriers (under section 1842), peer review organizations (under part B of title XI), Medicare+Choice organizations offering Medicare+Choice plans under part C, other entities under contract with the Secretary to make initial determinations under part A or part B or title XI, and to the public. The Secretary shall establish a methodology under which qualified independent contractors shall carry out this subparagraph. "(H) ENSURING CONSISTENCY IN DECISIONS. —Each qualified independent contractor shall monitor its decisions with respect to reconsiderations to ensure the consistency of such decisions with respect to requests for reconsideration of similar or related matters. "(I) DATA COLLECTION. — "(i) IN GENERAL. —Consistent with the requirements of clause (ii), a qualified independent contractor shall collect such information relevant to its functions, and keep and maintain such records in such form and manner as the Secretary may require to carry out the purposes of this section and shall permit access to and use of any such information and records as the Secretary may require for such purposes. "(ii) TYPE OF DATA COLLECTED.—Each qualified independent contractor shall keep accurate records of each decision made, consistent with standards established by the Secretary for such purpose. Such records shall be maintained in an electronic database in a manner that provides for identification of the following: "(I) Specific claims that give rise to appeals. "(II) Situations suggesting the need for increased education for providers of services, physicians, or suppliers. "(Ill) Situations suggesting the need for changes in national or local coverage policy. "(IV) Situations suggesting the need for changes in local medical review policies. "(iii) ANNUAL REPORTING. —Each qualified independent contractor shall submit annually to the Secretary (or otherwise as the Secretary may request)

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