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25 U.S.C. § 1678 — Confidentiality of medical quality assurance records; qualified immunity for participants
Federal law — U.S. Code and appendices · legal_authorities
**(a) Definitions** In this section:
(1) **Health care provider** — The term “health care provider” means any health care professional, including community health aides and practitioners certified under section 1616l of this title, who is—
(A) granted clinical practice privileges or employed to provide health care services at—
(i) an Indian health program; or
(ii) a health program of an urban Indian organization; and
(B) licensed or certified to perform health care services by a governmental board or agency or professional health care society or organization.
(2) **Medical quality assurance program** — The term “medical quality assurance program” means any activity carried out before, on, or after March 23, 2010, by or for any Indian health program or urban Indian organization to assess the quality of medical care, including activities conducted by or on behalf of individuals, Indian health program or urban Indian organization medical or dental treatment review committees, or other review bodies responsible for quality assurance, credentials, infection control, patient safety, patient care assessment (including treatment procedures, blood, drugs, and therapeutics), medical records, health resources management review, and identification and prevention of medical or dental incidents and risks.
(3) **Medical quality assurance record** — The term “medical quality assurance record” means the proceedings, records, minutes, and reports that—
(A) emanate from quality assurance program activities described in paragraph (2); and
(B) are produced or compiled by or for an Indian health program or urban Indian organization as part of a medical quality assurance program.
**(b) Confidentiality of records** Medical quality assurance records created by or for a
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Stable record: federal_law:legal_authorities:record_usc_5d7d957f6aa196c2e70ed774
Source file: Laws/federal/codes/united-states-code/title-25/section-1678-confidentiality-of-medical-quality-assurance-records-qualified-immunity--295b7e7b77.md
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Source location: Title 25, Chapter 18, § 1678; chapter-018-indian-health-care.md
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**(a) Definitions** In this section:
(1) **Health care provider** — The term “health care provider” means any health care professional, including community health aides and practitioners certified under section 1616l of this title, who is—
(A) granted clinical practice privileges or employed to provide health care services at—
(i) an Indian health program; or
(ii) a health program of an urban Indian organization; and
(B) licensed or certified to perform health care services by a governmental board or agency or professional health care society or organization.
(2) **Medical quality assurance program** — The term “medical quality assurance program” means any activity carried out before, on, or after March 23, 2010, by or for any Indian health program or urban Indian organization to assess the quality of medical care, including activities conducted by or on behalf of individuals, Indian health program or urban Indian organization medical or dental treatment review committees, or other review bodies responsible for quality assurance, credentials, infection control, patient safety, patient care assessment (including treatment procedures, blood, drugs, and therapeutics), medical records, health resources management review, and identification and prevention of medical or dental incidents and risks.
(3) **Medical quality assurance record** — The term “medical quality assurance record” means the proceedings, records, minutes, and reports that—
(A) emanate from quality assurance program activities described in paragraph (2); and
(B) are produced or compiled by or for an Indian health program or urban Indian organization as part of a medical quality assurance program.
**(b) Confidentiality of records** Medical quality assurance records created by or for any Indian health program or a health program of an urban Indian organization as part of a medical quality assurance program are confidential and privileged. Such records may not be disclosed to any person or entity, except as provided in subsection (d).
**(c) Prohibition on disclosure and testimony**
(1) **In general** — No part of any medical quality assurance record described in subsection (b) may be subject to discovery or admitted into evidence in any judicial or administrative proceeding, except as provided in subsection (d).
(2) **Testimony** — An individual who reviews or creates medical quality assurance records for any Indian health program or urban Indian organization who participates in any proceeding that reviews or creates such records may not be permitted or required to testify in any judicial or administrative proceeding with respect to such records or with respect to any finding, recommendation, evaluation, opinion, or action taken by such person or body in connection with such records except as provided in this section.
**(d) Authorized disclosure and testimony**
(1) **In general** — Subject to paragraph (2), a medical quality assurance record described in subsection (b) may be disclosed, and an individual referred to in subsection (c) may give testimony in connection with such a record, only as follows:
(A) To a Federal agency or private organization, if such medical quality assurance record or testimony is needed by such agency or organization to perform licensing or accreditation functions related to any Indian health program or to a health program of an urban Indian organization to perform monitoring, required by law, of such program or organization.
(B) To an administrative or judicial proceeding commenced by a present or former Indian health program or urban Indian organization provider concerning the termination, suspension, or limitation of clinical privileges of such health care provider.
(C) To a governmental board or agency or to a professional health care society or organization, if such medical quality assurance record or testimony is needed by such board, agency, society, or organization to perform licensing, credentialing, or the monitoring of professional standards with respect to any health care provider who is or was an employee of any Indian health program or urban Indian organization.
(D) To a hospital, medical center, or other institution that provides health care services, if such medical quality assurance record or testimony is needed by such institution to assess the professional qualifications of any health care provider who is or was an employee of any Indian health program or urban Indian organization and who has applied for or been granted authority or employment to provide health care services in or on behalf of such program or organization.
(E) To an officer, employee, or contractor of the Indian health program or urban Indian organization that created the records or for which the records were created. If 11 So in original. Probably should be “were created, if”. that officer, employee, or contractor has a need for such record or testimony to perform official duties.
(F) To a criminal or civil law enforcement agency or instrumentality charged under applicable law with the protection of the public health or safety, if a qualified representative of such agency or instrumentality makes a written request that such record or testimony be provided for a purpose authorized by law.
(G) In an administrative or judicial proceeding commenced by a criminal or civil law enforcement agency or instrumentality referred to in subparagraph (F), but only with respect to the subject of such proceeding.
(2) **Identity of participants** — With the exception of the subject of a quality assurance action, the identity of any person receiving health care services from any Indian health program or urban Indian organization or the identity of any other person associated with such program or organization for purposes of a medical quality assurance program that is disclosed in a medical quality assurance record described in subsection (b) shall be deleted from that record or document before any disclosure of such record is made outside such program or organization.
**(e) Disclosure for certain purposes**
(1) **In general** — Nothing in this section shall be construed as authorizing or requiring the withholding from any person or entity aggregate statistical information regarding the results of any Indian health program or urban Indian organization’s medical quality assurance programs.
(2) **Withholding from Congress** — Nothing in this section shall be construed as authority to withhold any medical quality assurance record from a committee of either House of Congress, any joint committee of Congress, or the Government Accountability Office if such record pertains to any matter within their respective jurisdictions.
**(f) Prohibition on disclosure of record or testimony** An individual or entity having possession of or access to a record or testimony described by this section may not disclose the contents of such record or testimony in any manner or for any purpose except as provided in this section.
**(g) Exemption from Freedom of Information Act** Medical quality assurance records described in subsection (b) may not be made available to any person under [section 552 of title 5](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title5-section552&num=0&edition=prelim).
**(h) Limitation on civil liability** An individual who participates in or provides information to a person or body that reviews or creates medical quality assurance records described in subsection (b) shall not be civilly liable for such participation or for providing such information if the participation or provision of information was in good faith based on prevailing professional standards at the time the medical quality assurance program activity took place.
**(i) Application to information in certain other records** Nothing in this section shall be construed as limiting access to the information in a record created and maintained outside a medical quality assurance program, including a patient’s medical records, on the grounds that the information was presented during meetings of a review body that are part of a medical quality assurance program.
**(j) Regulations** The Secretary, acting through the Service, shall promulgate regulations pursuant to [section 1672 of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title25-section1672&num=0&edition=prelim).
**(k) Continued protection** Disclosure under subsection (d) does not permit redisclosure except to the extent such further disclosure is authorized under subsection (d) or is otherwise authorized to be disclosed under this section.
**(l) Inconsistencies** To the extent that the protections under part C of title IX of the Public Health Service Act ([42 U.S.C. 229b–21](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section229b–21&num=0&edition=prelim) et seq.) [[42 U.S.C. 299b–21](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section299b–21&num=0&edition=prelim) et seq.] (as amended by the Patient Safety and Quality Improvement Act of 2005 (Public Law 109–41; 119 Stat. 424)) and this section are inconsistent, the provisions of whichever is more protective shall control.
**(m) Relationship to other law** This section shall continue in force and effect, except as otherwise specifically provided in any Federal law enacted after March 23, 2010.
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Federal law — U.S. Code and appendices · legal_authorities
In this part:
(1) **HIPAA confidentiality regulations** — The term “HIPAA confidentiality regulations” means regulations promulgated under section 264(c) of the Health Insurance Portability and Accountability Act of 1996 (Public Law 104–191; 110 Stat. 2033).
(2) **Identifiable patient safety work product** — The term “identifiable patient safety work product” means patient safety work product that—
(A) is presented in a form and manner that allows the identification of any provider that is a subject of the work product, or any providers that participate in activities that are a subject of the work product;
(B) constitutes individually identifiable health information as that term is defined in the HIPAA confidentiality regulations; or
(C) is presented in a form and manner that allows the identification of an individual who reported information in the manner specified in [section 299b–22(e) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section299b–22/e&num=0&edition=prelim).
(3) **Nonidentifiable patient safety work product** — The term “nonidentifiable patient safety work product” means patient safety work product that is not identifiable patient safety work product (as defined in paragraph (2)).
(4) **Patient safety organization** — The term “patient safety organization” means a private or public entity or component thereof that is listed by the Secretary pursuant to [section 299b–24(d) of this title](https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title42-section299b–24/d&num=0&edition=prelim).
(5) **Patient safety activities** — The term “patient safety activities” means the following activities:
(A) Efforts to improve patient safety and the quality of health care delivery.
(B) The collection and a
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 299b–21
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Federal law — U.S. Code and appendices · legal_authorities
**(a)** Each agency shall make available to the public information as follows:
(1) Each agency shall separately state and currently publish in the Federal Register for the guidance of the public—
(A) descriptions of its central and field organization and the established places at which, the employees (and in the case of a uniformed service, the members) from whom, and the methods whereby, the public may obtain information, make submittals or requests, or obtain decisions;
(B) statements of the general course and method by which its functions are channeled and determined, including the nature and requirements of all formal and informal procedures available;
(C) rules of procedure, descriptions of forms available or the places at which forms may be obtained, and instructions as to the scope and contents of all papers, reports, or examinations;
(D) substantive rules of general applicability adopted as authorized by law, and statements of general policy or interpretations of general applicability formulated and adopted by the agency; and
(E) each amendment, revision, or repeal of the foregoing.
Except to the extent that a person has actual and timely notice of the terms thereof, a person may not in any manner be required to resort to, or be adversely affected by, a matter required to be published in the Federal Register and not so published. For the purpose of this paragraph, matter reasonably available to the class of persons affected thereby is deemed published in the Federal Register when incorporated by reference therein with the approval of the Director of the Federal Register.
(2) Each agency, in accordance with published rules, shall make available for public inspection in an electronic format—
(A) final opinions, including concurring and dissen
Source: Supplied U.S. Code snapshot — release unconfirmed · 5 U.S.C. § 552
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Federal law — U.S. Code and appendices · legal_authorities
The Secretary shall carry out such activities as the Secretary determines to be necessary to encourage Indian tribes, tribal organizations, and other mental health care providers to obtain the services of predoctoral psychology and psychiatry interns—
(1) to increase the quantity of patients served by the Indian tribes, tribal organizations, and other mental health care providers; and
(2) for purposes of recruitment and retention.
Source: Supplied U.S. Code snapshot — release unconfirmed · 25 U.S.C. § 1672
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Federal law — U.S. Code and appendices · legal_authorities
Beginning with fiscal year 2010, the Secretary shall transfer from the Public Health and Social Services Emergency Fund such sums as may be necessary to carry out this part.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 201
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Federal law — U.S. Code and appendices · legal_authorities
Page 345
TITLE 25—INDIANS
§ 1679
1980, 94 Stat. 3179; amended Pub. L. 102–285,
§ 10(b), May 18, 1992, 106 Stat. 172; renumbered
title VIII, § 807, and amended Pub. L. 102–573,
title VII, § 701(a), (b), title VIII, § 813(b), Oct. 29,
1992, 106 Stat. 4572, 4590.)
Editorial Notes
AMENDMENTS
1992—Subsec. (f). Pub. L. 102–573, § 813(b), struck out
subsec. (f) which authorized appropriation of $300,000 to
carry out the study as provided in subsec. (a), such
amount to be expended by the date eighteen months
after Dec. 17, 1980.
Statutory Notes and Related Subsidiaries
CHANGE OF NAME
‘‘United States Bureau of Mines’’ substituted for
‘‘Bureau of Mines’’ in subsec. (d)(1) pursuant to section
10(b) of Pub. L. 102–285, set out as a note under section
1 of Title 30, Mineral Lands and Mining. For provisions
relating to closure and transfer of functions of the
United States Bureau of Mines, see note set out under
section 1 of Title 30, Minerals and Mining.
NUCLEAR RESOURCE DEVELOPMENT HEALTH HAZARDS;
STUDY AND REPORT
Pub. L. 100–713, title VII, § 717, Nov. 23, 1988, 102 Stat.
4837, provided for a study to determine the number of
active nuclear resource development sites on Indian
lands in the United States and the health hazards that
exist as a result of such sites and required a report to
Congress describing the findings and conclusions of the
study by no later than 2 years after Nov. 23, 1988.
§ 1678. Arizona as contract health service deliv-
ery area
(a) In general
The State of Arizona shall be designated as a
contract health service delivery area by the
Service for the purpose of providing contract
health care services to members of Indian tribes
in the State of Arizona.
(b) Maintenance of services
The Service shall not curtail any health care
Source: Supplied 2024 U.S. Code historical extraction · 25 U.S.C. § 1678
Stored review status: historical_2024_not_currentness_verified. Same stored citation; legal effect and authority still require review.
Federal law — U.S. Code and appendices · legal_authorities
**(a) Evidence rating systems** In collaboration with experts from the public and private sector, the Agency shall identify and disseminate methods or systems to assess health care research results, particularly methods or systems to rate the strength of the scientific evidence underlying health care practice, recommendations in the research literature, and technology assessments. The Agency shall make methods or systems for evidence rating widely available. Agency publications containing health care recommendations shall indicate the level of substantiating evidence using such methods or systems.
**(b) Health care improvement research centers and provider-based research networks**
(1) **In general** — In order to address the full continuum of care and outcomes research, to link research to practice improvement, and to speed the dissemination of research findings to community practice settings, the Agency shall employ research strategies and mechanisms that will link research directly with clinical practice in geographically diverse locations throughout the United States, including—
(A) health care improvement research centers that combine demonstrated multidisciplinary expertise in outcomes or quality improvement research with linkages to relevant sites of care;
(B) provider-based research networks, including plan, facility, or delivery system sites of care (especially primary care), that can evaluate outcomes and evaluate and promote quality improvement; and
(C) other innovative mechanisms or strategies to link research with clinical practice.
(2) **Requirements** — The Director is authorized to establish the requirements for entities applying for grants under this subsection.
Source: Supplied U.S. Code snapshot — release unconfirmed · 42 U.S.C. § 299b
Stored review status: release_metadata_unconfirmed. The source passage cites 42 U.S.C. § 299b. This identifies an authority to review, not proof of applicability.
Federal law — U.S. Code and appendices · legal_authorities
Page 1120
TITLE 42—THE PUBLIC HEALTH AND WELFARE
§ 299b
PART B—HEALTH CARE IMPROVEMENT RESEARCH
§ 299b. Health care outcome improvement re-
search
(a) Evidence rating systems
In collaboration with experts from the public
and private sector, the Agency shall identify
and disseminate methods or systems to assess
health care research results, particularly meth-
ods or systems to rate the strength of the sci-
entific evidence underlying health care practice,
recommendations in the research literature, and
technology assessments. The Agency shall make
methods or systems for evidence rating widely
available.
Agency
publications
containing
health care recommendations shall indicate the
level of substantiating evidence using such
methods or systems.
(b) Health care improvement research centers
and provider-based research networks
(1) In general
In order to address the full continuum of
care and outcomes research, to link research
to practice improvement, and to speed the dis-
semination of research findings to community
practice settings, the Agency shall employ re-
search strategies and mechanisms that will
link research directly with clinical practice in
geographically diverse locations throughout
the United States, including—
(A) health care improvement research cen-
ters that combine demonstrated multidisci-
plinary expertise in outcomes or quality im-
provement research with linkages to rel-
evant sites of care;
(B) provider-based research networks, in-
cluding plan, facility, or delivery system
sites of care (especially primary care), that
can evaluate outcomes and evaluate and pro-
mote quality improvement; and
(C) other innovative mechanisms or strate-
gies to link research with clinical practice.
(2) Requirements
The Director is authori
Source: Supplied 2024 U.S. Code historical extraction · 42 U.S.C. § 299b
Stored review status: historical_2024_not_currentness_verified. The source passage cites 42 U.S.C. § 299b. This identifies an authority to review, not proof of applicability.