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This proposed rule would promulgate regulations under 25 U.S.C. 1675. To encourage thorough review and open discussion of the medical care provided by the IHS, other Indian health programs, and urban Indian organizations, Congress elected to make IHS medical quality assurance (MQA) records and related testimony confidential and privileged. Under 25 U.S.C. 1675, disclosure of MQA records may only be made under limited circumstances. Congress instructed the Secretary of the U.S. Department of Health and Human Services, acting through IHS, to promulgate regulations under the MQA statute (25 U.S.C. 1675) and pursuant to 25 U.S.C. 1672.