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Code of Federal Regulations (Last Updated: October 10, 2024) |
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Title 5 - Administrative Personnel |
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Chapter I - Office of Personnel Management |
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SubChapter B - Civil Service Regulations |
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Part 890 - Federal Employees Health Benefits Program |
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Subpart J - Administrative Sanctions Imposed Against Health Care Providers |
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Civil Monetary Penalties and Financial Assessments |
§ 890.1061 - Bases for penalties and assessments.
Latest version.
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§ 890.1061 Bases for penalties and assessments.
(a) Improper claims. OPM may impose penalties and assessments on a provider if a claim presented by that provider for payment from FEHBP funds meets the criteria set forth in 5 U.S.C. 8902a(d)(1).
(b) False or misleading statements. OPM may impose penalties and assessments on a provider who makes a false statement or misrepresentation as set forth in 5 U.S.C. 8902a(d)(2).
(c) Failing to provide claims-related information. OPM may impose penalties and assessments on a provider who knowingly fails to provide claims-related information as otherwise required by law.