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Code of Federal Regulations (Last Updated: July 5, 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 |
| Civil Monetary Penalties and Financial Assessments |
| § 890.1060 - Purpose and scope of civil monetary penalties and assessments. |
| § 890.1061 - Bases for penalties and assessments. |
| § 890.1062 - Deciding whether to impose penalties and assessments. |
| § 890.1063 - Maximum amounts of penalties and assessments. |
| § 890.1064 - Determining the amounts of penalties and assessments to be imposed on a provider. |
| § 890.1065 - Deciding whether to suspend or debar a provider in a case that also involves penalties and assessments. |
| § 890.1066 - Notice of proposed penalties and assessments. |
| § 890.1067 - Provider contests of proposed penalties and assessments. |
| § 890.1068 - Effect of not contesting proposed penalties and assessments. |
| § 890.1069 - Information the debarring official must consider in deciding a provider's contest of proposed penalties and assessments. |
| § 890.1070 - Deciding contests of proposed penalties and assessments. |
| § 890.1071 - Further appeal rights after final decision to impose penalties and assessments. |
| § 890.1072 - Collecting penalties and assessments. |
| Reinstatement |
| § 890.1051 - Applying for reinstatement when period of debarment expires. |
| § 890.1052 - Reinstatements without application. |
| § 890.1053 - Table of procedures and effective dates for reinstatements. |
| § 890.1054 - Agencies and entities to be notified of reinstatements. |
| § 890.1055 - Contesting a denial of reinstatement. |
| Notifying Outside Parties About Debarment and Suspension Actions |
| § 890.1044 - Entities notified of OPM-issued debarments and suspensions. |
| § 890.1045 - Informing persons covered by FEHBP about debarment or suspension of their provider. |
| Exceptions to the Effect of Debarments |
| § 890.1046 - Effect of debarment or suspension on payments for services furnished in emergency situations. |
| § 890.1047 - Special rules for institutional providers. |
| § 890.1048 - Waiver of debarment for a provider that is the sole source of health care services in a community. |
| Permissive Debarments |
| § 890.1011 - Bases for permissive debarments. |
| § 890.1012 - Time limits for OPM to initiate permissive debarments. |
| § 890.1013 - Deciding whether to propose a permissive debarment. |
| § 890.1014 - Notice of proposed permissive debarment. |
| § 890.1015 - Minimum and maximum length of permissive debarments. |
| § 890.1016 - Aggravating and mitigating factors used to determine the length of permissive debarments. |
| § 890.1017 - Determining length of debarment based on revocation or suspension of a provider's professional licensure. |
| § 890.1018 - Determining length of debarment for an entity owned or controlled by a sanctioned provider. |
| § 890.1019 - Determining length of debarment based on ownership or control of a sanctioned entity. |
| § 890.1020 - Determining length of debarment based on false, wrongful, or deceptive claims. |
| § 890.1021 - Determining length of debarment based on failure to furnish information needed to resolve claims. |
| § 890.1022 - Contesting proposed permissive debarments. |
| § 890.1023 - Information considered in deciding a contest. |
| § 890.1024 - Standard and burden of proof for deciding contests. |
| § 890.1025 - Cases where additional fact-finding is not required. |
| § 890.1026 - Procedures if a fact-finding proceeding is not required. |
| § 890.1027 - Cases where an additional fact-finding proceeding is required. |
| § 890.1028 - Conducting a fact-finding proceeding. |
| § 890.1029 - Deciding a contest after a fact-finding proceeding. |
| Suspension |
| § 890.1030 - Effect of a suspension. |
| § 890.1031 - Grounds for suspension. |
| § 890.1032 - Length of suspension. |
| § 890.1033 - Notice of suspension. |
| § 890.1034 - Counting a period of suspension as part of a subsequent debarment. |
| § 890.1035 - Provider contests of suspensions. |
| § 890.1036 - Information considered in deciding a contest. |
| § 890.1037 - Cases where additional fact-finding is not required. |
| § 890.1038 - Deciding a contest without additional fact-finding. |
| § 890.1039 - Cases where additional fact-finding is required. |
| § 890.1040 - Conducting a fact-finding proceeding. |
| § 890.1041 - Deciding a contest after a fact-finding proceeding. |
| Mandatory Debarments |
| § 890.1004 - Bases for mandatory debarments. |
| § 890.1005 - Time limits for OPM to initiate mandatory debarments. |
| § 890.1006 - Notice of proposed mandatory debarment. |
| § 890.1007 - Minimum length of mandatory debarments. |
| § 890.1008 - Mandatory debarment for longer than the minimum length. |
| § 890.1009 - Contesting proposed mandatory debarments. |
| § 890.1010 - Debarring official's decision of contest. |
| Special Exceptions to Protect Covered Persons |
| § 890.1049 - Claims for non-emergency items or services furnished by a debarred or suspended provider. |
| § 890.1050 - Exception to a provider's debarment for an individual enrollee. |
| Effect of Debarment |
| § 890.1042 - Effective dates of debarments. |
| § 890.1043 - Effect of debarment on a provider. |
| General Provisions and Definitions |
| § 890.1001 - Scope and purpose. |
| § 890.1002 - Use of terminology. |
| § 890.1003 - Definitions. |
| §§ 890.1007--890.1009 - [Reserved] |