Code of Federal Regulations > 5 CFR Administrative Personnel > I Office of Personnel Management > 890 Federal Employees Health Ben...

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Subpart J — Administrative Sanctions Imposed Against Health Care Providers

Authority: 5 U.S.C. 8902a.

Source: 68 FR 5475, Feb. 3, 2003, unless otherwise noted.

§890.1001 — Scope and purpose

§890.1002 — Use of terminology

§890.1003 — Definitions

§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

§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

§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

§890.1042 — Effective dates of debarments

§890.1043 — Effect of debarment on a provider

§890.1044 — Entities notified of OPM-issued debarments and suspensions

§890.1045 — Informing persons covered by FEHBP about debarment or suspension of their provider

§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

§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

§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

§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