2005 CFR Title 5, Volume 2

Title 5--Administrative Personnel CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM
	890.101	Definitions; time computations.
	890.102	Coverage.
	890.103	Correction of errors.
	890.104	Initial decision and reconsideration on enrollment.
	890.105	Filing claims for payment or service.
	890.106	Delegation of authority for resolving certain contract disputes.
	890.107	Court review.
	890.108	Waiver of requirements for continued coverage during retirement.
	890.109	Exclusion of certain periods of eligibility when determining continued coverage during retirement.
	890.110	Enrollment reconciliation.
	890.201	Minimum standards for health benefits plans.
	890.202	Minimum standards for health benefits carriers.
	890.203	Application for approval of, and proposal of amendments to, health benefit plans.
	890.204	Withdrawal of approval of health benefits plans or carriers.
	890.205	Nonrenewal of contracts of health benefits plans.
	890.301	Opportunities for employees who are not participants in premium conversion to enroll or change enrollment; effective dates.
	890.302	Coverage of family members.
	890.303	Continuation of enrollment.
	890.304	Termination of enrollment.
	890.305	Reinstatement of enrollment after military service.
	890.306	When can annuitants or survivor annuitants change enrollment or reenroll and what are the effective dates?
	890.307	Waiver or suspension of annuity or compensation.
	890.308	Disenrollment.
	890.401	Temporary extension of coverage and conversion.
	890.501	Government contributions.
	890.502	Employee withholdings and contributions.
	890.503	Reserves.
	890.504	Disposition of contingency reserves upon reorganization or merger of plans.
	890.505	Recurring premium payments to carriers.
	890.601	Coverage.
	890.602	Opportunity to change enrollment.
	890.603	Effective date.
	890.605	Persons confined on effective date.
	890.701	Definitions.
	890.702	Payment to any licensed practitioner.
	890.801	Introduction.
	890.802	Definition.
	890.803	Who may enroll.
	890.804	Coverage.
	890.805	Application time limitations.
	890.806	When can former spouses change enrollment or reenroll and what are the effective dates?
	890.807	When do enrollments terminate, cancel or suspend?
	890.808	Employing office responsibilities.
	890.901	Purpose.
	890.902	Definition.
	890.903	Covered services.
	890.904	Determination of FEHB benefit payment.
	890.905	Limits on inpatient hospital and physician charges.
	890.906	Retired enrolled individuals coinsurance payments.
	890.907	Effective dates.
	890.908	Notification of HHS.
	890.909	End-of-year settlements.
	890.910	Provider information.
	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.
	890.1101	Purpose.
	890.1102	Definitions.
	890.1103	Eligibility.
	890.1104	Notification by agency.
	890.1105	Initial election of temporary continuation of coverage; application time limitations and effective dates.
	890.1106	Coverage.
	890.1107	Length of temporary continuation of coverage.
	890.1108	Opportunities to change enrollment; effective dates.
	890.1109	Premium payments.
	890.1110	Termination of enrollment or coverage.
	890.1111	Employing office responsibilities.
	890.1112	Denial of continuation of coverage due to involuntary separation for gross misconduct.
	890.1113	The administrative charge.
	890.1201	Purpose.
	890.1202	Definitions.
	890.1203	Coverage.
	890.1204	Effective date of coverage.
	890.1205	Change in type of enrollment.
	890.1206	Cancellation of coverage.
	890.1207	Termination of coverage.
	890.1208	Premiums.
	890.1209	Responsibilities of the U.S. Department of State.
	890.1210	Reconsideration and appeal rights.
	890.1301	Purpose.
	890.1302	Duration.
	890.1303	Eligibility.
	890.1304	Enrollment.
	890.1305	Termination and cancellation.
	890.1306	Government premium contributions.
	890.1307	Data collection.
	890.1308	Carrier participation.