[Code of Federal Regulations]
[Title 5, Volume 2]
[Revised as of January 1, 2005]
From the U.S. Government Printing Office via GPO Access
[CITE: 5CFR890.1008]

[Page 487-488]
 
                    TITLE 5--ADMINISTRATIVE PERSONNEL
 
          CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED)
 
PART 890_FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM--Table of Contents
 
Subpart J_Administrative Sanctions Imposed Against Health Care Providers
 
Sec. 890.1008  Mandatory debarment for longer than the minimum length.

    (a) Aggravating factors. OPM may debar a provider for longer than 
the 3-year minimum period for mandatory debarments if aggravating 
factors are associated with the basis for the debarment. The factors OPM 
considers to be aggravating are:
    (1) Whether the FEHBP incurred a financial loss as the result of the 
acts underlying the conviction, or similar acts that were not 
adjudicated, and the level of such loss. In determining the amount of 
financial loss, OPM shall not consider any amounts of restitution that a 
provider may have paid;
    (2) Whether the sentence imposed by the court included 
incarceration;
    (3) Whether the underlying offense(s), or similar acts not 
adjudicated, occurred repeatedly over a period of time, and whether 
there is evidence that the offense(s) was planned in advance;
    (4) Whether the provider has a prior record of criminal, civil, or 
administrative adjudication of related offenses or similar acts; or
    (5) Whether the actions underlying the conviction, or similar acts 
that were not adjudicated, adversely affected the physical, mental, or 
financial well-being of one or more covered individuals or other 
persons.
    (b) Mitigating factors. If the aggravating factors justify a 
debarment longer than the 3 year minimum period for mandatory 
debarments, OPM shall also consider whether mitigating factors may 
justify reducing the debarment period to not less than 3 years. The 
factors that OPM considers to be mitigating are:
    (1) Whether the conviction(s) on which the debarment is based 
consist entirely or primarily of misdemeanor offenses;
    (2) Whether court records, including associated sentencing reports, 
contain an official determination that the provider had a physical, 
mental, or emotional condition before or during the commission of the 
offenses underlying the conviction that reduced his level of 
culpability; or
    (3) Whether the provider's cooperation with Federal and/or State 
investigative officials resulted in criminal convictions, civil 
recoveries, or administrative actions against other individuals, or 
served as the basis for identifying program weaknesses. Restitution made 
by the provider for funds wrongfully, improperly, or illegally received 
from Federal or State programs may

[[Page 488]]

also be considered as a mitigating circumstance.
    (c) Maximum period of debarment. There is no limit on the maximum 
period of a mandatory debarment based on a conviction.