[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: 5CFR890.1031]

[Page 494]
 
                    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. 890.1031  Grounds for suspension.

    (a) Basis for suspension. OPM may suspend a provider if:
    (1) OPM obtains reliable evidence indicating that one of the grounds 
for suspension listed in paragraph (b) of this section applies to the 
provider; and
    (2) The suspending official determines under paragraph (c) of this 
section that immediate action to suspend the provider is necessary to 
protect the health and safety of persons covered by FEHBP.
    (b) Grounds for suspension. Evidence constituting grounds for a 
suspension may include, but is not limited to:
    (1) Indictment or conviction of a provider for a criminal offense 
that is a basis for mandatory debarment under this subpart;
    (2) Indictment or conviction of a provider for a criminal offense 
that reflects a risk to the health, safety, or well-being of FEHBP-
covered individuals;
    (3) Other credible evidence indicating, in the judgment of the 
suspending official, that a provider has committed a violation that 
would warrant debarment under this subpart. This may include, but is not 
limited to:
    (i) Civil judgments;
    (ii) Notice that a Federal, State, or local government agency has 
debarred, suspended, or excluded a provider from participating in a 
program or revoked or declined to renew a professional license; or
    (iii) Other official findings by Federal, State, or local bodies 
that determine factual or legal matters.
    (c) Determining need for immediate action. Suspension is intended to 
protect the public interest, including the health and safety of covered 
individuals or the integrity of FEHBP funds. The suspending official has 
wide discretion to decide whether to suspend a provider. A specific 
finding of immediacy or necessity is not required to issue a suspension. 
The suspending official may draw reasonable inferences from the nature 
of the alleged misconduct and from a provider's actual or potential 
transactions with the FEHBP.