[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: 5CFR890.1048]

[Page 498-499]
 
                    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. 890.1048  Waiver of debarment for a provider that is the sole source 
of health care services in a community.

    (a) Application required. A provider may apply for a limited waiver 
of debarment at any time after receiving OPM's notice of proposed 
debarment. Suspended providers are not eligible to request a waiver of 
suspension.
    (b) Criteria for granting waiver. To receive a waiver, a provider 
shall clearly demonstrate that:
    (1) The provider is the sole community provider or the sole source 
of essential specialized services in a community;
    (2) A limited waiver of debarment would be in the best interests of 
covered individuals in the defined service area;
    (3) There are reasonable assurances that the actions which formed 
the basis for the debarment shall not recur; and
    (4) There is no basis under this subpart for continuing the 
debarment.
    (c) Waiver applies only in the defined service area. A limited 
waiver applies only to items or services provided within the defined 
service area where a provider is the sole community provider or sole 
source of essential specialized services.
    (d) Governmentwide effect continues. A limited waiver applies only 
to a provider's FEHBP transactions. Even if OPM waives a debarment for 
FEHBP purposes, the governmentwide effect under section 2455 of the 
Federal Acquisition Streamlining Act of 1994 (Pub. L. 103-355) continues 
for all other Federal agencies' procurement and nonprocurement programs 
and activities.
    (e) Waiver rescinded if circumstances change. OPM shall rescind the 
limited waiver when any of its underlying bases no longer apply. If OPM 
rescinds the limited waiver, the provider's debarment shall resume full 
effect for all FEHBP transactions. Events warranting rescission include, 
but are not limited to:
    (1) The provider ceases to furnish items or services in the defined 
service area;
    (2) Another provider begins to furnish equivalent items or services 
in the defined service area, so that the provider who received a waiver 
is no longer the sole provider or sole source; or
    (3) The actions that formed the basis for the provider's debarment, 
or similar acts, recur.
    (f) Effect on period of debarment. The minimum period of debarment 
is established when the debarment is initially imposed. A subsequent 
decision to grant, deny, or rescind a limited waiver shall not change 
that period.
    (g) Application is necessary for reinstatement. A provider who has 
received a limited waiver shall apply for reinstatement at the end of 
the debarment period, even if a limited waiver is in effect when the 
debarment expires.
    (h) Finality of debarring official's decision. The debarring 
official's decision to grant or deny a limited waiver is final and not 
subject to further administrative review or reconsideration.

[[Page 499]]

              Special Exceptions to Protect Covered Persons