[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: 5CFR890.1062]

[Page 501-502]
 
                    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. 890.1062  Deciding whether to impose penalties and assessments.

    (a) Authority of debarring official. The debarring official has 
discretionary authority to impose penalties and assessments in 
accordance with 5 U.S.C. 8902a and this subpart.
    (b) Factors to be considered. In deciding whether to impose 
penalties and assessments against a provider that has committed one of 
the violations identified in Sec. 890.1061, OPM must consider:
    (1) The number and frequency of the provider's violations;
    (2) The period of time over which the violations were committed;
    (3) The provider's culpability for the specific conduct underlying 
theviolations;
    (4) The nature of any claims involved in the violations and the 
circumstances under which the claims were presented to FEHBP carriers;
    (5) The provider's history of prior offenses or improper conduct, 
including any actions that could have constituted a basis for a 
suspension, debarment, penalty, or assessment by any Federal or State 
agency, whether or not any sanction was actually imposed;

[[Page 502]]

    (6) The monetary amount of any damages, losses, and costs, as 
described in Sec. 890.1064(c), attributable to the provider's 
violations; and
    (7) Such other factors as justice may require.
    (c) Additional factors when penalty or assessment is based on 
provisions of Sec. 890.1061(b) or (c). In the case of violations 
involving false or misleading statements or the failure to provide 
claims-related information, OPM must also consider:
    (1) The nature and circumstances of the provider's failure to 
properly report information; and
    (2) The materiality and significance of the false statements or 
misrepresentations the provider made or caused to be made, or the 
information that the provider knowingly did not report.