[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: 5CFR890.1066]

[Page 503]
 
                    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. 890.1066  Notice of proposed penalties and assessments.

    (a) Written notice. OPM must inform a provider of proposed penalties 
and assessments by written notice, sent via certified mail with return 
receipt requested, to the provider's last known street or post office 
address. OPM may, at its discretion, use an express service that 
furnishes a verification of delivery instead of postal mail.
    (b) Statutory limitations period. OPM must send the notice to the 
provider within 6 years of the date on which the claim underlying the 
proposed penalties and assessments was presented to an FEHBP carrier. If 
the proposed penalties and assessments do not involve a claim presented 
for payment, OPM must send the notice within 6 years of the date of the 
actions on which the proposed penalties and assessments are based.
    (c) Contents of the notice. OPM's notice must contain, at a minimum:
    (1) The statement that OPM proposes to impose penalties and/or 
assessments against the provider;
    (2) Identification of the actions, conduct, and claims that comprise 
the basis for the proposed penalties and assessments;
    (3) The amount of the proposed penalties and assessments, and an 
explanation of how OPM determined those amounts;
    (4) The statutory and regulatory bases for the proposed penalties 
and assessments; and
    (5) Instructions for responding to the notice, including specific 
explanations regarding:
    (i) The provider's right to contest the imposition and/or amounts of 
penalties and assessments before they are formally imposed; and
    (ii) OPM's right, if the provider does not contest the proposed 
penalties and assessments within 30 days of the date he receives the 
notice, to implement them immediately without further administrative 
appeal or recourse.
    (d) Proposing debarment in the same notice. OPM may propose a 
provider's debarment in the same notice that also proposes penalties and 
assessments. In this case, the notice must also provide the elements of 
information required to appear in a notice of proposed debarment under 
Sec. 890.1006(b).
    (e) Procedures if the notice cannot be delivered. OPM must apply the 
provisions of Sec. 890.1006(f) if the notice of proposed penalties and 
assessments cannot be delivered as originally addressed.
    (f) Sending notice by electronic means.[Reserved]