[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: 5CFR890.908]

[Page 484]
 
                    TITLE 5--ADMINISTRATIVE PERSONNEL
 
          CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (CONTINUED)
 
PART 890_FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM--Table of Contents
 
 Subpart I_Limit on Inpatient Hospital Charges, Physician Charges, and 
                          FEHB Benefit Payments
 
Sec. 890.908  Notification of HHS.

    An FEHB plan, under the oversight of OPM, will notify the Secretary 
of HHS, or the Secretary's designee, if the plan finds that:
    (a) A hospital knowingly and willfully collects, on a repeated 
basis, more than the amount determined to be equivalent to the Medicare 
part A payment under the DRG-based PPS.
    (b) A Medicare participating physician or supplier knowingly and 
willfully collects, on a repeated basis, more than the amount determined 
to be equivalent to the Medicare part B payment under the Medicare 
Participating Physician Fee Schedule.
    (c) A Medicare nonparticipating physician or supplier knowingly and 
willfully charges, on a repeated basis, more than the amount determined 
to be equivalent to the Medicare limiting charge amount.

[60 FR 26668, May 18, 1995]