U. S. Office of Personnel Management
FEDERAL REGISTER DOCUMENTS
April 1996
April 5, 1996: Federal Employees Health
Benefits Acquisition Regulation; Filing Health Benefit Claims; Addition of Contract
Clause
The Office of Personnel Management (OPM) is issuing final regulations
to add a new contract clause in part 1652 of the Federal Employees Health Benefits
Acquisition Regulation (FEHBAR). The clause clarifies for both FEHB carriers and covered
individuals the circumstances under which OPM may render a decision
regarding a covered individual who asks OPM to review a health benefits
plan's denial of a claim if the plan has either affirmed its denial when the covered
individual requested reconsideration, or failed to respond to the covered individual's
request for reconsideration as provided by OPM's regulations.
[Federal Register Regulation: PDF or text]
April 5, 1996: Federal Employees Health
Benefits Program: Filing Claims; Disputed Claims Procedures and Court Actions
The Office of Personnel Management (OPM) is issuing final regulations
revising the requirement that legal actions to recover on a claim under the Federal
Employees Health Benefits (FEHB) Program should be brought against the health benefits
carrier rather than OPM and clarifying the procedures for filing claims
for payment or service under the FEHB Program.
[Federal Register Regulation: PDF or text]
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