[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: 5CFR890.1037]

[Page 495]
 
                    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. 890.1037  Cases where additional fact-finding is not required.

    The suspending official may decide a contest without an additional 
fact-finding process if:
    (a) Previously adjudicated facts. The suspension is based on an 
indictment or on facts determined by a prior adjudication in which the 
provider was afforded due process rights. Examples of due process 
proceedings include, but are not limited to, the adjudication procedures 
associated with licensure revocation, suspension, restriction, or 
nonrenewal by a State licensing authority; similar administrative 
adjudications by Federal, State, or local agencies; a criminal 
conviction or civil judgment; or an action by the provider that 
constitutes a waiver of his right to a due process adjudication, such as 
surrender of professional licensure during the pendency of a 
disciplinary hearing, entering a guilty plea or confession of judgment 
in a judicial proceeding, or signing a settlement agreement stipulating 
facts that constitute a sanctionable violation. Neither the existence of 
the prior adjudication nor any of the underlying circumstances are 
considered to be subject to genuine factual dispute as part of the 
suspension proceeding.
    (b) Advisory by law enforcement officials. OPM is advised by the 
Department of Justice, the appropriate U.S. Attorney's Office, a State 
attorney general's office, or a State or local prosecutor's office that 
proceedings before a presiding official would prejudice the substantial 
interests of the Government in pending or contemplated legal proceedings 
based on the same facts as the suspension.
    (c) No bona fide dispute of material facts. The information, 
arguments, and documents submitted to the suspending official do not 
establish that there is a bona fide factual dispute regarding facts 
material to the suspension.