|
Section 890.101
|
Coverage |
|
Section 890.102
|
Correction of errors |
|
Section 890.103
|
Initial decision and reconsideration on enrollment |
|
Section 890.104
|
Filing claims for payment or service |
|
Section 890.105
|
Delegation of authority for resolving certain contract disputes |
|
Section 890.106
|
Court review |
|
Section 890.107
|
Will OPM waive requirements for continued coverage during retirement? |
|
Section 890.108
|
Exclusion of certain periods of eligibility when determining continued coverage during retirement |
|
Section 890.109
|
Enrollment reconciliation |
|
Section 890.110
|
Continuation of eligibility for former Federal employees of the Civilian Marksmanship Program |
|
Section 890.111
|
Continuation of coverage for certain Senate Restaurants employees |
|
Section 890.112
|
Minimum standards for health benefits plans |
|
Section 890.201
|
Minimum standards for health benefits carriers |
|
Section 890.202
|
Application for approval of, and proposal of amendments to, health benefit plans |
|
Section 890.203
|
Withdrawal of approval of health benefits plans or carriers |
|
Section 890.204
|
Nonrenewal of contracts of health benefits plans |
|
Section 890.205
|
Opportunities for employees who are not participants in premium conversion to enroll or change enrollment; effective dates |
|
Section 890.301
|
Coverage of family members |
|
Section 890.302
|
Continuation of enrollment |
|
Section 890.303
|
Termination of enrollment |
|
Section 890.304
|
Reinstatement of enrollment after military service |
|
Section 890.305
|
When can annuitants or survivor annuitants change enrollment or reenroll and what are the effective dates? |
|
Section 890.306
|
Waiver or suspension of annuity or compensation |
|
Section 890.307
|
Disenrollment |
|
Section 890.308
|
Temporary extension of coverage and conversion |
|
Section 890.401
|
Government contributions |
|
Section 890.501
|
Withholdings, contributions, LWOP, premiums, and direct premium payment |
|
Section 890.502
|
Reserves |
|
Section 890.503
|
Disposition of contingency reserves upon reorganization or merger of plans |
|
Section 890.504
|
Recurring premium payments to carriers |
|
Section 890.505
|
Coverage |
|
Section 890.601
|
Opportunity to change enrollment |
|
Section 890.602
|
Effective date |
|
Section 890.603
|
Persons confined on effective date |
|
Section 890.605
|
Introduction |
|
Section 890.801
|
Definition |
|
Section 890.802
|
Who may enroll |
|
Section 890.803
|
Coverage |
|
Section 890.804
|
Application time limitations |
|
Section 890.805
|
When can former spouses change enrollment or reenroll and what are the effective dates? |
|
Section 890.806
|
When do enrollments terminate, cancel or suspend? |
|
Section 890.807
|
Employing office responsibilities |
|
Section 890.808
|
Purpose |
|
Section 890.901
|
Definition |
|
Section 890.902
|
Covered services |
|
Section 890.903
|
Determination of FEHB benefit payment |
|
Section 890.904
|
Limits on inpatient hospital and physician charges |
|
Section 890.905
|
Retired enrolled individuals coinsurance payments |
|
Section 890.906
|
Effective dates |
|
Section 890.907
|
Notification of HHS |
|
Section 890.908
|
End-of-year settlements |
|
Section 890.909
|
Provider information |
|
Section 890.910
|
Scope and purpose |
|
Section 890.1001
|
Use of terminology |
|
Section 890.1002
|
Definitions |
|
Section 890.1003
|
Bases for mandatory debarments |
|
Section 890.1004
|
Time limits for OPM to initiate mandatory debarments |
|
Section 890.1005
|
Notice of proposed mandatory debarment |
|
Section 890.1006
|
Minimum length of mandatory debarments |
|
Section 890.1007
|
Mandatory debarment for longer than the minimum length |
|
Section 890.1008
|
Contesting proposed mandatory debarments |
|
Section 890.1009
|
Debarring official's decision of contest |
|
Section 890.1010
|
Bases for permissive debarments |
|
Section 890.1011
|
Time limits for OPM to initiate permissive debarments |
|
Section 890.1012
|
Deciding whether to propose a permissive debarment |
|
Section 890.1013
|
Notice of proposed permissive debarment |
|
Section 890.1014
|
Minimum and maximum length of permissive debarments |
|
Section 890.1015
|
Aggravating and mitigating factors used to determine the length of permissive debarments |
|
Section 890.1016
|
Determining length of debarment based on revocation or suspension of a provider's professional licensure |
|
Section 890.1017
|
Determining length of debarment for an entity owned or controlled by a sanctioned provider |
|
Section 890.1018
|
Determining length of debarment based on ownership or control of a sanctioned entity |
|
Section 890.1019
|
Determining length of debarment based on false, wrongful, or deceptive claims |
|
Section 890.1020
|
Determining length of debarment based on failure to furnish information needed to resolve claims |
|
Section 890.1021
|
Contesting proposed permissive debarments |
|
Section 890.1022
|
Information considered in deciding a contest |
|
Section 890.1023
|
Standard and burden of proof for deciding contests |
|
Section 890.1024
|
Cases where additional fact-finding is not required |
|
Section 890.1025
|
Procedures if a fact-finding proceeding is not required |
|
Section 890.1026
|
Cases where an additional fact-finding proceeding is required |
|
Section 890.1027
|
Conducting a fact-finding proceeding |
|
Section 890.1028
|
Deciding a contest after a fact-finding proceeding |
|
Section 890.1029
|
Effect of a suspension |
|
Section 890.1030
|
Grounds for suspension |
|
Section 890.1031
|
Length of suspension |
|
Section 890.1032
|
Notice of suspension |
|
Section 890.1033
|
Counting a period of suspension as part of a subsequent debarment |
|
Section 890.1034
|
Provider contests of suspensions |
|
Section 890.1035
|
Information considered in deciding a contest |
|
Section 890.1036
|
Cases where additional fact-finding is not required |
|
Section 890.1037
|
Deciding a contest without additional fact-finding |
|
Section 890.1038
|
Cases where additional fact-finding is required |
|
Section 890.1039
|
Conducting a fact-finding proceeding |
|
Section 890.1040
|
Deciding a contest after a fact-finding proceeding |
|
Section 890.1041
|
Effective dates of debarments |
|
Section 890.1042
|
Effect of debarment on a provider |
|
Section 890.1043
|
Entities notified of OPM-issued debarments and suspensions |
|
Section 890.1044
|
Informing persons covered by FEHBP about debarment or suspension of their provider |
|
Section 890.1045
|
Effect of debarment or suspension on payments for services furnished in emergency situations |
|
Section 890.1046
|
Special rules for institutional providers |
|
Section 890.1047
|
Waiver of debarment for a provider that is the sole source of health care services in a community |
|
Section 890.1048
|
Claims for non-emergency items or services furnished by a debarred or suspended provider |
|
Section 890.1049
|
Exception to a provider's debarment for an individual enrollee |
|
Section 890.1050
|
Applying for reinstatement when period of debarment expires |
|
Section 890.1051
|
Reinstatements without application |
|
Section 890.1052
|
Table of procedures and effective dates for reinstatements |
|
Section 890.1053
|
Agencies and entities to be notified of reinstatements |
|
Section 890.1054
|
Contesting a denial of reinstatement |
|
Section 890.1055
|
Purpose and scope of civil monetary penalties and assessments |
|
Section 890.1060
|
Bases for penalties and assessments |
|
Section 890.1061
|
Deciding whether to impose penalties and assessments |
|
Section 890.1062
|
Maximum amounts of penalties and assessments |
|
Section 890.1063
|
Determining the amounts of penalties and assessments to be imposed on a provider |
|
Section 890.1064
|
Deciding whether to suspend or debar a provider in a case that also involves penalties and assessments |
|
Section 890.1065
|
Notice of proposed penalties and assessments |
|
Section 890.1066
|
Provider contests of proposed penalties and assessments |
|
Section 890.1067
|
Effect of not contesting proposed penalties and assessments |
|
Section 890.1068
|
Information the debarring official must consider in deciding a provider's contest of proposed penalties and assessments |
|
Section 890.1069
|
Deciding contests of proposed penalties and assessments |
|
Section 890.1070
|
Further appeal rights after final decision to impose penalties and assessments |
|
Section 890.1071
|
Collecting penalties and assessments |
|
Section 890.1072
|
Purpose |
|
Section 890.1101
|
Definitions |
|
Section 890.1102
|
Eligibility |
|
Section 890.1103
|
Notification by agency |
|
Section 890.1104
|
Initial election of temporary continuation of coverage; application time limitations and effective dates |
|
Section 890.1105
|
Coverage |
|
Section 890.1106
|
Length of temporary continuation of coverage |
|
Section 890.1107
|
Opportunities to change enrollment; effective dates |
|
Section 890.1108
|
Premium payments |
|
Section 890.1109
|
Termination of enrollment or coverage |
|
Section 890.1110
|
Employing office responsibilities |
|
Section 890.1111
|
Denial of continuation of coverage due to involuntary separation for gross misconduct |
|
Section 890.1112
|
The administrative charge |
|
Section 890.1113
|
Purpose |
|
Section 890.1201
|
Definitions |
|
Section 890.1202
|
Coverage |
|
Section 890.1203
|
Effective date of coverage |
|
Section 890.1204
|
Change in type of enrollment |
|
Section 890.1205
|
Cancellation of coverage |
|
Section 890.1206
|
Termination of coverage |
|
Section 890.1207
|
Premiums |
|
Section 890.1208
|
Responsibilities of the U |
|
Section 890.1209
|
Reconsideration and appeal rights |
|
Section 890.1210
|
Purpose |
|
Section 890.1301
|
Duration |
|
Section 890.1302
|
Eligibility |
|
Section 890.1303
|
Enrollment |
|
Section 890.1304
|
Termination and cancellation |
|
Section 890.1305
|
Government premium contributions |
|
Section 890.1306
|
Data collection |
|
Section 890.1307
|
Carrier participation |
|
Section 890.1308
|
Relationship to part 890 of this chapter |