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Current as of January 02, 2025 | Updated by Findlaw Staff
(a) Review factors. The factors OPM shall consider in deciding whether to propose a provider's debarment under a permissive debarment authority are:
(1) The nature of any claims involved in the basis for the proposed debarment and the circumstances under which they were presented to FEHBP carriers;
(2) The improper conduct involved in the basis for the proposed debarment, and the provider's degree of culpability and history of prior offenses;
(3) The extent to which the provider poses or may pose a risk to the health and safety of FEHBP–covered individuals or to the integrity of FEHBP transactions; and
(4) Other factors specifically relevant to the provider's debarment that shall be considered in the interests of fairness.
(b) Absence of a factor. The absence of a factor shall be considered neutral, and shall have no effect on OPM's decision.
(c) Specialized review in certain cases. In determining whether to propose debarment under 5 U.S.C 8902a(c)(4) for providing items or services substantially in excess of the needs of a covered individual or for providing items or services that fail to meet professionally-recognized quality standards, OPM shall obtain the input of trained reviewers, based on written medical protocols developed by physicians. If OPM cannot reach a decision on this basis, it shall consult with a physician in an appropriate specialty area.
Cite this article: FindLaw.com - Code of Federal Regulations Title 5. Administrative Personnel § 5.890.1013 Deciding whether to propose a permissive debarment - last updated January 02, 2025 | https://codes.findlaw.com/cfr/title-5-administrative-personnel/cfr-sect-5-890-1013/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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