Federal employees health benefits program; coverage of temporary employees--OPM. Interim rule with request for comments

The Office of Personnel Management (OPM) is issuing interim regulations to clarify the eligibility of temporary employees to continue their Federal Employees Health Benefits (FEHB) coverage when they become compensationers. These regulations are necessary to distinguish between retirement as an employee annuitant and "retirement" as a compensationer. OPM is also issuing regulations to allow temporary employees an opportunity to change health plans if their salary is insufficient to pay the premium withholdings, to show the effective date of such an enrollment change, and to provide for the termination of these employees' enrollment if they do not change health plans.     

Federal Employees Health Benefits program: direct payment of FEHB premiums for annuitants--OPM. Final rule

The Office of Personnel Management (OPM) is adopting its previously issued interim regulation that implements section 1 of Public Law 101-303. This section of law allows all annuitants to make direct payment of premiums for their Federal Employees Health Benefits (FEHB) coverage when their annuity is too low to cover the insurance premiums. Previously, only annuitants in the Federal Employees Retirement System (FERS) were allowed to make direct payment of their FEHB premiums.     

Federal employees health benefits program: effective dates--OPM. Proposed rule

The Office of Personnel Management (OPM) is issuing proposed regulations to change the existing Federal Employees Health Benefits (FEHB) Program regulations concerning the effective date for new enrollments made by employees during the annual open season. These regulations would also change the effective date of open season changes in enrollment made by employees, annuitants, former spouses and individuals enrolled under the temporary continuation of coverage (TCC) provisions of FEHB law. The proposed regulations would standardize the effective date of most of these new enrollments or changes in enrollment. This would make it easier for employing offices and health plan carriers to administer the Program and reduce the potential for error in determining effective dates.     

Suspension of enrollment in the Federal Employees Health Benefits (FEHB) Program for Peace Corps volunteers. Final rule

The Office of Personnel Management is issuing a final regulation to allow Peace Corps volunteers who are FEHB Program enrolled annuitants, survivors, and former spouses to suspend their FEHB enrollments and then return to the FEHB Program during the Open Season, or return to FEHB coverage immediately, if they involuntarily lose health benefits coverage under the Peace Corps. The intent of this final rule is to allow these beneficiaries to avoid the expense of continuing to pay FEHB Program premiums while they have other health coverage as Peace Corps volunteers, without endangering their ability to return to the FEHB Program in the future.     

Federal employees health benefits children's equity. Final rule

The Office of Personnel Management (OPM) is issuing final regulations to implement the Federal Employees Health Benefits Children's Equity Act of 2000, which was enacted October 30, 2000. This law mandates the enrollment of a Federal employee for self and family coverage in the Federal Employees Health Benefits (FEHB) Program, if the employee is subject to a court or administrative order requiring him or her to provide health benefits for his or her child or children and the employee does not provide documentation of compliance with the order.     

Prohibition of "gag clauses" in the Federal Employees Health Benefits Program--OPM. Final rule making

The office of Personnel Management (OPM) is issuing a final regulation amending the Federal Employees Health Benefits Acquisition Regulations (FEHBAR) to prohibit health benefit carriers participating in the Federal Employees Health Benefits (FEHB) Program from entering into contracts or employment agreements with health care providers, provider groups, or health care workers that would include provisions or financial incentives that have the effect of limiting or restricting communication of medically necessary services to FEHB enrollees.     

Federal employees health benefits program: miscellaneous changes--Office of Personnel Management. Final rulemaking

The Office of Personnel Management (OPM) is issuing final regulations which implement a number of miscellaneous changes to the Federal Employees Health Benefits (FEHB) Program regulations. The regulations will improve the administration of the FEHB Program and result in better service to enrollees.     

Federal employees health benefits program: debarment--OPM. Final rule

The Office of Personnel Management (OPM) is issuing final regulations to incorporate into regulations the statutory requirement that carriers in the Federal Employees Health Benefits (FEHB) Program may not deny claims for services or supplies due to the debarment of the providers who supplied them if the claimants could not have known that the provider was debarred. The purpose of these regulations is to comply with the provision of law that requires OPM to prescribe regulations on this issue.     

Federal Employees Health Benefits Program; benefits for medically underserved areas--Office of Personnel Management. Final rule

The Office of Personnel Management (OPM) is amending its regulations pertaining to benefits under the Federal Employees Health Benefits (FEHB) Program for individuals in medically underserved areas, these regulations are necessary to implement the FEHB law, as amended, which mandates special consideration for enrollees of certain FEHB plans who receive covered health service in States with critical shortages of primary care physicians.     

Federal Employees Health Benefits Program; benefits for medically underserved areas--Office of Personnel Management. Final rule

The Office of Personnel Management (OPM) is amending its regulations pertaining to benefits under the Federal Employees Health Benefits (FEHB) Program for individuals in medically underserved areas. These regulations are necessary to implement the FEHB law, as amended, which mandates special consideration for enrollees of certain FEHB plans who receive covered health service in States with critical shortages of primary care physicians.     

Prohibition of "gag clauses" in the Federal Employees Health Benefits Program--OPM. Notice of proposed rule making

The Office of Personnel Management (OPM) is proposing to amend the regulations to prohibit health benefit carriers participating in the Federal Employees Health Benefits (FEHB) Program from entering into contractual provisions with health care providers or health care workers that would include a provision for incentive payments as an inducement to reduce or limit communication with, or the delivery of health care services to, FEHB enrollees. The rule is intended to ensure providers' and health care workers' ability to communicate with, and advise patients of, any medically necessary treatment options.     

Federal employees health benefits program: limitation on physician charges and FEHB Program payments--Office of Personnel Management. Final rule

The Office of Personnel Management (OPM) is making final its interim regulation that amends current Federal Employees Health Benefits (FEHB) Program regulations. The final regulation requires that the charges and FEHB fee-for-service plans' benefit payments for certain physician services furnished to retired enrolled individuals do not exceed the limits on charges and payments established under the Medicare fee schedule for physician services.     

Federal employees health benefits program: discontinuance of health plan in an emergency. Final regulation

The Office of Personnel Management (OPM) is issuing a final rule to amend the Federal Employees Health Benefits (FEHB) regulations regarding discontinuance of a health plan to include situations in which a health plan becomes incapacitated, either temporarily or permanently, as the result of a disaster.     

Federal Employees Health Benefits (FEHB) program and Department of Defense (DoD) demonstration project; and other miscellaneous changes. Office of Personnel Management. Final rule

OPM is issuing a final regulation to implement the portion of the Defense Authorization Act for 1999 that establishes authority for a demonstration project under which certain Medicare and other eligible DoD beneficiaries can enroll in health benefit plans in certain geographic areas under the Federal Employees Health Benefits (FEHB) Program. The demonstration project will run for a period of three years from January 1, 2000, through December 31, 2002. This regulation specifies only the requirements that differ from existing FEHB Program regulations because of unique aspects of the demonstration project. This regulation also makes other miscellaneous changes to the Federal Employees Health Benefits Acquisition Regulations.     

Federal Employees Health Benefits Program--Office of Personnel Management. Final rule

These regulations call for the simultaneous submission of Federal Employees Health Benefit (FEHB) carriers' benefit and rate proposals. The regulations will permit an assessment of the impact of benefit and rate proposals on both the Government and enrollees in a more timely and orderly fashion than is possible with the present FEHB contract negotiation cycle.     

Procurement regulations--Office of Personnel Management. Final rule

These regulations call for the simultaneous submission of Federal Employees Health Benefit (FEHB) carriers' benefit and rate proposals. The regulations will permit an assessment of the impact of benefit and rate proposals on both the Government and enrollees in a more timely and orderly fashion than is possible with the present FEHB contract negotiation cycle.     

Federal employees health benefits program: disenrollment--OPM. Final rule

The Office of Personnel Management (OPM) is issuing final regulations that are consistent with existing administrative procedures requiring employing offices to provide information about enrollees in the Federal Employees Health Benefits (FEHB) Program to the carriers of the FEHB plans in which they are enrolled. Carriers are also required to use the information provided by employing offices to reconcile their enrollment records. These regulations will regularize the conditions that would allow carriers to disenroll individuals when their employing office of record does not show them as enrolled in the carrier's plan and the carrier is otherwise unable to verify the enrollment. The purpose of these regulations is to facilitate reconciliation of carrier and employing office enrollment records, especially in cases where the carrier has not previously received a notice showing an enrollment no longer is valid.     

Federal employees health benefits acquisition regulation: large provider agreements, subcontracts, and miscellaneous changes. Final rule

The Office of Personnel Management (OPM) is issuing this final regulation to amend the Federal Employees Health Benefits Acquisition Regulation (FEHBAR). It establishes requirements, including audit, for Federal Employees Health Benefits Program (FEHB) experience-rated carriers' Large Provider Agreements. It also modifies the dollar threshold for review of carriers' subcontract agreements; revises the definitions of Cost or Pricing Data and Experience-rate to reflect mental health parity requirements; updates the contract records retention requirement; updates the FEHB Clause Matrix; and conforms subpart and paragraph references to Federal Acquisition Regulation (FAR) revisions made since we last updated the FEHBAR.     

Medicare program; grace period and termination for nonpayment of Supplementary Medical Insurance (Part B) premiums for insured and uninsured persons--HCFA. Final rule

This final rule changes the termination date for Supplementary Medical Insurance (SMI) (Part B) enrollees who fail to pay their Medicare Part B premiums. Presently, there is a 90 day grace period for the enrollee during which he or she may pay all overdue premiums and continue Part B coverage uninterrupted. The grace period begins at different times depending on whether the individual is or is not eligible for monthly social security, railroad retirement or civil service retirement benefits. This final rule establishes a uniform timeframe for determining the 90 day grace period which precedes the termination of SMI enrollees who fail to pay their Medicare Part B premiums.     

Federal Employees Health Benefits (FEHB) Program and Department of Defense (DoD) demonstration project. Office of Personnel Management. Final rule

OPM is issuing a final regulation to implement the portion of the National Defense Authorization Act for 1999 that establishes authority for a demonstration project under which certain Medicare and other eligible DoD beneficiaries can enroll in health benefit plans in certain geographic areas under the Federal Employees Health Benefits (FEHB) Program. The demonstration project will run for a period of three years from January 1, 2000, through December 31, 2002. This regulation specifies only the requirements that differ from existing FEHB Program regulations because of unique aspects of the demonstration project.