SUMMARY OF H.R. 5102 THE FEDERAL EMPLOYEES HEALTH BENEFITS AMENDMENTS ACT OF 1988
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Document Number (FOIA) /ESDN (CREST):
CIA-RDP90M00005R000200050034-3
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RIFPUB
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K
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2
Document Creation Date:
December 23, 2016
Document Release Date:
August 17, 2012
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34
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Declassified and Approved For Release 2012/08/17: CIA-RDP90M00005R000200050034-3
SUMMARY OF H.R. 5102
THE FEDERAL EMPLOYEES HEALTH BENEFITS
AMENDMENTS ACT OF 1988
Source: H.R. 5102 was introduced on July 28, 1988, by
Mr. Ackerman, Mrs. Morella, Ms. Dakar, Mr. Myers and
Mr. Leland.
Purpose: To protect the Federal Employees' Health Benefit
Program (FEHBP) and its enrollees from unfit
health care providers, and providers who commit
certain types of financial misconduct. To provide
temporary continuation of FEHBP coverage to separated
enrollees, their unmarried dependent children, and
certain former spouses.
Summary: H.R. 5102 amends chapter 89 of title 5, United
States Code, to empower the office of Personnel
Management (OPM) to exclude certain health care
providers from participating in FEHBP. The
actions for which a provider may be barred include:
conviction relating to fraud, corruption, breach of
fiduciary responsibility, financial misconduct, neglect
or abuse of patients, obstruction or interference with
an investigation, or crimes concerning a controlled
substance; the revocation, suspension, restriction, or
nonrenewal of a license; and the submission of
fraudulent claims, claims which contain charges
substantially in excess of usual charges, or claims for
services which were medically unnecessary or which fail
to meet professionally recognized standards. In
addition, OPM is authorized to impose civil monetary
penalties on providers in instances of improper claims.
This provision is similar to the exclusion section in
the Medicare and Medicaid programs.
In addition, H.R. 5102 amends chapter 89 to provide for
the temporary continuation of FEHBP coverage for
separated employees, their unmarried dependent
children, and certain former spouses. Employees would
be permitted to extend their health insurance coverage
for up to 18 months, and their children and former
spouses may extend coverage for up to 36 months.
Beneficiaries would be required to pay an amount equal
to the combined employee and agency contribution to
continue FEHBP coverage. Additionally, the Office of
Personnel Management (OPM) may charge no more than an
additional 2% of the total premium to cover
administrative expenses. This section is similar to
the continuation coverage which was afforded to private
sector employees in the Consolidated Omnibus
Reconciliation Act of 1985.
Declassified and Approved For Release 2012/08/17: CIA-RDP90M00005R000200050034-3
Declassified and Approved For Release 2012/08/17: CIA-RDP90M00005R000200050034-3
Background: The Subcommittee on Compensation and Employee
Benefits held oversight hearings relating to FEHBP on
May 11 and May 18, 1988. H.R. 5102 incorporates two
changes to FEHBP which were suggested at the May 11
hearing. On August 3, 1988, the Subcommittee approved
H.R. 5102, without amendment, for full Committee
consideration, by a unanimous vote.
Administration Views: During the May 11 hearing, the Director of
OPM testified in support of legislation which would
provide OPM with the authority to exclude certain
health care providers from participating in FEHBP. In
response to follow-up questions, OPM wrote that any
proposal to provide continuation of FEHBP coverage
should be budget-neutral.
Cost: The Subcommittee has been advised by the Congressional
Budget Office that H.R. 5102 is budget-neutral.
Declassified and Approved For Release 2012/08/17: CIA-RDP90M00005R000200050034-3