[Federal Register: December 12, 2001 (Volume 66, Number 239)]
[Proposed Rules]
[Page 64160-64173]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr12de01-32]
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Proposed Rules
Federal Register
________________________________________________________________________
This section of the FEDERAL REGISTER contains notices to the public of
the proposed issuance of rules and regulations. The purpose of these
notices is to give interested persons an opportunity to participate in
the rule making prior to the adoption of the final rules.
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[[Page 64160]]
OFFICE OF PERSONNEL MANAGEMENT
5 CFR Part 890
RIN 3206-AD76
Debarments and Suspensions of Health Care Providers From the
Federal Employees Health Benefits Program
AGENCY: Office of Personnel Management.
ACTION: Proposed rule.
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SUMMARY: The Office of Personnel Management (OPM) is proposing to amend
its regulations on administrative sanctions of health care providers
participating in the Federal Employees Health Benefits Program (FEHBP).
The proposed regulations implement the suspension and debarment
provisions of section 2 of the Federal Employees Health Care Protection
Act of 1998 (Pub. L. 105-266). This statute modified both the
substantive and procedural requirements for FEHBP administrative
sanctions. These regulations supercede interim regulations issued in
1989 to implement the earlier sanctions legislation that was amended by
Pub. L. 105-266. They will promote quicker, more uniform decisionmaking
for suspensions and debarments, and will enhance protection against
unfit providers for both the FEHBP and the individuals it covers.
DATES: Submit comments on or before February 11, 2002.
ADDRESSES: Send or deliver written comments to David Cope, U.S. Office
of Personnel Management, 1900 E Street NW., Room 6400, Washington, DC
20415, or submit comments electronically to debar@opm.gov.
FOR FURTHER INFORMATION CONTACT: David Cope, 202-606-2851, FAX 202-606-
2153.
SUPPLEMENTARY INFORMATION:
Background
A 1991 GAO report (GGD-91-95, ``Fraud and Abuse: Stronger Controls
Needed in Federal Employees Health Benefits Program'') concluded that
OPM needed to be more aggressive in dealing with health care provider
integrity problems. Among other steps, GAO recommended that the agency
take action to implement effective administrative sanctions
authorities.
OPM recognized that an appropriate administrative sanctions program
for FEHBP would necessitate legislative action to replace earlier
sanctions legislation that had proved to be costly and ultimately
unworkable. As an interim measure, in May 1993, OPM adopted the
Governmentwide Nonprocurement Suspension and Debarment Common Rule
(common rule), a standardized regulatory program that permitted the
agency to effectuate sanctions issued by other agencies. Under this
authority, OPM has debarred from the FEHBP over 18,700 health care
providers who had previously been excluded from the Medicare, Medicaid,
and other programs under the Social Security Act by the Office of
Inspector General (OIG) of the Department of Health and Human Services.
The OPM common rule regulations appear at 5 CFR part 970.
While operating under the common rule, OPM developed legislative
proposals for health care provider sanctions that were comprehensive
(i.e., offering a full range of sanctions authorities) and procedurally
efficient, while affording appropriate due process protections to the
subjects of sanctions action. Bills containing these authorities were
introduced in both the 104th and 105th Congresses, and a version that
closely paralleled the OPM proposals was enacted as part of Pub. L.
105-266 on October 19, 1998.
This proposed rule is the first of two planned regulatory issuances
that together will implement all of the Pub. L. 105-266 sanctions
authorities. We are addressing debarments and suspensions in the first
issuance because we expect them to constitute the majority of our
sanctions workload. OPM is currently developing a separate regulatory
issuance to address the financial sanctions authorities enacted by Pub.
L. 105-266, including financial assessments and civil monetary
penalties.
Purposes of Administrative Sanctions
Administrative sanctions are civil remedies that agencies impose
under their own authority to protect their programs from transactions
with untrustworthy individuals or entities and to recover program funds
paid improperly or fraudulently. Because administrative sanctions are
not considered to be ``punitive,'' they can, and frequently are,
imposed in addition to other remedies, such as criminal or civil
judicial action.
Virtually every federal agency has some form of sanctions
authority. The most common types of administrative sanctions are:
Debarment--removing an individual or entity from
participation in a program for a designated period of time, after a due
process proceeding;
Suspension--removing an individual or entity from program
participation on an immediate basis, without prior due process, because
he currently poses a threat to the public interest; and
Financial sanctions--imposing double or treble damages,
fines, and monetary assessments or penalties, based on a due process
proceeding.
Administrative Sanctions of Health Care Providers
Various studies by the GAO, the Office of the Inspector General
(OIG) of the Department of Health and Human Services, and health
insurance industry groups have placed the overall rate of provider
fraud in the American health care system within a range of 6 to 12
percent of the total dollar value of claims. The OIG of the Office of
Personnel Management has recognized for many years that fraud by health
care providers poses a significant problem for both the financial
integrity of the Federal Employees Health Benefits Program (FEHBP) and
the health care interests of the persons who obtain coverage through
it.
One of the difficulties in pursuing provider-related fraud within
FEHBP has been the inadequacy of the legal remedies available to
address the problem, prior to the passage of Pub. L. 105-266. Although
the false claims, false statements, and mail fraud statutes are
nominally applicable to many instances of health care fraud, in
practice they are seldom invoked because of the high burden of proof in
criminal cases and the fact that the dollar amounts in question
typically do not reach prosecutorial thresholds. In fact, most
instances of provider fraud
[[Page 64161]]
are not amenable to being handled appropriately within the federal
judicial system. However, the Pub. L. 105-266 administrative sanctions
authorities, as implemented by the proposed regulation, are
specifically designed to address fraudulent or improper conduct by
health care providers quickly, efficiently, and cost-effectively.
Transition to Statutory Debarment System
Adoption of this proposed regulation will have the following effect
on existing OPM regulations:
Upon issuance, this rule will replace the 1989 interim
final version of 5 CFR part 890, subpart J, which reflected the
legislation superseded by Pub. L. 105--266.
As of the date this regulation goes into effect, OPM will
discontinue issuing new debarments under the common rule (5 CFR part
970) in favor of actions under 5 CFR part 890, subpart J. Common rule
debarments already in effect will remain so until the exclusions on
which they are based are terminated by the originating agency.
Administrative Sanctions Will Not Affect FEHBP Operations
The proposed regulation fully reflects the policy concepts
underlying OPM's operation of the FEHBP. The principal objectives of
administrative sanctions activities will be to protect the health and
safety of covered persons and the integrity of the FEHBP by excluding
providers whose conduct indicates that they may pose a threat to either
of those interests. Other than terminating the rights of certain
providers to receive payment of FEHBP funds, the regulations will not
affect the manner or conditions through which health care services are
delivered to FEHBP-covered persons, or any other aspect of the
provider--patient relationship. There will be no effect on the ability
of FEHBP subscribers to select health insurance coverage appropriate to
their circumstances. Finally, sanctions imposed under these regulations
will apply only to health care providers, and will not affect the
contractual relationship between OPM and the FEHBP carriers. As a
related matter, OPM is committed to coordinating with other agencies to
combat health care fraud and abuse. The proposed rule attempts wherever
possible to maintain consistency and cooperation between FEHBP
sanctions and the Medicare administrative sanctions program operated by
the OIG, Department of Health and Human Services.
Mandatory and Permissive Debarment
Pub. L. 105-266 established two broad categories of debarments,
distinguished by their underlying bases and the debarring official's
range of discretion in imposing the sanction. Mandatory debarment
authorities require OPM to debar providers who, in prior due process
proceedings, were found to have committed certain types of violations.
This concept has been part of the Medicare administrative sanctions
statute for many years. As detailed in Sec. 890.1004 of the proposed
rule, grounds for mandatory debarment include conviction of crimes
involving (1) fraud or other financial misconduct, (2) abuse of
patients, (3) abuse of controlled substances, or (4) obstruction of an
investigation of those crimes. Mandatory debarment also applies to
providers who have been debarred, suspended, or excluded by another
Federal agency.
Permissive debarment authorities cover violations for which the
debarring official may exercise discretion to impose or not impose
debarment, according to the facts of each case. Pub. L. 105-266
established 12 separate grounds for permissive debarment. Section 1011
of the proposed rule arranges these grounds into four broad categories.
The categories are (1) actions involving revocation, suspension,
nonrenewal, or surrender of health care licensure; (2) ownership or
control of an entity by a debarred provider, or ownership/control by a
provider of a debarred entity; (3) false, deceptive, or wrongful claims
practices; and (4) refusal to provide information requested by OPM or a
FEHBP carrier to determine the validity or amount of a claim.
Length of Debarments
Pub. L. 105-266 and the proposed rule establish a minimum 3-year
period of debarment for mandatory debarments based on convictions. The
proposed rule also adopts the Medicare practice of using specific
aggravating and mitigating factors to determine whether a period of
debarment longer than the minimum period should be imposed (see
Sec. 890.1008). Mandatory debarments based on another agency's sanction
will always be for an indefinite period running concurrently with the
sanction on which they are based. Therefore, they are not subject to a
specified minimum period or to extension because of aggravating
factors.
Unlike mandatory debarments, Pub. L. 105-266 does not specify
statutory minimum periods for permissive debarments. However, to foster
economical and consistent decisionmaking, Secs. 890.1016-890.1021 of
the proposed rule recommend periods for permissive debarments that may
be increased or decreased, based on factors specified in the statute.
In the interests of sound administration, Sec. 890.1015 establishes an
overall minimum period of not less than one year for any permissive
debarment.
Procedures and Appeals
Pub. L. 105-266, and these proposed regulations, require OPM to
implement the findings of prior criminal, civil, or administrative due
process proceedings with regard to all categories of mandatory
debarments. For permissive debarments, the debarring official may, but
is not required to, accept the relevant findings of a prior
adjudication at the Federal, State, or local level as satisfying the
requisite factual basis for debarment (e.g., a licensure revocation or
suspension by a Federal regulatory board).
The subject of a proposed mandatory debarment will receive a 30-day
advance notice of the impending debarment and may challenge
(``contest'') OPM's action by submitting information and arguments on
their behalf (see Sec. 890.1006). If OPM proposes a period of debarment
exceeding the 3-year statutory minimum, the provider has the further
right to make a personal appearance before the debarring official. The
proposed mandatory debarment can be withdrawn only if the basis for it
no longer exists, such as a conviction being reversed on appeal, or if
the proposed subject is incorrectly identified. No further
administrative appeal or reconsideration is available. Mandatory
debarments become effective when implemented by OPM and remain in force
during all judicial appeals. Sections 890.1009 and 890.1010 of the
proposed rule address these procedures.
Permissive debarments (other than those based on prior
adjudications) inherently require more extensive adjudication of
individual cases than mandatory debarments. However, Pub. L. 105-266
provided an effective method of administering them by establishing
specific factors that OPM must consider when deciding whether to impose
a permissive debarment. These are enumerated in Sec. 890.1013 of the
proposed rule. A provider proposed for debarment on permissive grounds
that have been previously adjudicated will receive advance written
notice and an opportunity to contest the proposed debarment on
essentially the same basis as an individual proposed for debarment on
mandatory grounds. These procedures are reflected in
[[Page 64162]]
Sec. Sec. 890.1022-890.1026 of the proposed rule.
When the grounds for a permissive debarment have not previously
been determined through a due process adjudication, Pub. L. 105-266
requires that OPM provide an opportunity for a due process hearing to
establish the underlying facts. If the debarring official determines
that the administrative record contains a bona fide dispute about facts
material to the debarment, he must request a fact-finding hearing
before imposing debarment. If the debarring official decides that there
is no genuine and material factual dispute on the record, he may issue
a decision without a hearing. Except for debarments based on refusal to
provide requested information or false/wrongful claims, the debarment
will remain in effect while the hearing and associated procedures are
held. The presiding official's findings (whether the hearing is held
before or after debarment) are binding on the debarring official. No
further administrative appeals are available after the debarring
official's final decision. Sections 890.1027-890.1029 of the proposed
rule detail the procedural rights of a provider subject to permissive
debarment on previously unadjudicated grounds.
Suspension
Suspension is a temporary measure, equivalent in its effect to
debarment, i.e., FEHBP funds may not be paid for items or services
furnished while a provider is suspended. However, in contrast to a
debarment, suspension can be imposed without prior due process, pending
the completion of legal or administrative proceedings. Although Pub. L.
105-266 does not address suspension per se, it does confer discretion
to make debarments effective immediately, if necessary to protect the
health and safety of covered individuals. To exercise this authority
systematically, we are proposing in Secs. 890.1030-890.1041 to treat
suspension as a separate form of sanction. This is also consistent with
governmentwide practice under the Uniform Suspension and Debarment
Common Rule. Section 890.1031 outlines the bases for taking a
suspension action. To suspend a provider, OPM must have reasonable
cause to believe that he has committed a violation warranting debarment
and adequate evidence that the health and safety of covered
individuals, or the integrity of FEHBP funds, would be at risk if a
suspension were not issued immediately.
As provided in Sec. 890.1032, the initial period of a suspension
may not exceed 12 months. The Department of Justice or a Federal or
local prosecutor may request that the suspension be extended for an
additional six months. When formal legal or administrative proceedings
are initiated during the period of suspension, it may continue
indefinitely, pending their completion. If a suspended provider is
subsequently debarred, Sec. 890.1034 authorizes the debarring official
to account for the period of suspension in determining the period of
debarment.
Sections 890.1035-890.1041 provide a reconsideration procedure for
suspensions, including the opportunity to make a personal appearance
before the suspending official and the right to request a fact-finding
proceeding before a presiding official when there is a bona fide
dispute regarding facts material to the suspension.
Waivers and Exceptions
The proposed rule contains a number of waivers and exceptions that
protect the financial and health care interests of persons who obtain
their health insurance coverage through the FEHBP. These include
provisions that (1) claims will be paid for covered persons who obtain
services from a debarred provider without knowledge of his debarment
[Sec. 890.1045]; (2) services furnished by a debarred provider in an
emergency situation will be paid under each carrier's emergency
coverage provisions [Sec. 890.1046]; (3) inpatients who were admitted
to a debarred institution before its debarment will have continued
coverage for inpatient institutional services until they are discharged
or transferred, unless OPM determines that their health and safety
require an earlier termination of payments [Sec. 890.1047]; (4)
providers who are the sole provider of health care services or the sole
source of essential specialized services in a community may apply for a
limited waiver of debarment to continue their participation in FEHBP
[Sec. 890.1048]; and (5) covered persons may apply for individual
exceptions to permit continued payment of FEHBP funds for services they
receive from a debarred provider if equivalent services are not
reasonably available to them from a nondebarred provider or if
interrupting an ongoing course of treatment by the debarred provider
would create a risk to their health [Sec. 890.1050].
Reinstatement
The proposed rule recognizes two types of reinstatement. First,
Sec. 890.1051 implements the provisions of Pub. L. 105-266 authorizing
OPM to establish regulations under which debarred providers may be
reinstated after expiration of the term of their debarment. The statute
makes all such reinstatements permissive on OPM's part and requires the
provider to prove that they meet the criteria of Sec. 890.1051(c). The
proposed rule requires the debarred provider to apply for
reinstatement. The effective date of a provider's reinstatement is to
be established by OPM, but it may not occur before the period of
debarment expires.
The second type of reinstatement, addressed in Sec. 890.1052,
applies when administrative or legal action occurring after the
debarment has the effect of retroactively invalidating the basis for
the debarment. This will occur, for example, where a conviction or
licensure action that was the grounds for our debarment is overturned
on appeal. In this case, the provider may qualify for reinstatement
before their period of debarment expires. Also included in this
category are cases where a provider excluded by another agency is
reinstated by that agency, thus removing the basis for debarment. In
all of these situations, OPM will reinstate the provider without an
application being filed. The effective date of these ``automatic''
reinstatements will reflect the date of the event forming the basis for
the reinstatement. Therefore, if an appeals court's reversal of a
criminal conviction or licensure revocation has the effect of
invalidating the action from its inception, we will normally make the
reinstatement retroactive to the beginning date of the debarment.
However, in the case of a termination of a sanction imposed by another
Federal agency, the effective date of the automatic reinstatement will
be the date of the other agency's reinstatement. The table in
Sec. 890.1053 provides an additional reference aid on these issues.
Regulatory Flexibility Act
I certify that this proposed regulation will not have a significant
economic impact on a substantial number of small entities.
Executive Order 12866, Regulatory Review
This rule has been reviewed by the Office of Management and Budget
in accordance with Executive Order 12866.
List of Subjects in 5 CFR Part 890
Administrative practice and procedure, Government employees, Health
facilities, Health insurance, Health professions, Hostages, Iraq,
Kuwait, Lebanon.
[[Page 64163]]
Office of Personnel Management.
Kay Coles James,
Director.
Accordingly, OPM proposes to amend part 890 of title 5, Code of
Federal Regulations as follows:
PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM
1. The authority citation for Part 890 continues to read as
follows:
Authority: 5 U.S.C. 8913; Sec. 890.803 also issued under 50
U.S.C. 403(p), 22 U.S.C. 4069c and 4069c-1; subpart L also issued
under sec. 599C of Pub. L. 101-513, 104 Stat. 2064, as amended;
Sec. 890.102 also issued under sections 11202(f), 11232(e), 11246(b)
and (c) of Pub. L. 105-33, 111 Stat. 251; and section 721 of Pub. L.
105-261, 112 Stat. 2061.
2. Subpart J of part 890 is revised to read as follows:
Subpart J--Administrative Sanctions Imposed Against Health Care
Providers
Sec.
General Provisions and Definitions
890.1001 What are the scope and purpose of these regulations?
890.1002 How is this subpart written and organized?
890.1003 What terms in this subpart have specialized meanings?
Mandatory Debarments
890.1004 What are the grounds for mandatory debarments?
890.1005 What is OPM's time limit for initiating a mandatory
debarment?
890.1006 How will OPM notify me of my proposed debarment?
890.1007 What is the minimum period of debarment for mandatory
debarments?
890.1008 When can the period of a mandatory debarment based on a
conviction exceed the statutory minimum period?
890.1009 How may I contest OPM's proposal to debar me under a
mandatory debarment authority?
890.1010 How will the debarring official decide my contest?
Permissive Debarments
890.1011 What are the grounds for permissive debarments?
890.1012 What are OPM's time limits for initiating a permissive
debarment?
890.1013 How will OPM decide whether to propose a permissive
debarment?
890.1014 How will OPM notify me of my proposed debarment under a
permissive debarment authority?
890.1015 What are the minimum and maximum periods for permissive
debarments?
890.1016 What aggravating and mitigating factors will OPM consider
in making a final determination of the period of my debarment?
890.1017 How will OPM determine the period of my debarment based on
revocation or suspension of my professional licensure?
890.1018 How will OPM determine the period of debarment for an
entity owned or controlled by a sanctioned person?
890.1019 How will OPM determine the period of my debarment based on
my ownership or control of a sanctioned entity?
890.1020 How will OPM determine the period of my debarment based on
false, wrongful, or deceptive claims?
890.1021 How will OPM determine the period of my debarment based on
my failure to provide information needed to resolve claims?
890.1022 How may I contest OPM's proposal to debar me under a
permissive debarment authority?
890.1023 What information will the debarring official consider as
part of my contest?
890.1024 What standards and burdens of proof apply to my contest?
890.1025 When can the debarring official decide my contest without
an additional fact-finding proceeding?
890.1026 How will the debarring official resolve my contest if a
fact-finding proceeding is not required?
890.1027 When must the debarring official request a fact-finding
proceeding before deciding my contest?
890.1028 How will the presiding official conduct the fact-finding
proceeding?
890.1029 How will the debarring official decide my contest after
the fact-finding proceeding?
Suspension
890.1030 What is a suspension?
890.1031 Under what circumstances may OPM suspend me?
890.1032 How long will my suspension last?
890.1033 How will OPM notify me of a suspension?
890.1034 If I am debarred after being suspended, will the
suspension period count as part of the debarment period?
890.1035 How may I contest OPM's decision to suspend me?
890.1036 What information will the suspending official consider as
part of my contest?
890.1037 When can the suspending official decide my contest without
arranging an additional fact-finding proceeding?
890.1038 How will the suspending official resolve my contest if he
determines that a fact-finding proceeding is not required?
890.1039 Under what circumstances must the suspending official
arrange a fact-finding proceeding before deciding my contest?
890.1040 How will the presiding official conduct the fact-finding
proceeding?
890.1041 How will the suspending official decide my contest after
the fact-finding proceeding is completed?
Effect of Debarment
890.1042 When will my debarment go into effect?
890.1043 How does my debarment affect me?
Notifying Outside Parties About Debarment and Suspension Actions
890.1044 What entities will OPM notify of my debarment or
suspension?
890.1045 How will OPM inform persons covered by FEHBP about my
debarment or suspension?
Exceptions to the Effect of Debarments
890.1046 How does my debarment affect payments to me for services I
furnish in emergency situations?
890.1047 What special rules apply to me as an institutional
provider?
890.1048 How may I obtain a waiver of my debarment if I am the sole
source of health care services in a community?
Special Exceptions To Protect Covered Persons
890.1049 How will FEHBP carriers handle claims for items or
services furnished after a provider's debarment?
890.1050 How may an FEHBP covered individual request an exception
to a provider's debarment?
Reinstatement
890.1051 How may I be reinstated when my period of debarment
expires?
890.1052 Under what circumstances will OPM reinstate me without my
filing an application?
890.1053 Table of procedures and effective dates for
reinstatements.
890.1054 What agencies and entities will OPM notify about my
reinstatement?
890.1055 How may I contest OPM's decision to deny my reinstatement
application?
Civil Monetary Penalties and Financial Assessments [Reserved]
Subpart J--Administrative Sanctions Imposed Against Health Care
Providers
General Provisions and Definitions
Sec. 890.1001 What are the scope and purpose of these regulations?
(a) Scope. This subpart implements section 8902a of title 5, United
States Code, as amended by Public Law 105-266 (October 19, 1998). It
establishes a system of administrative sanctions that OPM may, or in
some cases, must apply to health care providers who have committed
certain violations. The sanctions include debarment, suspension, civil
monetary penalties, and financial assessments.
(b) Purpose. OPM will use the authorities in this subpart to
protect the health and safety of the persons who obtain their health
insurance coverage through the FEHBP and the financial and programmatic
integrity of FEHBP transactions.
Sec. 890.1002 How is this subpart written and organized?
(a) Plain language format. We wrote this subpart in a question-and-
answer
[[Page 64164]]
format to make it easier for the public and health care providers to
use. In this format, the questions comprising most section headings are
integral parts of the respective sections and subsections, because the
reader cannot interpret the answers without the context of the
questions. Therefore, each question and answer are a unified whole with
regulatory effect. The tables contained in this subpart also have
regulatory effect.
(b) Words connoting OPM and health care providers. Unless otherwise
indicated, the words ``you,'' ``me,'' and ``I'' connote a health care
provider(s) and the word ``we'' connotes the Office of Personnel
Management.
Sec. 890.1003 What terms in this subpart have specialized meanings?
The following terms have the meanings shown throughout this
subpart:
(a) Carrier means an entity responsible for operating a health
benefits plan described by section 8903 or section 8903a of title 5,
United States Code.
(b) Community means a geographically-defined area in which you
furnish health care services or supplies and for which you may request
a limited waiver of debarment in accordance with this subpart. Defined
service area has the same meaning as community.
(c) Contest means your request for the debarring or suspending
official to reconsider your proposed sanction, its length, or its
amount.
(d) Control interest means that:
(1) You have a direct and/or indirect ownership interest of 5
percent or more in an entity;
(2) You own a whole or part interest in a mortgage, deed of trust,
note, or other obligation secured by the entity, its property, or its
assets, equating to a direct interest of 5 percent or more of the total
property or assets of the entity;
(3) You are an officer or director of the entity, if it is
organized as a corporation;
(4) You are a partner in the entity, if it is organized as a
partnership;
(5) You are a managing employee of the entity, including but not
limited to a general manager, business manager, administrator, or other
employee who exercises, either directly or through other employees,
operational or managerial control over the activities of the entity or
a portion of it;
(6) You have substantive control over an entity or a critical
influence over the activities of the entity or some portion of it,
whether or not you are employed by the entity; or
(7) You act as an agent of the entity.
(e) Conviction or convicted means the following, without regard to
the pendency or outcome of an appeal (other than a judgment of
acquittal based on innocence) or request for relief:
(1) A Federal, State, or local court has entered a judgment of
conviction against you for a felony or misdemeanor offense;
(2) A Federal, State, or local court has found you guilty of a
felony or misdemeanor offense;
(3) A Federal, State, or local court has accepted your plea of
guilty, nolo contendere, or the equivalent to a felony or misdemeanor
offense; or
(4) You have entered a first offender, diversion, or other program
in which a judgment of conviction for a felony or misdemeanor offense
has been withheld.
(f) Covered individual means an employee, annuitant, family member,
or former spouse covered by a health benefits plan described by section
8903 or section 8903a of title 5, United States Code, or an individual
eligible under section 8905(d) of title 5, United States Code.
(g) Debarment means a decision by the debarring official to
prohibit payment of FEHBP funds to you, based on section 8902a (b),
(c), or (d) of title 5, United States Code and this subpart.
(h) Debarring official means an OPM employee authorized to issue
debarments under this subpart.
(i) FEHBP means the Federal Employees Health Benefits Program.
(j) Health care services or supplies means health care or services
and supplies such as diagnosis and treatment; drugs and biologicals;
supplies, appliances and equipment; and hospitals or other
institutional entities that furnish supplies and services.
(k) Incarceration means imprisonment, or any type of confinement
with or without supervised release, including but not limited to home
detention, community confinement, house arrest, or similar
arrangements.
(l) Limited waiver means an approval by the debarring official of
your request to receive payments of FEHBP funds for items or services
rendered in a defined geographical area, notwithstanding your
debarment, because you are the sole community provider or sole source
of essential specialized services in a community.
(m) Mandatory debarment means a debarment based on section 8902a(b)
of title 5, United States Code. OPM must debar providers who have
committed violations listed in that section.
(n) Office or OPM means the United States Office of Personnel
Management or the component thereof responsible for conducting the
administrative sanctions program described by this subpart.
(o) Permissive debarment means a debarment based on sections
8902a(c) or (d) of title 5, United States Code. The debarring official
has discretionary authority to debar providers who have committed
violations listed in those sections.
(p) Provider or provider of health care services or supplies means
a physician, hospital, or other individual or entity that, directly or
indirectly, furnishes health care services or supplies.
(q) Reinstatement means a decision by OPM to terminate your
debarment and restore your eligibility to receive payment of FEHBP
funds.
(r) Sanction or administrative sanction means any administrative
action authorized by section 8902a of Title 5, United States Code, or
this subpart, including debarment, suspension, civil monetary
penalties, and financial assessments.
(s) Should know or should have known means that you act(ed) in
deliberate ignorance or reckless disregard of the truth or falsity of
information. For the purpose of imposing a sanction when the grounds
incorporate a ``should know'' standard, no proof of specific intent to
defraud is required to determine that you have committed an actionable
violation.
(t) Sole community provider means that you are the only source of
primary medical care within a defined service area.
(u) Sole source of essential specialized services in a community
means that you are the only source of specialized health care items or
services in a defined service area and items or services furnished by a
non-specialist cannot be substituted without jeopardizing the health or
safety of covered individuals.
(v) Suspending official means an OPM employee authorized to issue
suspensions under this subpart.
Mandatory Debarments
Sec. 890.1004 What are the grounds for mandatory debarments?
OPM must debar you if any of the factors listed in paragraph (a) or
(b) of this section applies to you.
(a) Conviction for criminal offenses. You have been convicted under
Federal or State law of a criminal offense relating to:
(1) Fraud, corruption, breach of fiduciary responsibility, or other
[[Page 64165]]
financial misconduct in connection with the delivery of a health care
service or supply;
(2) Neglect or abuse of patients in connection with the delivery of
a health care service or supply;
(3) Interference with or obstruction of an investigation or
prosecution of a criminal offense described in paragraph (a)(1) or
(a)(2) of this section; or
(4) Unlawful manufacture, distribution, prescription, or dispensing
of a controlled substance.
(b) Administrative sanction currently in effect. You are currently
debarred, suspended, or otherwise excluded from any Federal procurement
or nonprocurement activity, within the meaning of section 2455 of the
Federal Acquisition Streamlining Act of 1994.
(c) Direct involvement with an OPM program unnecessary. Your
conviction of an offense listed in paragraph (a) of this section or
your receiving a sanction described in paragraph (b) of this section
need not have involved an FEHBP covered individual or transaction, or
any other OPM program, in order to serve as a basis for mandatory
debarment.
Sec. 890.1005 What is OPM's time limit for initiating a mandatory
debarment?
OPM must issue you written notice of a proposed mandatory debarment
within 6 years of the event that forms the basis for the debarment. If
the basis for the proposed debarment is a conviction, the notice must
be issued within 6 years of the date of the conviction. If the basis is
another agency's suspension, debarment, or exclusion, the OPM notice
must be issued within 6 years of the effective date of the other
agency's action.
Sec. 890.1006 How will OPM notify me of my proposed debarment?
(a) Written notice. We will inform you of your proposed debarment
by written notice sent not less than 30 days prior to the proposed
effective date.
(b) Contents of the notice. The notice will contain the following
items of information:
(1) Effective date of your debarment;
(2) Minimum length of your debarment;
(3) Basis for your debarment;
(4) The provisions of law and regulation authorizing OPM to debar
you;
(5) Effect of the debarment;
(6) Your right to contest the debarment to the debarring official;
(7) Your right to request that we reduce the period of your
debarment, if it exceeds the minimum required by law or this subpart;
and
(8) The procedures you must follow to apply for reinstatement at
the end of your period of debarment, or to seek a waiver of the
debarment on the basis that you are the sole health care provider in a
community or the sole source of essential specialized services.
(c) Methods of sending notice. We will send the notice of proposed
debarment to you by one of the following means:
(1) First class mail or, at our option, express delivery service,
to your last known street or post office address;
(2) Facsimile transmission (fax), if you have furnished us a
current fax number; or
(3) E-mail, if you have furnished us a current e-mail address.
(d) Delivery to attorney, agent, or representatives.
(1) If we are proposing to debar you as an individual, we may send
the notice of proposed debarment to you or to any other person you have
designated to act on your behalf during debarment proceedings.
(2) If we are proposing to debar an entity, we may send the notice
of proposed debarment to any owner, partner, director, officer,
registered agent for service of process, attorney, or managing
employee.
(e) Presumed timeframes for receipt of notice. When we compute
deadlines associated with your receipt of notices we send to you, we
will apply the timeframes specified in paragraphs (e)(1) through (e)(3)
of this section.
(1) We will consider any notice we send by first class mail or
express delivery service to your last known street or post office
address as having been received by you not later than 5 days after we
send it.
(2) We will consider any notice we send by facsimile (fax)
transmission to a number that you provided to us as having been
received by you when we transmit it.
(3) We will consider any notice we send by e-mail to an e-mail
address that you furnished to us as having been received by you when we
transmit it to your email service provider.
(f) Procedures if notice cannot be delivered.
(1) If we learn that a notice we sent to you was undeliverable as
addressed or routed, we will make reasonable efforts to obtain a
current and accurate address or to use alternative methods of
transmitting the notice to you.
(2) If we are unable to deliver a notice to you after reasonable
followup efforts, we will presume that you received it 5 days after the
date of our final attempt to send it to you.
Sec. 890.1007 What is the minimum period of debarment for mandatory
debarments?
(a) Debarment based on a conviction. The statutory minimum period
of debarment for a mandatory debarment based on a conviction is 3
years.
(b) Debarment based on another agency's action. A mandatory
debarment based on another Federal agency's debarment, suspension, or
exclusion remains in effect until the originating agency terminates its
sanction.
Sec. 890.1008 When can the period of a mandatory debarment based on a
conviction exceed the statutory minimum period?
(a) Aggravating factors. OPM may debar you for longer than the 3-
year minimum period if aggravating factors are associated with the
basis for your debarment. The factors we consider to be aggravating are
as follows:
(1) The FEHBP incurred a financial loss as the result of the acts
underlying your conviction, or similar acts that were not adjudicated.
In determining whether a financial loss occurred, we will not consider
any amounts of restitution you may have paid;
(2) The sentence imposed by the court included incarceration;
(3) The underlying offense(s), or similar acts not adjudicated,
occurred repeatedly over a period of time, or there is evidence that
you planned the offense(s) in advance;
(4) You have a prior record of criminal, civil, or administrative
adjudication of related offenses or similar acts; or
(5) The actions underlying your conviction, or similar acts that
were not adjudicated, adversely affected the physical, mental, or
financial well-being of one or more covered individuals or other
persons.
(b) Mitigating factors. If the aggravating factors justify
debarring you for longer than 3 years, we will also consider whether
mitigating factors may justify reducing your debarment period to not
less than 3 years. The only factors that we will consider to be
mitigating are as follows:
(1) The conviction(s) on which your debarment is based consist
entirely or primarily of misdemeanor offenses;
(2) Court records, including associated sentencing reports, contain
an official determination that you had a physical, mental, or emotional
condition before or during the commission of the offenses underlying
the conviction that reduced your level of culpability; or
(3) Your cooperation with Federal and/or State investigative
officials
[[Page 64166]]
resulted in criminal convictions, civil recoveries, or administrative
actions against other individuals, or served as the basis for
identifying program weaknesses.
(c) Maximum period of debarment. There is no limit on the maximum
period of a mandatory debarment based on a conviction.
Sec. 890.1009 How may I contest OPM's proposal to debar me under a
mandatory debarment authority?
(a) Contesting the debarment. Within 30 days after receiving
written notice that we intend to debar you under a mandatory debarment
authority, you may submit information, documents, and written arguments
in opposition to the proposed debarment. Our notice will give you
specific information about where and how to submit this material. If
you do not file a timely contest, your debarment will become effective
as stated in the notice, without further action by OPM.
(b) Requesting a reduction of the debarment period. If we propose
to debar you for a period longer than the 3-year minimum required by
Sec. 890.1007(a), you may request us to reduce the debarment period to
not less than 3 years. You may make this request even if you are not
contesting the debarment itself. In addition to providing written
material, you may appear before the debarring official personally or
through a representative to present oral arguments in support of your
contest. Our notice will give you specific information about arranging
an in-person presentation.
Sec. 890.1010 How will the debarring official decide my contest?
(a) Prior adjudication is dispositive. Evidence indicating that you
were the subject of a prior adjudication of a type described in
Sec. 890.1004 fully satisfies the standard of proof for a mandatory
debarment.
(b) Debarring official's decision. The debarring official will
issue a written decision, based on all the information in the
administrative record, within 30 days after the administrative record
is complete. This decision period may be extended for good cause.
(c) No further administrative proceedings. The debarring official's
decisions regarding mandatory debarment and the period of your
debarment are final and are not subject to further administrative
review.
Permissive Debarments
Sec. 890.1011 What are the grounds for permissive debarments?
(a) Licensure actions. We may debar you if either paragraph (a)(1)
or (a)(2) of this section applies to you. We may take this action even
if you retain current and valid professional licensure in another
State(s).
(1) A State licensing authority revokes, suspends, restricts, or
declines to renew your license to provide health care items or services
for reasons related to your professional competence, professional
performance, or financial integrity; or
(2) You surrender your license to provide health care items or
services while a formal disciplinary proceeding concerning your
professional competence, professional performance, or your financial
integrity is pending before a State licensing authority.
(b) Ownership or control interests.
(1) We may debar a health care provider that is an entity because a
person who holds an ownership or control interest of 5 percent or more
in the entity has been:
(i) Convicted of a criminal offense listed in Sec. 890.1003(a) as a
basis for debarment;
(ii) Debarred under this subpart from participating in the FEHBP;
or
(iii) Assessed with a civil monetary penalty under section 8902a of
title 5, United States Code and this subpart.
(2) We may debar you as an individual if both paragraphs (b)(2)(i)
and (b)(2)(ii) of this section apply to you.
(i) You have an ownership or control interest in an entity that has
been:
(A) Convicted of a criminal offense listed in Sec. 890.1004(a) as a
basis for debarment;
(B) Debarred under this subpart from participating in the FEHBP; or
(C) Assessed with a civil monetary penalty under section 8902a of
title 5, United States Code and this subpart; and
(ii) You know or should know of the actions underlying the entity's
conviction, debarment, or civil monetary penalty.
(c) False, deceptive, or wrongful claims practices. We may debar
you if, in connection with a claim or claims submitted to a FEHBP
carrier, you commit any of the following violations:
(1) You charge for health care items or services in an amount
substantially in excess of your customary charges for those items or
services;
(2) You charge for health care items or services that are
substantially in excess of the needs of the covered individual to whom
they are furnished;
(3) You charge for health care items or services whose quality
fails to meet professionally recognized standards for items or services
of that type;
(4) You charge for health care items or services that you knew or
should have known were not furnished to the covered individual as
claimed;
(5) You knowingly make, or cause to be made, a false statement or
misrepresentation of a material fact reflected in a claim;
(6) You charge for items or services that you knew or should have
known were furnished while you were debarred from participation in the
FEHBP under this subpart; or
(7) You charge for items and services that you knew or should have
known are in violation of the applicable charge limitations of section
8904(b) of title 5, United States Code.
(d) Failure to furnish required information. We may debar you if
you knowingly fail to provide any information requested by a FEHBP
carrier or OPM to determine:
(1) Whether a payment or reimbursement is properly payable; or
(2) The proper amount of payment or reimbursement that may be due.
Sec. 890.1012 What are OPM's time limits for initiating a permissive
debarment?
(a) Licensure cases. If the basis for your proposed debarment is a
licensure action, we must issue you a notice of proposed debarment
within 6 years of the effective date on which a State licensing
authority revoked, suspended, restricted, or declined to renew your
license, or the date on which you surrendered your license to the State
authority.
(b) Ownership or control. If the basis for the proposed debarment
is ownership or control of an entity by a sanctioned person, or
ownership or control of a sanctioned entity by a person who knew or
should have known of the basis for the entity's sanction, we must issue
a notice of proposed debarment within 6 years of the effective date of
the sanction on which the proposed debarment is based.
(c) False, deceptive, or wrongful claims practices. If the basis
for your proposed debarment involves a claim filed with a FEHBP
carrier, we must issue you a notice of proposed debarment within 6
years of the date you presented the claim for payment to the covered
person's FEHBP carrier.
(d) Failure to furnish requested information. If the basis for your
proposed debarment involves your failure to furnish information
requested by an FEHBP carrier or OPM, we must issue you a notice of
proposed
[[Page 64167]]
debarment within 6 years of the date on which the carrier or OPM
requested you to furnish the information in question.
Sec. 890.1013 How will OPM decide whether to propose a permissive
debarment?
(a) Review factors. We will consider the factors listed in
paragraphs (a)(1) through (a)(4) of this section in deciding whether to
propose your debarment under a permissive debarment authority. The
absence of a factor will be considered neutral; that is, it will have
no effect on our decision.
(1) The nature of any claims involved in the basis for your
proposed debarment and the circumstances under which they were
presented to FEHBP carriers;
(2) The improper conduct involved in the basis for your proposed
debarment, your degree of culpability, and your history of prior
offenses;
(3) The extent to which you pose 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 your debarment that must
be considered in the interests of fairness.
(b) Specialized review in certain cases. In determining whether to
propose debarment under Sec. 890.1011(c)(2), providing items or
services substantially in excess of the needs of a covered individual,
or Sec. 890.1011(c)(3), providing items or services that fail to meet
professionally-recognized quality standards, we will obtain the input
of trained reviewers, based on written medical protocols developed by
physicians. If we cannot reach a decision on this basis, we will
consult with a physician in an appropriate specialty area.
Sec. 890.1014 How will OPM notify me of my proposed debarment under a
permissive debarment authority?
We will apply the provisions of Sec. 890.1006 to notify you of your
proposed permissive debarment.
Sec. 890.1015 What are the minimum and maximum periods for permissive
debarments?
We will not issue a permissive debarment for a period of less than
one year, unless we specifically determine that a shorter period is in
the interests of the FEHBP and its covered individuals. There is no
limit on the maximum period of a permissive debarment.
Sec. 890.1016 What aggravating and mitigating factors will OPM
consider in making a final determination of the period of my debarment?
(a) Aggravating factors. We will consider the presence of any of
the factors listed in paragraphs (a)(1) through (a)(5) of this section,
to represent aggravating circumstances that may support increasing the
length of a debarment beyond the periods specified in Secs. 890.1016
through 890.1021, respectively. The absence of a factor will have no
effect either to increase or lower the nominal period of debarment.
(1) Your actions underlying the basis for the debarment, or similar
acts, had an adverse impact on the physical or mental health or well-
being of one or more FEHBP-covered individuals or other persons.
(2) You have a documented history of prior criminal wrongdoing;
civil violations related to health care items or services; improper
conduct; or administrative violations addressed by a Federal or State
agency. We will consider matters involving violence, patient abuse,
drug abuse, or controlled substances convictions or violations to be
particularly serious.
(3) Your actions underlying the basis for the debarment, or similar
acts, resulted in financial loss to the FEHBP, FEHBP-covered
individuals, or other persons. In determining whether, or to what
extent, a financial loss occurred, we will not consider any amounts of
restitution you may have paid.
(4) You filed false, wrongful, or improper claims to FEHBP carriers
that were numerous, submitted over a prolonged period of time, part of
an on-going pattern of wrongful acts, or of which you were specifically
aware or directly responsible.
(5) You attempted to obstruct, hinder, or impede official inquiries
into the wrongful conduct underlying your debarment.
(b) Mitigating factors. The presence of either of the factors
identified in paragraphs (b)(1) or (b)(2) of this section may support
shortening your period of debarment to not less than one year. Their
absence will have no effect to either raise or lower the period of
debarment.
(1) Your cooperation with Federal, State, or local authorities
resulted in criminal convictions, civil recoveries, or administrative
actions against other violators, or served as the basis for official
determinations of program weaknesses or vulnerabilities; and
(2) Official records of judicial proceedings or the proceedings of
State licensing authorities contain a formal determination that you had
a physical, mental, or emotional condition that reduced your level of
culpability before or during the period in which you committed the
violations in question.
Sec. 890.1017 How will OPM determine the period of my debarment based
on revocation or suspension of my professional licensure?
(a) Indefinite term of debarment. Subject to the exceptions in
paragraph (b) of this section, your debarment under Sec. 890.1011(a)
will be for an indefinite period coinciding with the period during
which your license is revoked, suspended, restricted, surrendered, or
otherwise not in effect in the State whose action against your license
formed the basis for our debarment.
(b) Aggravating circumstances. If any of the aggravating
circumstances in Sec. 890.1016 apply to you, we may debar you for a
stated period beyond the duration of your licensure revocation or
suspension.
Sec. 890.1018 How will OPM determine the period of debarment for an
entity owned or controlled by a sanctioned person?
We will determine the length of debarments issued under
Sec. 890.1011(b)(1) as described in paragraphs (a) through (c) of this
section.
(a) Concurrent with owner/controller's debarment. The debarment of
an entity based on debarment of an individual with an ownership or
control interest will be for a period concurrent with the individual's
debarment. If any aggravating or mitigating circumstances identified in
Sec. 890.1016 apply to the entity itself and were not considered in
setting the period of the individual's debarment, we may debar the
entity for a period longer or shorter than the individual's debarment.
(b) Debarment based on owner/controller's conviction. The debarment
of an entity based on the criminal conviction of a person with an
ownership or control interest for an offense listed in
Sec. 890.1004(a)(1) through (a)(4), will be for a period of no less
than 3 years, subject to adjustment for any aggravating or mitigating
circumstances identified in Sec. 890.1016 that apply to the entity
itself.
(c) Debarment based on owner/controller's civil monetary penalty.
The debarment of an entity based on a civil monetary penalty imposed on
a person with an ownership or control interest, will be for a period of
no less than 3 years, subject to adjustment for any aggravating or
mitigating circumstances identified in Sec. 890.1016 that apply to the
entity itself.
[[Page 64168]]
Sec. 890.1019 How will OPM determine the period of my debarment based
on my ownership or control of a sanctioned entity?
We will determine the period of a debarment issued under
Sec. 890.1011(b)(2) as described in paragraphs (a) through (c) of this
section.
(a) Concurrent with entity's debarment. If your debarment is based
on your ownership or control of a debarred entity, we may debar you for
a period concurrent with the entity's debarment. If any of the
aggravating or mitigating circumstances identified in Sec. 890.1016
applies to you personally and was not considered in setting the period
of the entity's debarment, we may debar you for a period longer or
shorter than the entity's debarment.
(b) Debarment based on conviction of entity. If your debarment is
based on the criminal conviction of an entity you own or control for an
offense listed in Sec. 890.1004(a)(1) through (a)(4), we will debar you
for a period of no less than 3 years, subject to adjustment for any
aggravating or mitigating circumstances identified in Sec. 890.1016
that apply to you as an individual.
(c) Debarment based on civil monetary penalty against entity. If
your debarment is based on a civil monetary penalty imposed on an
entity you own or control, we will debar you for 3 years, subject to
adjustment on the basis of the aggravating and mitigating circumstances
listed in Sec. 890.1016 that apply to you as an individual.
Sec. 890.1020 How will OPM determine the period of my debarment based
on false, wrongful, or deceptive claims?
Debarments under Sec. 890.1011(c) will be for a period of 3 years,
subject to adjustment based on the aggravating and mitigating factors
listed in Sec. 890.1016.
Sec. 890.1021 How will OPM determine the period of my debarment based
on my failure to provide information needed to resolve claims?
Debarments under Sec. 890.1011(d) will be for a period of 3 years,
subject to adjustment based on the aggravating and mitigating factors
listed in Sec. 890.1016.
Sec. 890.1022 How may I contest OPM's proposal to debar me under a
permissive debarment authority?
(a) Right to contest your proposed debarment. You may challenge a
proposed debarment by filing a written contest with the debarring
official during the 30-day notice period. If you do not file a timely
contest, the debarment will become effective as stated in the notice,
without further action by OPM.
(b) Challenging the length of your proposed debarment. You may
contest the length of the proposed debarment, even if you are not
challenging the debarment itself, or you may challenge both the length
of a debarment and the debarment itself in the same contest. However,
issues involving the length of a debarment are not subject to a fact-
finding hearing under Sec. 890.1028.
Sec. 890.1023 What information will the debarring official consider as
part of my contest?
(a) Documents and oral and written arguments. You may submit
documents and written arguments in opposition to the proposed debarment
and/or its length, and you may appear personally or through a
representative before the debarring official to provide any other
information you believe to be relevant.
(b) Specific factual basis for contesting the proposed debarment.
You must identify the specific facts that contradict the basis for your
proposed debarment as stated in your notice of proposed debarment. A
general or unsupported denial that the basis for debarment applies to
you does not raise a genuine dispute over facts material to the
debarment, and the debarring official will not give it any probative
weight.
(c) Mandatory disclosures. In addition to any other information
that you submit during the contest, you must inform the debarring
official of any of the matters in paragraphs (c)(1) through (c)(3) of
this section, that applies to you. If you fail to provide applicable
information, OPM may initiate further legal or administrative action
against you.
(1) Any existing, proposed, or prior exclusion, debarment, penalty,
or other sanction imposed on you by a Federal, State, or local
government agency, including any administrative agreement that purports
to affect only a single agency;
(2) Any criminal or civil legal proceeding not referenced in the
notice of proposed debarment that arose from facts relevant to the
basis for debarment stated in the notice; and
(3) Any entity in which you have a control interest, as that term
is defined in Sec. 890.1003(d).
Sec. 890.1024 What standards and burdens of proof apply to my contest?
(a) Preponderance of evidence. OPM must prove by a preponderance of
the evidence that you have committed a sanctionable violation.
(b) Demonstrating basis for not imposing debarment. If OPM
establishes an evidentiary basis for your debarment, you have the
burden of demonstrating that you are presently responsible to
participate in FEHBP and that debarment is not necessary to protect the
interests of the program and its covered individuals.
Sec. 890.1025 When can the debarring official decide my contest
without an additional fact-finding proceeding?
A fact-finding proceeding in addition to your presentation of
arguments, documents, and information to the debarring official is not
required in the following circumstances:
(a) Previously adjudicated facts. Your proposed debarment is based
on facts determined in a prior due process adjudication. Examples of
prior due process proceedings include, but are not limited to, the
adjudication procedures associated with:
(1) Licensure revocation, suspension, restriction, or nonrenewal by
a State licensing authority;
(2) Debarment, exclusion, suspension, civil monetary penalties, or
similar legal or administrative adjudications by Federal, State, or
local agencies;
(3) A criminal conviction or civil judgment; or
(4) An action on your part that constitutes a waiver of your right
to a due process adjudication, such as surrender of your professional
license during the pendency of a disciplinary hearing, entering a
guilty plea or confession of judgment in a judicial proceeding, or
entering a settlement agreement to resolve or forestall a civil,
criminal, or administrative action.
(b) No dispute of material facts. Your contest does not identify a
bona fide dispute concerning facts material to the basis for your
proposed debarment.
Sec. 890.1026 How will the debarring official resolve my contest if a
fact-finding proceeding is not required?
(a) Debarring official's procedures. If the debarring official
determines that a fact-finding proceeding is not required, you will
receive the final decision on your contest within 30 days after the
record closes for submitting evidence, arguments, and information as
part of your contest. The debarring official may extend this timeframe
for good cause.
(b) No further administrative review available. There are no
further administrative proceedings after the presiding official's final
decision. If you are adversely affected by the decision, you may appeal
to the appropriate United States District Court under section
8902a(h)(2) of title 5, United States Code.
[[Page 64169]]
Sec. 890.1027 When must the debarring official request a fact-finding
proceeding before deciding my contest?
(a) Criteria for holding fact-finding proceeding. The debarring
official must request another OPM official (``presiding official'') to
hold a fact-finding proceeding if both paragraphs (a)(1) and (a)(2) of
this section apply.
(1) Facts material to your proposed debarment have not been
adjudicated in a prior due process proceeding; and
(2) These facts are genuinely in dispute, based on the entire
administrative record available to the debarring official.
(b) Qualification to serve as presiding official. The presiding
official is designated by the OPM Director or another OPM official
authorized by the Director to make such designations. The presiding
official will be a senior official who is able to conduct informal
adjudicative processes. He will have had no previous contact with your
proposed debarment or the contest.
(c) Effect on contest. The debarring official must defer his
decision on your contest pending the results of the fact-finding
proceeding.
Sec. 890.1028 How will the presiding official conduct the fact-finding
proceeding?
(a) Informal proceeding. The presiding official will conduct the
fact-finding proceedings as informally as practicable, consistent with
principles of fundamental fairness. Formal rules of evidence or
procedure do not apply to these proceedings.
(b) Proceeding limited to disputed material facts. The presiding
official can consider only the genuinely disputed facts identified by
the debarring official as relevant to the basis for your debarment.
Matters previously adjudicated or about which there is no bona fide
dispute on the record are outside the presiding official's
jurisdiction.
(c) Right to present information, evidence, and arguments. You may
appear before the presiding official with your counsel, submit oral and
written arguments and documentary evidence, present witnesses on your
behalf, question any witnesses testifying in support of your
suspension, and challenge the accuracy of any other evidence that the
agency offers as a basis for your suspension.
(d) Record of proceedings. The presiding official will make an
audio recording of the proceedings before him. If you wish to have a
transcribed record, you may purchase it.
(e) Presiding official's findings. The presiding official will
determine all of the disputed facts identified by the debarring
official, on the basis of a preponderance of the evidence in the entire
administrative record. Within 30 days after the record of the
proceeding closes, the presiding official must issue a written report
of all findings of fact to the debarring official.
Sec. 890.1029 How will the debarring official decide my contest after
the fact-finding proceeding?
(a) Findings must be accepted. The debarring official must accept
the presiding official's findings of fact, unless they are arbitrary,
capricious, or clearly erroneous. In such a case, the debarring
official must remand the material facts to the presiding official for
additional proceedings in accordance with Sec. 890.1028.
(b) Timeframe for final decision. The debarring official will issue
a final written decision on your contest within 30 days after receiving
the presiding official's findings. The debarring official may extend
this decision period for good cause.
(c) Debarring official's final decision.
(1) The debarring official must observe the evidentiary standards
and burdens of proof stated in Sec. 890.1024 in reaching a final
decision to debar.
(2) In any case where the final decision is to debar, the debarring
official has the discretion to set the period of debarment, subject to
the factors identified in Secs. 890.1015 through 890.1021.
(3) The debarring official has the discretion to decide not to
impose debarment in any case involving a permissive debarment
authority.
(e) No further administrative proceedings. If you are adversely
affected by the debarring official's final decision, you may appeal to
the appropriate United States District Court under section 8902a(h)(2)
of title 5, United States Code.
Suspension
Sec. 890.1030 What is a suspension?
(a) Temporary action pending formal proceedings. Suspension is a
temporary action pending completion of an investigation or ensuing
criminal, civil, or administrative proceedings.
(b) Immediate effect. Suspension is effective immediately upon the
suspending official's decision, without prior notice to you.
(c) Effect equivalent to debarment. The effect of a suspension is
the same as the effect of a debarment. You may not receive payment from
FEHBP funds for items or services you furnish to covered individuals
during the period of your suspension.
Sec. 890.1031 Under what circumstances may OPM suspend me?
(a) Basis for suspension. We may suspend you if both paragraphs
(a)(1) and (a)(2) of this section apply.
(1) We obtain reliable evidence indicating that one of the grounds
for suspension listed in paragraph (b) of this section applies to you;
and
(2) The suspending official determines under paragraph (c) of this
section that immediate action to suspend you is necessary to protect
the public interest.
(b) Grounds for suspension. Evidence of any of the following
situations may constitute grounds for a suspension:
(1) You are indicted for or convicted of a criminal offense that is
a basis for mandatory debarment under this subpart;
(2) You are indicted for or convicted of a criminal offense that
reflects a risk to the health, safety, or well-being of covered
individuals who may obtain health care services or supplies from you;
or
(3) OPM obtains credible evidence indicating, in the judgment of
the suspending official, that you have committed a violation that would
warrant your debarment under this subpart. This evidence may include,
but is not limited to:
(i) Civil judgments;
(ii) Notice that a Federal, State, or local government agency has
debarred, suspended, or excluded you from participating in its programs
or revoked or declined to renew a professional license; or
(iii) Other official findings by Federal, State, or local bodies
that determine factual or legal matters.
(c) Determining need for immediate action. Suspension is intended
to protect the public interest, including the health and safety of
covered individuals or the integrity of FEHBP funds. The suspending
official has wide discretion to decide whether to suspend you. He does
not need to make a specific finding of immediacy or necessity before
suspending you, and he may draw reasonable inferences from the nature
of the alleged misconduct and from your actual or potential
transactions with the FEHBP.
Sec. 890.1032 How long will my suspension last?
(a) Initial period. The suspending official will establish the
initial term of all suspensions as an indefinite period not to exceed
12 months.
(b) Formal legal proceedings not initiated. If formal legal or
administrative proceedings have not begun against you within 12 months
[[Page 64170]]
after the effective date of your suspension, the suspending official
may:(1) Terminate the suspension; or(2) If requested by the Department
of Justice, the cognizant United States Attorney's Office, or other
responsible Federal, State, or local prosecuting official, extend the
suspension for an additional period, not to exceed 6 months.
(c) Formal proceedings initiated. If formal criminal, civil, or
administrative proceedings are initiated against you while you are
suspended, the suspension may continue indefinitely, pending the
outcome of those proceedings.
(d) Terminating the suspension. The suspending official may
terminate your suspension at any time, and must terminate it after 18
months, unless formal proceedings have begun within that period.
Sec. 890.1033 How will OPM notify me of a suspension?
(a) Written notice. OPM will send you a written notice of
suspension under the procedures and methods described in
Sec. 890.1006(c)-(e).
(b) Contents of notice. The suspension notice will contain the
following information:
(1) That you are suspended, effective on the date of the notice;
(2) The initial period of your suspension;
(3) The basis for your suspension;
(4) The provisions of law and regulation authorizing your
suspension;
(5) The effect of your suspension; and
(6) Your rights to contest the suspension.
Sec. 890.1034 If I am debarred after being suspended, will the
suspension period count as part of the debarment period?
The debarring official may consider your contiguous period of
suspension when determining the length of your debarment.
Sec. 890.1035 How may I contest OPM's decision to suspend me?
(a) Filing a contest of the suspension. You may challenge a
suspension by filing a contest, in writing, with the suspending
official not later than 30 days after you receive notice of your
suspension. The suspension will remain in effect during the contest,
unless it is rescinded by the suspending official.
(b) Informal proceeding. The suspending official will use informal,
flexible procedures to conduct the contest. Formal rules of evidence
and procedure do not apply to this proceeding.
Sec. 890.1036 What information will the suspending official consider
as part of my contest?
(a) Presenting information and arguments to the suspending
official. You may submit documents and written arguments in opposition
to the suspension, and you may appear personally, or through a
representative, before the suspending official to provide any other
information that you believe to be relevant.
(b) Specific factual basis for contesting the suspension. You must
identify specific facts that contradict the basis for your suspension
as stated in the suspension notice. A general denial that the basis for
the suspension applies to you will not raise a genuine dispute over
facts material to the suspension, and the suspending official will not
give it any probative weight.
(c) Mandatory disclosures. You must inform the suspending official
of any information described in paragraphs (c)(1) through (c)(3) of
this section that applies to you:
(1) Any existing, proposed, or prior exclusion, debarment, penalty,
or other sanction imposed by a Federal, State, or local government
agency, including any administrative agreement that purports to affect
only a single agency;
(2) Any criminal or civil proceeding not referenced in the
suspension notice that arose from facts relevant to the basis for the
suspension stated in the notice; and
(3) Any entity in which you have a control interest, as that term
is defined in Sec. 890.1003(d).
Sec. 890.1037 When can the suspending official decide my contest
without arranging an additional fact-finding proceeding?
In the situations described in paragraphs (a) through (c) of this
section apply, the suspending official may decide your contest without
an additional fact-finding process.
(a) Previously adjudicated facts. Your suspension is based on an
indictment or on facts determined by a prior adjudication in which you
were 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 on your part that constitutes a waiver of your
right to a due process adjudication, such as surrender of your
professional license during the pendency of a disciplinary hearing,
entering a guilty plea or confession of judgment in a judicial
proceeding, or entering a settlement agreement to resolve or forestall
a civil, criminal, or administrative action. 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 cognizant U.S. Attorney, 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 factual dispute. The information, arguments, and
documents you submit to the suspending official do not establish that
there is a bona fide factual dispute regarding facts material to your
suspension.
Sec. 890.1038 How will the suspending official resolve my contest if
he determines that a fact-finding proceeding is not required?
(a) Written decision. The suspending official will issue a written
decision on your contest within 30 days after the record closes for
submitting evidence, arguments, and information as part of your
contest. He may extend this timeframe for good cause.
(b) No further administrative review available. The suspending
official's decision is final and is not subject to further
administrative review.
Sec. 890.1039 Under what circumstances must the suspending official
arrange a fact-finding proceeding before deciding my contest?
(a) Disputed material facts. If the suspending official determines
that your contest establishes the existence of a bona fide factual
dispute regarding facts material to the suspension, he must arrange for
them to be resolved through a fact-finding process conducted by another
OPM official (``presiding official''), unless the restriction of
Sec. 890.1037(b) applies.
(b) Qualification to serve as presiding official. The presiding
official is designated by the OPM Director or another OPM official
authorized by the Director to make such designations. He will be a
senior official qualified to conduct informal administrative
adjudications. The presiding official must have had no previous contact
with your suspension or the contest.
(c) Decision on contest deferred. The suspending official must
defer any
[[Page 64171]]
decision on your contest pending the results of the fact-finding
process.
Sec. 890.1040 How will the presiding official conduct the fact-finding
proceeding?
(a) Informal proceeding. The presiding official will conduct the
fact-finding proceedings as informally as practicable, consistent with
principles of fundamental fairness. Specific rules of evidence or
procedure do not apply to these proceedings.
(b) Proceeding limited to disputed material facts. The presiding
official can consider only the genuinely disputed facts identified by
the suspending official as relevant to the basis for your suspension.
Matters previously adjudicated or about which there is no bona fide
dispute on the record are outside the presiding official's
jurisdiction.
(c) Right to present information, evidence, and arguments. You may
appear before the presiding official with your counsel, submit oral and
written arguments and documentary evidence, present witnesses on your
behalf, question any witnesses testifying in support of your
suspension, and challenge the accuracy of any other evidence that the
agency offers as a basis for your suspension.
(d) Record of proceedings. The presiding official will make an
audio recording of the proceedings before him. If you wish to have a
transcribed record, you may purchase it.
(e) Presiding official's findings. Within 30 days after the record
of the fact-finding proceeding closes, the presiding official will
forward to the suspending official a written report of findings that
resolves all of the disputed material facts. You will receive a copy of
this report simultaneously.
Sec. 890.1041 How will the suspending official decide my contest after
the fact-finding proceeding is completed?
(a) Presiding official's findings must be accepted. The suspending
official must accept the presiding official's findings, unless they are
arbitrary, capricious, or clearly erroneous.
(b) Suspending official's decision. Within 30 days after receiving
the presiding official's report, the suspending official must issue a
final written decision that either sustains, modifies, or terminates
the suspension. The suspending official may extend this period for good
cause.
(c) Effect on subsequent debarment or suspension proceedings. A
decision by the suspending official to modify or terminate your
suspension will not prevent OPM from subsequently debarring you, or any
other Federal agency from either suspending or debarring you, based on
the same facts.
Effect of Debarment
Sec. 890.1042 When will my debarment go into effect?
(a) Minimum notice period. Your debarment will take effect no
sooner than 30 days after the date of OPM's notice of proposed
debarment, unless the debarring official specifically determines that
the health or safety of covered individuals or the integrity of the
FEHBP warrants an earlier effective date. In that situation, the notice
will specifically inform you that the debarring official decided to
shorten or eliminate the 30-day notice period.
(b) Uncontested debarments. If you do not contest the proposed
debarment, it will take effect on the date stated in the notice of
proposed debarment, without further procedures, actions, or notice by
OPM.
(c) Contested debarments and requests for reducing the period of
debarment. If you contest the proposed debarment, it will not go into
effect until the debarring official issues a final written decision,
unless the health or safety of covered individuals or the integrity of
the FEHBP requires your debarment to be effective while your contest is
pending.
Sec. 890.1043 How does my debarment affect me?
(a) FEHBP payments prohibited. You may not receive payment,
directly or indirectly, from FEHBP funds for items or services that you
provide to a covered individual on or after the effective date of your
debarment. Also, you may not accept an assignment of a claim for items
or services furnished to a covered individual during the period of your
debarment. These restrictions remain in effect until you are reinstated
by OPM.
(b) Governmentwide effect. Your debarment precludes you from
participating in all other Federal agencies' procurement and
nonprocurement programs and activities, as required by section 2455 of
the Federal Acquisition Streamlining Act of 1994. Other agencies may
grant you a waiver or exception under their own regulations, to permit
you to participate in their programs.
(c) Civil or criminal liability. You may be subject to civil
monetary penalties or criminal liability if you knowingly file claims,
cause claims to be filed, or accept payment from FEHBP carriers for
items or services that you provide to a covered individual on or after
the effective date of your debarment.
Notifying Outside Parties About Debarment and Suspension Actions
Sec. 890.1044 What entities will OPM notify of my debarment or
suspension?
We will notify the entities listed in paragraphs (a)-(d) of this
section about your debarment or suspension.
(a) FEHBP carriers;
(b) General Services Administration, for publication in the
comprehensive governmentwide list of Federal agency exclusions;
(c) Other Federal agencies that administer health care or health
benefits programs; and
(d) State and local agencies, authorities, boards, or other
organizations with health care licensing or certification
responsibilities.
Sec. 890.1045 How will OPM inform persons covered by FEHBP about my
debarment or suspension?
After receiving OPM's notice of your debarment or suspension, FEHBP
carriers must inform covered individuals who have previously obtained
items or services from you of the following:
(a) That you are debarred or suspended;
(b) The minimum period remaining in your period of debarment; and
(c) That OPM must terminate your debarment or suspension before
FEHBP funds can be paid for items or services you furnish to covered
individuals.
Exceptions to the Effect of Debarments
Sec. 890.1046 How does my debarment affect payments to me for services
I furnish in emergency situations?
You may receive FEHBP funds paid for items or services you furnish
on an emergency basis if the FEHBP carrier serving the covered
individual determines that:
(a) Your treatment was essential to the health and safety of the
covered individual; and
(b) No other source of equivalent treatment was reasonably
available.
Sec. 890.1047 What special rules apply to me as an institutional
provider?
(a) Covered individual admitted before debarment. If a covered
person is admitted before the effective date of your debarment, you may
continue to receive payment of FEHBP funds for inpatient institutional
services until the covered person is released or transferred, unless
the debarring official terminates payments under paragraph (b) of this
section.
(b) Health and safety of covered individuals. If the debarring
official determines that the health and safety of covered persons would
be at risk if they
[[Page 64172]]
remain in a debarred institution, OPM may terminate your FEHBP payments
for them at any time.
(c) Notice of payment limitations. If we limit any payment under
paragraph (b) of this section, we will inform you of our decision in
writing.
(d) Finality of debarring official's decision. The debarring
official's decision to limit or deny payments under paragraph (b) of
this section is not subject to further administrative review or
reconsideration.
Sec. 890.1048 How may I obtain a waiver of my debarment if I am the
sole source of health care services in a community?
(a) Application required. You may apply for a limited waiver of
your debarment at any time after you receive OPM's notice of proposed
debarment. Suspended providers are not eligible to request a waiver of
their suspension.
(b) Criteria for granting waiver. To receive a waiver, you must
clearly demonstrate that you meet all of the following criteria:
(1) You are the sole community provider or the sole source of
essential specialized services in a community;
(2) A limited waiver of the debarment would be in the best
interests of covered individuals in the defined service area;
(3) There are reasonable assurances that the actions which formed
the basis for your debarment will not recur; and
(4) There is no basis under this subpart for continuing your
debarment.
(c) Waiver applies only in the defined service area. A limited
waiver applies only to items or services provided within the defined
service area where you are the sole community provider or sole source
of essential specialized services.
(d) Governmentwide effect continues. A limited waiver applies only
to your FEHBP transactions. Even if we waive your debarment for FEHBP
purposes, the governmentwide effect under section 2455 of the Federal
Acquisition Streamlining Act of 1994 continues for all other Federal
agencies' procurement and nonprocurement programs and activities.
(e) Waiver rescinded if circumstances change. We will rescind the
limited waiver when any of the conditions on which it is based no
longer apply. Examples include, but are not limited to the following:
(1) You cease to provide items or services in the defined service
area;
(2) Another provider begins to furnish equivalent items or services
in the defined service area, so that you are no longer the sole
provider or sole source; or
(3) The actions that formed the basis for your debarment, or
similar acts, recur. If we rescind the limited waiver, your debarment
will resume full effect for all FEHBP transactions.
(f) Effect on period of debarment. The minimum period of your
debarment is established when the debarment is initially imposed. A
subsequent decision to grant, deny, or rescind a limited waiver will
not change that period.
(g) Application is necessary for reinstatement. You must apply for
reinstatement at the end of your period of debarment, even if your
limited waiver is in effect when your debarment expires.
(h) Finality of debarring official's decision. The debarring
official's decision to grant or deny a limited waiver is final and not
subject to further administrative review or reconsideration.
Special Exceptions To Protect Covered Persons
Sec. 890.1049 How will FEHBP carriers handle claims for items or
services furnished after a provider's debarment?
(a) Covered individual unaware of debarment. FEHBP funds may be
paid for items and services furnished by a debarred provider if, at the
time the items or services were furnished, the covered individual did
not know, and could not reasonably be expected to know, that the
provider was debarred. This provision is intended solely to protect the
interests of FEHBP covered persons who obtain services from a debarred
or suspended provider in good faith and without knowledge that the
provider has been sanctioned. It does not authorize sanctioned
providers to submit claims for payment to FEHBP carriers.
(b) Notice sent by carrier. When paying a claim under the authority
of paragraph (a) of this section, the carrier must send a written
notice to the covered individual that includes the following
information:
(1) That the provider is debarred and prohibited from receiving
payment of FEHBP funds for items or services furnished after the
debarment date;
(2) That claims will not be paid for items or services furnished by
the debarred provider after the covered individual receives notice of
the debarment;
(3) That the current claim is being paid as a legally-authorized
exception to the effect of the debarment in order to protect covered
individuals who obtain items or services without knowledge of their
provider's debarment;
(4) That FEHBP carriers must deny payment of any claim for items or
services rendered by a debarred provider 15 days or longer after the
date of the notice described in this subsection, unless the covered
individual had no knowledge of the provider's debarment when the items
or services were rendered;
(5) The minimum period remaining in the provider's debarment; and
(6) OPM must terminate the provider's debarment or suspension
before FEHBP funds can be paid for items or services furnished to
covered individuals.
Sec. 890.1050 How may an FEHBP covered individual request an exception
to a provider's debarment?
(a) Request by a covered individual. Any individual in whose name
an FEHBP subscription is issued may submit a request through the FEHBP
carrier for continued payment of items or services furnished by a
debarred provider to any person covered under that enrollment. Requests
will not be accepted for continued payments to suspended providers.
(b) OPM action on the request. OPM will consider the recommendation
of the FEHBP carrier before acting on the request. To be approved, the
request must demonstrate that at least one of the situations in
paragraphs (b)(1) or (b)(2) of this section applies.
(1) Interrupting an existing, ongoing course of treatment by the
provider would have a detrimental effect on the covered individual's
health or safety; or
(2) The covered individual does not have access to an alternative
source of the same or equivalent health care items or services within a
reasonably accessible service area.
(c) Scope of the exception. An approved exception applies only to
the covered individual(s) who requested it, or on whose behalf it was
requested. The governmentwide effect of the provider's debarment under
section 2455 of the Federal Acquisition Streamlining Act is not altered
by an exception.
(d) Provider requests not allowed. OPM will not consider an
exception request submitted by a provider on behalf of a covered
individual.
(e) Finality of debarring official's decision. The debarring
official's decision on an exception request is not subject to further
administrative review or reconsideration.
Reinstatement
Sec. 890.1051 How may I be reinstated when my period of debarment
expires?
(a) Application required. Reinstatement is not automatic when the
minimum period of your debarment expires. You must apply in writing to
[[Page 64173]]
OPM, supplying specific information about the reinstatement criteria
outlined in paragraph (c) of this section.
(b) Reinstatement date. We will accept your reinstatement
application no earlier than 60 days before the nominal expiration date
of your debarment. However, in no case will we reinstate you before
your minimum period of debarment expires.
(c) Reinstatement criteria. Your reinstatement application must
clearly demonstrate that you meet all of the following criteria:
(1) There are reasonable assurances that the actions resulting in
your debarment have not and will not recur;
(2) There is no basis under this subpart for continuing your
debarment; and
(3) There is no pending criminal, civil, or administrative action
that would subject you to debarment by OPM.
(d) Written notice of OPM action. We will inform you in writing of
our decision on your reinstatement application.
(e) Limitation on reapplication. If we deny your reinstatement
application, you may not reapply until 1 year after the date of our
decision.
Sec. 890.1052 Under what circumstances will OPM reinstate me without
my filing an application?
If any of the situations identified in paragraphs (a) through (c)
of this section occurs, you should inform the debarring official
immediately. OPM will reinstate you without the need for a
reinstatement application in these circumstances. OPM will send you a
written notice concerning the effective date of your reinstatement.
(a) Conviction reversed. The conviction on which your debarment was
based is reversed or vacated on appeal.
(b) Sanction terminated. A sanction imposed by another Federal
agency, on which your debarment was based, is terminated by that
agency.
(c) Court order. A Federal court orders OPM to stay, rescind, or
terminate your debarment.
Sec. 890.1053 Table of procedures and effective dates for
reinstatements.
The following table indicates the procedures and effective dates
for reinstatements under this subpart:
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Basis for debarment Application required? Effective date
--------------------------------------------------------------------------------------------------------------------------------------------------------
Period of debarment expires........ Yes.................................................... After debarment expires.
Conviction reversed on appeal...... No..................................................... Retroactive (start of debarment).
Other agency sanction ends......... No..................................................... Ending date of sanction.
Court order ending debarment....... No..................................................... Retroactive (start of debarment).
--------------------------------------------------------------------------------------------------------------------------------------------------------
Sec. 890.1054 What agencies and entities will OPM notify about my
reinstatement?
We will inform the FEHBP carriers, government agencies and other
organizations that were originally notified of your debarment.
Sec. 890.1055 How may I contest OPM's decision to deny my
reinstatement application?
(a) Obtaining reconsideration of the initial decision. You, or a
representative acting on your behalf, may submit documents and written
arguments to the debarring official, opposing the decision to deny your
reinstatement application. In addition, you and/or your representative
may request to appear in person to present oral arguments to the
debarring official. You must submit these materials within 30 days
after the date of the decision notice in paragraph (a) of this section.
(b) Debarring official's final decision on reinstatement. The
debarring official will issue a final written decision, based on the
entire administrative record, within 30 days of the record closing to
receipt of information. The debarring official may extend the decision
period for good cause.
(c) Finality of debarring official's decision. The debarring
official's final decision is not subject to further administrative
review or reconsideration.
Civil Monetary Penalties and Financial Assessments [Reserved]
[FR Doc. 01-30529 Filed 12-11-01; 8:45 am]
BILLING CODE 6325-52-P