5 U.S.C. § 8910 — Studies, reports, and audits
submitted 60 years ago by Pub. L. 89-554 to r/title-5-GOVERNMENT-ORGANIZATION-AND-EMPLOYEES · 234 words · no verdicts yet
OPM must continually study how the federal employee health benefits program is working, including surveys of the plans offered. Health-plan carriers must give OPM required reports and let OPM and the GAO inspect their records, and federal agencies must keep records and share information OPM needs. OPM must also build a system to check which enrollees qualify for Medicare, so doctors do not overcharge on coordinated claims.
(a) OPM must keep studying how this health-benefits chapter is being run, including surveys and reports on the health plans available to employees and how those plans are performing.
(b) Every contract OPM signs with a carrier under section 8902 must require the carrier to: (1) give OPM whatever reasonable reports OPM needs to do its job under this chapter; and (2) let OPM and the Government Accountability Office examine the carrier's records as needed to carry out this chapter's purposes.
(c) Every government agency must keep the records, make the certifications, and give OPM the information and reports OPM needs to do its job under this chapter.
(d) OPM, working with the Department of Health and Human Services, must build a system so a health plan's carrier can identify which annuitants or other covered people are also entitled to Medicare Part A or B benefits — so that when Medicare and the health plan coordinate payments, doctors do not charge more than the legal maximum allowed for Medicare patients.
The Office of Personnel Management shall make a continuing study of the operation and administration of this chapter, including surveys and reports on health benefits plans available to employees and on the experience of the plans.
Each contract entered into under section 8902 of this title shall contain provisions requiring carriers to—
furnish such reasonable reports as the Office determines to be necessary to enable it to carry out its functions under this chapter; and
permit the Office and representatives of the Government Accountability Office to examine records of the carriers as may be necessary to carry out the purposes of this chapter.
Each Government agency shall keep such records, make such certifications, and furnish the Office with such information and reports as may be necessary to enable the Office to carry out its functions under this chapter.
The Office, in consultation with the Department of Health and Human Services, shall develop and implement a system through which the carrier for an approved health benefits plan described by section 8903 or 8903a will be able to identify those annuitants or other individuals covered by such plan who are entitled to benefits under part A or B of title XVIII of the Social Security Act in order to ensure that payments under coordination of benefits with Medicare do not exceed the statutory maximums which physicians may charge Medicare enrollees.
Source credit: (Pub. L. 89–554, Sept. 6, 1966, 80 Stat. 606; Pub. L. 95–454, title IX, § 906(a)(2), (3), Oct. 13, 1978, 92 Stat. 1224; Pub. L. 101–508, title VII, § 7002(d), Nov. 5, 1990, 104 Stat. 1388–330; Pub. L. 108–271, § 8(b), July 7, 2004, 118 Stat. 814.)
- 1966Enacted · Pub. L. 89-554 · 80 Stat. 606
- 1978Amended · Pub. L. 95-454 · 92 Stat. 1224
- 1990Amended · Pub. L. 101-508 · 104 Stat. 1388
- 2004Amended · Pub. L. 108-271 · 118 Stat. 814
A history note hasn’t been published yet. The record shows enactment by Pub. L. 89-554 on 1966-09-06.
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