CFR > Title 5 - Administrative Personnel > CHAPTER I—OFFICE OF PERSONNEL MANAGEMENT > SUBCHAPTER B—CIVIL SERVICE REGULATIONS (parts 110 to 990) > PART 890—FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM > SUBPART J—Administrative Sanctions Imposed Against Health Care Providers (§890.1001 to §890.1072) > 890.1061—Bases for penalties and assessments.

890.1061—Bases for penalties and assessments.

(a) Improper claims. OPM may impose penalties and assessments on a provider if a claim presented by that provider for payment from FEHBP funds meets the criteria set forth in 5 U.S.C. 8902a(d)(1).
(b) False or misleading statements. OPM may impose penalties and assessments on a provider who makes a false statement or misrepresentation as set forth in 5 U.S.C. 8902a(d)(2).
(c) Failing to provide claims-related information. OPM may impose penalties and assessments on a provider who knowingly fails to provide claims-related information as otherwise required by law.