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 I—Limit on Inpatient Hospital Charges, Physician Charges, and FEHB Benefit Payments (§890.901 to §890.910) > 890.908—Notification of HHS.

890.908—Notification of HHS.

An FEHB plan, under the oversight of OPM, will notify the Secretary of HHS, or the Secretary's designee, if the plan finds that:
(a) A hospital knowingly and willfully collects, on a repeated basis, more than the amount determined to be equivalent to the Medicare part A payment under the DRG-based PPS.
(b) A Medicare participating physician or supplier knowingly and willfully collects, on a repeated basis, more than the amount determined to be equivalent to the Medicare part B payment under the Medicare Participating Physician Fee Schedule.
(c) A Medicare nonparticipating physician or supplier knowingly and willfully charges, on a repeated basis, more than the amount determined to be equivalent to the Medicare limiting charge amount.

Code of Federal Regulations

[60 FR 26668, May 18, 1995]