5 C.F.R. § 890.1062

Current through September 30, 2024
Section 890.1062 - Deciding whether to impose penalties and assessments
(a)Authority of debarring official. The debarring official has discretionary authority to impose penalties and assessments in accordance with 5 U.S.C. 8902a and this subpart.
(b)Factors to be considered. In deciding whether to impose penalties and assessments against a provider that has committed one of the violations identified in § 890.1061 , OPM must consider:
(1) The number and frequency of the provider's violations;
(2) The period of time over which the violations were committed;
(3) The provider's culpability for the specific conduct underlying the violations;
(4) The nature of any claims involved in the violations and the circumstances under which the claims were presented to FEHBP carriers;
(5) The provider's history of prior offenses or improper conduct, including any actions that could have constituted a basis for a suspension, debarment, penalty, or assessment by any Federal or State agency, whether or not any sanction was actually imposed;
(6) The monetary amount of any damages, losses, and costs, as described in § 890.1064(c) , attributable to the provider's violations; and
(7) Such other factors as justice may require.
(c)Additional factors when penalty or assessment is based on provisions of § 890.1061(b) or (c) . In the case of violations involving false or misleading statements or the failure to provide claims-related information, OPM must also consider:
(1) The nature and circumstances of the provider's failure to properly report information; and
(2) The materiality and significance of the false statements or misrepresentations the provider made or caused to be made, or the information that the provider knowingly did not report.

5 C.F.R. §890.1062