> **FEHB Program Carrier Letter U.S. Office of Personnel Management**

### All Carriers Office of Insurance Programs

> **Letter No. 2000-15 Date: March 27, 2000**
>
> Fee-for-service \[ 12 \] Experience-rated HMO \[ 14 \] Community-rated
> \[ 15 \]
>
> **SUBJECT:** **Corrections to FEHB Program Carrier Letters**

1.  [Carrier Letter 2000-09.]{.underline} Please insert the enclosed
    page 5 into the routine reports summary. The page corrects the HEDIS
    pilot information. For more information about the change, contact
    Janet Pfleeger at 202/606-0004.

2.  [Carrier Letter 2000-10]{.underline}. Please correct the link to the
    Benefits Administration Letter for premium conversion to this:
    <http://www.opm.gov/asd/htm/2000/00-204.htm>. For more information
    about the change, contact Eric Figg at 202/606-0745.

Sincerely,

(signed)

Frank D. Titus

Assistant Director

for Insurance Programs

> Enclosure

+-----------------+-------+-----+------+---------+------+----------+---+
| **ROUTINE       |       |     |      |         |      |          | * |
| REPORTS         |       |     |      |         |      |          | * |
| REQUIRED OF     |       |     |      |         |      |          | 5 |
| FEHB CARRIERS** |       |     |      |         |      |          | * |
|                 |       |     |      |         |      |          | * |
+-----------------+-------+-----+------+---------+------+----------+---+
| **REPORT**      | **Fr  | *   | **   | **Refer | *    | **For    |   |
|                 | equen | *Re | Date | ence:** | *Gui | inf      |   |
|                 | cy:** | qui | Du   |         | danc | ormation |   |
|                 |       | red | e:** |         | e:** | about    |   |
|                 |       | of  |      |         |      | this     |   |
|                 |       | :** |      |         |      | report,  |   |
|                 |       |     |      |         |      | co       |   |
|                 |       |     |      |         |      | ntact:** |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Satis         |       |     |      |         |      |          |   |
| faction/Quality |       |     |      |         |      |          |   |
| Assessment**    |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Customer        | A     | All | Jun  | C       | CL   | OIP/IPE  |   |
| Satisfaction    | nnual | exc | 15   | ontract | 9    | D/Pierce |   |
| Survey Results  |       | ept |      | \'1.9   | 8-45 |          |   |
| (CAHPS)         |       | pl  |      |         |      | (*R      |   |
|                 |       | ans |      |         | CL   | Pierce@o |   |
|                 |       | w   |      |         | 98   | pm.gov*) |   |
|                 |       | ith |      |         | -45A |          |   |
|                 |       | \<  |      |         |      |          |   |
|                 |       | 500 |      |         |      |          |   |
|                 |       | F   |      |         |      |          |   |
|                 |       | EHB |      |         |      |          |   |
|                 |       | e   |      |         |      |          |   |
|                 |       | nro |      |         |      |          |   |
|                 |       | lle |      |         |      |          |   |
|                 |       | es) |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| HEDIS (HMO      | A     | H   | June | C       | CL   | O        |   |
| Pilot)          | nnual | MOs | 15   | ontract | 99   | IP/IPID/ |   |
|                 |       | w   |      | \'1.9   | -016 | Pfleeger |   |
| *(Corrected     |       | ith |      |         |      |          |   |
| entry)*         |       | \>  |      |         | CL   | *(jp     |   |
|                 |       | 500 |      |         | 0    | fleege@o |   |
|                 |       | F   |      |         | 0-06 | pm.gov)* |   |
|                 |       | EHB |      |         |      |          |   |
|                 |       | enr |      |         |      |          |   |
|                 |       | oll |      |         |      |          |   |
|                 |       | ees |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| HEDIS (PPO      | A     | Sel | Au   | C       | Let  | O        |   |
| Pilot)          | nnual | ect | gust | ontract | ters | IP/IPID/ |   |
|                 |       | P   | 11   | \'1.9   | ma   | Pfleeger |   |
| *(Corrected     |       | POs |      |         | iled | *(jp     |   |
| entry)*         |       | (t  |      |         | to   | fleege@o |   |
|                 |       | hat |      |         | the  | pm.gov)* |   |
|                 |       | a   |      |         | PPOs |          |   |
|                 |       | lre |      |         |      |          |   |
|                 |       | ady |      |         |      |          |   |
|                 |       | h   |      |         |      |          |   |
|                 |       | ave |      |         |      |          |   |
|                 |       | b   |      |         |      |          |   |
|                 |       | een |      |         |      |          |   |
|                 |       | co  |      |         |      |          |   |
|                 |       | ntr |      |         |      |          |   |
|                 |       | act |      |         |      |          |   |
|                 |       | ed) |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Quality         | A     | All | Jan  | C       | \    | OIP/ICD/ |   |
| assurance       | nnual |     | 31   | ontract | -\-- | Contract |   |
| performance     |       |     |      | \'1.9   |      | Rep      |   |
| standards       |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| **Other         |       |     |      |         |      |          |   |
| Reports**       |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| FEHB Carrier    | S     | All | Apr  | C       | OIG  | Ofc of   |   |
| Debarment       | emi-a |     | 15   | ontract | Inst | I        |   |
| ActionsB        | nnual |     |      | \'2.7   | ruct | nspector |   |
|                 |       |     | Oct  |         | ions | G        |   |
| (reported to    |       |     | 15   |         |      | en/Smith |   |
| [O              |       |     |      |         |      |          |   |
| IG]{.underline} |       |     |      |         |      | (*J      |   |
| on providers    |       |     |      |         |      | LSmith@o |   |
| excluded after  |       |     |      |         |      | pm.gov*) |   |
| 1/29/92)        |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| FEHB Carrier    | A     | FFS | Mar  | Annual  | CL   | OIP/IPED |   |
| Debarment       | nnual |     | 31   | appropr | 9    | /Kalland |   |
| ActionsB        |       | (   |      | iations | 3-01 |          |   |
|                 |       | not |      |         |      | (*AM     |   |
| (reported to    |       | H   |      |         | CL   | Kallan@o |   |
| [O              |       | MO) |      |         | 9    | pm.gov*) |   |
| IP]{.underline} |       |     |      |         | 3-20 |          |   |
| on providers    |       |     |      |         |      |          |   |
| excluded before |       |     |      |         |      |          |   |
| 1/29/92)        |       |     |      |         |      |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+
| Fraud and abuse | S     | All | Jan  | C       | CL   | O        |   |
| cases report    | emi-a |     | 31   | ontract | 9    | IP/IPED/ |   |
|                 | nnual |     |      | \'1.9   | 1-10 | Saunders |   |
|                 |       |     | Jul  |         |      |          |   |
|                 |       |     | 31   |         | CL   | (*MF     |   |
|                 |       |     |      |         | 9    | Saunde@o |   |
|                 |       |     |      |         | 3-32 | pm.gov*) |   |
|                 |       |     |      |         |      |          |   |
|                 |       |     |      |         | CL   |          |   |
|                 |       |     |      |         | 9    |          |   |
|                 |       |     |      |         | 4-02 |          |   |
+-----------------+-------+-----+------+---------+------+----------+---+