FEHB Protection Act

Bill: 118-hr-7868
Sponsor: full_name: Rep. Waltz, Michael [R-FL-6]
Introduced: 2024-04-05
Policy area: Health
Subjects: Accounting and auditing

Fraud offenses and financial crimes

Government employee pay, benefits, personnel management

Health care costs and insurance
Latest action: action_date: 2024-04-10
text: Ordered to be Reported (Amended) by the Yeas and Nays: 37 - 6.

Summaries:

tv_txt: I 118th CONGRESS 2d Session H. R. 7868 IN THE HOUSE OF REPRESENTATIVES April 5, 2024 Mr. Waltz introduced the following bill; which was referred to the Committee on Oversight and Accountability A BILL To require the Director of the Office of Personnel Management to take certain actions with respect to the health insurance program carried out under chapter 89 of title 5, United States Code, and for other purposes.

1. Short title This Act may be cited as the FEHB Protection Act . 2. FEHB improvements (a) Definitions In this section: (1) Director The term Director means the Director of the Office of Personnel Management. (2) Employing office The term employing office has the meaning given the term in section 890.101(a) of title 5, Code of Federal Regulations, or any successor regulation. (3) Health benefits plan; member of family The terms health benefits plan and member of family have the meanings given those terms in section 8901 of title 5, United States Code. (4) Open season The term open season means an open season described in section 890.301(f) of title 5, Code of Federal Regulations, or any successor regulation. (5) Program The term Program means the health insurance programs carried out under chapter 89 of title 5, United States Code, including the program carried out under section 8903c of that title. (6) Qualifying life event The term qualifying life event has the meaning given the term in section 892.101 of title 5, Code of Federal Regulations, or any successor regulation. (b) Verification requirements Not later than 1 year after the date of the enactment of this Act, the Director shall issue regulations and implement a process to require each employing office to verify— (1) the veracity of any qualifying life event through which an enrollee in the Program seeks to add a member of family with respect to the enrollee to a health benefits plan under the Program; and (2) that, when an enrollee in the Program seeks to add a member of family with respect to the enrollee to the health benefits plan of the enrollee under the Program, including during any open season, the individual so added is a qualifying member of family with respect to the enrollee. (c) Fraud risk assessment In any fraud risk assessment conducted with respect to the Program on or after the date of the enactment of this Act, the Director shall include an assessment of individuals who are enrolled in, or covered under, a health benefits plan under the Program even though those individuals are not eligible to be so enrolled or covered. (d) Family member eligibility verification audit (1) In general During the 3-year period beginning 1 year after the date of the enactment of this Act, the Director, in coordination with the head of each employing office, shall conduct a comprehensive audit regarding members of family who are covered under an enrollment in a health benefits plan under the Program. (2) Contents In conducting an audit required under paragraph (1), the Director, in coordination with the head of each employing office, shall review marriage certificates, birth certificates, and other appropriate documents that are necessary to determine eligibility to enroll in a health benefits plan under the Program. (e) Disenrollment or removal Not later than 6 months after the date of the enactment of this Act, the Director shall develop a process by which any individual enrolled in, or covered under, a health benefits plan under the Program who is not eligible to be so enrolled or covered shall be disenrolled or removed from enrollment in a health benefits plan under the Program.