118 S4035 IS: FEHB Protection Act U.S. Senate 2024-03-21 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

II118th CONGRESS2d SessionS. 4035IN THE SENATE OF THE UNITED STATESMarch 21, 2024Mr. Scott of Florida (for himself and Mr. Carper) introduced the following bill; which was read twice and referred to the Committee on Homeland Security and Governmental AffairsA BILLTo 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 program 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

Beginning on the date that is 180 days after the date of enactment of this Act, the Director shall 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 during any open season, the individual so added is actually a 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 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 5-year period beginning on the date of enactment of this Act, the Director shall conduct a comprehensive audit regarding members of family— (A)who are covered under an enrollment in a health benefits plan under the Program; and(B)with respect to whom the basis for the eligibility for the coverage described in subparagraph (A) has not been verified.(2)

Contents

In conducting the audit required under paragraph (1), the Director 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

Beginning on the date of enactment of this Act, the Director may disenroll or remove from enrollment any individual enrolled in, or covered under, a health benefits plan under the Program if the Director determines that such individual is not eligible to be so enrolled or covered.