subsection on a repeated basis and the Secretary may invoke appropriate sanctions in accordance with section 1866(b)(2) of the Social Security Act (42 U.S.C. 1395cc(b)(2)) and applicable regulations.

(B)(i) A plan, other than a prepayment plan described in section 8903(4), may not provide benefits, in the case of any retired enrolled individual who is age 65 or older and is not entitled to Medicare supplementary medical insurance benefits under part B of title XVIII of the Social Security Act (42 U.S.C. 1395j et seq.), to pay a charge imposed for physicians' services (as defined in section 1848(j) of such Act, 42 U.S.C. 1395w-4(j)) which are covered for purposes of benefit payments under this chapter and under such part, to the extent that such charge exceeds the fee schedule amount under section 1848(a) of such Act (42 U.S.C. 1395w-4(a)).

(ii) Physicians and suppliers who have in force participation agreements with the Secretary of Health and Human Services consistent with section 1842(h)(1) of such Act (42 U.S.C. 1395u(h)(1)), whereby the participating provider accepts Medicare benefits (including allowable deductible and coinsurance amounts) as full payment for covered items and services shall accept equivalent benefit and enrollee cost-sharing under this chapter as full payment for services described in clause (i). Physicians and suppliers who are nonparticipating physicians and suppliers for purposes of part B of title XVIII of such Act shall not impose charges that exceed the limiting charge under section 1848(g) of such Act (42 U.S.C. 1395w-4(g)) with respect to services described in clause (i) provided to enrollees described in such clause. The Office of Personnel Management shall notify a physician or supplier who is found to have violated this clause and inform them of the requirements of this clause and sanctions for such a violation. The Office of Personnel Management shall notify the Secretary of Health and Human Services if a physician or supplier is found to knowingly and willfully violate this clause on a repeated basis and the Secretary of Health and Human Services may invoke appropriate sanctions in accordance with sections 1128A(a) and 1848(g)(1) of such Act (42 U.S.C. 1320a-7a(a), 1395w-4(g)(1)) and applicable regulations.

(C) If the Secretary of Health and Human Services determines that a violation of this subsection warrants excluding a provider from participation for a specified period under title XVIII of the Social Security Act, the Office shall enforce a corresponding exclusion of such provider for purposes of this chapter.

(2) Notwithstanding any other provision of law, the Secretary of Health and Human Services and the Director of the Office of Personnel Management, and their agents, shall exchange any information necessary to implement this subsection.

(3)(A) Not later than December 1, 1991, and periodically thereafter, the Secretary of Health and Human Services (in consultation with the Director of the Office of Personnel Management) shall supply to carriers of plans described in paragraphs (1) through (3) of section

8903 the Medicare program information necessary for them to comply with paragraph (1).

(B) For purposes of this paragraph, the term "Medicare program information" includes (i) the limitations on hospital charges established for Medicare purposes under section 1886 of the Social Security Act (42 U.S.C. 1395ww) and the identity of hospitals which have in force agreements with the Secretary of Health and Human Services consistent with section 1814(a) and 1866 of the Social Security Act (42 U.S.C. 1395f(a) and 1395cc), and (ii) the fee schedule amounts and limiting charges for physicians' services established under section 1848 of such Act (42 U.S.C. 1395w-4) and the identity of participating physicians and suppliers who have in force agreements with such Secretary under section 1842(h) of such Act (42 U.S.C. 1395u(h)).

(4) The Director of the Office of Personnel Management shall enter into an arrangement with the Secretary of Health and Human Services, to be effective before the first day of the fifth month that begins before each contract year, under which

(A) physicians and suppliers (whether or not participating) under the Medicare program will be notified of the requirements of paragraph (1)(B);

(B) enforcement procedures will be in place to carry out such paragraph (including enforcement of protections against overcharging of beneficiaries); and

(C) Medicare program information described in paragraph (3)(B)(ii) will be supplied to carriers under paragraph (3)(A). (As amended Pub. L. 101-508, title VII, § 7002(f)(1), Nov. 5, 1990, 104 Stat. 1388-330; Pub. L. 102-378, § 2(76), Oct. 2, 1992, 106 Stat. 1355; Pub. L. 103-66, title XI, § 11003(a), Aug. 10, 1993, 107 Stat. 409.)

REFERENCES IN TEXT

The Social Security Act, referred to in subsec. (b)(1), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended. Title XVIII of the Act is classified generally to subchapter XVIII (§ 1395 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. Parts A and B of title XVIII of the Act are classified generally to part A (§ 1395c et seq.) and part B (§ 1395j et seq.), respectively, of subchapter XVIII of chapter 7 of Title 42. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

AMENDMENTS

1993-Subsec. (b)(1). Pub. L. 103-66, § 11003(a)(1), designated existing provisions as subpar. (A) and added subpars. (B) and (C).

Subsec. (b)(3)(B). Pub. L. 103-66, § 11003(a)(2), inserted cl. (i) designation and added cl. (ii).

Subsec. (b)(4). Pub. L. 103-66, § 11003(a)(3), added par. (4).

1992-Subsec. (a). Pub. L. 102-378 substituted "this subsection" for "this section" in pars. (3) and (4) and in last sentence.

1990-Pub. L. 101-508 designated existing provisions as subsec. (a) and added subsec. (b).

EFFECTIVE DATE OF 1993 AMENDMENT

Section 11003(b) of Pub. L. 103-66 provided that: "The amendments made by subsection (a) [amending this section] shall apply with respect to contract years beginning on or after January 1, 1995."

EFFECTIVE Date of 1990 AMENDMENT

Section 7002(f)(2) of Pub. L. 101-508 provided that: "The amendments made by this subsection (amending this section] shall apply with respect to contract years beginning on or after January 1, 1992.”

§ 8905. Election of coverage

[See main edition for text of (a)]

(b) An annuitant who at the time he becomes an annuitant was enrolled in a health benefits plan under this chapter

[See main edition for text of (1) and (2)] may continue his enrollment under the conditions of eligibility prescribed by regulations of the Office. The Office may, in its sole discretion, waive the requirements of this subsection in the case of an individual who fails to satisfy such requirements if the Office determines that, due to exceptional circumstances, it would be against equity and good conscience not to allow such individual to be enrolled as an annuitant in a health benefits plan under this chapter 1

(c)(1) A former spouse may

[See main edition for text of (A) and (B)] enroll in an approved health benefits plan described by section 8903 or 8903a of this title as an individual or for self and family as provided in paragraph (2) of this subsection, subject to agreement to pay the full subscription charge of the enrollment, including the amounts determined by the Office to be necessary for administration and reserves pursuant to section 8909(b) of this title. The former spouse shall submit an enrollment application and make premium payments to the agency which, at the time of divorce or annulment, employed the employee to whom the former spouse was married or, in the case of a former spouse who is receiving annuity payments under section 8341(h), 8345(j), 8445, or 8467 of this title, to the Office of Personnel Management.

[See main edition for text of (2); (d) to (†)] (As amended Pub. L. 102-378, § 2(77), Oct. 2, 1992, 106 Stat. 1355.)

AMENDMENTS

1992-Subsec. (b). Pub. L. 102-378, § 2(77)(A), substituted "this chapter" for "this subchapter." at end. Subsec. (c)(1). Pub. L. 102-378, § 2(77)(B), inserted comma after "8341(h)" in last sentence.

88905a. Continued coverage

[See main edition for text of (a) to (c)] (d)(1)(A) Except as provided in paragraph (4), an individual receiving continued coverage under this section shall be required to pay currently into the Employees Health Benefits Fund, under arrangements satisfactory to the Office, an amount equal to the sum of—

[See main edition for text of (i) and (ii), (B)] (2) If an individual elects to continue coverage under this section before the end of the ap

1 So in original. Probably should be followed by a period.

plicable period under subsection (c)(2), but after such individual's coverage under this chapter (including any temporary extensions of coverage) expires, coverage shall be restored retroactively, with appropriate contributions (determined in accordance with paragraph (1) or (4), as the case may be) and claims (if any), to the same extent and effect as though no break in coverage had occurred.

[See main edition for text of (3)]

(4)(A) If the basis for continued coverage under this section is an involuntary separation from a position in or under the Department of Defense due to a reduction in force

(i) the individual shall be liable for not more than the employee contributions referred to in paragraph (1)(A)(i); and

(ii) the agency which last employed the individual shall pay the remaining portion of the amount required under paragraph (1)(A). (B) This paragraph shall apply with respect to any individual whose continued coverage is based on a separation occurring on or after the date of enactment of this paragraph and before

(i) October 1, 1997; or

(ii) February 1, 1998, if specific notice of such separation was given to such individual before October 1, 1997.

[See main edition for text of (e) and (f)] (As amended Pub. L. 102-484, div. D, title XLIV, § 4438(a), Oct. 23, 1992, 106 Stat. 2725.)

REFERENCES IN TEXT

The date of enactment of this paragraph, referred to in subsec. (d)(4)(B), is the date of enactment of Pub. L. 102-484, which was approved Oct. 23, 1992.

AMENDMENTS

1992-Subsec. (d)(1)(A). Pub. L. 102-484, § 4438(a)(1), substituted "Except as provided in paragraph (4), an individual" for "An individual".

Subsec. (d)(2). Pub. L. 102-484, § 4438(a)(2), substituted "in accordance with paragraph (1) or (4), as the case may be)" for "in accordance with paragraph (1))". Subsec. (d)(4). Pub. L. 102-484, § 4438(a)(3), added par. (4).

SOURCE OF PAYMENTS

Section 4438(b)(1) of Pub. L. 102-484 provided that: "Any amount which becomes payable by an agency as a result of the enactment of subsection (a) [amending this section] shall be paid out of funds or appropriations available for salaries and expenses of such agency."

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 8902, 8903, 8905, 8909 of this title; title 10 sections 1078a, 1086a, 1145.

§ 8906. Contributions

[See main edition for text of (a)]

(b) [See main edition for text of (1) and (2)] (3) In the case of an employee who is occupying a position on a part-time career employment basis (as defined in section 3401(2) of this title), the biweekly Government contribution

shall be equal to the percentage which bears the same ratio to the percentage determined under this subsection (without regard to this paragraph) as the average number of hours of such employee's regularly scheduled workweek bears to the average number of hours in the regularly scheduled workweek of an employee serving in a comparable position on a full-time career basis (as determined under regulations prescribed by the Office).

(c) There shall be withheld from the pay of each enrolled employee and (except as provided in subsection (i) of this section) the annuity of each enrolled annuitant and there shall be contributed by the Government, amounts, in the same ratio as the contributions of the employee or annuitant and the Government under subsection (b) of this section, which are necessary for the administrative costs and the reserves provided for by section 8909(b) of this title.

(d) The amount necessary to pay the total charge for enrollment, after the Government contribution is deducted, shall be withheld from the pay of each enrolled employee and (except as provided in subsection (i) of this section) from the annuity of each enrolled annuitant. The withholding for an annuitant shall be the same as that for an employee enrolled in the same health benefits plan and level of benefits.

[See main edition for text of (e) and (]

(g) [See main edition for text of (1)] (2)(A) The Government contributions authorized by this section for health benefits for an individual who first becomes an annuitant by reason of retirement from employment with the United States Postal Service on or after July 1, 1971, or for a survivor of such an individual or of an individual who died on or after July 1, 1971, while employed by the United States Postal Service, shall be paid by the United States Postal Service.

(B) In determining any amount for which the Postal Service is liable under this paragraph, the amount of the liability shall be prorated to reflect only that portion of total service which is attributable to civilian service performed (by the former postal employee or by the deceased individual referred to in subparagraph (A), as the case may be) after June 30, 1971, as estimated by the Office of Personnel Management.

[See main edition for text of (h)]

(i) An annuitant whose annuity is insufficient to cover the withholdings required for enrollment in a particular health benefits plan may enroll (or remain enrolled) in such plan, notwithstanding any other provision of this section, if the annuitant elects, under conditions prescribed by regulations of the Office, to pay currently into the Employees Health Benefits Fund, through the retirement system that administers the annuitant's health benefits enrollment, an amount equal to the withholdings that would otherwise be required under this section.

(As amended Pub. L. 101-239, title IV, § 4003(a), Dec. 19, 1989, 103 Stat. 2135; Pub. L. 101-303, § 1(a), (b), May 29, 1990, 104 Stat. 250; Pub. L.

101-508, title VII, § 7102(a), (b), Nov. 5, 1990, 104 Stat. 1388-333; Pub. L. 102-378, § 2(78), Oct. 2, 1992, 106 Stat. 1355.)

AMENDMENTS

1992-Subsec. (b)(3). Pub. L. 102-378, § 2(78)(A), inserted period after "Office)".

Subsec. (c). Pub. L. 102-378, § 2(78)(B), substituted "and (except” for “and except".

1990-Subsec. (c). Pub. L. 101-303, § 1(b)(1), inserted "except as provided in subsection (i) of this section)" after "enrolled employee and".

Subsec. (d). Pub. L. 101-303, § 1(b)(2), inserted "(except as provided in subsection (i) of this section)" after "enrolled employee and".

Subsec. (g)(2). Pub. L. 101-508 designated existing provisions as subpar. (A), substituted "July 1, 1971," for "October 1, 1986," in two places, and added subpar. (B).

Subsec. (i). Pub. L. 101-303, § 1(a), added subsec. (i). 1989-Subsec. (g)(2). Pub. L. 101-239 inserted "or for a survivor of such an individual or of an individual who died on or after October 1, 1986, while employed by the United States Postal Service," after "1986,".

EFFECTIVE DATE of 1990 AMENDMENTS

Section 7102(c) of Pub. L. 101-508 provided that: "The amendments made by this section [amending this section] shall take effect on October 1, 1990, and shall apply with respect to amounts payable for periods beginning on or after that date."

Section 1(c) of Pub. L. 101-303 provided that: "The amendments made by this section [amending this section] shall take effect on the date of enactment of this Act [May 29, 1990]. Any annuitant whose enrollment was terminated at any time before such date on account of such annuitant's annuity being insufficient to cover the amount of the required withholdings may, under regulations prescribed by the Office of Personnel Management, be prospectively reinstated in any available health benefits plan upon application of the annuitant."

EFFECTIVE DATE OF 1989 AMENDMENT

Section 4003(b) of Pub. L. 101-239 provided that: "The amendment made by subsection (a) [amending this section] shall take effect on October 1, 1989, and shall apply with respect to amounts payable for periods beginning on or after that date."

TRANSFER OF FUNCTIONS

Certain functions of Clerk of House of Representatives transferred to Director of Non-legislative and Financial Services by section 7 of House Resolution No. 423, One Hundred Second Congress, Apr. 9, 1992. PAYMENTS BY POSTAL SERVICE RELATING TO CORRECTED CALCULATIONS FOR PAST HEALTH BENEFITS

Pub. L. 103-66, title XI, § 11101(b), Aug. 10, 1993, 107 Stat. 413, provided that: “In addition to any other payments required under section 8906(g)(2) of title 5, United States Code, or any other provision of law, the United States Postal Service shall pay into the Employees Health Benefits Fund a total of $348,000,000, of which

"(1) at least one-third shall be paid not later than September 30, 1996;

"(2) at least two-thirds shall be paid not later than September 30, 1997; and

"(3) any remaining balance shall be paid not later than September 30, 1998."

COMPUTATION OF GOVERNMENT CONTRIBUTIONS TO FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM FOR 1990 THROUGH 1993

Pub. L. 101-76, Aug. 11, 1989, 103 Stat. 556, as amended by Pub. L. 101-508, title VII, § 7002(e), Nov.

5, 1990, 104 Stat. 1388-330; Pub. L. 103-66, title XI, § 11005, Aug. 10, 1993, 107 Stat. 412, provided: "That (a)(1) in the administration of chapter 89 of title 5, United States Code, for each of contract years 1990 through 1998 (inclusive), in order to compute the average subscription charges under section 8906(a) of such title for such contract years, the subscription charges in effect for the indemnity benefit plan on the beginning date of each such contract year

"(A) shall be deemed to be the subscription charges which were in effect for such plan on the beginning date of the preceding contract year as adjusted under paragraph (2); or

“(B) if subparagraph (A) does not apply, shall be deemed to be

"(i) the subscription charges which were deemed under this Act to have been in effect for such plan with respect to the preceding contract year as adjusted under paragraph (2), except as provided in clause (ii); or

"(ii) for each of contract years 1997 and 1998, the subscription charges which would be derived by applying the terms of clause (i), reduced by 1 percent.

"(2) The subscription charges under paragraph (1) shall be increased or decreased (as appropriate) by the average percentage by which the respective subscription charges taken into account under paragraphs (1), (3), and (4) of such section 8906(a) for that contract year increased or decreased from the subscription charges taken into account under such paragraphs (1), (3), and (4) for the preceding contract year.

"(b) Separate percentages shall be computed under subsection (a)(2) with respect to enrollments for self alone and enrollments for self and family, respectively.

"(c) The provisions of this Act shall not apply to a contract year (or any period thereafter), if comprehensive reform legislation is enacted to amend section 8906 of title 5, United States Code, and such amendment is required to be implemented by the commencement of negotiations pertaining to rates and benefits for such contract year.

"(d) Any reference in this Act to a 'contract year' shall be considered to be a reference to a contract year under chapter 89 of title 5, United States Code.

"(e) No later than 180 days after the date of the enactment of this Act [Aug. 11, 1989], the Director of the Office of Personnel Management shall transmit recommendations to the Congress for comprehensive reform of the Federal Employee Health Benefits Program."

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 8906a, 8909 of this title; title 40 section 214c; title 42 section 1395s; title 45 section 1212.

§ 8909. Employees Health Benefits Fund

(a) There is in the Treasury of the United States an Employees Health Benefits Fund which is administered by the Office of Personnel Management. The contributions of enrollees and the Government described by section 8906 of this title shall be paid into the Fund. The Fund is available

(1) without fiscal year limitation for all payments to approved health benefits plans; and (2) to pay expenses for administering this chapter within the limitations that may be specified annually by Congress. Payments from the Fund to a plan participating in a letter-of-credit arrangement under this chapter shall, in connection with any payment or reimbursement to be made by such plan for a health service or supply, be made, to the maximum extent practicable, on a checks-presented

basis (as defined under regulations of the Department of the Treasury).

[See main edition for text of (b) to (e)] (f)(1) No tax, fee, or other monetary payment may be imposed, directly or indirectly, on a carrier or an underwriting or plan administration subcontractor of an approved health benefits plan by any State, the District of Columbia, or the Commonwealth of Puerto Rico, or by any political subdivision or other governmental authority thereof, with respect to any payment made from the Fund.

(2) Paragraph (1) shall not be construed to exempt any carrier or underwriting or plan administration subcontractor of an approved health benefits plan from the imposition, payment, or collection of a tax, fee, or other monetary payment on the net income or profit accruing to or realized by such carrier or underwriting or plan administration subcontractor from business conducted under this chapter, if that tax, fee, or payment is applicable to a broad range of business activity.

(As amended Pub. L. 101-508, title VII, § 7002(b), (c), Nov. 5, 1990, 104 Stat. 1388-330.) AMENDMENTS

1990-Subsec. (a). Pub. L. 101-508, § 7002(b), inserted at end "Payments from the Fund to a plan participating in a letter-of-credit arrangement under this chapter shall, in connection with any payment or reimbursement to be made by such plan for a health service or supply, be made, to the maximum extent practicable, on a checks-presented basis (as defined under regulations of the Department of the Treasury)." Subsec. (f). Pub. L. 101-508, § 7002(c), added subsec. (f).

EFFECTIVE DATE of 1990 AMENDMENT Amendment by Pub. L. 101-508 applicable with respect to contract years beginning on or after Jan. 1, 1991, see section 7002(g) of Pub. L. 101-508, set out as a note under section 8902 of this title.

SECTION REFERRED TO IN OTHER SECTIONS

This section is referred to in sections 6386, 8905, 8906 of this title; title 22 sections 4069c, 4069c-1; title 25 section 4501; title 50 section 403p.

§ 8910. Studies, reports, and audits

[See main edition for text of (a) to (c)] (d) The Office, in consultation with the Department of Health and Human Services, shall develop and implement a system through which the carrier for an approved health benefits plan described by section 8903 or 8903a will be able to identify those annuitants or other individuals covered by such plan who are entitled to benefits under part A or B of title XVIII of the Social Security Act in order to ensure that payments under coordination of benefits with Medicare do not exceed the statutory maximums which physicians may charge Medicare enrollees.

(As amended Pub. L. 101-508, title VII, §7002(d), Nov. 5, 1990, 104 Stat. 1388-330.)

REFERENCES IN TEXT

The Social Security Act, referred to in subsec. (d), is act Aug. 14, 1935, ch. 531, 49 Stat. 620, as amended.

89101. Criminal history record information for national security purposes

[See main edition for text of (a)] (b)(1) Upon request by the Department of Defense, the Department of State, the Office of Personnel Management, the Central Intelligence Agency, or the Federal Bureau of Investigation, criminal justice agencies shall make available criminal history record information regarding individuals under investigation by such department, office, agency, or bureau for the purpose of determining eligibility for (A) access to classified information or (B) assignment to or retention in sensitive national security duties. Such a request to a State central criminal history record repository shall be accompanied by the fingerprints of the individual who is the subject of the request if required by State law and if the repository uses the fingerprints in an automated fingerprint identification system. Fees, if any, charged for providing criminal history record information pursuant to this subsection shall not exceed the reasonable cost of providing such information, nor shall they in any event exceed those charged to

State or local agencies other than criminal justice agencies for such information.

[See main edition for text of (2)]

(3)(A) Upon request by a State or locality, the Department of Defense, the Department of State, the Office of Personnel Management, the Central Intelligence Agency, or the Federal Bureau of Investigation shall enter into an agreement with such State or locality to indemnify and hold harmless such State or locality, and its officers, employees and agents, from any claim against such State or locality, or its officer, employee or agent, for damages, costs and other monetary loss, whether or not suit is instituted, arising from the disclosure or use by such department, office, agency, or bureau of criminal history record information obtained from the State or locality pursuant to this subsection, if the laws of such State or locality, as of the date of enactment of this section, otherwise have the effect of prohibiting the disclosure of such criminal history record information to such department, office, agency, or bureau.

(B) When the Department of Defense, the Department of State, the Office of Personnel Management, the Central Intelligence Agency, or the Federal Bureau of Investigation and a State or locality have entered into an agreement described in subparagraph (A), and a claim described in such subparagraph is made against such State or locality, or its officer, employee, or agent, the State or locality shall expeditiously transmit notice of such claim to the Attorney General and to the United States Attorney of the district embracing the place wherein the claim is made, and the United States shall have the opportunity to make all determinations regarding the settlement or defense of such claim.

(c) The Department of Defense, the Department of State, the Office of Personnel Management, the Central Intelligence Agency, or the Federal Bureau of Investigation shall not obtain criminal history record information pursuant to this section unless it has received written consent from the individual under investigation for the release of such information for the purposes set forth in paragraph (b)(1).

[See main edition for text of (d)]

(e) The authority provided under this section with respect to the Department of State may be exercised only so long as the Department of State continues to extend to its employees and applicants for employment, at a minimum, those procedural safeguards provided for as part of the security clearance process that were made available, as of May 1, 1987, pursuant to section 163.4 of volume 3 of the Foreign Affairs Manual.

(As amended Pub. L. 101-246, title I, § 114, Feb. 16, 1990, 104 Stat. 22.)

AMENDMENTS