[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7868 Introduced in House (IH)]
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118th CONGRESS
2d Session
H. R. 7868
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.
_______________________________________________________________________
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.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``FEHB Protection Act''.
SEC. 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.
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