U.S. Office of Personnel Management - Ensuring the Federal Government has an effective civilian workforce

Federal Employees Health Benefits Program

Fee-for-service [28]   Experience-rated HMO [29]   Community-rated [27]

SUBJECT: Standard Contract Amendments

We recently sent Federal Employees Health Benefits (FEHB) Program carriers the 2007 Standard Contract Amendments for signature. We are removing the amendments for section 1.9-Plan Performance regarding inquiries accuracy, paragraph (6) in community-rated and experience-rated health maintenance organizations (HMO) amendments and paragraph (8) in fee-for-service (FFS) carriers amendments.

For community-rated and experience-rated HMOs, the only change to section 1.9(e) for the 2007 contract year is the name change to Consumer Assessments of Healthcare Providers and Systems (CAHPS).  For FFS carriers, the changes for the 2007 contract year are the name change in 1.9(e) and requirements for clinical care measures requiring HEDIS data measures in section (b).

Please have your Plan’s contracting officer initial section 1.9 that is attached and return it to the appropriate Office of Personnel Management (OPM) contracting officer (Mary Beth Lynch or William T. Stuart).  In addition, for those carriers who have not signed the 2007 contract amendments, please return the contract and the amendments together.

The attachments include Section 1.9-Plan Performance in its entirety, including the changes indicated above.  Attachment I includes the new Section 1.9 language for community-rated HMO contracts.  Attachment II includes the new Section 1.9 language for experience-rated HMO contracts.  Attachment III includes the new Section 1.9 language for FFS contracts.

Attachment: Standard Contract Amendments [62 KB]

Download this Letter as a PDF File [18 KB]


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