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News Release

Friday, December 05, 2008
Contact: Michael Orenstein
Tel: 202-606-2402

OPM to Provide Additional Protections in 2009 for FEHB Enrollees Who Use Out-of-Network Surgeons

OPM also instructs Federal agencies to accept belated Open Season enrollments

Washington, D.C.  --  The U.S. Office of Personnel Management today announced it has taken steps to provide additional protections for federal employees participating in the Federal Employees Health Benefits (FEHB) Program who have non-emergency surgeries performed by out-of-network surgeons. The agency has asked FEHB carriers to re-evaluate their benefits for non-emergency surgeries and has instructed Federal agencies to accept belated Open Season enrollments.

OPM is taking this action in response to concerns over a change in coverage in the Blue Cross Blue Shield reimbursement that would have established a $7,500 co-pay for out-of-network surgeries. The agency had negotiated this change to address situations where enrollees could be billed tens-of-thousands of dollars for non-emergency surgeries performed by out-of-network providers, a practice known as balanced billing.

Carriers have been asked to propose changes no later than Monday, December 8. OPM will not allow changes to premiums in 2009 or to other types of benefits in 2009.

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Our mission is to Recruit, Retain and Honor a World-Class Workforce to Serve the American People. OPM supports U.S. agencies with personnel services and policy leadership including staffing tools, guidance on labor-management relations and programs to improve work force performance.

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