§ 890.905 Limits on inpatient hospital and physician charges.
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Title 5 CFR: Administrative Personnel › Chapter I: OFFICE OF PERSONNEL MANAGEMENT › Part 890: FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM › Subpart I: Limit on Inpatient Hospital Charges, Physician Charges, and FEHB Benefit Payments › § 890.905: § 890.905 Limits on inpatient hospital and physician charges.
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(a) Hospitals may not collect from FEHB plans and retired enrolled individuals for inpatient hospital services more than the amount determined to be equivalent to the Medicare part A payment under the DRG-based PPS.
(b) Medicare participating providers may not collect from FEHB plans and retired enrolled individuals for physician services more than the amount determined to be equivalent to the Medicare part B payment under the Medicare Participating Physician Fee Schedule.
(c) Medicare nonparticipating providers may not collect from FEHB plans and retired enrolled individuals for physician services more than the amount determined to be equivalent to the Medicare limiting charge amount.
[60 FR 26668, May 18, 1995; 60 FR 28019, May 26, 1995]
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