§ 890.1048 Waiver of debarment for a provider that is the sole source of health care services in a community

5 CFR 890.1048(a)(a) Application required. A provider may apply for a limited waiver of debarment at any time after receiving OPM's notice of proposed debarment. Suspended providers are not eligible to request a waiver of suspension.

5 CFR 890.1048(b)(b) Criteria for granting waiver. To receive a waiver, a provider shall clearly demonstrate that:

5 CFR 890.1048(b)(1)(1) The provider is the sole community provider or the sole source of essential specialized services in a community;

5 CFR 890.1048(b)(2)(2) A limited waiver of debarment would be in the best interests of covered individuals in the defined service area;

5 CFR 890.1048(b)(3)(3) There are reasonable assurances that the actions which formed the basis for the debarment shall not recur; and

5 CFR 890.1048(b)(4)(4) There is no basis under this subpart for continuing the debarment.

5 CFR 890.1048(c)(c) Waiver applies only in the defined service area. A limited waiver applies only to items or services provided within the defined service area where a provider is the sole community provider or sole source of essential specialized services.

5 CFR 890.1048(d)(d) Governmentwide effect continues. A limited waiver applies only to a provider's FEHBP transactions. Even if OPM waives a debarment for FEHBP purposes, the governmentwide effect under section 2455 of the Federal Acquisition Streamlining Act of 1994 (Pub. L. 103-355) continues for all other Federal agencies' procurement and nonprocurement programs and activities.

5 CFR 890.1048(e)(e) Waiver rescinded if circumstances change. OPM shall rescind the limited waiver when any of its underlying bases no longer apply. If OPM rescinds the limited waiver, the provider's debarment shall resume full effect for all FEHBP transactions. Events warranting rescission include, but are not limited to:

5 CFR 890.1048(e)(1)(1) The provider ceases to furnish items or services in the defined service area;

5 CFR 890.1048(e)(2)(2) Another provider begins to furnish equivalent items or services in the defined service area, so that the provider who received a waiver is no longer the sole provider or sole source; or

5 CFR 890.1048(e)(3)(3) The actions that formed the basis for the provider's debarment, or similar acts, recur.

5 CFR 890.1048(f)(f) Effect on period of debarment. The minimum period of debarment is established when the debarment is initially imposed. A subsequent decision to grant, deny, or rescind a limited waiver shall not change that period.

5 CFR 890.1048(g)(g) Application is necessary for reinstatement. A provider who has received a limited waiver shall apply for reinstatement at the end of the debarment period, even if a limited waiver is in effect when the debarment expires.

5 CFR 890.1048(h)(h) Finality of debarring official's decision. The debarring official's decision to grant or deny a limited waiver is final and not subject to further administrative review or reconsideration.