Other Fields
Agency Scheme: 
OPMOIGSD0004
ADJUDICATION STRUCTURE
Hearing Level: Basic Structure
Name of Hearing Office (local name): 
Office of the Inspector General
Name of Hearing Office (global name): 
Office of Personnel Management: Office of the Inspector General
Hearing Officer #1 (Title): 
Assistant Inspector General for Legal Affairs
Hearing Officer #2 (Title): 
Designated Presiding Official
Are administrative appeals permitted from final decisions at the hearing-level stage?: 
No
Comments/Notes on Adjudication Structure: 

Adjudication scheme for imposition of administrative sanctions (e.g., debarment, suspension, civil monetary penalties, and other monetary assessments) by OPM against Federal Employee Health Benefit (FEHB) providers under the Federal Employees Health Care Protection Act of 1998. The OPM Director has delegated authorities under the FEHB program to the OPM Office of the Inspector General.

[*Note: In cases involving disputed issues of material fact, the Suspending/Debarring Official must refer FEHB cases for a fact-finding by another presiding official.]

PROCESS & PROCEDURE - General Information
Are private parties permitted to have representation at hearings?: 
Yes (All Types of Cases)
Who may serve as a private party representative?: 
Either
Is the agency permitted to have representation at hearings?: 
No
Regulations/rules of practice for hearings (please include CFR citations): 
FEHB: 5 CFR pt. 890, subpt. J (5 CFR 890.1001 - 890.1072)
PROCESS & PROCEDURE - Pre-Hearing Procedure
Is discovery permitted by either party at the hearing-level stage?: 
No
Does the hearing officer have subpoena authority?: 
No
Are ex parte contacts prohibited?: 
No
Are parties provided notice of hearing?: 
Yes (All Types of Cases)
PROCESS & PROCEDURE - Hearing Procedure
What types of hearings are permitted at the hearing-level stage?: 
Written (Document-Only) Hearing
In-Person
How is the type of hearing selected: 
Required by Rule
Depends on Nature of Case/Claim
Please describe: 
FEHB providers may contest the proposed agency action by submitting written materials and appear before the suspending/debarring official to present oral arguments. (See 5 CFR 890.1009(c), 890.1023(a), 890.1068(a) & (c)). Additionally, the suspending/debarring official has discretion to conduct an evidentiary hearing in all proceedings except mandatory debarment of FEHB providers when there are material disputed facts that cannot be resolved by review of the documentary record. (See 5 CFR 890.1027(a), 890.1068(c)).
How many hearing officers preside at each hearing?: 
One
Is witness testimony permitted at hearings?: 
Varies by Case
If "Varies by Case," please describe: 
Witness testimony may be permitted at in-person hearings. For document-only hearings, this question is N/A.
Can parties cross-examine witnesses?: 
Varies by Case
If "Varies by Case," please describe: 
Cross-examination may be permitted at in-person hearings. For document-only hearings, this question is N/A.
Can third-parties submit amicus briefs and/or evidence?: 
No
Are hearings recorded and/or transcribed?: 
Yes
N/A (Document-Only Hearings)
PROCESS & PROCEDURE - Post-Hearing Procedure
Who typically drafts the decision at the hearing-level stage?: 
Adjudication Officer
Who has authority to issue final decisions?: 
Adjudication Officer
Do agency regulations or guidance provide time limits for issuance of final decisions?: 
Yes (All Types of Cases)
If "Yes," please specify these time limit(s): 
The suspending or debarring official must issue a written decision within 30 days of closing the official record.
Is judicial review available after issuance of a final decision?: 
No
PROCESS & PROCEDURE - Case Management
Does the agency permit web-based electronic filing of hearing-related briefs or other documents?: 
No
Are final decisions published and/or posted on the agency website?: 
No
Do agency regulations/rules of practice specify the contents of the administrative record at the hearing-level stage?: 
Yes (All Types of Cases)
If "Yes," please provide citation(s): 
5 CFR 890.1010, 890.1026
Do agency regulations/rules of practice provide for closure of the record at the hearing-level stage (subject to applicable exce: 
Yes (All Types of Cases)
If "Yes," please provide citation(s): 
5 CFR 890.1010(c), 890.1026(a)
PROCESS & PROCEDURE - Comments
Comments/Notes on Hearing-Level Process & Procedures (Optional): 
All final decisions imposing a suspension or debarment are published in the sense that information concerning such suspension/debarment is required to be posted on the government-wide Excluded Parties List System (EPLS). (Federal agency officials use the EPLS) to determine whether or not to enter into a transaction.) While there is no "discovery" permitted in these proceedings in the traditional sense, in FEHB cases involving permissive debarment or civil penalties, OPM regulations impose an affirmative (mandatory) disclosure obligation on providers to disclose specified background information related to (a) existing, proposed, or prior debarment/suspension proceedings by a federal, state, or local government; and (b) criminal or civil proceedings arising from the same facts serving as the basis for the current suspension/debarment action. (5 CFR 890.1023(c), 890.1069(b)).
ADJUDICATORS
Comments/Notes on Hearing-Level Adjudicators (Optional): 
The suspending/debarring official issues a final decision on the noticed administrative action; however, when an evidentiary (fact-finding) hearing is conducted to determine disputed material facts in a proposed permissive debarment, a "presiding official" --who is a "senior official" without prior involvement in the proposed debarment -- is designated to preside over such hearing and issue written findings of fact. The presiding official's factual findings must be accepted by the suspending/debarring official unless arbitrary, capricious, or clearly erroneous." (5 CFR 890.1027(b), 890.1039(b) & (e)).
ADR: General Information
Is ADR available at one or more points during the hearing process?: 
No
Verified by Agency: 
Not verified