[Code of Federal Regulations]
[Title 5, Volume 2]
[Revised as of January 1, 2002]
From the U.S. Government Printing Office via GPO Access
[CITE: 5CFR890.906]

[Page 467-468]
 
                    TITLE 5--ADMINISTRATIVE PERSONNEL
 
          CHAPTER I--OFFICE OF PERSONNEL MANAGEMENT (Continued)
 
PART 890--FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM--Table of Contents
 
 Subpart I--Limit on Inpatient Hospital Charges, Physician Charges, and 
                          FEHB Benefit Payments
 
Sec. 890.906  Retired enrolled individuals coinsurance payments.

    (a) A retired enrolled individual's coinsurance responsibility for 
inpatient hospital services is calculated in accordance with the plan's 
contractual benefit structure and is based on the amount determined to 
be equivalent to the Medicare part A payment under the DRG-based PPS.
    (b) A retired enrolled individual's coinsurance responsibility for 
physician services is calculated in accordance with the plan's 
contractual benefit

[[Page 468]]

structure and is based on the lower of the actual charges or the amount 
determined to be equivalent to the Medicare part B payment under the 
Medicare Participating Physician Fee Schedule for Medicare participating 
physicians and the Medicare Nonparticipating Physician Fee Schedule for 
Medicare nonparticipating physicians.

[60 FR 26668, May 18, 1995]