Bill > HR2193

This bill aims to improve the Federal Employees Health Benefits (FEHB) Program by implementing several key oversight and verification measures. The bill requires the Director of the Office of Personnel Management (OPM) to develop a robust process to verify the eligibility of family members enrolled in federal health insurance plans, including checking the authenticity of qualifying life events and conducting comprehensive audits of family member coverage. Specifically, the Director must create regulations within one year to verify that individuals added to health plans during open enrollment or through qualifying life events are truly eligible family members. The bill mandates a three-year comprehensive audit of family member coverage, which will involve reviewing marriage and birth certificates to confirm eligibility. Additionally, the Director must develop a process to disenroll or remove individuals who are not eligible for coverage. The bill also provides funding for OPM to conduct these oversight and audit activities, allocating specific amounts from fiscal year 2026 through 2035 for enrollment and eligibility system oversight, with increases of 2.2% annually after 2035. In the first year, $80 million is allocated specifically for conducting the required family member eligibility audit, with the option to transfer funds to employing offices as needed.

Government Affairs

https://www.congress.gov/bill/119th-congress/house-bill/2193/all-info