text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Federal Employees Health Benefits 
  Access Act''.
  
  SEC. 2. PROVISIONS TO MAKE FEHBP AVAILABLE TO THE GENERAL PUBLIC.
  
      (a) In General.--Chapter 89 of title 5, United States Code, is 
  amended by adding at the end the following:
  ``Sec. 8915. Provisions to require that benefits be extended to the 
                general public
      ``(a) A contract may not be made or a plan approved unless the 
  carrier agrees to offer to the general public, throughout each term for 
  which the contract or approval remains effective, the same benefits 
  (subject to the same maximums, limitations, exclusions, and other 
  similar terms or conditions) as would be offered under such contract or 
  plan to employees and annuitants and their family members.
      ``(b)(1) Premiums for coverage under this section shall be 
  established in conformance with such requirements as the Office of 
  Personnel Management shall by regulation prescribe, including 
  provisions to ensure conformance with generally accepted standards and 
  practices associated with community rating.
      ``(2) In no event shall the enactment of this section result in--
              ``(A) any increase in the level of individual or Government 
          contributions required under section 8906 or any other 
          provision of this chapter, including copayments or deductibles;
              ``(B) any decrease in the types of benefits offered under 
          this chapter; or
              ``(C) any other change that would adversely affect the 
          coverage afforded under this chapter to employees and 
          annuitants and their family members.
      ``(c) Benefits under this section shall, with respect to an 
  individual who is entitled to benefits under part A of title XVIII of 
  the Social Security Act, be offered (for use in coordination with those 
  Social Security benefits) to the same extent and in the same manner as 
  if coverage were under the preceding provisions of this chapter, rather 
  than under this section.
      ``(d)(1) A carrier may file an application with the Office setting 
  forth reasons why it, or a plan provided by such carrier, should be 
  excluded from the requirements of this section.
      ``(2) In reviewing any such application, the Office may consider 
  such factors as--
              ``(A) any bona fide enrollment restrictions which would 
          make the application of this section inappropriate, including 
          those common to plans which are limited to individuals having a 
          past or current employment relationship with a particular 
          agency or other authority of the Government;
              ``(B) whether compliance with this section would jeopardize 
          the financial solvency of the plan or carrier, or otherwise 
          compromise its ability to offer health benefits under the 
          preceding provisions of this chapter; and
              ``(C) the anticipated duration of the requested exclusion, 
          and what efforts the plan or carrier proposes to take in order 
          to be able to comply with this section.
      ``(e) Except as the Office may by regulation prescribe, any 
  reference to this chapter (or any requirement of this chapter), made in 
  any provision of law, shall not be considered to include this section 
  (or any requirement of this section).''.
      (b) Conforming Amendment.--The table of sections for chapter 89 of 
  title 5, United States Code, is amended by adding at the end the 
  following:
  
  ``8915. Provisions to require that benefits be extended to the general 
                              public.''.
  
  SEC. 3. STANDARDIZED CLAIMS PROCESSING.
  
      Section 8902 of title 5, United States Code, is amended by adding 
  at the end the following:
      ``(o) A claim for payment or reimbursement under this chapter 
  (whether electronic or otherwise) shall be submitted on such a standard 
  form or in such a standard manner as may be required by the Office in 
  relation to health benefit plans. Each contract under this chapter 
  shall include appropriate provisions to carry out the preceding 
  sentence.''.
  
  SEC. 4. ADVANCE DIRECTIVES.
  
      Section 8907 of title 5, United States Code, is amended by adding 
  at the end the following:
      ``(c) The Office shall--
              ``(1) prepare information relating to the use of advance 
          directives regarding the type or intensity of care which an 
          individual desires in the event that such individual becomes 
          unable to communicate by reason of incapacity due to illness or 
          injury; and
              ``(2) require, as a condition for approval of any contract 
          under section 8902, that appropriate provisions be included so 
          that such information may be made available to enrollees of the 
          plan involved.''.
  
  SEC. 5. DEMONSTRATION PROJECT TO EXAMINE THE FEASIBILITY OF OFFERING 
                FEHBP ENROLLEES THE OPTION OF USING ARBITRATION INSTEAD 
                OF LITIGATION TO RESOLVE MEDICAL MALPRACTICE CLAIMS.
  
      (a) In General.--The Office of Personnel Management shall conduct a 
  demonstration project to assess the feasibility and desirability of 
  offering the use of arbitration, instead of litigation, to resolve 
  medical malpractice claims arising out of covered health care services.
      (b) Definition.--For the purpose of this section, the term 
  ``covered health care services'' means any care, treatment, or other 
  service for which the individual who receives such service has coverage 
  under chapter 89 of title 5, United States Code.
      (c) Project Requirements.--
              (1) In general.--The demonstration project shall be 
          conducted as a demonstration project under section 4703 of 
          title 5, United States Code.
              (2) Plan design.--In developing a plan for such project 
          under section 4703 of title 5, United States Code, the Office 
          shall include (in addition to any information otherwise 
          required)--
                      (A) suggestions for incentives that may be offered 
                  in order to obtain the voluntary participation of 
                  enrollees, such as reductions in premiums, copayments, 
                  or deductibles;
                      (B) the criteria for identifying the types of 
                  health benefit plans which are appropriate for 
                  inclusion, and the procedures and conditions in 
                  accordance with which any such plan may participate;
                      (C) the general framework for arbitration, 
                  including (to the extent the Office considers 
                  appropriate) methods for the selection of arbitrators, 
                  length of hearings, and limitations on damages; and
                      (D) the effect of an award resulting from the 
                  arbitration process, and the extent to which review of 
                  such an award may be obtained.
      (d) Evaluation.--The evaluation required under section 4703(h) of 
  title 5, United States Code, with respect to the demonstration project 
  shall include data and analysis relating to matters such as--
              (1) the number of claims brought for arbitration;
              (2) how those claims were disposed of (whether by 
          settlement, hearing, or otherwise), and the percentage of the 
          total number of claims represented by each;
              (3) the average dollar amount of those awards or 
          settlements;
              (4) the various costs involved in connection with those 
          claims; and
              (5) the advantages and disadvantages of arbitration, 
          relative to other methods of dispute resolution, and the extent 
          to which arbitration should continue to be used under chapter 
          89 of such title.
  
  SEC. 6. APPLICABILITY.
  
      The amendments made by this Act shall apply with respect to 
  contract terms beginning after the end of the 6-month period beginning 
  on the date of the enactment of this Act.
target: Federal Employees Health Benefits Access Act -    Prohibits a Government health services contract from being made or a plan approved unless the carrier agrees to offer to the general public the same benefits as would be offered under such contract or plan to Federal employees and annuitants and their family members.  Requires premiums for coverage to be established in conformance with such requirements as the Office of Personnel Management (OPM) shall prescribe. 
  Specifies that in no event shall this Act's enactment result in any:  (1) increase in the level of individual or Government contributions required, including copayments or deductibles; (2) decrease in the types of benefits offered; or (3) other change that would adversely affect the coverage afforded to employees and annuitants and their family members. 
  Permits a carrier to file an application with OPM setting forth reasons why it, or a plan provided by such carrier, should be excluded from the requirements of this Act.  Allows OPM, in reviewing any such application, to consider such factors as:  (1) any bona fide enrollment restrictions which would make the application of this Act inappropriate; (2) whether compliance would jeopardize the financial solvency of the plan or carrier or otherwise compromise its ability to offer health benefits; and (3) the anticipated duration of the requested exclusion and what efforts the plan or carrier proposes to take in order to be able to comply with this Act. 
  Requires a claim for payment or reimbursement to be submitted on a standard form or in a standard manner as may be required by OPM in relation to health benefit plans. 
  Directs OPM to:  (1) prepare information relating to the use of advance directives regarding the type or intensity of care which an individual desires in the event that such individual becomes unable to communicate by reason of incapacity due to illness or injury; and (2) require, as a condition for contract approval, that appropriate provisions be included so that such information may be made available to enrollees of the plan involved. 
  Requires OPM to conduct a demonstration project to assess the feasibility and desirability of offering the use of arbitration, instead of litigation, to resolve medical malpractice claims arising out of covered health care services. 
  Sets forth provisions regarding project requirements and evaluation.
feat_title: Federal Employees Health Benefits Access Act