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Content Last Revised: 2/14/75
---DISCLAIMER---

CFR  

Code of Federal Regulations Pertaining to ESA

Title 20  

Employees' Benefits

 

Chapter I  

Office of Workers' Compensation Programs, Department of Labor

 

 

Part 10  

Claims for Compensation Under the Federal Employees' Compensation Act, As Amended

 

 

 

Subpart D  

Medical and Related Benefits

20 CFR 10.337 - If OWCP reimburses an employee only partially for a medical expense, must the provider refund the balance of the amount paid to the employee?

  • Section Number: 10.337
  • Section Name: If OWCP reimburses an employee only partially for a medical expense, must the provider refund the balance of the amount paid to the employee? 
    (a) The OWCP fee schedule sets maximum limits on the amounts payable 
for many services (see Sec. 10.805). The employee may be only partially 
reimbursed for medical expenses because the amount he or she paid to the 
medical provider for a service exceeds the maximum allowable charge set 
by the OWCP fee schedule.
    (b) If this happens, OWCP shall advise the employee of the maximum 
allowable charge for the service in question and of his or her 
responsibility to ask the provider to refund to the employee, or credit 
to the employee's account, the amount he or she paid which exceeds the 
maximum allowable charge. The provider may request reconsideration of 
the fee determination as set forth in Sec. 10.812.
    (c) If the provider does not refund to the employee or credit to his 
or her account the amount of money paid in excess of the charge which 
OWCP allows, the employee should submit documentation of the attempt to 
obtain such refund or credit to OWCP. OWCP may make reasonable 
reimbursement to the employee after reviewing the facts and 
circumstances of the case.
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