FEHB improvements

(a) Short title This section may be cited as the FEHB Protection Act of 2025. (b) Definitions In this section: (1) Director The term Director means the Director of the Office of Personnel Management. (2) Health benefits plan; member of family The terms health benefits plan and member of family have the meanings given those terms in section 8901 of title 5, United States Code. (3) Open season The term open season means an open season described in section 890.301(f) of title 5, Code of Federal Regulations, or any successor regulation. (4) Program The term Program means the health insurance programs carried out under chapter 89 of title 5, United States Code, including the program carried out under section 8903c of that title. (5) Qualifying life event The term qualifying life event has the meaning given the term in section 892.101 of title 5, Code of Federal Regulations, or any successor regulation. (c) Verification requirements Not later than 1 year after the date of enactment of this Act, the Director shall issue regulations and implement a process to verify— (1) the veracity of any qualifying life event through which an enrollee in the Program seeks to add a member of family with respect to the enrollee to a health benefits plan under the Program; and (2) that, when an enrollee in the Program seeks to add a member of family with respect to the enrollee to the health benefits plan of the enrollee under the Program, including during any open season, the individual so added is a qualifying member of family with respect to the enrollee. (d) Fraud risk assessment In any fraud risk assessment conducted with respect to the Program on or after the date of enactment of this Act, the Director shall include an assessment of individuals who are enrolled in, or covered under, a health benefits plan under the Program even though those individuals are not eligible to be so enrolled or covered. (e) Family member eligibility verification audit (1) In general During the 3-year period beginning on the date that is 1 year after the date of enactment of this Act, the Director shall carry out a comprehensive audit regarding members of family who are covered under an enrollment in a health benefits plan under the Program. (2) Contents With respect to the audit carried out under paragraph (1), the Director shall review marriage certificates, birth certificates, and other appropriate documents that are necessary to determine eligibility to enroll in a health benefits plan under the Program. (f) Disenrollment or removal Not later than 180 days after the date of enactment of this Act, the Director shall develop a process by which any individual enrolled in, or covered under, a health benefits plan under the Program who is not eligible to be so enrolled or covered shall be disenrolled or removed from enrollment in, or coverage under, that health benefits plan. (g) Earned benefits and health care administrative services associated oversight and audit funding Section 8909 of title 5, United States Code, is amended— (1) in subsection (a)(2), by inserting before the period at the end the following:, except that the amounts required to be set aside under subsection (b)(2) shall not be subject to the limitations that may be specified annually by Congress; and (2) in subsection (b)— (A) by redesignating paragraph (2) as paragraph (3); and (B) by inserting after paragraph (1) the following: (2) In fiscal year 2026, $66,000,000, to be derived from all contributions, and to remain available until the end of fiscal year 2035, for the Director of the Office to carry out subsections (c) through (f) of the FEHB Protection Act of 2025..