Page:United States Statutes at Large Volume 118.djvu/4033

From Wikisource
Jump to navigation Jump to search
This page needs to be proofread.

118 STAT. 4003 PUBLIC LAW 108–496—DEC. 23, 2004 ‘‘(i) to establish internal procedures designed to expedi- tiously resolve such disputes; and ‘‘(ii) to establish, for disputes not resolved through procedures under clause (i), procedures for 1 or more alter- native means of dispute resolution involving independent third-party review under appropriate circumstances by entities mutually acceptable to the Office and the qualified company. ‘‘(2) A determination by a qualified company as to whether or not a particular individual is eligible to obtain coverage under this chapter shall be subject to review only to the extent and in the manner provided in the applicable contract. ‘‘(3) For purposes of applying the Contract Disputes Act of 1978 to disputes arising under this chapter between a qualified company and the Office— ‘‘(A) the agency board having jurisdiction to decide an appeal relative to such a dispute shall be such board of contract appeals as the Director of the Office of Personnel Management shall specify in writing (after appropriate arrangements, as described in section 8(c) of such Act); and ‘‘(B) the district courts of the United States shall have original jurisdiction, concurrent with the United States Court of Federal Claims, of any action described in section 10(a)(1) of such Act relative to such a dispute. ‘‘(e) Nothing in this section shall be considered to grant authority for the Office or third-party reviewer to change the terms of any contract under this chapter. ‘‘(f) Contracts under this chapter shall be for a uniform term of 7 years and may not be renewed automatically. ‘‘§ 8954. Benefits ‘‘(a) The Office may prescribe reasonable minimum standards for enhanced dental benefits plans offered under this chapter and for qualified companies offering the plans. ‘‘(b) Each contract may include more than 1 level of benefits that shall be made available to all eligible individuals. ‘‘(c) The benefits to be provided under enhanced dental benefits plans under this chapter may be of the following types: ‘‘(1) Diagnostic. ‘‘(2) Preventive. ‘‘(3) Emergency care. ‘‘(4) Restorative. ‘‘(5) Oral and maxillofacial surgery. ‘‘(6) Endodontics. ‘‘(7) Periodontics. ‘‘(8) Prosthodontics. ‘‘(9) Orthodontics. ‘‘(d) A contract approved under this chapter shall require the qualified company to cover the geographic service delivery area specified by the Office. The Office shall require qualified companies to include dentally underserved areas in their service delivery areas. ‘‘(e) If an individual has dental coverage under a health benefits plan under chapter 89 and also has coverage under a plan under this chapter, the health benefits plan under chapter 89 shall be the first payor of any benefit payments. Procedures. VerDate 11-MAY-2000 13:54 Nov 10, 2005 Jkt 029194 PO 00000 Frm 00537 Fmt 6580 Sfmt 6581 C:\STATUTES\2004\29194PT4.001 APPS10 PsN: 29194PT4