OPM Wants Your FEHB Medical Claims: What the New CRS Report Says
OPM’s request for FEHB medical claims data would place health information for more than eight million federal employees, retirees, and family members in the hands of the agency that manages federal employment. Nothing has been approved yet — the request is reported pending at the Office of Management and Budget — but a Congressional Research Service report issued August 11, 2026 sets out what OPM is asking for and which legal questions remain open.
What OPM Is Asking For
OPM published an information collection notice in December 2025 and a follow-up in June 2026 seeking service use and cost data from Federal Employees Health Benefits carriers. The scope is broad: medical and pharmacy claims for everyone covered by FEHB, which includes employees, annuitants, spouses, and children. Once OMB approves the collection, carriers can be required to comply.
Two Points From the CRS Report
First, OPM says it needs record-level, identifiable data — in OPM’s own words, “to create person-level longitudinal records.” That describes a health file on an individual, tracked over time.
Second, the privacy plan is pseudonymization rather than de-identification. Identifying fields are stripped with one exception: the member ID is retained. Stakeholders have warned that a retained member ID could be matched against information OPM already holds, which would make re-identification possible.
The Legal Question: How Far Does Section 8910 Reach
OPM’s stated authority is 5 U.S.C. § 8910, which lets OPM require “reasonable reports” from FEHB carriers. Whether that language reaches every covered person’s claims history is the unresolved question. The carriers’ trade group says it does not, taking the position that the request “falls outside the scope of Section 8910.” The CRS report also raises whether a collection of this scope should have gone through formal rulemaking rather than the information collection process. No court has ruled either way.
Why the 2015 Breach Still Matters
Federal employees who hesitate here are not overreacting. In 2015, OPM disclosed a breach affecting more than 21 million background investigation records. That history is part of why a proposal to centralize claims data on eight million people — including spouses and children who never worked a day for the federal government — draws the reaction it does.
What Federal Employees Can Do Now
- Track the status, do not assume it. The collection is reported pending at OMB and no court has weighed in. Watch for OMB action rather than assuming data is already moving.
- Use the ordinary channels. Public comment and congressional oversight are where this gets decided. The Capitol switchboard is 202-224-3121.
- Keep your own matter separate. If your health information is already an issue in your employment — a medical documentation request, a fitness-for-duty referral, a reasonable accommodation dispute — that runs on its own rules and its own deadlines, and it is worth getting advice early rather than late.
The Bottom Line
This is a live policy fight, not a settled rule. The useful posture for federal employees is an informed one: know what is being requested, know that the legal authority is contested, and know that FEHB coverage means your family’s records are part of the conversation too. If a health-related employment action of your own is in play, the federal employee lawyers at Southworth PC represent federal employees nationwide.
Legal Disclaimer: This content is for general informational purposes only and does not constitute legal advice. Federal employment situations are fact-specific and time-sensitive. Please consult a qualified federal employment attorney about your specific situation.