868 General Procedures

868.1 Medical Provider Services

868.11 Special

The national medical director is responsible for the medical delegation/re-delegation for local buying authority as identified in Handbook AS-709, Local Buying and Purchase Card Policies and Procedures, requiring Senior Area Medical Directors (SAMD), Area Occupational Health Nurse Administrator (AOHNA), and District Occupational Health Nurse Administrators (DOHNA) to schedule and purchase medical services for use in emergencies and when Independent Medical Agreements (IMA) are not available to perform the required exams to meet the needs of the Area or District.

Medical services may be purchased under local buying authority but only when:

  1. The purchase amount is valued at $2,500 or less per one-time expenditure, or
  2. An office estimates that a particular service provided by the same supplier will not exceed $2,500 per year.

Any purchase of medical services valued at more than $2,500 per one-time expenditure, or when an office estimates that a particular service provided by the same supplier will exceed $2,500 per year, must be forwarded to the appropriate Supply Management CMC (AS-709, 1.15.21 Medical Services). Purchases by local buying authority must not be made in lieu of utilizing current IMAs.

Purchases under $2500 using local buying authority will follow the procedures outlined in the Handbook AS-709.

868.12 Medical Surveillance and Surveys

Exposure to toxic substances is identified and quantified by the district Human Resources manager, Safety, or senior safety specialist. The district occupational health nurse administrator or area medical director negotiates the surveillance. Such surveys must be coordinated with the senior area medical director. The district Human Resources manager implements appropriate action and notifies the area Human Resources manager.

868.13 Contract Medical Agreement
868.131 Initiating Independent Medical Agreements (IMA)

The following are the procedures for initiating medical agreements with community based medical providers:

  1. The medical director or occupational health nurse administrator (OHNA) will request the development of an IMA when current suppliers under national contract or another IMA do not provide the necessary services to meet the needs of the district.
  2. Medical service examinations which are rare or infrequent the Medical Director or OHNA must refer to the “Medical Service Purchase — Standard Operating Procedure (SOP)” located on the OHS BlueShare site.
  3. All requests for the development of an IMA must include an approved eBuy2 to be forwarded to the Employee, Financial, and Technical Services CMC.
  4. A copy of the IMA will be provided by Employee, Financial, and Technical Services CMC to the occupational health nurse administrator when completed.
868.132 Certification for Payment of Invoices

As invoices are received for services provided by a supplier under national contract or an IMA supplier, the certifying official, OHNA, or medical director executes the following procedures before submitting invoices for payment processing:

  1. Verify that the specific services have been rendered and that the invoices are accurate.
  2. Review invoices to detect any inconsistencies such as double-billing (billing twice for the same service on separate invoices).
  3. Certify invoices by stamping, typing, or handwriting on each original invoice the following information:
    1. Signature and title of the certifying official,
    2. Printed name and title of the certifying official,
    3. Name of postal facility,
    4. Finance number,
    5. Account Number,
    6. Order or Contract Number,
    7. AIC (local payments),
    8. Date goods were received or that the services were rendered.
    9. TIN: EIN or SSN
    10. IRS 1099

A sample stamp reads: “I certify that the goods or services have been received and the invoice is correct and proper for payment.”

868.133 Payment Hierarchy (Electronic Funds Transfer)

In addition to cost savings through a reduction in administrative processing, the reasons for using eBuy2 are as follows:

  1. eBuy2 is the preferred method for order placement after in-house excess resources have been checked. It is mandatory for all employees with Blue intranet access to use eBuy2.
  2. eBuy2 is also the Postal Service’s web-based electronic requisitioning and approval workflow that replaced PS Form 7381, Requisition for Supplies, Services, or Equipment.
  3. eBuy2 allows users to order online from national mandatory and priority source contracts with:
    1. Order status checking.
    2. Reconciliation.
    3. Reporting based on General Ledger Accounts selected.
    4. Electronic payment capabilities.

National or area contracts or agreements are available service-wide or to specific geographical areas for headquarters and/or field customer use. Other features include the following:

  1. Electronic payment can be made through either the electronic transfer of funds or with a purchase card account if authorized by the Contracting Officer.
  2. Multiple orders can be placed against these contracts and agreements. These orders are not considered split purchases regardless of the payment method used as long as they do not exceed the ordering limits in the governing contract or agreement.
868.134 Payment — Non–Statement of Account Offices

For those postal installations that do not have a Statement of Account, the following payment procedures apply:

  1. Forward certified invoices to the installation finance office for recording and subsequent forwarding to the San Mateo Postal Data Center (94497–9133).
  2. Send copies of invoices (certifying official) to the occupational health nurse administrator or area medical director or designees for their files.
  3. Charge payment for non–job–related medical services (such as routine medical examinations, nursing services, and first aid treatment that is not related to an on-the-job injury or illness) to General Ledger Account (GLA) 52428.
  4. Charge payment for medical services that are job–related (such as office visits, X-rays, lab work, pharmaceutical bills, and fitness–for–duty examinations that are required because of an on-the-job injury or illness) to GLA 52427.
  5. Charge payment for medical services for customers involved in accidents on or with Postal Service property (only for the initial visit) to GLA 55216.
  6. Note: AICs 578, 577, and 597 automatically crosswalk to five–digit expense accounts 52428, 52427, and 55216, respectively, in the General Ledger.

Example: A sample payment log used for recording payment information follows:


Medical Payment Control Log — Calendar Year





ZIP + 4:

Social Security Number:

Invoice Amount

Date Paid

Total Year to Date










868.14 Health Agreements

Health agreements are negotiated between the Postal Service and other federal agencies to provide medical services to those agencies at Postal Service facilities. The occupational health nurse administrator and facility manager are responsible for approving such agreements.

868.2 Malpractice

Malpractice insurance is not available for postal medical personnel. Representation in civil or criminal proceedings is provided in accordance with 668.1.

868.3 Preservation of Privacy

Preservation of the privacy of medical records is a direct responsibility of the postal physician or nurse (see Management Instruction EL–860–98–2, Employee Medical Records). In facilities where no medical personnel are assigned, the district occupational health nurse administrator arranges with the installation head to properly secure the medical records.

868.4 Medical Training

868.41 General

See 740.

868.42 Continuation of Training

The Postal Service authorizes training for employees to upgrade or maintain proficiency in their current positions. Continuing medical education by the following is encouraged:

  1. Attendance at seminars and medical meetings to improve the professional skills of:
    1. Occupational health nurse administrators,
    2. Occupational health nurses, and
    3. Medical directors.
  2. CPR training (with annual recertification) is required for all medical personnel, at Postal Service expense.
868.43 Requests for Training

Requests for medical training by medical personnel are to be submitted through the employee’s supervisor to the appropriate approving official at the installation.

868.5 Conflict of Interest

868.51 Full-time Medical Personnel

The following provisions apply for full-time personnel:

  1. Full-time medical personnel must not accept any postal employee as a private patient.
    1. Medical personnel are defined as physicians, nurses, and other professional personnel.
    2. This rule applies to new patients and does not affect physician-patient relationships that were in existence prior to the issuance of this subchapter.
    3. The exception is where an existing private relationship creates an actual conflict of interest (see 662.1), in which case the relationship must be terminated.
  2. Postal physicians who are treating postal employees in the scope of their duties may not refer employees to their private practice or that of a relative.
868.52 Part-Time and Contract Medical Personnel

The following provisions apply for part-time personnel:

Part-time and contract medical personnel may treat postal employees privately within the bounds of the general ethical conduct standard (see 662.1) that provides that outside employment may not interfere with the duties and responsibilities of Postal Service employment. Specifically, part-time or contract medical personnel may not:

  1. Coerce, solicit, or inhibit an employee from the free choice of physician in the treatment of an occupational injury or illness.
  2. Serve as the private physician to, or treat in private practice, postal employees sustaining occupational injuries or illness unless the physician is the physician of choice. Any treatment of an employee for an occupational injury or disease by a part-time or contract physician is, in all cases, considered to be performed within the scope of the physician’s postal duties or pursuant to the terms of any contract with the Postal Service for up to two visits. If treatment of the medical condition goes beyond two visits, and if the injured employee selects the contract physician as “physician of choice,” the contract physician then becomes the employee’s physician and subject to OWCP’s regulations rather than those of the Postal Service.
  3. Continue to treat postal employees for a non–job–related injury or illness when the employee initially sought treatment while the physician, nurse, etc., was acting in an official capacity with the Postal Service.
868.53 Contract Medical Facilities and Providers

The provisions described in 868.52 are also applicable to medical clinics or other similar facilities under contract with the Postal Service.