US No Surprises Act (42 USC 300gg-111 to 300gg-139) and 45 CFR Part 149 149.130: Cover nonparticipating air ambulance services at in-network cost sharing calculated on the lesser of the QPA and the billed amount, with direct payment within 30 days

What does 149.130 require?

A plan or issuer covering air ambulance services must apply to a nonparticipating air ambulance provider the same cost-sharing requirements as for a participating one, calculated as if the participating charge equalled the lesser of the qualifying payment amount and the billed amount; must count that cost sharing toward in-network deductibles and out-of-pocket maximums; must within 30 calendar days of the complete claim send an initial payment or notice of denial; and must pay the out-of-network rate less cost sharing directly to the provider within the statutory or State timing.