US No Surprises Act (42 USC 300gg-111 to 300gg-139) and 45 CFR Part 149
Provider, facility and air ambulance duties: balance billing, notice and consent, disclosure (45 CFR 149.410 to 149.450; 42 U.S.C. 300gg-131 to 300gg-139) – US No Surprises Act (42 USC 300gg-111 to 300gg-139) and 45 CFR Part 149

US No Surprises Act (42 USC 300gg-111 to 300gg-139) and 45 CFR Part 149 149.410(a),(c): Do not balance bill patients for emergency services beyond in-network cost sharing, including for unforeseen urgent needs after stabilization

A nonparticipating emergency facility, and a nonparticipating provider furnishing emergency services at a hospital emergency department or independent freestanding emergency department, must not bill or hold liable a participant, beneficiary or enrollee for more than the cost-sharing amount calculated under 149.110(b)(3)(ii) and (iii) (or the parallel Labor and Treasury rules). For items and services furnished because of unforeseen, urgent medical needs arising at the time of care the prohibition always applies, whatever notice and consent documents were signed.

Maintained by Gerard Blokdyk

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