Post-stabilization items and services at a nonparticipating facility, or from a nonparticipating provider at a participating emergency facility, escape the balance billing prohibition only when all of the following hold: the attending emergency physician or treating provider determines the patient can travel by nonmedical or nonemergency medical transport to an available participating provider or facility within a reasonable distance (binding on the facility); the notice and consent criteria of 149.420(c) to (g) are met, with the notice also listing participating providers at the facility who could furnish the services (participating facility case) or the good faith estimated charges of the nonparticipating facility and its providers (nonparticipating facility case); the patient or authorized representative is in a condition to receive the information and consent, as the physician judges; and any further State requirements are satisfied.
The graph holds this control, the 0 it maps to, and the evidence behind each claim, over MCP and REST.