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 149 149.420(c)-(d): Give the standard written notice, separately from other documents, at least 72 hours before a scheduled service (or 3 hours on same-day scheduling), with the required content

To satisfy the notice and consent criteria the nonparticipating provider (or the participating facility on its behalf) must give the patient, in paper or electronic form as the patient selects, a written notice in the HHS standard form, physically separate from other documents, not later than 72 hours before the service where the appointment was made at least 72 hours ahead, otherwise on the day of scheduling and in any case at least 3 hours before the service. The notice must state that the provider is nonparticipating; give a good faith estimate of the charges including items reasonably expected to be furnished with them, and state that neither the estimate nor the consent is a contract or binds the patient to that provider; say that prior authorization or other care management may be required; and state clearly that consent is optional and that care from an available participating provider would carry only in-network cost sharing.

Maintained by Gerard Blokdyk

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