US No Surprises Act (42 USC 300gg-111 to 300gg-139) and 45 CFR Part 149 149.510(b)(1): Start open negotiation within 30 business days of the initial payment or denial, using the prescribed notice, and respond by the 15th business day

What does 149.510(b)(1) require?

For a qualified IDR item or service (emergency, facility-based non-emergency or air ambulance services where no specified State law or All-Payer Model Agreement sets the rate and the notice and consent exception does not apply) either the provider, facility or air ambulance provider or the plan or issuer may, within 30 business days of the provider receiving the initial payment or notice of denial of payment, begin a 30-business-day open negotiation period by sending the other party and the Secretary a written open negotiation notice with the prescribed content (party identification and the plan's registry number, the item or service, dates, claim number, the initial payment or denial, the remittance advice and the offer). The receiving party must send a written response with supporting documentation to the initiating party and the Secretary by the 15th business day of the period. Open negotiation is a precondition of the Federal IDR process.