US No Surprises Act (42 USC 300gg-111 to 300gg-139) and 45 CFR Part 149
Uninsured and self-pay individuals: good faith estimates and patient-provider dispute resolution (45 CFR 149.610 and 149.620; 42 U.S.C. 300gg-136 and 300gg-137) – 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 149 149.610(b)(1)(vii)-(viii),(x),(b)(2): Reissue the estimate at least 1 business day before the service when the scope changes, bind replacement providers to the prior estimate, and limit recurring-service estimates to 12 months

What does 149.610(b)(1)(vii)-(viii),(x),(b)(2) require?

If the convening provider, convening facility, co-provider or co-facility anticipates or is notified of a change in the scope of a previously issued estimate (charges, items, services, frequency, recurrences, duration, providers or facilities) a new good faith estimate must be issued no later than 1 business day before the scheduled service; a provider or facility substituted less than 1 business day before the service must accept the replaced provider's estimate as its own. A single estimate may cover recurring primary items or services only if it states the expected scope (timeframes, frequency and total number) and does not exceed 12 months, after which a new estimate explaining the changes is required. Co-providers and co-facilities must send their estimate information within 1 business day of the convening provider's request, must notify changes to it, and become convening providers when the patient schedules with them directly.

Maintained by Gerard Blokdyk

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