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Code of Federal Regulations (Last Updated: November 8, 2024) |
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Title 45 - Public Welfare |
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Subtitle A - Department of Health and Human Services |
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SubChapter B - Requirements Relating to Health Care Access |
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Part 149 - Surprise Billing and Transparency Requirements |
| Subpart A - General Provisions |
| § 149.1 - Purpose and basis. |
| § 149.2 - Definitions. |
| § 149.10 - Basis and scope. |
| § 149.20 - Applicability. |
| § 149.30 - Definitions. |
| Subpart B - Protections Against Balance Billing for the Group and Individual Health Insurance Markets |
| § 149.35 - Requirements to participate. |
| § 149.40 - Application. |
| § 149.41 - Consequences of Non-Compliance, Fraud, or Similar Fault. |
| § 149.45 - Funding limitation. |
| § 149.110 - Preventing surprise medical bills for emergency services. |
| § 149.120 - Preventing surprise medical bills for non-emergency services performed by nonparticipating providers at certain participating facilities. |
| § 149.130 - Preventing surprise medical bills for air ambulance services. |
| § 149.140 - Methodology for calculating qualifying payment amount. |
| § 149.150 - Complaints process for surprise medical bills regarding group health plans and group and individual health insurance coverage. |
| Subpart C - XXX |
| § 149.100 - Amount of reimbursement. |
| § 149.105 - Transition provision. |
| § 149.115 - Cost threshold and cost limit. |
| Subpart D - Additional Patient Protections |
| § 149.200 - Use of reimbursements. |
| § 149.310 - Choice of health care professional. |
| Subpart E - Health Care Provider, Health Care Facility, and Air Ambulance Service Provider Requirements |
| § 149.300 - General reimbursement rules. |
| § 149.315 - Reimbursement conditioned upon available funds. |
| § 149.320 - Universe of claims that must be submitted. |
| § 149.325 - Requirements for eligibility of claims. |
| § 149.330 - Content of claims. |
| § 149.335 - Documentation of costs of actual claims involved. |
| § 149.340 - Rule for insured plans. |
| § 149.345 - Use of information provided. |
| § 149.350 - Maintenance of records. |
| § 149.410 - Balance billing in cases of emergency services. |
| § 149.420 - Balance billing in cases of non-emergency services performed by nonparticipating providers at certain participating health care facilities. |
| § 149.430 - Provider and facility disclosure requirements regarding patient protections against balance billing. |
| § 149.440 - Balance billing in cases of air ambulance services. |
| § 149.450 - Complaint process for balance billing regarding providers and facilities. |
| Subpart F - Independent Dispute Resolution Process |
| § 149.500 - Appeals. |
| § 149.510 - Independent dispute resolution process. |
| § 149.520 - Independent dispute resolution process for air ambulance services. |
| Subpart G - Protection of Uninsured or Self-Pay Individuals |
| § 149.600 - Sponsor's duty to report data inaccuracies. |
| § 149.610 - Requirements for provision of good faith estimates of expected charges for uninsured (or self-pay) individuals. |
| § 149.620 - Requirements for the patient-provider dispute resolution process. |
| Subpart H - Prescription Drug and Health Care Spending |
| § 149.700 - Change of ownership requirements. |
| § 149.710 - Definitions. |
| § 149.720 - Reporting requirements related to prescription drug and health care spending. |
| § 149.730 - Aggregate reporting. |
| § 149.740 - Required information. |