Title 42 — The Public Health and WelfareRelease 119-73

§300gg–133 Provider requirements with respect to disclosure on patient protections against balance billing

Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER XXV— - REQUIREMENTS RELATING TO HEALTH INSURANCE COVERAGE › Part Part E— - Health Care Provider Requirements › § 300gg–133

Last updated Apr 6, 2026|Official source

Summary

Starting January 1, 2022, health care providers and facilities must make a one-page notice available to the public, post it on their website if they have one, and send it to people who are participants, beneficiaries, or enrollees of group health plans or group or individual insurance—by mail or email as the person chooses. The notice must explain the provider’s duties and the bans on balance billing in certain situations (under sections 300gg–131 and 300gg–132), any state rules about what the provider may charge when they don’t have a contract and after the plan and patient have paid, and how to contact state and federal agencies if someone thinks the provider broke these rules.

Full Legal Text

Title 42, §300gg–133

The Public Health and Welfare — Source: USLM XML via OLRC

Beginning not later than January 1, 2022, each health care provider and health care facility shall make publicly available, and (if applicable) post on a public website of such provider or facility and provide to individuals who are participants, beneficiaries, or enrollees of a group health plan or group or individual health insurance coverage offered by a health insurance issuer a one-page notice (either postal or electronic mail, as specified by the participant, beneficiary, or enrollee) in clear and understandable language containing information on—

(1)the requirements and prohibitions of such provider or facility under section 300gg–131 and 300gg–132 of this title (relating to prohibitions on balance billing in certain circumstances);

(2)any other applicable State law requirements on such provider or facility regarding the amounts such provider or facility may, with respect to an item or service, charge a participant, beneficiary, or enrollee of a group health plan or group or individual health insurance coverage offered by a health insurance issuer with respect to which such provider or facility does not have a contractual relationship for furnishing such item or service under the plan or coverage, respectively, after receiving payment from the plan or coverage, respectively, for such item or service and any applicable cost-sharing payment from such participant, beneficiary, or enrollee; and

(3)information on contacting appropriate State and Federal agencies in the case that an individual believes that such provider or facility has violated any requirement described in paragraph (1) or (2) with respect to such individual.

Reference

Citations & Metadata

Citation

42 U.S.C. § 300gg–133

Title 42 — The Public Health and Welfare

Last Updated

Apr 6, 2026

Release point: 119-73