36870 Federal Register / Vol. 86, No. 131 / Tuesday, July 13, 2021 / Proposed Rules 

DEPARTMENT OF THE TREASURY 

Internal Revenue Service 

26 CFR Part 54 

[REG–107706–21] 

RIN 1545–BQ01 

Requirements Related to Surprise 

Billing; Part I 

AGENCY: Internal Revenue Service (IRS), 

Treasury. 

ACTION: Notice of proposed rulemaking. 

SUMMARY: The IRS is proposing 

regulations that protect consumers from 

surprise medical bills for emergency 

services, air ambulance services 

furnished by nonparticipating 

providers, and non-emergency services 

furnished by nonparticipating providers 

at participating facilities in certain 

circumstances. Elsewhere in this issue 

of the Federal Register, the IRS is 

issuing the temporary regulations that 

correspond to this proposal at the same 

time that the Office of Personnel 

Management (OPM), the Employee 

Benefits Security Administration of the 

Department of Labor (DOL), and the 

Office of Consumer Information and 

Insurance Oversight of the Department 

of Health and Human Services (HHS) 

are issuing substantially similar interim 

final rules with request for comments. 

The text of those temporary regulations 

also serves as the text of these proposed 

regulations. 

DATES:

Comment date: To be assured 

consideration, comments must be 

received at one of the addresses 

provided below, no later than 5 p.m. on 

September 13, 2021. 

Applicability date: It is proposed that 

these regulations apply on and after 

plan years beginning on or after January 

1, 2022. 

ADDRESSES: In commenting, please refer 

to file code REG–107706–21. Comments, 

including mass comment submissions, 

must be submitted in one of the 

following three ways (please choose 

only one of the ways listed): 

1. Electronically. You may submit 

electronic comments on this regulation 

to http://www.regulations.gov. Follow 

the ‘‘Submit a comment’’ instructions. 

2. By regular mail. You may mail 

written comments to the following 

address ONLY: Centers for Medicare & 

Medicaid Services, Department of 

Health and Human Services, Attention: 

CMS–9909–IFC, P.O. Box 8016, 

Baltimore, MD 21244–8016. 

Please allow sufficient time for mailed 

comments to be received before the 

close of the comment period. 

3. By express or overnight mail. You 

may send written comments to the 

following address ONLY: Centers for 

Medicare & Medicaid Services, 

Department of Health and Human 

Services, Attention: CMS–9909–IFC, 

Mail Stop C4–26–05, 7500 Security 

Boulevard, Baltimore, MD 21244–1850. 

FOR FURTHER INFORMATION CONTACT: Kari 

DiCecco, (202) 317–5500, Internal 

Revenue Service, Department of the 

Treasury, for issues related to Surprise 

Billing. 

SUPPLEMENTARY INFORMATION: Inspection 

of Public Comments: All comments 

received before the close of the 

comment period are available for 

viewing by the public, including any 

personally identifiable or confidential 

business information that is included in 

a comment. We post all comments 

received before the close of the 

comment period on the following 

website as soon as possible after they 

have been received: http://

regulations.gov. Follow the search 

instructions on that website to view 

public comments. 

Background and Regulatory Impact 

Analysis 

The Treasury Department and the IRS 

proposes to add §§ 54.9816–1, 54.9816– 

2, 54.9816–3, 54.9816–4, 54.9816–5, 

54.9816–6, 54.9817–1, and 54.9822–1 to 

the Miscellaneous Excise Tax 

Regulations to protect consumers from 

surprise medical bills for emergency 

services, air ambulance services 

furnished by nonparticipating 

providers, and non-emergency services 

furnished by nonparticipating providers 

at participating facilities in certain 

circumstances. 

The temporary regulations published 

elsewhere in this issue of the Federal 

Register add §§ 54.9816–1T, 54.9816– 

2T, 54.9816–3T, 54.9816–4T, 54.9816– 

5T, 54.9816–6T, 54.9817–1T, and 

54.9822–1T to the Miscellaneous Excise 

Tax Regulations. The proposed and 

temporary regulations are being 

published as part of a joint rulemaking 

with the OPM, DOL, and HHS. The text 

of temporary sections added elsewhere 

also serves as the text of the 

corresponding sections proposed in this 

document. The preamble to the 

temporary regulations contains the 

agency’s rationale and provides a 

regulatory impact analysis. 

Drafting Information 

The principal author of this notice of 

proposed rulemaking is Kari DiCecco, 

Office of Associate Chief Counsel 

(Employee Benefits, Exempt 

Organizations and Employment Taxes). 

The proposed regulations, as well as the 

temporary regulations, have been 

developed in coordination with 

personnel from the OPM, DOL, and 

HHS. 

List of Subjects in 26 CFR Part 54 

Excise taxes, Pensions, Reporting and 

recordkeeping requirements. 

Proposed Amendments to the 

Regulations 

Accordingly, 26 CFR part 54 is 

proposed to be amended as follows: 

PART 54—PENSION EXCISE TAXES 

■ Paragraph. 1. The general authority 

citation for part 54 continues to read as 

follows: 

Authority: 26 U.S.C. 7805, unless 

otherwise noted. 

* * * * * 

■ Par. 2. Section 54.9801–1 is revised to 

read as follows: 

§ 54.9801–1 Basis and scope. 

[The text of proposed § 54.9801–1 is 

the same as the text of § 54.9801–1T 

published elsewhere in this issue of the 

Federal Register]. 

■ Par. 3. Section 54.9801–2 is amended 

by revising the introductory text to read 

as follows: 

§ 54.9801–2 Definitions. 

[The text of proposed § 54.9801–2 

introductory text is the same as the text 

of § 54.9801–2T introductory text 

published elsewhere in this issue of the 

Federal Register]. 

■ Par. 4. Section 54.9815–2719A is 

amended by revising paragraph (c) to 

read as follows: 

§ 54.9815–2719A Patient protections. 

[The text of proposed § 54.9815– 

2719A(c) is the same as the text of 

§ 54.9815–2719AT(c) published 

elsewhere in this issue of the Federal 

Register]. 

■ Par. 5. Sections 54.9816–1, 54.9816– 

2, 54.9816–3, 54.9816–4, 54.9816–5, 

54.9816–6, 54.9816–7, 54.9817–1, and 

54.9822–1 are added to read as follows: 

Sec. 

54.9816–1 Basis and scope. 

54.9816–2 Applicability. 

54.9816–3 Definitions. 

54.9816–4 Preventing surprise medical bills 

for emergency services. 

54.9816–5 Preventing surprise medical bills 

for non-emergency services performed by 

nonparticipating providers at certain 

participating facilities. 

54.9816–6 Methodology for calculating 

qualifying payment amount. 

54.9816–7 Complaints process for surprise 

medical bills regarding group health 

plans. 

54.9817–1 Preventing surprise medical bills 

for air ambulance services. 


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Federal Register / Vol. 86, No. 131 / Tuesday, July 13, 2021 / Proposed Rules 36871 

54.9822–1 Choice of health care 

professional. 

* * * * * 

§ 54.9816–1 Basis and scope. 

[The text of proposed § 54.9816–1 is 

the same as the text of § 54.9816–1T 

published elsewhere in this issue of the 

Federal Register]. 

§ 54.9816–2 Applicability. 

[The text of proposed § 54.9816–2 is 

the same as the text of § 54.9816–2T 

published elsewhere in this issue of the 

Federal Register]. 

§ 54.9816–3 Definitions. 

[The text of proposed § 54.9816–3 is 

the same as the text of § 54.9816–3T 

published elsewhere in this issue of the 

Federal Register]. 

§ 54.9816–4 Preventing surprise medical 

bills for emergency services. 

[The text of proposed § 54.9816–4 is 

the same as the text of § 54.9816–4T 

published elsewhere in this issue of the 

Federal Register]. 

§ 54.9816–5 Preventing surprise medical 

bills for non-emergency services performed 

by nonparticipating providers at certain 

participating facilities. 

[The text of proposed § 54.9816–5 is 

the same as the text of § 54.9816–5T 

published elsewhere in this issue of the 

Federal Register]. 

§ 54.9816–6 Methodology for calculating 

qualifying payment amount. 

[The text of proposed § 54.9816–6 is 

the same as the text of § 54.9816–6T 

published elsewhere in this issue of the 

Federal Register]. 

§ 54.9816–7 Complaints process for 

surprise medical bills regarding group 

health plans. 

[The text of proposed § 54.9816–7 is 

the same as the text of § 54.9816–7T 

published elsewhere in this issue of the 

Federal Register]. 

§ 54.9817–1 Preventing surprise medical 

bills for air ambulance services. 

[The text of proposed § 54.9817–1 is 

the same as the text of § 54.9817–1T 

published elsewhere in this issue of the 

Federal Register]. 

§ 54.9822–1 Choice of health care 

professional. 

[The text of proposed § 54.9822–1 is 

the same as the text of § 54.9822–1T 

published elsewhere in this issue of the 

Federal Register]. 

Douglas W. O’Donnell, 

Deputy Commissioner for Services and 

Enforcement. 

[FR Doc. 2021–14382 Filed 7–6–21; 4:15 pm] 

BILLING CODE 4830–01–P 


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