[Federal Register Volume 86, Number 192 (Thursday, October 7, 2021)]
[Proposed Rules]
[Pages 55756-55757]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-21419]


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DEPARTMENT OF THE TREASURY

Internal Revenue Service

26 CFR Part 54

[REG-107707-21]
RIN 1545-BQ02


Requirements Related to Surprise Billing; Part II

AGENCY: Internal Revenue Service, Department of the Treasury.

ACTION: Notice of proposed rulemaking.

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SUMMARY: The Department of the Treasury (Treasury Department) and 
Internal Revenue Service (IRS) are proposing regulations that provide 
for a federal independent dispute resolution (IDR) process to permit 
group health plans and nonparticipating providers, facilities, and 
providers of air ambulance services to determine the out-of-network 
rate for items and services that are emergency services, nonemergency 
services furnished by nonparticipating providers at participating 
facilities, and air ambulance services furnished by nonparticipating 
providers of air ambulance services, under 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 
Center for Medicare & Medicaid Services 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 December 6, 2021.
    Applicability date: It is proposed that these regulations apply for 
plan years beginning on or after January 1, 2022.

ADDRESSES: In commenting, please refer to file code REG-107707-21. 
Comments, including mass comment submissions, must be submitted in one 
of the following two 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 mail. You may mail written comments to the following address 
ONLY: Office of Health Plan Standards and Compliance Assistance, 
Employee Benefits Security Administration, U.S. Department of Labor, 
200 Constitution Avenue NW, Room N-5653, Washington, DC 20210, 
Attention: RIN 1210-AB00.
    Please allow sufficient time for mailed comments to be received 
before the close of the comment period.

FOR FURTHER INFORMATION CONTACT: Kari DiCecco, (202) 317-5500, Internal 
Revenue Service, Department of the Treasury.

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 propose to amend paragraphs 
(a), (c), (d), and (g) of Sec.  54.9815-2719 of the Miscellaneous 
Excise Tax Regulations to expand the scope of claims eligible for 
external review to include adverse benefit determinations related to 
compliance with the surprise billing and cost-sharing protections under 
the No Surprises Act.
    The Treasury Department and the IRS also propose to add Sec. Sec.  
54.9816-8 and 54.9817-2 to establish a federal IDR process that 
nonparticipating providers or facilities, nonparticipating providers of 
air ambulance services, and group health plans may use following the 
end of an unsuccessful open negotiation period to determine the out-of-
network rate for certain services.
    The temporary regulations published elsewhere in this issue of the 
Federal Register add Sec. Sec.  54.9815-2719T, 54.9816-8T, and 54.9817-
2T. 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

[[Page 55757]]

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

0
Paragraph. 1. The general authority citation for part 54 continues to 
read as follows:

    Authority: 26 U.S.C. 7805, unless otherwise noted.
* * * * *
0
Par. 2. Section 54.9815-2719 is amended by revising paragraphs (a), 
(c), (d), and (g) to read as follows:


Sec.  54.9815-2719  Internal claims and appeals and external review 
processes.

    [The text of proposed Sec.  54.9815-2719(a), (c), (d), and (g) is 
the same as the text of Sec.  54.9815-2719T(a), (c), (d), and (g) 
published elsewhere in this issue of the Federal Register].
0
Par. 3. Section 54.9816-1 is added to read as follows:
    [The text of proposed Sec.  54.9816-1 is the same as the text of 
Sec.  54.9816-1T published elsewhere in this issue of the Federal 
Register].
0
Par. 4. Section 54.9816-2(a) and (b) is added to read as follows:
    [The text of proposed Sec.  54.9816-2(a) and (b) is the same as the 
text of Sec.  54.9816-2T(a) and (b) published elsewhere in this issue 
of the Federal Register].
0
Par. 5. Sections 54.9816-8 and 54.9817-2 are added to read as follows:


Sec.  54.9816-8   Independent dispute resolution process.

    [The text of proposed Sec.  54.9816-8 is the same as the text of 
Sec.  54.9816-8T published elsewhere in this issue of the Federal 
Register].


Sec.  54.9817-2   Independent dispute resolution process for air 
ambulance services.

    [The text of proposed Sec.  54.9817-2 is the same as the text of 
Sec.  54.9817-2T published elsewhere in this issue of the Federal 
Register].

Douglas W. O'Donnell,
Deputy Commissioner for Services and Enforcement.
[FR Doc. 2021-21419 Filed 9-30-21; 4:15 pm]
BILLING CODE 4830-01-P