Sec. 12. (a) If:
(1) the individual who requests a good faith estimate from a practitioner under this chapter is a covered individual with respect to a network plan; and
(2) the practitioner from which the individual requests the good faith estimate is in network with respect to the same network plan;
the good faith estimate that the practitioner provides to the individual under this chapter must be based on the negotiated price to which the practitioner has agreed as an in network provider.
(b) If the individual who requests a good faith estimate from a practitioner under this chapter:
(1) is not a covered individual with respect to any network plan; or
(2) is not a covered individual with respect to a network plan with respect to which the practitioner is in network;
the good faith estimate that the practitioner provides to the individual under this chapter must be based on the price that the practitioner charges for the nonemergency health care service in the absence of any network plan.
As added by P.L.93-2020, SEC.7.