In the case of an individual with benefits under a group health plan or group or individual health insurance coverage offered by a health insurance issuer and with respect to a health care provider or facility that has a contractual relationship with such plan or such issuer (as applicable) for furnishing items and services under such plan or such coverage, if, while such individual is a continuing care patient (as defined in subsection (b)) with respect to such provider or facility-
the plan or issuer, respectively, shall meet the requirements of paragraph (2) with respect to such individual.
The requirements of this paragraph are that the plan or issuer-
In this section:
The term "continuing care patient" means an individual who, with respect to a provider or facility-
The term "serious and complex condition" means, with respect to a participant, beneficiary, or enrollee under a group health plan or group or individual health insurance coverage-
The term "terminated" includes, with respect to a contract, the expiration or nonrenewal of the contract, but does not include a termination of the contract for failure to meet applicable quality standards or for fraud.
1So in original. Probably should be "a condition that-".
42 U.S.C. § 300gg-113
STATUTORY NOTES AND RELATED SUBSIDIARIES
EFFECTIVE DATESection applicable with respect to plan years beginning on or after Jan. 1, 2022, see section 113(e) of div. BB of Pub. L. 116-260 set out as a note under section 9818 of Title 26, Internal Revenue Code.