---
kind: "section"
citation: "42 U.S.C. § 300gg–139"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300gg–139"
heading: "Provider requirements to protect patients and improve the accuracy of provider directory information"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300gg-139"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter XXV — Requirements Relating to Health Insurance Coverage"
  - "Part E — Health Care Provider Requirements"
---

# §300gg–139. Provider requirements to protect patients and improve the accuracy of provider directory information

- (a) **Provider business processes—** Beginning not later than January 1, 2022, each [health care provider](/usc/42/300aa–33.md?p=1) and each health care facility shall have in place business processes to ensure the timely provision of [provider](/usc/42/299b–21.md?p=8) directory information to a [group health plan](/usc/42/300bb–8.md?p=1) or a [health insurance issuer](/usc/42/300gg–91.md?p=b-2) offering group or [individual health insurance coverage](/usc/42/300gg–91.md?p=b-5) to support compliance by such plans or issuers with [section 300gg–115(a)(1) of this title](/usc/42/300gg–115.md?p=a-1), [section 1185i(a)(1) of title 29](/usc/29/1185i.md?p=a-1), or [section 9820(a)(1) of title 26](/usc/26/9820.md?p=a-1), as applicable. Such [providers](/usc/42/299b–21.md?p=8) shall submit [provider](/usc/42/299b–21.md?p=8) directory information to a plan or issuers, at a minimum—
  - (1) when the [provider](/usc/42/299b–21.md?p=8) or facility begins a network agreement with a plan or with an issuer with respect to certain coverage;
  - (2) when the [provider](/usc/42/299b–21.md?p=8) or facility terminates a network agreement with a plan or with an issuer with respect to certain coverage;
  - (3) when there are material changes to the content of [provider](/usc/42/299b–21.md?p=8) directory information of the [provider](/usc/42/299b–21.md?p=8) or facility described in [section 300gg–115(a)(1) of this title](/usc/42/300gg–115.md?p=a-1), [section 1185i(a)(1) of title 29](/usc/29/1185i.md?p=a-1), or [section 9820(a)(1) of title 26](/usc/26/9820.md?p=a-1), as applicable; and
  - (4) at any other time (including upon the request of such issuer or plan) determined appropriate by the [provider](/usc/42/299b–21.md?p=8), facility, or the [Secretary](/usc/42/201.md?p=c).
- (b) **Refunds to enrollees—** If a [health care provider](/usc/42/300aa–33.md?p=1) submits a bill to an enrollee based on cost-sharing for [treatment](/usc/42/11851.md?p=11) or [services](/usc/42/201.md?p=a) provided by the [health care provider](/usc/42/300aa–33.md?p=1) that is in excess of the normal cost-sharing applied for such [treatment](/usc/42/11851.md?p=11) or [services](/usc/42/201.md?p=a) provided in-network, as prohibited under [section 300gg–115(b) of this title](/usc/42/300gg–115.md?p=b), [section 1185i(b) of title 29](/usc/29/1185i.md?p=b), or [section 9820(b) of title 26](/usc/26/9820.md?p=b), as applicable, and the enrollee pays such bill, the [provider](/usc/42/299b–21.md?p=8) shall reimburse the enrollee for the full amount paid by the enrollee in excess of the in-network cost-sharing amount for the [treatment](/usc/42/11851.md?p=11) or [services](/usc/42/201.md?p=a) involved, plus interest, at an interest rate determined by the [Secretary](/usc/42/201.md?p=c).
- (c) **Limitation—** Nothing in this section shall prohibit a [provider](/usc/42/299b–21.md?p=8) from requiring in the terms of a contract, or contract termination, with a [group health plan](/usc/42/300bb–8.md?p=1) or [health insurance issuer](/usc/42/300gg–91.md?p=b-2)—
  - (1) that the plan or issuer remove, at the time of termination of such contract, the [provider](/usc/42/299b–21.md?p=8) from a directory of the plan or issuer described in [section 300gg–115(a) of this title](/usc/42/300gg–115.md?p=a), [section 1185i(a) of title 29](/usc/29/1185i.md?p=a), or [section 9820(a) of title 26](/usc/26/9820.md?p=a), as applicable; or
  - (2) that the plan or issuer bear financial responsibility, including under [section 300gg–115(b) of this title](/usc/42/300gg–115.md?p=b), [section 1185i(b) of title 29](/usc/29/1185i.md?p=b), or [section 9820(b) of title 26](/usc/26/9820.md?p=b), as applicable, for providing inaccurate network status information to an enrollee.
- (d) **Definition—** For purposes of this section, the term “[provider](/usc/42/299b–21.md?p=8) directory information” includes the names, addresses, specialty, telephone numbers, and digital contact information of individual [health care providers](/usc/42/300aa–33.md?p=1), and the names, addresses, telephone numbers, and digital contact information of each medical group, clinic, or facility contracted to participate in any of the networks of the [group health plan](/usc/42/300bb–8.md?p=1) or [health insurance coverage](/usc/42/300gg–91.md?p=b-1) involved.
- (e) **Rule of construction—** Nothing in this section shall be construed to preempt any provision of [State](/usc/42/201.md?p=f) law relating to [health care provider](/usc/42/300aa–33.md?p=1) directories.

## Source credit

(July 1, 1944, ch. 373, title XXVII, § 2799B–9, as added Pub. L. 116–260, div. BB, title I, § 116(e), Dec. 27, 2020, 134 Stat. 2887.)