1. Short title This Act may be cited as the Reducing Costs for Out-of-Network Services Act of 2018 . 2. Limitations on cost-sharing for out-of-network services (a) In general Subpart II of part A of title XXVII of the Public Health Service Act ( 42 U.S.C. 300gg–11 et seq.) is amended by adding at the end the following: 2729. Limitations on cost-sharing for out-of-network services (a) Health insurance issuer requirement A health insurance issuer offering individual health insurance coverage that offers benefits with respect to a health care service provided in a State by a participating provider shall ensure that the cost-sharing requirement with respect to such service provided in the State by a nonparticipating provider does not exceed the rate selected by the applicable State authority under subsection (c)(1) for such service. (b) Limitation on charges by health care providers (1) In general A health care provider may not charge a patient for health care services in excess of the following: (A) In the case of a patient who is enrolled in individual health insurance coverage that does not provide out-of-network benefits for a given service, the health care provider may charge such patient no more than the rate selected by the applicable State authority under subsection (c)(1). (B) In the case of a patient enrolled in individual health insurance coverage that provides out-of-network benefits for a given service, the health care provider may charge such patient no more than— (i) the rate selected by the applicable State authority under subsection (c)(1); minus (ii) the sum of— (I) the payment made to the health care provider pursuant to such coverage; and (II) the out-of-network cost-sharing amount required under such coverage. (C) In the case of an uninsured individual, the health care provider may charge such patient no more than the lower of— (i) the rate selected by the applicable State authority under subsection (c)(2)