subsection and subsection (u): (A) The terms emergency medical condition and emergency services have the meanings given such terms, respectively, in section 2719A(b)(2) of the Public Health Service Act. (B) The terms group health plan , health insurance issuer , and health insurance coverage have the meanings given such terms, respectively, in section 2791 of the Public Health Service Act. (u) (1) Subject to paragraph (2), in the case of an individual with benefits under a health plan or health insurance coverage offered in the group or individual market who is furnished on or after January 1, 2021, items or services (other than emergency services to which subsection (t) applies) during an episode of care (as defined by the Secretary) at a participating health care facility by a nonparticipating provider (including imaging or laboratory services so furnished by a nonparticipating provider when ordered by a participating provider or after-emergency care furnished by a nonparticipating provider in the case that the participant, beneficiary, or enrollee cannot travel without medical transport), if such nonparticipating provider holds such individual liable for a payment amount for such an item or service furnished by such provider that is more than the cost-sharing amount for such item or service (as determined in accordance with section 2719A(e)(1)(A) of the Public Health Service Act), such provider shall be subject, in addition to any other penalties that may be prescribed by law, to a civil money penalty of not more than an amount determined appropriate by the Secretary for each specified claim. (2) Paragraph (1) shall not apply to a nonparticipating provider, with respect to items or services furnished by the provider to a participant, beneficiary, or enrollee of a health plan or health insurance coverage offered by a health insurance issuer, if the provider reimburses such participant, beneficiary, or enrollee any amount for such an item or service that is more than the cost-sharing amount for such item or