; and (B) includes, with respect to an item or service, a nonparticipating provider if there is no participating provider at such facility who can furnish such item or service. (c) Clarification In the case of a nonparticipating provider (other than a specified provider at a participating health care facility) that complies with the notice and consent requirements of subsection (d) with respect to an item or service (referred to in this subsection as a covered item or service ), such notice and consent requirements may not be construed as applying with respect to any item or service that is furnished as a result of unforeseen medical needs that arise at the time such covered item or service is furnished. (d) Compliance with notice and consent requirements (1) In general A nonparticipating provider or nonparticipating facility is in compliance with this subsection, with respect to items or services furnished by the provider or facility to a participant, beneficiary, or enrollee of a health plan, if the provider (or, if applicable, the participating health care facility on behalf of such provider) or nonparticipating facility— (A) provides to the participant, beneficiary, or enrollee (or to an authorized representative of the participant, beneficiary, or enrollee), on the date on which the participant, beneficiary, or enrollee makes an appointment to be furnished such items or services, if applicable, and on the date on which the individual is furnished such items or services— (i) an oral explanation of the written notice described in clause (ii); and (ii) a written notice specified, not later than July 1, 2020, by the Secretary through guidance (which shall be updated as determined necessary by the Secretary) that— (I) contains the information required under paragraph (2)