; and (bb) in the case of a sponsor or issuer offering a health plan in a geographic region that did not offer any health plan in such region during 2019, such sponsor or issuer shall use a methodology established by the Secretary for determining the median contracted rate for items and services covered by such plan for the first year in which such plan is offered in such region, and that, for each succeeding year, the median contracted rate for such items and services under such plan shall be the median contracted rate for such items and services under such plan for the previous year, increased by the percentage increase in the consumer price index for all urban consumers (United States city average) over such previous year. (II) Rule of construction Nothing in this subparagraph shall prevent the sponsor or issuer of a health plan from establishing separate calculations of a median contracted rate under this subparagraph for items and services delivered in non-hospital facilities, including independent freestanding emergency departments. (F) Nonparticipating emergency facility; participating emergency facility (i) Nonparticipating emergency facility The term nonparticipating emergency facility means, with respect to an item or service and a health plan, an emergency department of a hospital, or an independent freestanding emergency department, that does not have a contractual relationship with the plan (or, if applicable, issuer offering the plan) for furnishing such item or service under the plan. (ii) Participating emergency facility The term participating emergency facility means, with respect to an item or service and a health plan, an emergency department of a hospital, or an independent freestanding emergency department, that has a contractual relationship with the plan (or, if applicable, issuer offering the plan) for furnishing such item or service under the plan. (G) Nonparticipating providers