; ; and (vii) by adding at the end the following new clauses: (iii) such requirement is calculated as if the total amount that would have been charged for such services by such participating provider or participating emergency facility were equal to— (I) in the case of such services furnished in a State described in paragraph (3)(H)(ii), the median contracted rate (as defined in paragraph (3)(E)(i)) for such services; and (II) in the case of such services furnished in a State described in paragraph (3)(H)(i), the lesser of— (aa) the amount determined by such State for such services in accordance with the method described in such paragraph; and (bb) the median contracted rate (as so defined) for such services; (iv) the health plan pays to such provider or facility, respectively, the amount by which the recognized amount (as defined in paragraph (3)(H)) for such services exceeds the cost-sharing amount for such services (as determined in accordance with clauses (ii) and (iii)); and (v) any cost-sharing payments made by the participant, beneficiary, or enrollee with respect to such emergency services so furnished shall be counted toward any in-network deductible or out-of-pocket maximums applied under the plan in the same manner as if such cost-sharing payments were with respect to emergency services furnished by a participating provider and a participating emergency facility; and ; (2) by redesignating paragraph (2) as paragraph (3); (3) by inserting after paragraph (1) the following new paragraph: (2) Audit process for median contracted rates Not later than July 1, 2020, the Secretary shall, in consultation with appropriate State agencies, establish through rulemaking a process under which sponsors and issuers of health plans are audited to ensure that such sponsors and issuers are in compliance with the requirement of applying a median contracted rate under this section that satisfies the definition under paragraph (3)(E).