; other limitations (a) In general The Secretary shall ensure that no cost-sharing, including deductibles, coinsurance, copayments, or similar charges, is imposed on an individual for any benefits provided under this Act. (b) No balance billing No provider may impose a charge to an enrolled individual for covered services for which benefits are provided under this Act. (c) No prior authorization Benefits provided under this Act shall be covered without any need for any prior authorization determination and without any limitation applied through the use of step therapy protocols. 203. Exclusions and limitations (a) In general Benefits for items and services are not available under this Act unless the items and services meet the standards developed by the Secretary pursuant to section 201(a). (b) Treatment of experimental items and services and drugs (1) In general In applying subsection (a), the Secretary shall make national coverage determinations with respect to items and services that are experimental in nature. Such determinations shall be consistent with the national coverage determination process as defined in section 1869(f)(1)(B) of the Social Security Act ( 42 U.S.C. 1395ff(f)(1)(B) ). (2) Appeals process The Secretary shall establish a process by which individuals can appeal coverage decisions. The process shall, as much as is feasible, follow the process for appeals under the Medicare program described in section 1869 of the Social Security Act ( 42 U.S.C. 1395ff ). (c) Application of practice guidelines (1) In general In the case of items and services for which the Department of Health and Human Services has recognized a national practice guideline, such items and services shall be deemed to meet the standards specified in section 201(a) if they have been provided in accordance with such guideline. For purposes of this subsection, an item or service not provided in accordance with a practice guideline shall be deemed to have been provided in accordance with the guideline if the health care provider