The document was released on May 3, 2018, jointly by the U.S. Departments of Labor, Health and Human Services, and the Treasury. The document presents the departments’ reasoning behind a previous rule that set a methodology called “Greatest of Three” by which health plans can set a price to reimburse out-of-network emergency care professionals. The methodology calls for health plans to pay the out-of-network emergency professional the greatest of three possible reference prices: the Medicare rate; the median network rate for the emergency service furnished; or an amount calculated using the same method the plan generally uses to determine payments for out-of-network services, such as the usual, customary, and reasonable (UCR) amount.