General Laws of Massachusetts (Last Updated: January 16, 2020) |
PART I ADMINISTRATION OF THE GOVERNMENT |
TITLE XXII. CORPORATIONS |
CHAPTER 176A. NON-PROFIT HOSPITAL SERVICE CORPORATIONS |
SECTION 1. Corporations governed by chapter; services received in nonparticipating hospital; substitution of benefits in nursing homes |
SECTION 1A. Right to become subscriber; open enrollment periods |
SECTION 1B. Medicare supplemental group coverage; medical assistance recipients |
SECTION 1C. Retroactive premium rate increase |
SECTION 1D. Contracts of reinsurance |
SECTION 2. Incorporators; directors; certificate of organization; commissioner's examination report |
SECTION 3. Certificate of compliance; examination by commissioner |
SECTION 3A. Discrimination against abuse victims in terms of hospital service plans |
SECTION 3B. Medical service plans; genetic tests; discrimination based on genetic information |
SECTION 4. Accounting system; accountant, claim manager, underwriter and actuary |
SECTION 5. Joint administration with certain corporations |
SECTION 6. Approval of nongroup contracts |
SECTION 7. Information gathering authority of commissioner; confidentiality and privilege |
SECTION 8. Conditions to issuance or delivery of contract |
SECTION 81/2. Sale of group non-profit hospital service contracts |
SECTION 8A1/2. Repealed, 2000, 80, Sec. 5 |
SECTION 8B. Dependent coverage for newborn infants or adoptive children; inclusion in contracts |
SECTION 8C. Refusal to contract with blind or deaf persons; prohibition |
SECTION 8D. Limited extension of benefits |
SECTION 8E. Diethylstilbestrol exposure; discrimination |
SECTION 8F. Divorced or separated spouses; continuation of eligibility for benefits |
SECTION 8G. Cardiac rehabilitation expense benefits |
SECTION 8H. Prenatal, childbirth and postpartum care benefits; minimum coverage for in-patient care |
SECTION 8I. Home care benefits |
SECTION 8J. Minimum requirements for cytologic screening and mammographic examination expense benefits |
SECTION 8K. Infertility diagnosis and treatment benefits |
SECTION 8L. Nonprescription enteral formulas for home use |
SECTION 8M. Standardized claim form |
SECTION 8N. Off-label drug use; cancer |
SECTION 8O. Hospital service plan benefits for bone marrow transplants |
SECTION 8P. Items medically necessary for diagnosis and treatment of diabetes |
SECTION 8Q. HIV/AIDS treatment; off-label prescription drug coverage |
SECTION 8R. Coverage of hospice services for terminally ill patients |
SECTION 8S. Nurse anesthetist and nurse practitioner services |
SECTION 8T. Scalp hair prostheses necessary due to cancer or leukemia treatment |
SECTION 8U. Emergency services provided to insureds for emergency medical conditions |
SECTION 8V. Coverage for human leukocyte or histocompatibility locus antigen testing |
SECTION 8W. Outpatient services; hormone replacement therapy for peri and post menopausal women; contraceptive services; approved prescription contraceptive drugs and devices; exception |
SECTION 8X. Coverage for patient care services under qualified clinical trials |
SECTION 8Y. Diagnosis and treatment of speech, hearing and language disorders |
SECTION 8Z. Repealed, 2008, 451, Sec. 136 |
SECTION 8AA. Coverage of prosthetic devices and repairs |
SECTION 8BB. Coverage for eligible dependents under 26 years of age |
SECTION 8CC. Coverage for medically necessary hypodermic syringes or needles |
SECTION 8DD. Coverage for diagnosis and treatment of autism spectrum disorder |
SECTION 8EE. Coverage for children under age 18 for cleft lip and cleft palate |
SECTION 8FF. Coverage for orally administered anticancer medications |
SECTION 8GG. Coverage for abuse deterrent opioid drug products |
SECTION 8HH. Preauthorization for substance abuse treatment not to be required |
SECTION 8II. Coverage for medically necessary acute treatment or clinical stabilization services |
SECTION 8JJ. Coverage for long-term antibiotic therapy for patients with Lyme disease |
SECTION 8KK. Coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome |
SECTION 8LL. Filling of remaining portion of prescription for covered drug that is a narcotic substance earlier filled in lesser quantity |
SECTION 8MM. Pain management access plans |
SECTION 9. Repealed, 1996, 297, Sec. 11 |
SECTION 10. Group hospital service plan; approval or disapproval of contracts and rates; filing |
SECTION 10A. Preferred provider arrangements |
SECTION 11. Officers; duties |
SECTION 12. Publication of assets and liabilities |
SECTION 13. Hospitalization and medical service for officers and employees of corporation |
SECTION 14. Misrepresentation of terms of subscriber's contract |
SECTION 14A. [There is no 176A:14A.] |
SECTION 14B. Disclosure of information; mental or nervous conditions; exceptions |
SECTION 15. Costs of solicitation of subscribers and administration |
SECTION 16. Acquisition of real estate; leases; tax exemption; limit; approval of investments, sales, loans and places of deposit |
SECTION 17. Submission of disputes and controversies |
SECTION 18. Annual statement of condition; verification, filing, form, violations; applicability of chapter 176V |
SECTION 18A. Financial statements; inclusion of electronic data processing equipment as asset |
SECTION 19. Tax exemption |
SECTION 20. Filing of amendment of by-laws |
SECTION 21. Submission of advertising matter to commissioner |
SECTION 22. Filing of riders, endorsements and applications with commissioner |
SECTION 23. Grounds for enjoining transaction of business; rehabilitation proceedings; duties of receiver; distribution of assets |
SECTION 24. Special contingent reserve fund |
SECTION 25. Licensing of agents |
SECTION 26. Salaries, compensation or emoluments paid by corporation |
SECTION 27. Payroll deductions for governmental employees |
SECTION 27A. Repealed, 1955, 628, Sec. 3 |
SECTION 28. Violations; penalties |
SECTION 29. Application |
SECTION 30. Savings clause |
SECTION 31. Contracts for administrative or other services; loans and investments |
SECTION 32. Payment of sums owed to subscriber's estate |
SECTION 33. Insolvency of health maintenance organization; replacement coverage |
SECTION 34. Report of individuals provided with creditable coverage |
SECTION 35. [There is no 176A:35.] |
SECTION 36. Attribution of members to a primary care provider |
SECTION 37. Disclosure of patient-level data and contracted prices of individual health care services by carriers to providers |