General Laws of Massachusetts (Last Updated: January 16, 2020) |
PART I ADMINISTRATION OF THE GOVERNMENT |
TITLE XXII. CORPORATIONS |
CHAPTER 176B. MEDICAL SERVICE CORPORATIONS |
SECTION 1. Definitions |
SECTION 2. Incorporators; formation; articles of organization; certification |
SECTION 3. By-laws; joint service contracts; preferred provider arrangements |
SECTION 3A. Contracts of reinsurance |
SECTION 3B. Group medical service agreements; contribution percentages |
SECTION 4. Contracts for medical, chiropractic, visual, surgical, and other health services; approval, subscription certificates; classification of risks |
SECTION 4A1/2. Repealed, 2008, 256, Sec. 12 |
SECTION 4B. Repealed, 2000, 80, Sec. 7 |
SECTION 4C. Dependent coverage for newborn infants or adoptive children; inclusion of medical expenses as benefits |
SECTION 4D. Refusal to contract with blind or deaf persons; prohibition |
SECTION 4E. Diethylstilbestrol exposure; discrimination |
SECTION 4F. Cardiac rehabilitation expense benefits |
SECTION 4G. Certified nurse midwife services benefits |
SECTION 4H. Prenatal, childbirth and postpartum care benefits; minimum coverage for in-patient care |
SECTION 4I. Cytologic screening and mammographic examination benefits |
SECTION 4J. Infertility diagnosis and treatment benefits |
SECTION 4K. Nonprescription enteral formulas for home use |
SECTION 4L. Chiropractic services benefits |
SECTION 4M. Standardized claim form |
SECTION 4N. Off-label drug use; cancer |
SECTION 4O. Medical service agreement coverage for bone marrow transplants |
SECTION 4P. Off-label use of prescription drugs for HIV/AIDS treatment |
SECTION 4Q. Coverage for licensed hospice services |
SECTION 4R. Scalp hair prostheses necessary due to cancer or leukemia treatment |
SECTION 4S. Items medically necessary for diagnosis and treatment of diabetes |
SECTION 4T. Subscription certificate benefits for services rendered by a nurse anesthetist or nurse practitioner |
SECTION 4U. Emergency services provided to insureds for emergency medical conditions |
SECTION 4V. Coverage for human leukocyte or histocompatibility locus antigen testing |
SECTION 4W. Outpatient services; hormone replacement therapy for peri and post menopausal women; contraceptive services; approved prescription contraceptive drugs or devises; exception |
SECTION 4X. Coverage for patient care services provided under qualified clinical trials |
SECTION 4Y. Coverage for speech, hearing and language disorders |
SECTION 4Z. Repealed, 2008, 451, Sec. 138 |
SECTION 4AA. Coverage for prosthetic devices and repairs |
SECTION 4BB. Coverage for eligible dependents under 26 years of age |
SECTION 4CC. Coverage for medically necessary hypodermic syringes or needles |
SECTION 4DD. Coverage for diagnosis and treatment of autism spectrum disorder |
SECTION 4EE. Coverage for children 21 years of age or younger for hearing aids and related services |
SECTION 4FF. Coverage for orally administered anticancer medications |
SECTION 4GG. Coverage for abuse deterrent opioid drug products |
SECTION 4HH. Preauthorization for substance abuse treatment not to be required |
SECTION 4II. Coverage for medically necessary acute treatment or clinical stabilization services |
SECTION 4JJ. Coverage for long-term antibiotic therapy for patients with Lyme disease |
SECTION 4KK. Coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome |
SECTION 4LL. Filling of remaining portion of prescription for covered drug that is a narcotic substance earlier filled in lesser quantity |
SECTION 4MM. Pain management access plans |
SECTION 5. Subscribers; qualifications, misrepresentation; open enrollment periods |
SECTION 5A. Discrimination against abuse victims in terms of medical service plans |
SECTION 5B. Medical service plans; genetic tests; discrimination based on genetic information |
SECTION 6. Subscription certificate; issuance; content |
SECTION 6A. Limited extension of benefits |
SECTION 6B. Divorced or separated spouses; continuation of eligibility for benefits |
SECTION 7. Contracts between corporation and care providers |
SECTION 7A. Medicare supplemental group coverage; eligibility due to age or disability |
SECTION 7B. Medicare supplemental group coverage; medical assistance recipients |
SECTION 7C. Retroactive premium rate increase |
SECTION 8. Annual statement; verification, form, violations |
SECTION 8A. Financial statements; inclusion of electronic data processing equipment as asset |
SECTION 8B. Applicability of chapter 176V to medical service corporations governed by this chapter |
SECTION 8C. Applicability of chapter 176W to medical service corporations governed by this chapter |
SECTION 9. Inspection and examination of affairs of corporation; confidentiality and privilege; inability to pay providers; pro rata payments; termination of contract |
SECTION 10. Investments, sales, loans and places of deposit; approval; acquisition of real estate; leases; tax exemption; limit; special contingent surplus |
SECTION 11. Salaries, compensation or emoluments |
SECTION 12. Submission of disputes or controversies to board; privacy of patient information |
SECTION 13. Grounds for enjoining transaction of business; receivers |
SECTION 14. Liability of corporation; exemption from insurance laws; tax exemption |
SECTION 15. Repealed, 1951, 797 |
SECTION 16. Operators of medical service plan |
SECTION 16A. Payroll deductions of governmental employees |
SECTION 17. Enforcement |
SECTION 18. Contracts for administrative or other services; loans and investments |
SECTION 19. Payment of sums owed subscriber's estate |
SECTION 20. Disclosure of information; mental or nervous condition |
SECTION 21. Insolvency of health maintenance organization; replacement coverage |
SECTION 22. Statement provided to individuals provided with creditable coverage; report |
SECTION 23. Attribution of members to a primary care provider |
SECTION 24. Disclosure of patient-level data and contracted prices of individual health care services by carriers to providers |