Massachusetts General Laws|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 4A - Mental illness expenses; inclusion as benefits; biologically-based mental disorders; rape-related mental disorders; non-biologically-based mental disorders of children and adolescents under age 19

Section 4A1/2 - Repealed, 2008, 256, Sec. 12

Section 4B - Repealed, 2000, 80, Sec. 7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 4NN - Coverage for tobacco use cessation counseling and tobacco cessation products

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 7D - Retroactive claims denial for behavioral health services

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

Section 4OO - Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome

Section 25 - Coverage for health care services delivered via telehealth by a contracted health care provider