Mass. Gen. Laws ch. 176B – Medical Service Corporations | Midpage

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Massachusetts General Laws

Chapter 176B

Mass. Gen. Laws ch. 176B

Medical Service Corporations

1Definitions 2Incorporators; formation; articles of organization; certification 3By-laws; joint service contracts; preferred provider arrangements 3AContracts of reinsurance 3BGroup medical service agreements; contribution percentages 4Contracts for medical, chiropractic, visual, surgical, and other health services; approval, subscription certificates; classification of risks 4AMental 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 4CDependent coverage for newborn infants or adoptive children; inclusion of medical expenses as benefits 4DRefusal to contract with blind or deaf persons; prohibition 4EDiethylstilbestrol exposure; discrimination 4FCardiac rehabilitation expense benefits 4GCertified nurse midwife services benefits 4HAbortion, abortion-related care, prenatal, childbirth and postpartum care benefits; minimum coverage for in-patient care 4ICytologic screening and mammographic examination benefits 4JInfertility diagnosis and treatment benefits 4KNonprescription enteral formulas for home use 4LChiropractic services benefits 4MStandardized claim form 4NOff-label drug use; cancer 4OMedical service agreement coverage for bone marrow transplants 4POff-label use of prescription drugs for HIV/AIDS treatment 4QCoverage for licensed hospice services 4RScalp hair prostheses necessary due to cancer or leukemia treatment 4SItems medically necessary for diagnosis and treatment of diabetes 4TSubscription certificate benefits for services rendered by a nurse anesthetist or nurse practitioner 4UEmergency services provided to insureds for emergency medical conditions 4VCoverage for human leukocyte or histocompatibility locus antigen testing 4WOutpatient services; hormone replacement therapy for peri and post menopausal women; contraceptive services; approved prescription contraceptive drugs or devises; exception 4XCoverage for patient care services provided under qualified clinical trials 4YCoverage for speech, hearing and language disorders 4AACoverage for prosthetic devices and repairs 4BBCoverage for eligible dependents under 26 years of age or dependents mentally or physically incapable of earning their own living due to disability 4CCCoverage for medically necessary hypodermic syringes or needles 4DDCoverage for diagnosis and treatment of autism spectrum disorder 4EECoverage for children 21 years of age or younger for hearing aids and related services 4FFCoverage for orally administered anticancer medications 4GGCoverage for abuse deterrent opioid drug products 4HHPreauthorization for substance abuse treatment not to be required 4IICoverage for medically necessary acute treatment or clinical stabilization services 4KKCoverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome 4LLFilling of remaining portion of prescription for covered drug that is a narcotic substance earlier filled in lesser quantity 4MMPain management access plan; non-medication and nonsurgical treatment; review; educational materials 4NNCoverage for tobacco use cessation counseling and tobacco cessation products 4OOCoverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome 4QQCoverage for prescription eye drops 4RRCoverage for mental health or substance use disorder services delivered through psychiatric collaborative care model 4SSCoverage for medically necessary mental health acute treatment, community-based acute treatment, intensive community-based acute treatment 4TTBenefits for medically necessary emergency services programs 4UUCoverage for annual mental health wellness examination 4VVCoverage for federally-defined preventive services 4WWCoverage for standard fertility preservation services 4XXCoverage for postpartum depression and major depressive disorder screenings 4YYCoverage for the provision of medically necessary pasteurized donor human milk and donor human milk-derived products 4ZZCoverage for universal postpartum home visiting services 4AAACoverage for diagnostic examinations for breast cancer; digital breast tomosynthesis screening, MRIs and ultrasounds 4BBBCoverage for prescribed, ordered or dispensed opioid antagonists 4CCCCoverage for the provision of services by a recovery coach 4DD1/2Coverage for treatment of Down syndrome through speech therapy, occupational therapy, physical therapy and applied behavior analysis services 4DDDCoverage for identified generic and brand name drug used to treat diabetes, asthma, and certain heart conditions 5Subscribers; qualifications, misrepresentation; open enrollment periods 5ADiscrimination against abuse victims in terms of medical service plans 5BMedical service plans; genetic tests; discrimination based on genetic information 6Subscription certificate; issuance; content 6ALimited extension of benefits 6BDivorced or separated spouses; continuation of eligibility for benefits 7Contracts between corporation and care providers 7AMedicare supplemental group coverage; eligibility due to age or disability 7BMedicare supplemental group coverage; medical assistance recipients 7CRetroactive premium rate increase 7DRetroactive claims denial for behavioral health services 8Annual statement; verification, form, violations 8AFinancial statements; inclusion of electronic data processing equipment as asset 8BApplicability of chapter 176V to medical service corporations governed by this chapter 8CApplicability of chapter 176W to medical service corporations governed by this chapter 9Inspection and examination of affairs of corporation; confidentiality and privilege; inability to pay providers; pro rata payments; termination of contract 10Investments, sales, loans and places of deposit; approval; acquisition of real estate; leases; tax exemption; limit; special contingent surplus 11Salaries, compensation or emoluments 12Submission of disputes or controversies to board; privacy of patient information 13Grounds for enjoining transaction of business; receivers 14Liability of corporation; exemption from insurance laws; tax exemption 16Operators of medical service plan 16APayroll deductions of governmental employees 17Enforcement 18Contracts for administrative or other services; loans and investments 19Payment of sums owed subscriber's estate 20Disclosure of information; mental or nervous condition 21Insolvency of health maintenance organization; replacement coverage 22Statement provided to individuals provided with creditable coverage; report 23Attribution of members to a primary care provider 24Disclosure of patient-level data and contracted prices of individual health care services by carriers to providers 25Coverage for health care services delivered via telehealth by a contracted health care provider