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104 sections in this chapter.
Mass. Gen. Laws ch. 176A, § 8A3~4 /4 Retroactive claims denials for behavioral health services
Mass. Gen. Laws ch. 176A, § 8AA Coverage of prosthetic devices and repairs
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Section 8AA. (a) A contract between a subscriber and the corporation under an individual or group hospital service plan which provides hospital expense and surgical expense insurance, except contracts providing supplemental coverage to Medicare or other governmental programs, del…
Mass. Gen. Laws ch. 176A, § 8AAA Coverage for diagnostic examinations for breast cancer; digital breast tomosynthesis screening, MRIs and ultrasounds
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Section 8AAA. (a) As used in this section, the following words shall, unless the context clearly requires otherwise, have the following meanings:— ''Cost sharing'', a deductible, coinsurance, copayment and any maximum limitation on the application of such a deductible, coinsuranc…
Mass. Gen. Laws ch. 176A, § 8B Dependent coverage for newborn infants or adoptive children; inclusion in contracts
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Section 8B. Any contract, which provides for dependent coverage, between a subscriber and the corporation under an individual or group hospital service plan which shall be delivered or issued for delivery or subsequently renewed in this commonwealth shall include as insured membe…
Mass. Gen. Laws ch. 176A, § 8BB Coverage for eligible dependents under 26 years of age or dependents mentally or physically incapable of earning their own living due to disability
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Section 8BB. Any subscription certificate under an individual or group nonprofit hospital service agreement, except certificates which provide stand-alone dental services, supplemental coverage to Medicare or other governmental programs, that is delivered, issued or renewed in th…
Mass. Gen. Laws ch. 176A, § 8BBB Coverage for prescribed, ordered or dispensed opioid antagonists
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Section 8BBB. (a) Any contract between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed within the commonwealth shall provide coverage for prescribed, ordered or dispensed opioid antagonists, as defined in se…
Mass. Gen. Laws ch. 176A, § 8C Refusal to contract with blind or deaf persons; prohibition
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Section 8C. No corporation subject to this chapter shall refuse for the reason of blindness or deafness, to contract with a subscriber an individual hospital service plan.
Mass. Gen. Laws ch. 176A, § 8CC Coverage for medically necessary hypodermic syringes or needles
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Section 8CC. No contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed in the commonwealth shall restrict or discontinue coverage for medically necessary hypodermic syringes or needles to an indiv…
Mass. Gen. Laws ch. 176A, § 8CCC Coverage for the provision of services by a recovery coach
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Section 8CCC. Any contract between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed within the commonwealth shall provide coverage for the provision of services by a recovery coach licensed or otherwise autho…
Mass. Gen. Laws ch. 176A, § 8D Limited extension of benefits
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Section 8D. Whenever a subscriber of a group non-profit hospital service contract, other than one authorized under the provisions of chapter thirty-two A or chapter thirty-two B, becomes ineligible for continued participation in such group contract because of involuntary lay-off …
Mass. Gen. Laws ch. 176A, § 8DD Coverage for diagnosis and treatment of autism spectrum disorder
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Section 8DD. (a) As used in this section the following words shall, unless the context clearly requires otherwise, have the following meanings:— ''Actuary'', a person who is a member of American Academy of Actuaries and meets the academy's professional qualification standards for…
Mass. Gen. Laws ch. 176A, § 8DD1~2 /2 Coverage for treatment of Down syndrome through speech therapy, occupational therapy, physical therapy and applied behavior analysis services
Mass. Gen. Laws ch. 176A, § 8DDD Coverage for identified generic and brand name drug used to treat diabetes, asthma, and certain heart conditions
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Section 8DDD. (a) As used in this section, the following words shall have the following meanings unless the context clearly requires otherwise: ''Brand name drug'', a drug that is: (i) produced or distributed pursuant to an original new drug application approved under 21 U.S.C. 3…
Mass. Gen. Laws ch. 176A, § 8E Diethylstilbestrol exposure; discrimination
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Section 8E. No contract between a subscriber and the corporation under an individual or group hospital service plan which shall be delivered or issued in the commonwealth shall be denied, cancelled or fail to be renewed, nor shall any excessive rates be charged or restrictions on…
Mass. Gen. Laws ch. 176A, § 8EE Coverage for children under age 18 for cleft lip and cleft palate
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Section 8EE. A contract between a subscriber and the corporation under an individual or group hospital service plan which provides hospital expense and surgical expense insurance, except contracts providing supplemental coverage to Medicare or other governmental programs, deliver…
Mass. Gen. Laws ch. 176A, § 8F Divorced or separated spouses; continuation of eligibility for benefits
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Section 8F. (a) In the event of the granting of a judgment absolute of divorce or of separate support to which a subscriber of a group nonprofit hospital service contract is a party, the person who was the spouse of said subscriber prior to the issuance of such judgment shall be …
Mass. Gen. Laws ch. 176A, § 8FF Coverage for orally administered anticancer medications
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Section 8FF. Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth that provides coverage for cancer chemotherapy treatment shall provide coverage for prescribed, oral…
Mass. Gen. Laws ch. 176A, § 8G Cardiac rehabilitation expense benefits
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Section 8G. Any contract, except contracts providing supplemental coverage to medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan which shall be delivered or issued or renewed in the commonwealth sha…
Mass. Gen. Laws ch. 176A, § 8GG Coverage for abuse deterrent opioid drug products
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Section 8GG. Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth shall provide coverage for abuse deterrent opioid drug products listed on the formulary, compiled pu…
Mass. Gen. Laws ch. 176A, § 8H Abortion, abortion-related care, prenatal, childbirth and postpartum care benefits; minimum coverage for in-patient care
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Section 8H. Any contract, except contracts providing supplemental coverage to medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan which shall be delivered or issued or renewed in the commonwealth sha…
Mass. Gen. Laws ch. 176A, § 8HH Preauthorization for substance abuse treatment not to be required
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Section 8HH. For the purposes of this section the term ''substance abuse treatment'' shall include: early intervention services for substance use disorder treatment; a substance use disorder evaluation, as defined in section 511/2 of chapter 111; outpatient services including med…
Mass. Gen. Laws ch. 176A, § 8I Home care benefits
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Section 8I. Any subscription certificate under a group nonprofit hospital service agreement, except certificates which provide supplemental coverage to medicare or other governmental programs which shall be delivered, issued or renewed in the commonwealth, shall provide, as benef…
Mass. Gen. Laws ch. 176A, § 8II Coverage for medically necessary acute treatment or clinical stabilization services
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Section 8II. For the purposes of this section the following terms shall, unless the context clearly requires otherwise, have the following meanings:— ''Acute treatment services'', 24–hour medically supervised addiction treatment for adults or adolescents provided in a medically m…
Mass. Gen. Laws ch. 176A, § 8J Minimum requirements for cytologic screening and mammographic examination expense benefits
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Section 8J. Any contract, except contracts providing supplemental coverage to medicare or other governmental programs, between a subscriber and the corporation under an individual group hospital service plan which shall be delivered, issued or renewed in the commonwealth shall pr…
Mass. Gen. Laws ch. 176A, § 8K Infertility diagnosis and treatment benefits
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Section 8K. Any contract, except contracts providing supplemental coverage to medicare or other governmental programs, between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued for delivery or renewed in the commonwealt…
Mass. Gen. Laws ch. 176A, § 8KK Coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome
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Section 8KK. Any contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth shall provide coverage for medical or drug treatments to correct or repair disturbances of body comp…
Mass. Gen. Laws ch. 176A, § 8L Nonprescription enteral formulas for home use
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Section 8L. Any contract between a subscriber and the corporation under an individual or group hospital service plan that shall be delivered, issued or renewed in the commonwealth shall provide, as benefits to all individual subscribers and members within the commonwealth, covera…
Mass. Gen. Laws ch. 176A, § 8LL Filling of remaining portion of prescription for covered drug that is a narcotic substance earlier filled in lesser quantity
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Section 8LL. Any contract between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed within the commonwealth shall provide, for any covered drug that is a narcotic substance contained in schedule II pursuant to…
Mass. Gen. Laws ch. 176A, § 8M Standardized claim form
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Section 8M. The commissioner of insurance is hereby directed to produce a standardized claim form to be utilized by all health insurance companies licensed to do business in the commonwealth for billing purposes. Said form shall be made available to said companies no later than J…
Mass. Gen. Laws ch. 176A, § 8MM Pain management access plan; non-medication and nonsurgical treatment; review; educational materials
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Section 8MM. (a) A contract between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed within the commonwealth shall develop a plan to provide adequate coverage and access to a broad spectrum of pain management…
Mass. Gen. Laws ch. 176A, § 8N Off-label drug use; cancer
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Section 8N. Any contract between a subscriber and the corporation under an individual or group hospital service plan that shall be delivered, issued or renewed in the commonwealth, which provides coverage for prescription drugs, shall provide as benefits to all individual subscri…
Mass. Gen. Laws ch. 176A, § 8NN Coverage for tobacco use cessation counseling and tobacco cessation products
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Section 8NN. (a) Any contract between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed within the commonwealth shall provide coverage for: (i) tobacco use cessation counseling; and (ii) all generic United Sta…
Mass. Gen. Laws ch. 176A, § 8O Hospital service plan benefits for bone marrow transplants
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Section 8O. Any contract between a subscriber and the corporation under an individual or group hospital service plan that shall be delivered, issued or renewed in the commonwealth shall provide, as benefits to all individual subscribers or members within the commonwealth and to a…
Mass. Gen. Laws ch. 176A, § 8OO Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome
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Section 8OO. Any contract between a subscriber and a corporation under an individual or group hospital service plan delivered, issued or renewed within the commonwealth shall provide coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with strepto…
Mass. Gen. Laws ch. 176A, § 8P Items medically necessary for diagnosis and treatment of diabetes
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Section 8P. A contract between a subscriber and the corporation under an individual or group hospital service plan which provides hospital expense and surgical expense insurance, except contracts providing supplemental coverage to Medicare or other governmental programs, delivere…
Mass. Gen. Laws ch. 176A, § 8Q HIV/AIDS treatment; off-label prescription drug coverage
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Section 8Q. Any contract between a subscriber and the corporation under an individual or group hospital service plan that shall be delivered, issued or renewed in the commonwealth which provides coverage for prescription drugs shall provide as benefits to all individual subscribe…
Mass. Gen. Laws ch. 176A, § 8QQ Coverage for prescription eye drops
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Section 8QQ. A contract between a subscriber and the corporation under an individual or group hospital service plan which is delivered, issued or renewed within the commonwealth that provides coverage for prescription eye drops shall provide coverage for refills of prescription e…
Mass. Gen. Laws ch. 176A, § 8R Coverage of hospice services for terminally ill patients
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Section 8R. Any contract between a subscriber and the corporation under an individual or group hospital service plan that shall be delivered, issued or renewed in the commonwealth shall provide, as benefits to all individual subscribers and members within the commonwealth and to …
Mass. Gen. Laws ch. 176A, § 8RR Coverage for mental health or substance use disorder services delivered through psychiatric collaborative care model
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Section 8RR. (a) For the purposes of this section, ''psychiatric collaborative care model'' shall mean the evidence-based, integrated behavioral health service delivery method in which a primary care team consisting of a primary care provider and a care manager provides structure…
Mass. Gen. Laws ch. 176A, § 8S Nurse anesthetist and nurse practitioner services
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Section 8S. Any contract between a subscriber and the corporation under an individual or group hospital service plan delivered, issued or renewed in the commonwealth shall provide, as benefits to all individual subscribers and members within the commonwealth and to all group memb…
Mass. Gen. Laws ch. 176A, § 8SS Coverage for medically necessary mental health acute treatment, community-based acute treatment and intensive community-based acute treatment
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Section 8SS. (a) For the purposes of this section, the following terms shall have the following meanings unless the context clearly requires otherwise: ''Community-based acute treatment'', 24–hour clinically managed mental health diversionary or step-down services for children an…
Mass. Gen. Laws ch. 176A, § 8T Scalp hair prostheses necessary due to cancer or leukemia treatment
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Section 8T. (a) For the purpose of this section, the following words shall have the following meanings: ''Prosthesis'', an artificial appliance used to replace a lost natural structure; provided, however, that prosthesis shall include, but not be limited to, artificial arms, legs…
Mass. Gen. Laws ch. 176A, § 8TT Benefits for medically necessary emergency services programs
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Section 8TT. A contract between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed within or without the commonwealth shall provide benefits on a nondiscriminatory basis for medically necessary emergency servic…
Mass. Gen. Laws ch. 176A, § 8U Emergency services provided to insureds for emergency medical conditions
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Section 8U. (a) As used in this section, the following words shall have the following meanings:- ''Attending physician'', the emergency physician or consultant physician who actively treats the emergency medical condition of an insured at an emergency facility. ''Emergency medica…
Mass. Gen. Laws ch. 176A, § 8UU Coverage for annual mental health wellness examination
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Section 8UU. (a) For the purpose of this section, the following words shall have the following meanings: ''Licensed mental health professional,'' a licensed physician who specializes in the practice of psychiatry, a licensed psychologist, a licensed supervised mental health couns…
Mass. Gen. Laws ch. 176A, § 8V Coverage for human leukocyte or histocompatibility locus antigen testing
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Section 8V. Any contract between a subscriber and the corporation under an individual or group hospital service plan, except contracts providing supplemental coverage to Medicare or to other government programs, delivered, issued or renewed by agreement within or without the comm…
Mass. Gen. Laws ch. 176A, § 8VV Coverage for federally-defined preventive services
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Section 8VV. (a) For the purposes of this section, ''federally-defined preventive services'' shall mean: (i) evidence-based items or services that currently have a rating of ''A'' or ''B'' in the recommendations of the United States Preventive Services Task Force; (ii) immunizati…
Mass. Gen. Laws ch. 176A, § 8W Outpatient services; hormone replacement therapy for peri and post menopausal women; contraceptive services; approved prescription contraceptive drugs and devices; exception
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Section 8W. (a) Any contract between a subscriber and the corporation under an individual or group hospital service plan that is delivered, issued or renewed within or without the commonwealth and that provides benefits for outpatient services shall provide to all individual subs…
Mass. Gen. Laws ch. 176A, § 8WW Coverage for standard fertility preservation services
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Section 8WW. (a) For the purposes of this section, the following words shall have the following meanings unless the context clearly requires otherwise: ''Directly or indirectly cause impairment of fertility'', to cause circumstances where a disease or the necessary treatment for …
Mass. Gen. Laws ch. 176A, § 8X Coverage for patient care services under qualified clinical trials
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Section 8X. Any contract between a subscriber and the corporation under an individual or group hospital service plan delivered or issued or renewed within the commonwealth shall provide for coverage of patient care services furnished pursuant to qualified clinical trials as defin…
