Massachusetts Statutes

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…

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…

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…

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…

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 …

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…

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…

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…

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…

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…

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…

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…

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…

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…

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…

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 …

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…

Section 8XX. Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the commonwealth, which is considered creditable coverage under section 1 of chapter 111M, shall provide coverage for postpartum depression and major depressive diso…

Section 8Y. Any contract between a subscriber and the corporation under an individual or group hospital service plan that provides hospital expense and surgical expense insurance, delivered, issued or renewed by agreement between the insurer and the policyholder, within or withou…

Section 8YY. (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 the provision of medically necessary pasteurized donor human milk and …

Section 8ZZ. 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 universal postpartum home visiting services, in accordance with operation…

Section 1. In this chapter the following words shall have the following meanings: ''Certified nurse midwife'', a nurse midwife authorized to practice midwifery in the commonwealth by the board of registration in nursing pursuant to section eighty B of chapter one hundred and twel…

Section 10. No investment, sale or loan shall be made by a medical service corporation which has not first been authorized by the board of directors, or by a committee thereof charged with the duty of investing or loaning the funds of the corporation; nor shall any deposit be mad…

Section 11. No medical service corporation shall pay any salary, compensation or emolument to any officer, trustee or director thereof, nor any salary, compensation or emolument amounting in any year to more than twenty thousand dollars to any person, unless such payment be first…

Section 12. Any dispute or controversy arising between a medical service corporation and any participating physician, participating chiropractor, or any other participating provider of health services licensed under the laws of the commonwealth, or any subscriber, or any person w…

Section 13. If the commissioner is satisfied, as to any medical service corporation, that (1) it has failed to comply with the provisions of its charter, or (2) it is being operated for profit, or (3) it is fraudulently conducted, or (4) its condition is such as to render its fur…

Section 14. Every medical service corporation is hereby declared to be a charitable corporation. No such corporation shall be liable for injuries resulting from negligence or malpractice on the part of any participating physician, participating chiropractor or any other participa…

Section 16. It shall be unlawful for any person, firm, corporation or association, except a medical service corporation, to establish, maintain or operate a non-profit medical service plan; provided, however, that this chapter shall not render unlawful or affect any operation or …

Section 16A. The pertinent provisions of section one hundred and thirty-eight A of chapter one hundred and seventy-five shall apply to deductions on pay-roll schedules from the salary of any state, county or municipal employee for the payment of the amount payable by such an empl…

Section 17. The provisions of this chapter may be enforced by a bill in equity brought in the supreme judicial court by the commissioner, the attorney general, any district attorney or any aggrieved party.

Section 18. Any medical service corporation may contract with any person for the purpose of providing administrative or other services relating to the providing of medical or other health services or reimbursement therefor. In addition, with the approval of the commissioner who s…

Section 19. A medical service corporation which, upon the death of a subscriber, owes the subscriber's estate an aggregate sum not exceeding two thousand dollars under any medical service agreement, may, at any time not less than sixty days after the subscriber's death, pay such …

Section 2. For the purpose of establishing, maintaining and operating a non-profit medical service plan, seven or more persons may form a medical service corporation. Such a corporation shall be formed in the manner prescribed in and subject to section nine of chapter one hundred…

Section 20. No medical service corporation may, without the express and informed written consent of its subscriber or a covered family member of its subscriber, disclose any information it may have acquired from or about any such subscriber or covered family member pertaining to …

Section 21. (a) For purposes of this section, the following words shall, unless the context clearly requires otherwise, have the following meanings:- ''Carrier'', a health maintenance organization authorized under chapter 176G, an insurance company authorized to provide accident …

Section 22. Pursuant to section 8B of chapter 62C, any corporation subject to this chapter shall provide written statements to residents of the commonwealth for whom creditable coverage is provided and shall provide a separate report verifying those statements to the commissioner…

Section 23. To the maximum extent possible, every medical service corporation shall attribute every member to a primary care provider. Members may change their primary care provider, provided that the member gives notice to the carrier.

Section 24. To the extent permissible under applicable state and federal privacy laws, every medical service corporation shall disclose patient-level data to providers in their network solely for the purpose of carrying out treatment, coordinating care among providers and managin…

Section 25. (a) For the purposes of this section, the following words shall, unless the context clearly requires otherwise, have the following meanings: ''Behavioral health services'', care and services for the evaluation, diagnosis, treatment or management of patients with menta…

Section 3. The by-laws of a medical service corporation may contain any lawful provisions approved by the commissioner, and shall provide that a majority of the incorporators or members of the corporation and a majority of the directors shall at all times be persons who are not p…

Section 3A. Any corporation subject to this chapter may make contracts of reinsurance relating to the providing of medical or other health services or reimbursement thereof, but the costs of such reinsurance shall not inure to or otherwise affect the premiums charged for any poli…

Section 3B. A medical service corporation organized under this chapter may only enter into a group medical service agreement with an employer if the group medical service agreement is offered by that employer to all full-time employees who live in the commonwealth; provided, howe…

Section 4. Any medical service corporation may enter into contracts with its subscribers, and with participating physicians, chiropractors, nurse midwives, optometrists, dentists, podiatrists, psychologists, licensed independent clinical social workers, certified clinical special…

Section 4A. (a) A subscription certificate under an individual or group medical service agreement which is issued or renewed within or without the commonwealth shall provide mental health benefits on a nondiscriminatory basis to residents of the commonwealth and to all individual…

Section 4AA. (a) Any subscription certificate under an individual or group medical service agreement, except certificates which provide supplemental coverage to Medicare or other governmental programs that shall be delivered, issued or renewed within the commonwealth shall provid…