Massachusetts Chapter 176G — Health Maintenance Organizations

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Mass. Gen. Laws ch. 176G, § 1— Definitions
Mass. Gen. Laws ch. 176G, § 2— Application of laws
Mass. Gen. Laws ch. 176G, § 3— Organization; accounting; contracts
Mass. Gen. Laws ch. 176G, § 4— Required coverage for certain conditions and groups
Mass. Gen. Laws ch. 176G, § 4A— Employees terminated due to plant closings; coverage
Mass. Gen. Laws ch. 176G, § 4AA— Coverage for medically necessary acute treatment and clinical stabilization services
Mass. Gen. Laws ch. 176G, § 4B— Confidentiality of information; mental or nervous condition; exceptions
Mass. Gen. Laws ch. 176G, § 4BB— Repealed, 2016, 133, Sec. 116
Mass. Gen. Laws ch. 176G, § 4C— Home care benefits
Mass. Gen. Laws ch. 176G, § 4CC— Coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome
Mass. Gen. Laws ch. 176G, § 4D— Nonprescription enteral formulas for home use
Mass. Gen. Laws ch. 176G, § 4DD— Filling of remaining portion of prescription for covered drug that is a narcotic substance earlier filled in lesser quantity
Mass. Gen. Laws ch. 176G, § 4E— Off-label drug use; cancer treatment
Mass. Gen. Laws ch. 176G, § 4EE— Pain management access plan; non-medication and nonsurgical treatment; review; educational materials
Mass. Gen. Laws ch. 176G, § 4F— Group health maintenance contracts; coverage for bone marrow transplants
Mass. Gen. Laws ch. 176G, § 4FF— Coverage for tobacco use cessation counseling and tobacco cessation products
Mass. Gen. Laws ch. 176G, § 4G— Off-label use of prescription drugs for HIV/AIDS treatment
Mass. Gen. Laws ch. 176G, § 4GG— Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome
Mass. Gen. Laws ch. 176G, § 4H— Items medically necessary for diagnosis and treatment of diabetes
Mass. Gen. Laws ch. 176G, § 4HH— Repealed, 2021, 29, Sec. 27
Mass. Gen. Laws ch. 176G, § 4I— Abortion, abortion-related care, prenatal care, childbirth and postpartum care benefits; minimum coverage for in-patient care; exemptions
Mass. Gen. Laws ch. 176G, § 4II— Coverage for prescription eye drops
Mass. Gen. Laws ch. 176G, § 4J— Scalp hair prostheses necessary due to cancer or leukemia treatment
Mass. Gen. Laws ch. 176G, § 4JJ— Coverage for mental health or substance use disorder services delivered through psychiatric collaborative care model
Mass. Gen. Laws ch. 176G, § 4K— Newborn hearing screening tests
Mass. Gen. Laws ch. 176G, § 4KK— Coverage for medically necessary mental health acute treatment, community-based acute treatment and intensive community-based acute treatment
Mass. Gen. Laws ch. 176G, § 4L— Coverage for hospice services
Mass. Gen. Laws ch. 176G, § 4LL— Benefits for medically necessary emergency services programs
Mass. Gen. Laws ch. 176G, § 4M— Mental health benefits; biologically-based mental disorders; rape-related mental disorders; non-biologically-based mental disorders of children and adolescents under age 19
Mass. Gen. Laws ch. 176G, § 4MM— Coverage for annual mental health wellness examination
Mass. Gen. Laws ch. 176G, § 4N— Coverage for speech, hearing and language disorders; hearing aids
Mass. Gen. Laws ch. 176G, § 4NN— Coverage for federally-defined preventive services
Mass. Gen. Laws ch. 176G, § 4O— Outpatient services; hormone replacement therapy for peri and post menopausal women; contraceptive services; approved prescription contraceptive drugs or devices; exception
Mass. Gen. Laws ch. 176G, § 4OO— Coverage for standard fertility preservation services
Mass. Gen. Laws ch. 176G, § 4P— Patient care services provided pursuant to qualified clinical trials
Mass. Gen. Laws ch. 176G, § 4PP— Coverage for postpartum depression and major depressive disorder screenings
Mass. Gen. Laws ch. 176G, § 4Q— Coverage for human leukocyte or histocompatibility locus antigen testing
Mass. Gen. Laws ch. 176G, § 4QQ— Coverage for the provision of medically necessary pasteurized donor human milk and donor human milk-derived products
Mass. Gen. Laws ch. 176G, § 4R— Repealed, 2008, 451, Sec. 140
Mass. Gen. Laws ch. 176G, § 4RR— Coverage for universal postpartum home visiting services
Mass. Gen. Laws ch. 176G, § 4S— Coverage for prosthetic devices and repairs
Mass. Gen. Laws ch. 176G, § 4SS— Coverage for diagnostic examinations for breast cancer; digital breast tomosynthesis screening, MRIs and ultrasounds
Mass. Gen. Laws ch. 176G, § 4T— Coverage for eligible dependents under 26 years of age or dependents mentally or physically incapable of earning their own living due to disability
Mass. Gen. Laws ch. 176G, § 4TT— Coverage for prescribed, ordered or dispensed opioid antagonists
Mass. Gen. Laws ch. 176G, § 4U— Coverage for medically necessary hypodermic syringes or needles
Mass. Gen. Laws ch. 176G, § 4UU— Coverage for the provision of services by a recovery coach
Mass. Gen. Laws ch. 176G, § 4V— Coverage for diagnosis and treatment of autism spectrum disorder
Mass. Gen. Laws ch. 176G, § 4VV— Coverage for identified generic and brand name drug used to treat diabetes, asthma, and certain heart conditions
Mass. Gen. Laws ch. 176G, § 4W— Coverage for children under age 18 for cleft lip and cleft palate
Mass. Gen. Laws ch. 176G, § 4X— Coverage for orally administered anticancer medications
Mass. Gen. Laws ch. 176G, § 4Y— Coverage for abuse deterrent opioid drug products
Mass. Gen. Laws ch. 176G, § 4Z— Preauthorization for substance abuse treatment not to be required
Mass. Gen. Laws ch. 176G, § 5— Emergency services provided to members for emergency medical conditions
Mass. Gen. Laws ch. 176G, § 5A— Divorced or separated spouses; coverage
Mass. Gen. Laws ch. 176G, § 6— Contracts
Mass. Gen. Laws ch. 176G, § 6A— Group health maintenance contracts; contribution percentages
Mass. Gen. Laws ch. 176G, § 6B— Retroactive claims denials for behavioral health services
Mass. Gen. Laws ch. 176G, § 7— Repealed, 2000, 141, Sec. 21
Mass. Gen. Laws ch. 176G, § 8— Public dissemination of deceptive or misleading materials
Mass. Gen. Laws ch. 176G, § 9— Trade regulation practices; application of law
Mass. Gen. Laws ch. 176G, § 10— Reports; audits, examinations or inspections; confidentiality and privilege
Mass. Gen. Laws ch. 176G, § 10A— Applicability of chapter 176V to health maintenance organizations governed by this chapter
Mass. Gen. Laws ch. 176G, § 10B— Applicability of chapter 176W to health maintenance organizations governed by this chapter
Mass. Gen. Laws ch. 176G, § 11— Contracts with group insurance commission or local governments
Mass. Gen. Laws ch. 176G, § 11A— Alternative dental coverage option
Mass. Gen. Laws ch. 176G, § 12— Health regulations not limited
Mass. Gen. Laws ch. 176G, § 13— Name restriction
Mass. Gen. Laws ch. 176G, § 14— Licensure applicants; documents required; approval by commissioner
Mass. Gen. Laws ch. 176G, § 15— Bond; waiver
Mass. Gen. Laws ch. 176G, § 16— Contracts, rates, evidence of coverage; disapproval of commissioner
Mass. Gen. Laws ch. 176G, § 16A— Disapproval of certain health maintenance contracts based on high deductibles
Mass. Gen. Laws ch. 176G, § 16B— Disapproval of certain health maintenance contracts for coverage of young adults
Mass. Gen. Laws ch. 176G, § 17— Rules and regulations; standardized claim form
Mass. Gen. Laws ch. 176G, § 17A— Open enrollment for nongroup medicare beneficiaries; period, notice of termination
Mass. Gen. Laws ch. 176G, § 18— Repealed, 1993, 110, Sec. 214
Mass. Gen. Laws ch. 176G, § 19— Discrimination against abuse victims in terms of health maintenance contract
Mass. Gen. Laws ch. 176G, § 20— Insolvent health maintenance organization; administrative supervision, rehabilitation or liquidation; priority of claims
Mass. Gen. Laws ch. 176G, § 20A— Administrative supervision, rehabilitation or liquidation of health maintenance organizations; revocation or suspension of license
Mass. Gen. Laws ch. 176G, § 21— Participating provider; contracts with health maintenance organizations; hold harmless clause; limitation on collection actions
Mass. Gen. Laws ch. 176G, § 22— Health care providers; liability of member of health maintenance organization; limitation on collection of amounts owed
Mass. Gen. Laws ch. 176G, § 23— Insolvency of health maintenance organization; replacement coverage
Mass. Gen. Laws ch. 176G, § 24— Health maintenance contracts; genetic tests; discrimination based on genetic information
Mass. Gen. Laws ch. 176G, § 25— Net worth of health maintenance organization
Mass. Gen. Laws ch. 176G, § 26— Deposit maintained with trustee acceptable to commissioner
Mass. Gen. Laws ch. 176G, § 27— Merger or acquisition of control
Mass. Gen. Laws ch. 176G, § 28— Registration with commissioner
Mass. Gen. Laws ch. 176G, § 29— Violations of Secs. 27 to 29; application for order enjoining violations of Secs. 27 to 29; penalties
Mass. Gen. Laws ch. 176G, § 30— Statement for individuals provided with creditable coverage; reporting
Mass. Gen. Laws ch. 176G, § 31— Attribution of members to a primary care provider
Mass. Gen. Laws ch. 176G, § 32— Disclosure of patient-level data and contracted prices of individual health care services by carriers to providers
Mass. Gen. Laws ch. 176G, § 33— Coverage for health care services delivered via telehealth by a contracted health care provider