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Mass. General Laws c.176A

Non-profit hospital service corporations

This page links to the current version of each section of G.L. c.176A.

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Table of Contents

§ 1 Corporations governed by chapter; services received in nonparticipating hospital; substitution of benefits in nursing homes 
§ 1A Right to become subscriber; open enrollment periods 
§ 1B Medicare supplemental group coverage; medical assistance recipients 
§ 1C Retroactive premium rate increase 
§ 1D Contracts of reinsurance 
§ 2 Incorporators; directors; certificate of organization; commissioner's examination report 
§ 3 Certificate of compliance; examination by commissioner 
§ 3A Discrimination against abuse victims in terms of hospital service plans 
§ 3B Medical service plans; genetic tests; discrimination based on genetic information 
§ 4 Accounting system; accountant, claim manager, underwriter and actuary 
§ 5 Joint administration with certain corporations 
§ 6 Approval of nongroup contracts 
§ 7 Information gathering authority of commissioner; confidentiality and privilege 
§ 8 Conditions to issuance or delivery of contract 
§ 8 1/2 Sale of group non-profit hospital service contracts 
§ 8A Mental illness expenses; inclusion in contracts as benefits; biologically-based mental disorders; rape-related mental disorders; non-biologically-based mental disorders for children and adolescents under age 19 

Amended by St.2020, c.227, § 49, effective December 11, 2020

§ 8A 3/4 Retroactive claims denials for behavioral health services 

Added by St.2019, c. 41, § 56, July 31, 2019, effective July 1, 2019

§ 8B Dependent coverage for newborn infants or adoptive children; inclusion in contracts 
§ 8C Refusal to contract with blind or deaf persons; prohibition 
§ 8D Limited extension of benefits 
§ 8E Diethylstilbestrol exposure; discrimination 
§ 8F Divorced or separated spouses; continuation of eligibility for benefits 
§ 8G Cardiac rehabilitation expense benefits 
§ 8H Prenatal, childbirth and postpartum care benefits; minimum coverage for in-patient care 
§ 8I Home care benefits 
§ 8J Minimum requirements for cytologic screening and mammographic examination expense benefits 
§ 8K Infertility diagnosis and treatment benefits 
§ 8L Nonprescription enteral formulas for home use 
§ 8M Standardized claim form 
§ 8N Off-label drug use; cancer 
§ 8O Hospital service plan benefits for bone marrow transplants 
§ 8P Items medically necessary for diagnosis and treatment of diabetes 
§ 8Q HIV/AIDS treatment; off-label prescription drug coverage 
§ 8R Coverage of hospice services for terminally ill patients 
§ 8S Nurse anesthetist and nurse practitioner services 
§ 8T Scalp hair prostheses necessary due to cancer or leukemia treatment 
§ 8U Emergency services provided to insureds for emergency medical conditions 
§ 8V Coverage for human leukocyte or histocompatibility locus antigen testing 
§ 8W Outpatient services; hormone replacement therapy for peri and post menopausal women; contraceptive services; approved prescription contraceptive drugs and devices; exception 

Amended by St.2017, c. 120, § 4, effective November 20, 2017

§ 8X Coverage for patient care services under qualified clinical trials 
§ 8Y Diagnosis and treatment of speech, hearing and language disorders 
§ 8AA Coverage of prosthetic devices and repairs 
§ 8BB Coverage for eligible dependents under 26 years of age 
§ 8CC Coverage for medically necessary hypodermic syringes or needles 
§ 8DD Coverage for diagnosis and treatment of autism spectrum disorder 
§ 8EE Coverage for children under age 18 for cleft lip and cleft palate 
§ 8FF Coverage for orally administered anticancer medications 
§ 8GG Coverage for abuse deterrent opioid drug products 
§ 8HH Preauthorization for substance abuse treatment not to be required 

Amended by St.2018, c. 208, § 83, effective August 9, 2018

§ 8II Coverage for medically necessary acute treatment or clinical stabilization services 

Amended by St.2018, c. 208, § 84, effective August 9, 2018

§ 8JJ Coverage for long-term antibiotic therapy for patients with Lyme disease 
§ 8KK Coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome 
§ 8LL Filling of remaining portion of prescription for covered drug that is a narcotic substance earlier filled in lesser quantity 

Amended by St.2018, c. 208, § 85, effective August 9, 2018

§ 8MM Pain management access plans 

Amended by St.2018, c. 208, § 85, effective August 9, 2018

§ 8NN Tobacco use cessation 

Added by St.2019, c.133, § 21, effective for contracts and subscription certificates that are delivered, issued or renewed in the commonwealth on or after January 1, 2020

§ 8OO Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome 

Added by St.2020, c.260, § 48, for contracts that take effect or are renewed on or after January 1, 2022

§ 8PP Long-term antibiotic therapy for Lyme disease 

Added by St.2021, c.29, § 20, effective July 1, 2021

§ 8QQ Prescription eye drops 

Added by St.2021, c.29, § 20, effective July 1, 2021

§ 10 Group hospital service plan; approval or disapproval of contracts and rates; filing 
§ 10A Preferred provider arrangements 
§ 11 Officers; duties 
§ 12 Publication of assets and liabilities 
§ 13 Hospitalization and medical service for officers and employees of corporation 
§ 14 Misrepresentation of terms of subscriber's contract 
§ 14B Disclosure of information; mental or nervous conditions; exceptions 
§ 15 Costs of solicitation of subscribers and administration 
§ 16 Acquisition of real estate; leases; tax exemption; limit; approval of investments, sales, loans and places of deposit 
§ 17 Submission of disputes and controversies 
§ 18 Annual statement of condition; verification, filing, form, violations; applicability of chapter 176V 
§ 18A Financial statements; inclusion of electronic data processing equipment as asset 
§ 19 Tax exemption 
§ 20 Filing of amendment of by-laws 
§ 21 Submission of advertising matter to commissioner 
§ 22 Filing of riders, endorsements and applications with commissioner 
§ 23 Grounds for enjoining transaction of business; rehabilitation proceedings; duties of receiver; distribution of assets 
§ 24 Special contingent reserve fund 
§ 25 Licensing of agents 
§ 26 Salaries, compensation or emoluments paid by corporation 
§ 27 Payroll deductions for governmental employees 
§ 28 Violations; penalties 
§ 29 Application 
§ 30 Savings clause 
§ 31 Contracts for administrative or other services; loans and investments 
§ 32 Payment of sums owed to subscriber's estate 
§ 33 Insolvency of health maintenance organization; replacement coverage 
§ 34 Report of individuals provided with creditable coverage 
§ 36 Attribution of members to a primary care provider 
§ 37 Disclosure of patient-level data and contracted prices of individual health care services by carriers to providers 
§ 38 Coverage for telehealth services 

Added by St.2020, c.260, § 49, effective January 1, 2021

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