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Mass. General Laws c.176B

Medical service corporations

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

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Table of Contents

§ 1 Definitions 
§ 2 Incorporators; formation; articles of organization; certification 
§ 3 By-laws; joint service contracts; preferred provider arrangements 
§ 3A Contracts of reinsurance 
§ 3B Group medical service agreements; contribution percentages 
§ 4 Contracts for medical, chiropractic, visual, surgical, and other health services; approval, subscription certificates; classification of risks 
§ 4A Mental 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 

Amended by St.2020, c.227, § 50, effective December 11, 2020

§ 4C Dependent coverage for newborn infants or adoptive children; inclusion of medical expenses as benefits 
§ 4D Refusal to contract with blind or deaf persons; prohibition 
§ 4E Diethylstilbestrol exposure; discrimination 
§ 4F Cardiac rehabilitation expense benefits 
§ 4G Certified nurse midwife services benefits 
§ 4H Prenatal, childbirth and postpartum care benefits; minimum coverage for in-patient care 
§ 4I Cytologic screening and mammographic examination benefits 
§ 4J Infertility diagnosis and treatment benefits 
§ 4K Nonprescription enteral formulas for home use 
§ 4L Chiropractic services benefits 
§ 4M Standardized claim form 
§ 4N Off-label drug use; cancer 
§ 4O Medical service agreement coverage for bone marrow transplants 
§ 4P Off-label use of prescription drugs for HIV/AIDS treatment 
§ 4Q Coverage for licensed hospice services 
§ 4R Scalp hair prostheses necessary due to cancer or leukemia treatment 
§ 4S Items medically necessary for diagnosis and treatment of diabetes 
§ 4T Subscription certificate benefits for services rendered by a nurse anesthetist or nurse practitioner 
§ 4U Emergency services provided to insureds for emergency medical conditions 
§ 4V Coverage for human leukocyte or histocompatibility locus antigen testing 
§ 4W Outpatient services; hormone replacement therapy for peri and post menopausal women; contraceptive services; approved prescription contraceptive drugs or devises; exception 
§ 4X Coverage for patient care services provided under qualified clinical trials 
§ 4Y Coverage for speech, hearing and language disorders 
§ 4AA Coverage for prosthetic devices and repairs 
§ 4BB Coverage for eligible dependents under 26 years of age 
§ 4CC Coverage for medically necessary hypodermic syringes or needles 
§ 4DD Coverage for diagnosis and treatment of autism spectrum disorder 
§ 4EE Coverage for children 21 years of age or younger for hearing aids and related services 
§ 4FF Coverage for orally administered anticancer medications 
§ 4GG Coverage for abuse deterrent opioid drug products 
§ 4HH Preauthorization for substance abuse treatment not to be required 

Amended by St.2018, c. 208, § 86, effective August 9, 2018

§ 4II Coverage for medically necessary acute treatment or clinical stabilization services 

Amended by St.2018, c. 208, § 87, effective August 9, 2018

§ 4JJ Coverage for long-term antibiotic therapy for patients with Lyme disease 
§ 4KK Coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome 
§ 4LL 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, § 88, effective August 9, 2018

§ 4MM Pain management access plans 

Amended by St.2018, c. 208, § 88, effective August 9, 2018

§ 4NN Tobacco use cessation 

Added by St.2019, c.133, § 22, effective November 27, 2019

§ 4OO Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome 

Added by St.2020, c.260, § 50, effective for contracts that take effect or are renewed on or after January 1, 2022

§ 4PP Long-term antibiotic therapy for Lyme disease 

Added by St.2021, c.29, § 24, effective July 1, 2021

§ 4QQ Coverage for prescription eye drops 

Added by St.2021, c.29, § 24, effective July 1, 2021

§ 5 Subscribers; qualifications, misrepresentation; open enrollment periods 
§ 5A Discrimination against abuse victims in terms of medical service plans 
§ 5B Medical service plans; genetic tests; discrimination based on genetic information 
§ 6 Subscription certificate; issuance; content 
§ 6A Limited extension of benefits 
§ 6B Divorced or separated spouses; continuation of eligibility for benefits 
§ 7 Contracts between corporation and care providers 
§ 7A Medicare supplemental group coverage; eligibility due to age or disability 
§ 7B Medicare supplemental group coverage; medical assistance recipients 
§ 7C Retroactive premium rate increase 
§ 7D Retroactive claims denial for behavioral health services 

Added by St.2019, c.41, § 57, effective July 1, 2019

§ 8 Annual statement; verification, form, violations 
§ 8A Financial statements; inclusion of electronic data processing equipment as asset 
§ 8B Applicability of chapter 176V to medical service corporations governed by this chapter 
§ 8C Applicability of chapter 176W to medical service corporations governed by this chapter 
§ 9 Inspection and examination of affairs of corporation; confidentiality and privilege; inability to pay providers; pro rata payments; termination of contract 
§ 10 Investments, sales, loans and places of deposit; approval; acquisition of real estate; leases; tax exemption; limit; special contingent surplus 
§ 11 Salaries, compensation or emoluments 
§ 12 Submission of disputes or controversies to board; privacy of patient information 
§ 13 Grounds for enjoining transaction of business; receivers 
§ 14 Liability of corporation; exemption from insurance laws; tax exemption 
§ 16 Operators of medical service plan 
§ 16A Payroll deductions of governmental employees 
§ 17 Enforcement 
§ 18 Contracts for administrative or other services; loans and investments 
§ 19 Payment of sums owed subscriber's estate 
§ 20 Disclosure of information; mental or nervous condition 
§ 21 Insolvency of health maintenance organization; replacement coverage 
§ 22 Statement provided to individuals provided with creditable coverage; report 
§ 23 Attribution of members to a primary care provider 
§ 24 Disclosure of patient-level data and contracted prices of individual health care services by carriers to providers 
§ 25 Coverage for telehealth services 

Added by St.2020, c.260, § 51, effective January 1, 2021

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