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Mass. General Laws c.176B

Medical service corporations

This page links to an unofficial version of each section of G.L. c. 176B. Please note that sections that appear missing have been either reserved for future use or repealed.

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§ 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 

Amended by St. 2024, c. 343, § 76, effective April 8, 2025

§ 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.2022, c.177, § 56, effective November 8, 2022

§ 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 

Amended by St.2022, c. 127, §§ 27-29, effective July 29, 2022

§ 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 

Amended by St.2022, c.177, § 57, effective November 8, 2022

§ 4CC Coverage for medically necessary hypodermic syringes or needles 
§ 4DD Coverage for diagnosis and treatment of autism spectrum disorder 
§ 4DD 1/2 Coverage for the treatment of Down syndrome 

Added by St. 2024, c. 388, § 5, effective January 1, 2026

§ 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 
§ 4II Coverage for medically necessary acute treatment or clinical stabilization services 
§ 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 
§ 4MM Pain management access plans 

Amended by St. 2024, c. 285, § 26, applicable to all contracts entered into, renewed or amended on or after July 1, 2025

§ 4NN Coverage for tobacco use cessation counseling and tobacco cessation products 
§ 4OO Coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome 
§ 4QQ Coverage for prescription eye drops 
§ 4RR Coverage for mental health or substance use disorder services delivered through psychiatric collaborative care model 

Added by St.2022, c.177, § 58, effective November 8, 2022

§ 4SS Coverage for medically necessary mental health acute treatment, community-based acute treatment, intensive community-based acute treatment 

Added by St.2022, c.177, § 58, effective November 8, 2022

§ 4TT Benefits for medically necessary emergency services programs 

Added by St.2022, c.177, § 58, effective November 8, 2022

§ 4UU Coverage for annual mental health wellness examination 

Added by St.2022, c.177, § 58, effective November 8, 2022

§ 4VV Coverage for federally-defined preventive services 

Added by St.2023, c.28, § 59, effective July 1, 2023.

§ 4WW Subscription certificates; coverage for standard fertility preservation services when enrollee has diagnosed impairment of fertility 

Added by St. 2024, c. 140, § 149, effective July 1, 2024

§ 4XX Coverage for postpartum depression and major depressive disorder screenings 

Added by St. 2024, c. 186, § 46, effective November 21, 2024

§ 4YY Coverage for medically necessary pasteurized donor human milk and milk-derived products 

Amended by St. 2024, c. 248, § 21, effective December 4, 2024

§ 4ZZ Coverage for universal postpartum home visiting services 

Added by St. 2024, c. 186, § 46, effective November 21, 2024

§ 4AAA Coverage for medically necessary breast screenings and examinations 

Added by St. 2024, c. 231, § 5, and shall apply to all contracts entered into, renewed or amended on or after January 1, 2026.

§ 4BBB Coverage for prescribed, ordered or dispensed opioid antagonists 

Added by St. 2024, c. 285, § 27, applicable to all contracts entered into, renewed or amended on or after July 1, 2025

§ 4CCC Coverage for licensed recovery coach services 

Added by St. 2024, c. 285, § 27, applicable to all contracts entered into, renewed or amended on or after January 1, 2026

§ 4DDD Coverage for brand name and generic drugs for the purpose of treating diabetes, asthma, and 2 prevalent heart conditions 

Added by St. 2024, c. 342, § 34, applicable to all contracts entered into, renewed or amended on or after July 1, 2025.

§ 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 
§ 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 health care services delivered via telehealth by a contracted health care provider 

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