§ 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
§ 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 Abortion, abortion-related care, 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 or dependents mentally or physically incapable of earning their own living due to disability
§ 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
§ 4II Coverage for medically necessary acute treatment or clinical stabilization services
§ 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
§ 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
§ 4SS Coverage for medically necessary mental health acute treatment, community-based acute treatment, intensive community-based acute treatment
§ 4TT Benefits for medically necessary emergency services programs
§ 4UU Coverage for annual mental health wellness examination
§ 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

Terms Used In Massachusetts General Laws > Chapter 176B - Medical Service Corporations

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Bankruptcy: Refers to statutes and judicial proceedings involving persons or businesses that cannot pay their debts and seek the assistance of the court in getting a fresh start. Under the protection of the bankruptcy court, debtors may discharge their debts, perhaps by paying a portion of each debt. Bankruptcy judges preside over these proceedings.
  • Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Dependent: A person dependent for support upon another.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Donor: The person who makes a gift.
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Executor: A male person named in a will to carry out the decedent
  • Finance charge: The total cost of credit a customer must pay on a consumer loan, including interest. The Truth in Lending Act requires disclosure of the finance charge. Source: OCC
  • Fraud: Intentional deception resulting in injury to another.
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Oath: A promise to tell the truth.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Other entity: includes a domestic or foreign nonprofit corporation. See Massachusetts General Laws ch. 156D sec. 11.01
  • Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
  • Subpoena: A command to a witness to appear and give testimony.
  • Testify: Answer questions in court.
  • Trustee: A person or institution holding and administering property in trust.