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Section 1 - Definitions - Section 1. The following words as used in this chapter...
Section 2 - Application of Laws - Section 2. Except as hereinafter provided in this chapter, the...
Section 3 - Organization; Accounting; Contracts - Section 3. A carrier or any two or more such...
Section 4 - Required Coverage for Certain Conditions and Groups - Section 4. A health maintenance contract shall provide coverage for:...
Section 4a - Employees Terminated Due to Plant Closings; Coverage - Section 4A. Any health maintenance contract shall provide coverage for...
Section 4b - Confidentiality of Information; Mental or Nervous Condition; Exceptions - Section 4B. No health maintenance organization shall require as a...
Section 4c - Home Care Benefits - Section 4C. Any group health maintenance contract shall provide coverage...
Section 4d - Nonprescription Enteral Formulas for Home Use - Section 4D. A group health maintenance contract shall provide coverage...
Section 4e - Off-Label Drug Use; Cancer Treatment - Section 4E. A group health maintenance contract shall provide coverage...
Section 4f - Group Health Maintenance Contracts; Coverage for Bone Marrow Transplants - Section 4F. Any group health maintenance contract shall provide coverage...
Section 4g - Off-Label Use of Prescription Drugs for HIV/AIDS Treatment - Section 4G. Any individual or group health insurance maintenance contract...
Section 4h - Items Medically Necessary for Diagnosis and Treatment of Diabetes - Section 4H. Any individual or group health maintenance contract, except...
Section 4i - Prenatal, Childbirth and Postpartum Care Benefits; Minimum Coverage for In-Patient Care - Section 4I. Any health maintenance contract shall provide coverage for...
Section 4j - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment - Section 4J. (a) For the purposes of this section, the...
Section 4k - Newborn Hearing Screening Tests - Section 4K. A health maintenance contract shall provide coverage for...
Section 4l - Coverage for Hospice Services - Section 4L. Any group health maintenance contract shall provide coverage...
Section 4m - Mental Health Benefits; Biologically-Based Mental Disorders; Rape-Related Mental Disorders; Non-Biologically-Based Mental Disorders of Children and Adolescents Under Age 19 - Section 4M. (a) A health maintenance contract issued or renewed...
Section 4n - Coverage for Speech, Hearing and Language Disorders; Hearing AIDS - Section 4N. Any individual or group health maintenance contract that...
Section 4o - Outpatient Services; Hormone Replacement Therapy for Peri and Post Menopausal Women; Contraceptive Services; Approved Prescription Contraceptive Drugs or Devices; Exception - Section 4O. (a) Any individual or group health maintenance contract...
Section 4p - Patient Care Services Provided Pursuant to Qualified Clinical Trials - Section 4P. Any individual or group health maintenance contract shall...
Section 4q - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing - Section 4Q. Any group health maintenance contract, except contracts providing...
Section 4s - Coverage for Prosthetic Devices and Repairs - Section 4S. (a) Individual and group health maintenance contracts shall...
Section 4t - Coverage for Eligible Dependents Under 26 Years of Age - Section 4T. A health maintenance contract, except certificates which provide...
Section 4u - Coverage for Medically Necessary Hypodermic Syringes or Needles - Section 4U. No individual or group health maintenance contract shall...
Section 4v - Coverage for Diagnosis and Treatment of Autism Spectrum Disorder - Section 4V. (a) As used in this section the following...
Section 4w - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate - Section 4W. A health maintenance contract issued or renewed within...
Section 4x - Coverage for Orally Administered Anticancer Medications - Section 4X. Any individual or group health maintenance contract that...
Section 4y - Coverage for Abuse Deterrent Opioid Drug Products - Section 4Y. An individual or group health maintenance contract that...
Section 4z - Preauthorization for Substance Abuse Treatment Not to Be Required - Section 4Z. For the purposes of this section the term...
Section 4aa - Coverage for Medically Necessary Acute Treatment and Clinical Stabilization Services - Section 4AA. For the purposes of this section the following...
Section 4bb - Coverage for Long-Term Antibiotic Therapy for Patients With Lyme Disease - [ Text of section added by 2016, 183, Sec. 4...
Section 4cc - Coverage for Medical or Drug Treatments to Correct or Repair Disturbances of Body Composition Caused by HIV Associated Lipodystrophy Syndrome - Section 4CC. Any individual or group health maintenance contract shall...
Section 4dd - Filling of Remaining Portion of Prescription for Covered Drug That Is a Narcotic Substance Earlier Filled in Lesser Quantity - Section 4DD. An individual or group health maintenance contract that...
Section 4ee - Pain Management Access Plans - Section 4EE. (a) Any individual or group health maintenance contract...
Section 4ff - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products - Section 4FF. (a) An individual or group health maintenance contract...
Section 4hh - Coverage for Long-Term Antibiotic Therapy for Lyme Disease; Experimental Drugs - [ Text of section added by 2021, 29, Sec. 26...
Section 4ii - Coverage for Prescription Eye Drops - [Text of section republished.] [Text of section added by 2021,...
Section 4gg - Coverage for Treatment of Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections and Pediatric Acute-Onset Neuropsychiatric Syndrome - [Text of section applicable to contracts that take effect or...
Section 5 - Emergency Services Provided to Members for Emergency Medical Conditions - Section 5. (a) As used in this section, the following...
Section 5a - Divorced or Separated Spouses; Coverage - Section 5A. (a) In the event of the granting of...
Section 6 - Contracts - Section 6. A health maintenance organization may enter into contractual...
Section 6a - Group Health Maintenance Contracts; Contribution Percentages - Section 6A. A health maintenance organization may only enter into...
Section 6b - Retroactive Claims Denials for Behavioral Health Services - Section 6B. (a) For the purposes of this section, the...
Section 8 - Public Dissemination of Deceptive or Misleading Materials - Section 8. Public dissemination of any promotional material, evidence of...
Section 9 - Trade Regulation Practices; Application of Law - Section 9. The provisions of sections 1 to 14K, inclusive,...
Section 10 - Reports; Audits, Examinations or Inspections; Confidentiality and Privilege - Section 10. Every health maintenance organization shall annually file with...
Section 10a - Applicability of Chapter 176v to Health Maintenance Organizations Governed by This Chapter - Section 10A. Notwithstanding any general or special law to the...
Section 10b - Applicability of Chapter 176w to Health Maintenance Organizations Governed by This Chapter - Section 10B. Notwithstanding any general or special law to the...
Section 11 - Contracts With Group Insurance Commission or Local Governments - Section 11. Every health maintenance organization entering into a contract...
Section 11a - Alternative Dental Coverage Option - Section 11A. Each employer or other organization which employs or...
Section 12 - Health Regulations Not Limited - Section 12. Nothing in this chapter shall exempt any person...
Section 13 - Name Restriction - Section 13. No company, person, entity or health care plan...
Section 14 - Licensure Applicants; Documents Required; Approval by Commissioner - Section 14. Each applicant for a health maintenance organization license...
Section 15 - Bond; Waiver - Section 15. Each health maintenance organization shall furnish to the...
Section 16 - Contracts, Rates, Evidence of Coverage; Disapproval of Commissioner - Section 16. The subscriber contracts, rates and evidence of coverage...
Section 16a - Disapproval of Certain Health Maintenance Contracts Based on High Deductibles - Section 16A. The commissioner shall not disapprove a health maintenance...
Section 16b - Disapproval of Certain Health Maintenance Contracts for Coverage of Young Adults - Section 16B. The commissioner shall not disapprove a health maintenance...
Section 17 - Rules and Regulations; Standardized Claim Form - Section 17. The commissioner may promulgate rules and regulations as...
Section 17a - Open Enrollment for Nongroup Medicare Beneficiaries; Period, Notice of Termination - Section 17A. All health maintenance organizations governed by this chapter...
Section 19 - Discrimination Against Abuse Victims in Terms of Health Maintenance Contract - Section 19. No health maintenance organization subject to this chapter,...
Section 20 - Insolvent Health Maintenance Organization; Administrative Supervision, Rehabilitation or Liquidation; Priority of Claims - Section 20. Any administrative supervision, rehabilitation or liquidation of a...
Section 20a - Administrative Supervision, Rehabilitation or Liquidation of Health Maintenance Organizations; Revocation or Suspension of License - Section 20A. If the commissioner is satisfied, upon examination or...
Section 21 - Participating Provider; Contracts With Health Maintenance Organizations; Hold Harmless Clause; Limitation on Collection Actions - Section 21. (a) For purposes of this section, ''participating provider''...
Section 22 - Health Care Providers; Liability of Member of Health Maintenance Organization; Limitation on Collection of Amounts Owed - Section 22. (a) For purposes of this section, ''health care...
Section 23 - Insolvency of Health Maintenance Organization; Replacement Coverage - Section 23. (a) For purposes of this section, the following...
Section 24 - Health Maintenance Contracts; Genetic Tests; Discrimination Based on Genetic Information - Section 24. For the purposes of this section the following...
Section 25 - Net Worth of Health Maintenance Organization - Section 25. (a) The commissioner shall require upon issuance of...
Section 26 - Deposit Maintained With Trustee Acceptable to Commissioner - Section 26. (a) Except as provided in subsections (b) and...
Section 27 - Merger or Acquisition of Control - Section 27. (a) No person other than the health maintenance...
Section 28 - Registration With Commissioner - Section 28. (a) Every health maintenance organization which may do...
Section 29 - Violations of Secs. 27 to 29; Application for Order Enjoining Violations of Secs. 27 to 29; Penalties - Section 29. (a)(1) Whenever it appears to the commissioner that...
Section 30 - Statement for Individuals Provided With Creditable Coverage; Reporting - Section 30. Pursuant to section 8B of chapter 62C, carriers...
Section 31 - Attribution of Members to a Primary Care Provider - Section 31. To the maximum extent possible, every health maintenance...
Section 32 - Disclosure of Patient-Level Data and Contracted Prices of Individual Health Care Services by Carriers to Providers - Section 32. To the extent permissible under applicable state and...
Section 33 - Coverage for Health Care Services Delivered via Telehealth by a Contracted Health Care Provider - Section 33. (a) For the purposes of this section, the...