Massachusetts General Laws
Chapter 6d - Health Policy Commission
Section 12 - Negotiation of Network Contracts by Unregistered Provider or Provider Organization Prohibited

Section 12. (a) No provider or provider organization may negotiate network contracts with any carrier or third-party administrator except for a provider or provider organizations which are registered under this chapter and regulations promulgated under this chapter; provided, however, that nothing in this chapter shall require a provider or provider organization with a patient panel of 15,000 or fewer or which represents providers who collectively receive, less than $25,000,000 in annual net patient service revenue from carriers or third-party administrators to be registered if such provider or provider is not a risk-bearing provider organization.
(b) Nothing in this chapter shall require a carrier to negotiate a network contract with a registered provider organization or with a registered provider or provider organization for all providers that are part of, or represented by, a registered provider organization.

Structure Massachusetts General Laws

Massachusetts General Laws

Part I - Administration of the Government

Title II - Executive and Administrative Officers of the Commonwealth

Chapter 6d - Health Policy Commission

Section 1 - Definitions

Section 2 - Health Policy Commission; Governing Board; Members; Duties and Powers; Annual Report

Section 2a - Confidentiality of Nonpublic Clinical, Financial, Strategic or Operational Documents

Section 3 - Board Powers and Duties

Section 4 - Advisory Council

Section 5 - Monitoring of Health Care Delivery and Payment System

Section 6 - Payment by Acute Hospital, Ambulatory Surgical Center or Surcharge Payor for Estimated Expenses of Commission

Section 7 - Administration of the Healthcare Payment Reform Fund; Competitive Process for Development of Health Care Payment and Service Delivery Models; Annual Report

Section 8 - Public Hearings; Witnesses; Annual Report

Section 8a - Pharmaceutical Drug Pricing; Manufacturer Disclosure of Pricing Information; Determination of Supplemental Rebate, Proposed Value or Reasonableness of Pricing of a Drug

Section 9 - Health Care Cost Growth Benchmark; Modification

Section 10 - Notice to Health Care Entities Exceeding Health Care Cost Growth Benchmark; Performance Improvement Plan; Waiver; Penalty for Failure to Comply

Section 11 - Registration Program for Provider Organizations; Division of Insurance Risk Certificate

Section 12 - Negotiation of Network Contracts by Unregistered Provider or Provider Organization Prohibited

Section 13 - Notice of Material Changes to Operations or Governance Structure of Provider or Provider Organization; Cost and Market Impact Review

Section 14 - Standards of Certification for Patient-Centered Medical Homes; Coordination of Care; Quality Standards

Section 15 - Certification as Accountable Care Organization (Aco); Standards

Section 16 - Office of Patient Protection; Powers and Duties; External Review System

Section 17 - Annual Report; Audits

Section 18 - Adoption of Regulations to Implement Chapter 6d

Section 19 - Early Childhood Investment Opportunity Grant Program