Section 22. Notwithstanding any other general or special law to the contrary, each carrier shall require, as a condition of participation in the carrier's provider network by a physician, dentist, optometrist, podiatrist, nurse practicing in an advance practice nursing role, intern, resident, physician assistant, pharmacist with a collaborative practice agreement, psychologist and licensed independent clinical social worker, that such provider also apply to participate in the medical assistance program administered by the secretary of health and human services in accordance with chapter 118E and Title XIX of the Social Security Act and any federal demonstration or waiver relating to such medical assistance program for the limited purposes of ordering and referring services covered under such program, provided that regulations governing such limited participation are promulgated under said chapter 118E. Any such provider who chooses to participate in such medical assistance program as a provider of services shall be deemed to have fulfilled this requirement.
Structure Massachusetts General Laws
Part I - Administration of the Government
Chapter 176o - Health Insurance Consumer Protections
Section 2 - Bureau of Managed Care
Section 3 - Complaints Against Carriers; Notice; Hearing
Section 5 - Contracts; Liability
Section 5b - Policies and Procedures to Enforce Sec. 5a
Section 5c - Failure of Carrier to Comply With Coding Standards and Guidelines; Notice; Penalty
Section 7 - Information Provided by Carrier Upon Enrollment or Upon Request
Section 8 - Failure by Carrier to File Annual Statement; Fine
Section 9 - Utilization Review Programs; Annual Attestations
Section 10 - Contractual Financial Incentive Plans
Section 11 - Rights of Health Benefit Plans to Include as Providers Religious Non-Medical Providers
Section 12 - Utilization Review
Section 13 - Formal Internal Grievance Process; Expedited Resolution Policy
Section 14 - Review Panel; Patient Protection Office
Section 15 - Disenrollment of Provider; Continuation of Treatment; Specialty Health Care Coverage
Section 17 - Regulations; Promulgation
Section 18 - Responsibility of Carrier for Behavioral Health Services Compliance
Section 21 - Submission by Carrier of Annual Comprehensive Financial Statement
Section 25 - Use and Acceptance of Specifically Designated Prior Authorization Forms