Massachusetts General Laws
Chapter 176b - Medical Service Corporations
Section 23 - Attribution of Members to a Primary Care Provider

Massachusetts General Laws

Part I - Administration of the Government

Title XXII - Corporations

Chapter 176b - Medical Service Corporations

Section 1 - Definitions

Section 2 - Incorporators; Formation; Articles of Organization; Certification

Section 3 - By-Laws; Joint Service Contracts; Preferred Provider Arrangements

Section 3a - Contracts of Reinsurance

Section 3b - Group Medical Service Agreements; Contribution Percentages

Section 4 - Contracts for Medical, Chiropractic, Visual, Surgical, and Other Health Services; Approval, Subscription Certificates; Classification of Risks

Section 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

Section 4c - Dependent Coverage for Newborn Infants or Adoptive Children; Inclusion of Medical Expenses as Benefits

Section 4d - Refusal to Contract With Blind or Deaf Persons; Prohibition

Section 4e - Diethylstilbestrol Exposure; Discrimination

Section 4f - Cardiac Rehabilitation Expense Benefits

Section 4g - Certified Nurse Midwife Services Benefits

Section 4h - Prenatal, Childbirth and Postpartum Care Benefits; Minimum Coverage for In-Patient Care

Section 4i - Cytologic Screening and Mammographic Examination Benefits

Section 4j - Infertility Diagnosis and Treatment Benefits

Section 4k - Nonprescription Enteral Formulas for Home Use

Section 4l - Chiropractic Services Benefits

Section 4m - Standardized Claim Form

Section 4n - Off-Label Drug Use; Cancer

Section 4o - Medical Service Agreement Coverage for Bone Marrow Transplants

Section 4p - Off-Label Use of Prescription Drugs for HIV/AIDS Treatment

Section 4q - Coverage for Licensed Hospice Services

Section 4r - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment

Section 4s - Items Medically Necessary for Diagnosis and Treatment of Diabetes

Section 4t - Subscription Certificate Benefits for Services Rendered by a Nurse Anesthetist or Nurse Practitioner

Section 4u - Emergency Services Provided to Insureds for Emergency Medical Conditions

Section 4v - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing

Section 4w - Outpatient Services; Hormone Replacement Therapy for Peri and Post Menopausal Women; Contraceptive Services; Approved Prescription Contraceptive Drugs or Devises; Exception

Section 4x - Coverage for Patient Care Services Provided Under Qualified Clinical Trials

Section 4y - Coverage for Speech, Hearing and Language Disorders

Section 4aa - Coverage for Prosthetic Devices and Repairs

Section 4bb - Coverage for Eligible Dependents Under 26 Years of Age

Section 4cc - Coverage for Medically Necessary Hypodermic Syringes or Needles

Section 4dd - Coverage for Diagnosis and Treatment of Autism Spectrum Disorder

Section 4ee - Coverage for Children 21 Years of Age or Younger for Hearing AIDS and Related Services

Section 4ff - Coverage for Orally Administered Anticancer Medications

Section 4gg - Coverage for Abuse Deterrent Opioid Drug Products

Section 4hh - Preauthorization for Substance Abuse Treatment Not to Be Required

Section 4ii - Coverage for Medically Necessary Acute Treatment or Clinical Stabilization Services

Section 4jj - Coverage for Long-Term Antibiotic Therapy for Patients With Lyme Disease

Section 4kk - Coverage for Medical or Drug Treatments to Correct or Repair Disturbances of Body Composition Caused by HIV Associated Lipodystrophy Syndrome

Section 4ll - Filling of Remaining Portion of Prescription for Covered Drug That Is a Narcotic Substance Earlier Filled in Lesser Quantity

Section 4mm - Pain Management Access Plans

Section 4nn - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products

Section 4oo - Coverage for Treatment of Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections and Pediatric Acute-Onset Neuropsychiatric Syndrome

Section 4pp - Coverage for Long-Term Antibiotic Therapy for Lyme Disease; Experimental Drugs

Section 4qq - Coverage for Prescription Eye Drops

Section 5 - Subscribers; Qualifications, Misrepresentation; Open Enrollment Periods

Section 5a - Discrimination Against Abuse Victims in Terms of Medical Service Plans

Section 5b - Medical Service Plans; Genetic Tests; Discrimination Based on Genetic Information

Section 6 - Subscription Certificate; Issuance; Content

Section 6a - Limited Extension of Benefits

Section 6b - Divorced or Separated Spouses; Continuation of Eligibility for Benefits

Section 7 - Contracts Between Corporation and Care Providers

Section 7a - Medicare Supplemental Group Coverage; Eligibility Due to Age or Disability

Section 7b - Medicare Supplemental Group Coverage; Medical Assistance Recipients

Section 7c - Retroactive Premium Rate Increase

Section 7d - Retroactive Claims Denial for Behavioral Health Services

Section 8 - Annual Statement; Verification, Form, Violations

Section 8a - Financial Statements; Inclusion of Electronic Data Processing Equipment as Asset

Section 8b - Applicability of Chapter 176v to Medical Service Corporations Governed by This Chapter

Section 8c - Applicability of Chapter 176w to Medical Service Corporations Governed by This Chapter

Section 9 - Inspection and Examination of Affairs of Corporation; Confidentiality and Privilege; Inability to Pay Providers; Pro Rata Payments; Termination of Contract

Section 10 - Investments, Sales, Loans and Places of Deposit; Approval; Acquisition of Real Estate; Leases; Tax Exemption; Limit; Special Contingent Surplus

Section 11 - Salaries, Compensation or Emoluments

Section 12 - Submission of Disputes or Controversies to Board; Privacy of Patient Information

Section 13 - Grounds for Enjoining Transaction of Business; Receivers

Section 14 - Liability of Corporation; Exemption From Insurance Laws; Tax Exemption

Section 16 - Operators of Medical Service Plan

Section 16a - Payroll Deductions of Governmental Employees

Section 17 - Enforcement

Section 18 - Contracts for Administrative or Other Services; Loans and Investments

Section 19 - Payment of Sums Owed Subscriber's Estate

Section 20 - Disclosure of Information; Mental or Nervous Condition

Section 21 - Insolvency of Health Maintenance Organization; Replacement Coverage

Section 22 - Statement Provided to Individuals Provided With Creditable Coverage; Report

Section 23 - Attribution of Members to a Primary Care Provider

Section 24 - Disclosure of Patient-Level Data and Contracted Prices of Individual Health Care Services by Carriers to Providers

Section 25 - Coverage for Health Care Services Delivered via Telehealth by a Contracted Health Care Provider