[ Text of section added by 2021, 29, Sec. 24 effective July 1, 2021 until July 1, 2022. See 2021, 29, Sec. 69. Repealed by 2021, 29, Sec. 25.]
Section 4PP. (a) For the purposes of this section, "long-term antibiotic therapy'' and "Lyme disease'' shall have the meaning ascribed to them in section 12DD of chapter 112.
(b) A subscription certificate under an individual or group medical service agreement delivered, issued or renewed within the commonwealth shall provide coverage for long-term antibiotic therapy for a patient with Lyme disease when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient's symptoms, diagnostic test results or response to treatment. An experimental drug shall be covered as a long-term antibiotic therapy if it is approved for an indication by the United States Food and Drug Administration; provided, however, that a drug, including an experimental drug, shall be covered for an off-label use in the treatment of Lyme disease if the drug has been approved by the United States Food and Drug Administration.
Structure Massachusetts General Laws
Part I - Administration of the Government
Chapter 176b - Medical Service Corporations
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 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 4u - Emergency Services Provided to Insureds for Emergency Medical Conditions
Section 4v - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing
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 4mm - Pain Management Access Plans
Section 4nn - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products
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 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 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