Massachusetts General Laws
Chapter 176a - Non-Profit Hospital Service Corporations
Section 8m - Standardized Claim Form

Massachusetts General Laws

Part I - Administration of the Government

Title XXII - Corporations

Chapter 176a - Non-Profit Hospital Service Corporations

Section 1 - Corporations Governed by Chapter; Services Received in Nonparticipating Hospital; Substitution of Benefits in Nursing Homes

Section 1a - Right to Become Subscriber; Open Enrollment Periods

Section 1b - Medicare Supplemental Group Coverage; Medical Assistance Recipients

Section 1c - Retroactive Premium Rate Increase

Section 1d - Contracts of Reinsurance

Section 2 - Incorporators; Directors; Certificate of Organization; Commissioner's Examination Report

Section 3 - Certificate of Compliance; Examination by Commissioner

Section 3a - Discrimination Against Abuse Victims in Terms of Hospital Service Plans

Section 3b - Medical Service Plans; Genetic Tests; Discrimination Based on Genetic Information

Section 4 - Accounting System; Accountant, Claim Manager, Underwriter and Actuary

Section 5 - Joint Administration With Certain Corporations

Section 6 - Approval of Nongroup Contracts

Section 7 - Information Gathering Authority of Commissioner; Confidentiality and Privilege

Section 8 - Conditions to Issuance or Delivery of Contract

Section 81/2 - Sale of Group Non-Profit Hospital Service Contracts

Section 8a - Mental Illness Expenses; Inclusion in Contracts as Benefits; Biologically-Based Mental Disorders; Rape-Related Mental Disorders; Non-Biologically-Based Mental Disorders for Children and Adolescents Under Age 19

Section 8a3/4 - Retroactive Claims Denials for Behavioral Health Services

Section 8b - Dependent Coverage for Newborn Infants or Adoptive Children; Inclusion in Contracts

Section 8c - Refusal to Contract With Blind or Deaf Persons; Prohibition

Section 8d - Limited Extension of Benefits

Section 8e - Diethylstilbestrol Exposure; Discrimination

Section 8f - Divorced or Separated Spouses; Continuation of Eligibility for Benefits

Section 8g - Cardiac Rehabilitation Expense Benefits

Section 8h - Prenatal, Childbirth and Postpartum Care Benefits; Minimum Coverage for In-Patient Care

Section 8i - Home Care Benefits

Section 8j - Minimum Requirements for Cytologic Screening and Mammographic Examination Expense Benefits

Section 8k - Infertility Diagnosis and Treatment Benefits

Section 8l - Nonprescription Enteral Formulas for Home Use

Section 8m - Standardized Claim Form

Section 8n - Off-Label Drug Use; Cancer

Section 8o - Hospital Service Plan Benefits for Bone Marrow Transplants

Section 8p - Items Medically Necessary for Diagnosis and Treatment of Diabetes

Section 8q - HIV/AIDS Treatment; Off-Label Prescription Drug Coverage

Section 8r - Coverage of Hospice Services for Terminally Ill Patients

Section 8s - Nurse Anesthetist and Nurse Practitioner Services

Section 8t - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment

Section 8u - Emergency Services Provided to Insureds for Emergency Medical Conditions

Section 8v - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing

Section 8w - Outpatient Services; Hormone Replacement Therapy for Peri and Post Menopausal Women; Contraceptive Services; Approved Prescription Contraceptive Drugs and Devices; Exception

Section 8x - Coverage for Patient Care Services Under Qualified Clinical Trials

Section 8y - Diagnosis and Treatment of Speech, Hearing and Language Disorders

Section 8aa - Coverage of Prosthetic Devices and Repairs

Section 8bb - Coverage for Eligible Dependents Under 26 Years of Age

Section 8cc - Coverage for Medically Necessary Hypodermic Syringes or Needles

Section 8dd - Coverage for Diagnosis and Treatment of Autism Spectrum Disorder

Section 8ee - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate

Section 8ff - Coverage for Orally Administered Anticancer Medications

Section 8gg - Coverage for Abuse Deterrent Opioid Drug Products

Section 8hh - Preauthorization for Substance Abuse Treatment Not to Be Required

Section 8ii - Coverage for Medically Necessary Acute Treatment or Clinical Stabilization Services

Section 8jj - Coverage for Long-Term Antibiotic Therapy for Patients With Lyme Disease

Section 8kk - Coverage for Medical or Drug Treatments to Correct or Repair Disturbances of Body Composition Caused by HIV Associated Lipodystrophy Syndrome

Section 8ll - Filling of Remaining Portion of Prescription for Covered Drug That Is a Narcotic Substance Earlier Filled in Lesser Quantity

Section 8mm - Pain Management Access Plans

Section 8nn - Coverage for Tobacco Use Cessation Counseling and Tobacco Cessation Products

Section 8oo - Coverage for Treatment of Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections and Pediatric Acute-Onset Neuropsychiatric Syndrome

Section 8pp - Coverage for Long-Term Antibiotic Therapy for Lyme Disease; Experimental Drugs

Section 8qq - Coverage for Prescription Eye Drops

Section 10 - Group Hospital Service Plan; Approval or Disapproval of Contracts and Rates; Filing

Section 10a - Preferred Provider Arrangements

Section 11 - Officers; Duties

Section 12 - Publication of Assets and Liabilities

Section 13 - Hospitalization and Medical Service for Officers and Employees of Corporation

Section 14 - Misrepresentation of Terms of Subscriber's Contract

Section 14b - Disclosure of Information; Mental or Nervous Conditions; Exceptions

Section 15 - Costs of Solicitation of Subscribers and Administration

Section 16 - Acquisition of Real Estate; Leases; Tax Exemption; Limit; Approval of Investments, Sales, Loans and Places of Deposit

Section 17 - Submission of Disputes and Controversies

Section 18 - Annual Statement of Condition; Verification, Filing, Form, Violations; Applicability of Chapters 176v and 176w

Section 18a - Financial Statements; Inclusion of Electronic Data Processing Equipment as Asset

Section 19 - Tax Exemption

Section 20 - Filing of Amendment of By-Laws

Section 21 - Submission of Advertising Matter to Commissioner

Section 22 - Filing of Riders, Endorsements and Applications With Commissioner

Section 23 - Grounds for Enjoining Transaction of Business; Rehabilitation Proceedings; Duties of Receiver; Distribution of Assets

Section 24 - Special Contingent Reserve Fund

Section 25 - Licensing of Agents

Section 26 - Salaries, Compensation or Emoluments Paid by Corporation

Section 27 - Payroll Deductions for Governmental Employees

Section 28 - Violations; Penalties

Section 29 - Application

Section 30 - Savings Clause

Section 31 - Contracts for Administrative or Other Services; Loans and Investments

Section 32 - Payment of Sums Owed to Subscriber's Estate

Section 33 - Insolvency of Health Maintenance Organization; Replacement Coverage

Section 34 - Report of Individuals Provided With Creditable Coverage

Section 36 - Attribution of Members to a Primary Care Provider

Section 37 - Disclosure of Patient-Level Data and Contracted Prices of Individual Health Care Services by Carriers to Providers

Section 38 - Coverage for Health Care Services Delivered via Telehealth by a Contracted Health Care Provider