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- Section 4B Repealed, 2000, 80, Sec. 7
- 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 Abortion, abortion-related care, 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 4Z Repealed, 2008, 451, Sec. 138
- Section 4A1/2 Repealed, 2008, 256, Sec. 12
- Section 4AA Coverage for prosthetic devices and repairs
- Section 4BB Coverage for eligible dependents under 26 years of age or dependents mentally or physically incapable of earning their own living due to disability
- 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 Repealed, 2016, 133, Sec. 114
- 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 plan; non-medication and nonsurgical treatment; review; educational materials
- 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 Repealed, 2021, 29, Sec. 25
- Section 4QQ Coverage for prescription eye drops
- Section 4RR Coverage for mental health or substance use disorder services delivered through psychiatric collaborative care model
- Section 4SS Coverage for medically necessary mental health acute treatment, community-based acute treatment, intensive community-based acute treatment
- Section 4TT Benefits for medically necessary emergency services programs
- Section 4UU Coverage for annual mental health wellness examination
- Section 4VV Coverage for federally-defined preventive services
- Section 4WW Coverage for standard fertility preservation services
- Section 4XX Coverage for postpartum depression and major depressive disorder screenings
- Section 4YY Coverage for the provision of medically necessary pasteurized donor human milk and donor human milk-derived products
- Section 4ZZ Coverage for universal postpartum home visiting services
- Section 4AAA Coverage for diagnostic examinations for breast cancer; digital breast tomosynthesis screening, MRIs and ultrasounds
- Section 4BBB Coverage for prescribed, ordered or dispensed opioid antagonists
- Section 4CCC Coverage for the provision of services by a recovery coach
- Section 4DD1/2 Coverage for treatment of Down syndrome through speech therapy, occupational therapy, physical therapy and applied behavior analysis services
- Section 4DDD Coverage for identified generic and brand name drug used to treat diabetes, asthma, and certain heart conditions
- 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 15 Repealed, 1951, 797
- 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