reglab/housing_qa huggingface dataset:
MS Code § 83-41-205 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 5 - Provisions Common to Hospital, Medical, or Surgical Insurance|§ 83-41-205. Individual hospital and medical expense contracts and policies shall provide for continuation of coverage for persons having an intellectual or physical disability

 Any individual hospital or medical service plan contract or any individual hospital or medical expense insurance policy delivered or issued for delivery in this state after September 12, 1972, which provides that coverage of a dependent child shall terminate upon attainment of the limiting age for dependent children specified in the contract or policy, shall also provide in substance that attainment of such limiting age shall not operate to terminate the coverage of such child while the child is and continues to be both (a) incapable of self-sustaining employment by reason of having an intellectual disability or a physical disability, and (b) chiefly dependent upon the subscriber or policyholder for support and maintenance, provided proof of such incapacity and dependency is furnished to the hospital or medical service plan corporation or insurer by the subscriber or policyholder within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the corporation or insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age.   Any insurer or hospital service plan corporation continuing dependent coverage beyond the limiting age for dependent children as prescribed by this section, shall have the right to charge the standard adult premium for such coverage.
MS Code § 83-41-207 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 5 - Provisions Common to Hospital, Medical, or Surgical Insurance|§ 83-41-207. Group hospital and medical expense contracts and policies shall provide for continuation of coverage for persons having an intellectual or physical disability

 Any group hospital or medical service plan contract or any group hospital or medical expense insurance policy delivered or issued for delivery in this state after September 12, 1972, which provides that coverage of a dependent child of an employee, insured party, or other member of the covered group shall terminate upon attainment of the limiting age for dependent children specified in the contract or policy, shall also provide in substance that attainment of such limiting age shall not operate to terminate the coverage of such child while the child is and continues to be both (a) incapable of self-sustaining employment by reason of having an intellectual disability or a physical disability, and (b) chiefly dependent upon the employee, insured party, or member for support and maintenance, provided proof of such incapacity and dependency is furnished to the hospital or medical service plan corporation or insurer by the employee, insured party, or member within thirty-one (31) days of the child's attainment of the limiting age and subsequently as may be required by the corporation or insurer, but not more frequently than annually after the two-year period following the child's attainment of the limiting age.   Any insurer or hospital service plan corporation continuing dependent coverage beyond the limiting age for dependent children as prescribed by this section, shall have the right to charge the standard adult premium for such coverage.
MS Code § 83-41-209 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 5 - Provisions Common to Hospital, Medical, or Surgical Insurance|§ 83-41-209. Beneficiaries' freedom of choice of practitioner in performance of dental services

 Whenever any policy of insurance or any medical service plan or hospital service contract or hospital and medical service contract issued in this state provides for reimbursement for any service which is within the lawful scope of practice of a duly licensed dentist, as defined by the laws of the State of Mississippi, the insured, or other person entitled to benefits under such policy, shall be entitled to reimbursement for such services, whether such services are performed by a duly licensed physician or by a duly licensed dentist, notwithstanding any provision to the contrary in any statute or in such policy, plan or contract; duly licensed dentists shall be entitled to participate in such policies, plans or contracts providing for dental services, as authorized by the laws of the State of Mississippi.
MS Code § 83-41-211 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 5 - Provisions Common to Hospital, Medical, or Surgical Insurance|§ 83-41-211. Beneficiaries' freedom of choice of practitioner in treatment of mental, nervous or emotional disorders; psychologist, professional counselor or clinical social worker

 Whenever any policy of insurance or any medical service plan or hospital service contract or hospital and medical service contract issued in this state provides for reimbursement for any diagnosis and treatment of mental, nervous or emotional disorders only which are within the lawful scope of practice of a duly licensed psychologist as defined in Section 73-31-3, within the lawful scope of practice of a duly licensed professional counselor as defined in Section 73-30-3, within the lawful scope of practice of a duly licensed clinical social worker as defined in Section 73-53-3, or within the lawful scope of practice of a duly licensed marriage and family therapist as defined in Section 73-54-5, the insured or other person entitled to benefits under such policy shall be entitled to reimbursement for such services, whether such services are performed by a duly licensed physician or by a duly licensed psychologist, by a duly licensed professional counselor, by a duly licensed clinical social worker or by a duly licensed marriage and family therapist, notwithstanding any provision to the contrary in any statute or in such policy, plan or contract. Duly licensed psychologists shall be entitled to participate in such policies, plans or contracts providing for the diagnosis and treatment of mental, nervous or emotional disorders only as authorized by Section 73-31-3. A duly licensed professional counselor shall be entitled to participate in such policies, plans or contracts providing for the diagnosis and treatment of mental, nervous or emotional disorders only as authorized by Section 73-30-3. A duly licensed clinical social worker shall be entitled to participate in such policies, plans or contracts providing for the diagnosis and treatment of mental, nervous or emotional disorders only as authorized by Section 73-53-3. A duly licensed marriage and family therapist shall be entitled to participate in such policies, plans or contracts providing for the diagnosis and treatment of mental, nervous or emotional disorders only as authorized by Section 73-54-5 et seq.   The addition of marriage and family therapists as providers herein is intended to only allow them to treat mental, nervous or emotional disorders as treated by other providers, to the extent that marriage and family therapists are qualified to treat such disorders. Notwithstanding anything in this section to the contrary, the scope or definition of mental, nervous or emotional disorders shall remain the same and shall not be expanded by the addition of marriage and family therapists as allowable providers.
MS Code § 83-41-213 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 5 - Provisions Common to Hospital, Medical, or Surgical Insurance|§ 83-41-213. Right of insureds or other beneficiaries to be reimbursed for services performed by physicians or nurse practitioners within lawful scope of their practice

 From and after January 1, 1999, whenever any policy of insurance or any medical service plan or hospital service contract or hospital and medical service contract issued, delivered, administered, continued or renewed in this state provides for reimbursement for any service which is within the lawful scope of practice of a duly certified nurse practitioner as provided for by rules and regulations implemented by the Mississippi Board of Nursing under Section 73-15-5(2), the insured or other person entitled to benefits under such policy shall be entitled to reimbursement for such services, whether such services are performed by a duly licensed physician or by a duly certified nurse practitioner, notwithstanding any provision to the contrary in any statute or in such policy, plan or contract. Duly certified nurse practitioners shall be entitled to participate in such policies, plans or contracts providing for the services of nurse practitioners, as authorized by the rules and regulations implemented by the Mississippi Board of Nursing under Section 73-15-5(2). Reimbursement shall be based on services rendered by a duly certified nurse practitioner.   It is the intent of the Legislature by this section to provide for increased access of health delivery services to the underserved.
MS Code § 83-41-214 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 5 - Provisions Common to Hospital, Medical, or Surgical Insurance|§ 83-41-214. Payment by third parties of certified nurse practitioners

 A policy or contract providing for third-party payment or prepayment of health or medical expenses shall include a provision for the payment of necessary medical or surgical care and treatment provided by a duly certified nurse practitioner and performed within the scope of the license of the certified nurse practitioner if the policy or contract would pay for the care and treatment if the care and treatment were provided by a person engaged in the practice of medicine and surgery or osteopathic medicine and surgery. The policy or contract shall provide that policyholders and subscribers under the policy or contract may reject the coverage for services which may be provided by a certified nurse practitioner if the coverage is rejected for all providers of similar services. A policy or contract subject to this section shall not impose a practice or supervision restriction which is inconsistent with or more restrictive than the restriction already imposed by law. This section applies to services provided under a policy or contract delivered, issued for delivery, continued, or renewed in this on or after July 1, 1999, and to an existing policy or contract, on the policy's or contract's anniversary or renewal date, whichever is later. This section does not apply to policyholders or subscribers eligible for coverage under Title XVIII of the federal Social Security Act or any similar coverage under a state or federal government plan. For the purposes of this section, third-party payment or prepayment includes an individual or group health care service contract, an individual or group health maintenance organization contract, or a preferred provider organization contract. Nothing in this section shall be interpreted to require an individual or group health maintenance organization, or a preferred provider organization to provide payment or prepayment for services provided by a certified nurse practitioner unless the certified nurse practitioner or the certified nurse practitioner's collaborating physician has entered into a contract or other agreement to provide services with the individual or group health maintenance organization or the preferred provider organization or arrangement.
MS Code § 83-41-215 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 5 - Provisions Common to Hospital, Medical, or Surgical Insurance|§ 83-41-215. Right of beneficiary or insured to reimbursement for services performed by chiropractor; freedom of choice of practitioner and place of services

 Whenever any policy of insurance or any medical service plan or hospital service contract or hospital and medical service contract issued in this state provides for reimbursement for any service which is within the lawful scope of practice of a duly licensed chiropractor as defined in Section 73-6-1, Mississippi Code of 1972, then such service may be performed by a duly licensed chiropractor, and the insured or other person entitled to benefits under such policy, plan or contract shall be entitled to reimbursement for such services. The insured shall have the right to choose the place where the service is to be performed as well as the chiropractor to perform such service, provided that such service shall be performed in the chiropractor's office, clinic or regular place of business.
MS Code § 83-41-217 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 5 - Provisions Common to Hospital, Medical, or Surgical Insurance|§ 83-41-217. Direct access to obstetricians/gynecologists to be allowed; status as primary care physicians

 Any health care service plan contract that provides hospital, outpatient, medical or surgical coverage that is issued, amended, delivered or renewed in this state shall include obstetricians/gynecologists as primary care physicians and allow direct access to obstetricians/gynecologists by female patients if the obstetrician/gynecologist otherwise meets the policy or contract requirements.
MS Code § 83-41-219 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 5 - Provisions Common to Hospital, Medical, or Surgical Insurance|§ 83-41-219. Reciprocal time limitations on health insurance claim filing and claim audits; applicability

  If any health insurance issuer or other health insurance benefit payer limits the time in which a health care provider or other person is required to submit a claim for payment, the health insurance issuer or other health insurance benefit payer shall have the same time limit following payment of the claim to perform any review or audit for reconsidering the validity of the claim and requesting reimbursement for payment of an invalid claim or overpayment of a claim.   If any health insurance issuer or other health insurance benefit payer does not limit the time in which a health care provider or other person is required to submit a claim for payment, the health insurance issuer or other health insurance benefit payer may not request reimbursement or offset another claim payment for reimbursement of an invalid claim or overpayment of a claim more than twelve (12) months after the payment of an invalid or overpaid claim.   Nothing in this section shall apply to:   Audits that were opened before July 1, 2012;   Audits of pharmacies as provided in Section 73-21-175 et seq.;   Claims submitted by providers for reimbursement under the Mississippi Medicaid Program, except that all audits of claims and payments made by or on behalf of the Division of Medicaid are limited to a maximum of five (5) years after final filing of the claim; and   Claims submitted in the context of misrepresentation, omission, concealment, or fraud by the health care provider or other person.
MS Code § 83-41-301 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 7 - Health Maintenance Organization, Preferred Provider Organization and Other Prepaid Health Benefit Plans Protection Act|§ 83-41-301. Short title

 This article may be cited as the Health Maintenance Organization, Preferred Provider Organization and Other Prepaid Health Benefit Plans Protection Act.
MS Code § 83-41-307 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 7 - Health Maintenance Organization, Preferred Provider Organization and Other Prepaid Health Benefit Plans Protection Act|§ 83-41-307. Transmission of copies of application for certificate of authority to State Health Officer; duties of State Health Officer; grant or denial of certificate of authority

    Upon receipt of an application for issuance of a certificate of authority, the commissioner shall forthwith transmit copies of the application and accompanying documents to the State Health Officer.   The State Health Officer shall determine whether the applicant for a certificate of authority, with respect to health care services to be furnished has complied with Section 83-41-313.   Within forty-five (45) days of receipt of the application for issuance of a certificate of authority, the State Health Officer shall certify to the commissioner that the proposed health maintenance organization meets the requirements of Section 83-41-313 or notify the commissioner that the health maintenance organization does not meet the requirements and specify deficiencies.     The commissioner shall within forty-five (45) days of receipt of certification or notice of deficiencies from the State Health Officer issue a certificate of authority to any person filing a completed application upon receiving the prescribed fees and upon the commissioner being satisfied that:   The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations;   Any deficiencies identified by the State Health Officer have been corrected and the State Health Officer has certified to the commissioner that the health maintenance organization's proposed plan of operation meets the requirements of Section 83-41-313 and other related regulations;   The health maintenance organization will effectively provide or arrange for the provision of basic health care services on a prepaid basis, through insurance or otherwise, except to the extent of reasonable requirements for copayments and/or deductibles; and   The health maintenance organization is in compliance with Sections 83-41-325 and 83-41-329.     A certificate of authority shall be denied only after the commissioner complies with the requirements of Section 83-41-339.
MS Code § 83-41-309 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 7 - Health Maintenance Organization, Preferred Provider Organization and Other Prepaid Health Benefit Plans Protection Act|§ 83-41-309. Powers of health maintenance organization generally; notice of exercise of powers affecting financial condition of organization

  The powers of a health maintenance organization include, but are not limited to, the following:   The purchase, lease, construction, renovation, operation or maintenance of hospitals, medical facilities, or both, and their ancillary equipment, and any property as may reasonably be required for its principal office or for those purposes as may be necessary in the transaction of the business of the organization;   Transactions between affiliated entities, including loans and the transfer of responsibility under all contracts between affiliates loans from the health maintenance organization to a parent are prohibited without prior approval in writing from the commissioner;   The furnishing of health care services through providers, provider associations or agents for providers which are under contract with or employed by the health maintenance organization;   The contracting with any person for the performance on its behalf of certain functions such as marketing, enrollment and administration provided all entities are qualified under this article;   The contracting with an insurance company licensed in this state, or with a hospital or medical service corporation authorized to do business in this state, for the provision of insurance, indemnity or reimbursement against the cost of health care services provided by the health maintenance organization;   The offering of other health care services, in addition to basic health care services. Non-basic health care services may be offered by a health maintenance organization on a prepaid basis without offering basic health care services to any group or individual;   The joint marketing of products with an insurance company licensed in this state or with a hospital or medical service corporation authorized to do business in this state as long as the company that is offering each product is clearly identified.       A health maintenance organization shall file notice, with adequate supporting information, with the commissioner prior to the exercise of any power granted in subsection 1(a), (b) or (d) which may affect the financial condition of the health maintenance organization. The commissioner shall disapprove an exercise of power only if in his opinion it would substantially and adversely affect the financial condition of the health maintenance organization and endanger its ability to meet its obligations.   The commissioner may promulgate rules and regulations exempting from the filing requirement of paragraph (a) those activities having a de minimis effect.
MS Code § 83-41-311 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 7 - Health Maintenance Organization, Preferred Provider Organization and Other Prepaid Health Benefit Plans Protection Act|§ 83-41-311. Bonds or insurance for directors, officers, employees, partners and contractors

  Any director, officer, employee, contractor or partner of a health maintenance organization who receives, collects, disburses or invests funds in connection with the activities of such organization shall be responsible for the funds in a fiduciary relationship to the organization.   A health maintenance organization shall maintain in force a fidelity bond or fidelity insurance on employees and officers, directors and partners in an amount not less than Two Hundred Fifty Thousand Dollars ($250,000.00) for each health maintenance organization or a maximum of Five Million Dollars ($5,000,000.00) in aggregate maintained on behalf of health maintenance organizations owned by a common parent corporation, or such sum as may be prescribed by the commissioner.
MS Code § 83-41-317 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 7 - Health Maintenance Organization, Preferred Provider Organization and Other Prepaid Health Benefit Plans Protection Act|§ 83-41-317. Filing of annual reports, financial statements, etc.

  Every health maintenance organization shall annually, on or before the first day of March, file a report verified by at least two (2) principal officers with the commissioner, with a copy to the State Health Officer, covering the preceding calendar year. Such report shall be on and in accordance to the National Association of Insurance Commissioner's Annual Statement Blanks and Instruction thereto and the NAIC Accounting Practices and Procedures Manual. The health maintenance organization shall file by the first day of March of each year, unless otherwise stated:   Audited financial statements on or before June 1;   A list of the providers who have executed a contract that complies with Section 83-41-325(12); and     A description of the grievance procedures, and   The total number of grievances handled through such procedures, a compilation of the causes underlying those grievances, and a summary of the final disposition of those grievances.       The commissioner may require such additional reports as are deemed necessary and appropriate to enable the commissioner to carry out his duties and responsibilities under this article.