reglab/housing_qa huggingface dataset:
MA Gen L ch 176s § 1 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176s - Consumer Choice of Physician Assistant Services|Section 1 - Definitions

Section 1. As used in this chapter, the following words shall, unless the context clearly requires otherwise, have the following meanings:—  ''Carrier'', (1) an insurer licensed or otherwise authorized to transact accident or health insurance under chapter 175; (2) a nonprofit hospital service corporation organized under chapter 176A; (3) a nonprofit medical service corporation organized under chapter 176B; (4) a health maintenance organization organized under chapter 176G; (5) an organization entering into a preferred provider arrangement under chapter 176I; (6) a contributory group general or blanket insurance for persons in the service of the commonwealth under chapter 32A; (7) a contributory group general or blanket insurance for persons in the service of counties, cities, towns and districts, and their dependents under chapter 32B; (8) the medical assistance program administered by the office of Medicaid pursuant to chapter 118E and in accordance with Title XIX of the Social Security Act or any successor statute; and (9) any other medical assistance program operated by a governmental unit for persons categorically eligible for such program.  ''Commissioner'', the commissioner of insurance.  ''Insured'', an enrollee, covered person, insured, member, policyholder or subscriber of a carrier.  ''Nondiscriminatory basis'', a carrier shall be deemed to be providing coverage on a non-discriminatory basis if its plan does not contain any annual or lifetime dollar or unit of service limitation imposed on coverage for the care provided by a physician assistant which is less than any annual or lifetime dollar or unit of service limitation imposed on coverage for the same services by other participating providers.  ''Participating provider'', a provider who, under terms and conditions of a contract with the carrier or with its contractor or subcontractor, has agreed to provide health care services to an insured with an expectation of receiving payment, other than coinsurance, co-payments or deductibles, directly or indirectly from the carrier.  ''Physician assistant'', a person who is a graduate of an approved program for the training of physician assistants who is supervised by a registered physician in accordance with sections 9C to 9H, inclusive, of chapter 112, and who has passed the Physician Assistant National Certifying Exam or its equivalent.  ''Primary care provider'', a health care professional qualified to provide general medical care for common health care problems who (1) supervises, coordinates, prescribes, or otherwise provides or proposes health care services; (2) initiates referrals for specialist care; and (3) maintains continuity of care within the scope of practice.
MA Gen L ch 176s § 2 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176s - Consumer Choice of Physician Assistant Services|Section 2 - Physician Assistants to Be Recognized as Participating Providers Subject to Sec. 3

Section 2. The commissioner and the group insurance commission shall require that all carriers recognize physician assistants as participating providers subject to section 3 and shall include coverage on a nondiscriminatory basis to their insureds for care provided by physician assistants for the purposes of health maintenance, diagnosis and treatment. Such coverage shall include benefits for primary care, intermediate care and inpatient care, including care provided in a hospital, clinic, professional office, home care setting, long-term care setting, mental health or substance abuse program, or any other setting when rendered by a physician assistant who is a participating provider and is practicing within the scope of his or her professional authority as defined by statute, rule and physician delegation to the extent that such policy or contract currently provides benefits for identical services rendered by a provider of health care licensed by the commonwealth.
MA Gen L ch 176s § 3 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176s - Consumer Choice of Physician Assistant Services|Section 3 - Physician Assistant to Be Considered Qualified as Primary Care Provider

Section 3. A participating provider physician assistant practicing within the scope of such physician assistant's license, including all regulations requiring collaboration with or supervision by a physician under section 9E of chapter 112, shall be considered qualified within the carrier's definition of primary care provider to an insured.
MA Gen L ch 176s § 4 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176s - Consumer Choice of Physician Assistant Services|Section 4 - Participating Provider Physician Assistant Eligible as Primary Care Provider

Section 4. Notwithstanding any general or special law to the contrary, a carrier that requires the designation of a primary care provider shall provide its insured with an opportunity to select a participating provider physician assistant as a primary care provider.
MA Gen L ch 176s § 5 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176s - Consumer Choice of Physician Assistant Services|Section 5 - Participating Provider Physician Assistants to Be Included on Publicly Accessible List of Participating Providers

Section 5. Notwithstanding any general or special law to the contrary, a carrier shall ensure that all participating provider physician assistants are included on any publicly accessible list of participating providers for the carrier.
MA Gen L ch 176s § 6 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176s - Consumer Choice of Physician Assistant Services|Section 6 - Complaint for Noncompliance

Section 6. A complaint for noncompliance against a carrier shall be filed with and investigated by the commissioner or the group insurance commission, whichever shall have regulatory authority over the carrier. The commissioner and the group insurance commission shall promulgate regulations to enforce this chapter.
MA Gen L ch 176t § 2 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176t - Risk-Bearing Provider Organizations|Section 2 - Risk-Bearing Provider Organization Not Subject to Chapters 175, 176a, 176b, 176c, 176e, 176f, 176g and 176j

Section 2. Except as hereinafter provided, a risk-bearing provider organization shall not be subject to chapters 175, 176A, 176B, 176C, 176E, 176F, 176G and 176J; provided, however, that a risk-bearing provider organization that enters into a contract with employers or individuals under which the provider organization would assume a significant portion of downside risk, as defined through division regulations, may be subject to the provisions of said chapters 175, 176A, 176B, 176C, 176E, 176F, 176G and 176J for the purposes of such contracts.
MA Gen L ch 176t § 5 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176t - Risk-Bearing Provider Organizations|Section 5 - Threat of Financial Insolvency Due to Risk-Bearing Provider Organization's Alternative Payment Contracts With Downside Risk; Notice; Suspension or Cancellation of Risk Certificate; Hearing

Section 5. (a) If upon examination or at any other time the commissioner determines that the risk-bearing provider organization's existing or proposed alternative payment contracts with downside risk are likely to threaten the financial solvency of the risk-bearing provider organization, the commissioner shall provide notice to the risk-bearing provider organization.  (b) The commissioner may suspend, cancel, non-renew or refuse to issue a risk-bearing provider organization's risk certificate upon a determination that the risk-bearing provider organization has not cured a threat to financial solvency, that the risk-bearing provider organization's application for a risk certificate is incomplete or contains or is based on fraudulent information, or that the risk-bearing provider organization has otherwise failed to comply with the requirements of this chapter. The commissioner shall notify the risk-bearing provider organization and advise, in writing, of the reason for any refusal to issue or non-renew a risk certificate under this chapter. A copy of the notice shall be forwarded to the commission and center. The applicant or certified risk-bearing provider organization may make written demand upon the commissioner within 30 days of receipt of such notification for a hearing before the commissioner to determine the reasonableness of the commissioner's action. The hearing shall be held pursuant to chapter 30A.  (c) The commissioner shall not suspend or cancel a risk certificate unless the commissioner has first afforded the risk-bearing provider organization an opportunity for a hearing pursuant to chapter 30A.  (d) Upon a ruling by the commissioner to suspend or cancel a risk-I bearing provider organization's certification, a written notice shall be forwarded to the commission and the center.
MA Gen L ch 176t § 6 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176t - Risk-Bearing Provider Organizations|Section 6 - Health Care Provider Prohibited From Collecting or Attempting to Collect Money Owed by Risk-Bearing Provider Organization From Patient

Section 6. (a) For purposes of this section, ''health care provider'' shall mean any physician, hospital or other person or entity furnishing health services that has contracted to provide services according to its agreements with a risk-bearing provider organization.  (b) A health care provider or any representative of a health care provider shall not maintain any action against a patient to collect or attempt to collect any money owed to the health care provider by a risk-bearing provider organization.  (c) A risk-bearing provider organization shall include provisions within its contracts with health care providers that conspicuously prohibit health care providers from collecting or attempting to collect money from a patient that is owed to the health care provider by a risk-bearing provider organization.
MA Gen L ch 176t § 7 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176t - Risk-Bearing Provider Organizations|Section 7 - Availability of Information Provided by Risk-Bearing Provider Organizations

Section 7. All information provided by risk-bearing provider organizations to the division under this chapter shall be made available to the center and the commission.
MA Gen L ch 176t § 8 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176t - Risk-Bearing Provider Organizations|Section 8 - Non-Exemption of Applicable Provisions of Chapter 111, 112 or 176t

Section 8. Nothing in this chapter shall exempt any person from any applicable provisions of chapter 111, 112 or 176T including, but not limited to, provisions relating to determination of need, licensure and regulation of hospitals and clinics and registration of health professionals.
MA Gen L ch 176t § 9 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176t - Risk-Bearing Provider Organizations|Section 9 - Promulgation of Rules and Regulations Necessary to Carry Out Provisions of This Chapter

Section 9. The commissioner shall promulgate rules and regulations as are necessary to carry out the provisions of this chapter. In developing the rules and regulations, including risk-bearing standards, certification and reporting requirements, the commissioner shall consider other rules and regulations applicable to such organizations and shall consult with the center and the commission regarding standards concerning provider organizations which enter into alternative payment contracts.
MA Gen L ch 176u § 2 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176u - Long-Term Care Insurance|Section 2 - Extraterritorial Jurisdiction

Section 2. No group long-term care insurance policy shall be offered to a resident of the commonwealth under a group policy issued in another state to a group described in clause (4) of the definition of group long-term care insurance unless the commonwealth or another state having statutory and regulatory long-term care insurance requirements substantially similar to those adopted in the commonwealth has made a determination that the requirements of said clause (4) have been met.
MA Gen L ch 176u § 4 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176u - Long-Term Care Insurance|Section 4 - Incontestability Period

Section 4. (a) For a policy or certificate that has been in force for less than 6 months, an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is material to the acceptance for coverage.  (b) For a policy or certificate that has been in force for at least 6 months but less than 2 years an insurer may rescind a long-term care insurance policy or certificate or deny an otherwise valid long-term care insurance claim upon a showing of misrepresentation that is both material to the acceptance for coverage and which pertains to the condition for which benefits are sought.  (c) After a policy or certificate has been in force for 2 years it shall not be contestable upon the grounds of misrepresentation alone but may be contested only upon a showing that the insured knowingly and intentionally misrepresented relevant facts relating to the insured's health.  (d) A long-term care insurance policy or certificate may be field issued if the compensation to the field issuer is not based on the number of policies or certificates issued. For the purposes of this subsection, the term ''field issued'' shall mean a policy or certificate issued by a producer or a third-party administrator under the underwriting authority granted to the producer or third party administrator by an insurer and using the insurer's underwriting guidelines.  (e) If an insurer has paid benefits under a long-term care insurance policy or certificate, the insurer shall not be entitled to recover the benefit payments if the policy or certificate is rescinded.  (f) In the event of the death of the insured, this section shall not apply to the remaining death benefit of a life insurance policy that accelerates benefits for long-term care. In that event, the remaining death benefits under any such policy shall be governed by section 132 of chapter 175. In any other event, this section shall apply to life insurance policies that accelerate benefits for long-term care.
MA Gen L ch 176u § 5 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176u - Long-Term Care Insurance|Section 5 - Nonforfeiture Benefits

Section 5. (a) Except as provided in subsection (b), a long-term care insurance policy shall not be delivered or issued for delivery in the commonwealth unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate that includes a nonforfeiture benefit. The offer of a nonforfeiture benefit may be in the form of a rider that is attached to the policy. In the event the policyholder or certificate holder declines the nonforfeiture benefit, the insurer shall provide a contingent benefit upon lapse that shall be available for a specified period of time following a substantial increase in premium rates.  (b) When a group long-term care insurance policy is issued, the offer required in subsection (a) shall be made to the group policyholder. If the policy is issued as group long-term care insurance to a group defined in clause (4) of the definition of group long-term care insurance, other than to a continuing care retirement community or other similar entity, the offer shall be made to each proposed certificate holder.
MA Gen L ch 176u § 7 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176u - Long-Term Care Insurance|Section 7 - Promulgation of Rules and Regulations; Notice and Hearing on Rate Increases

Section 7. (a) The commissioner shall promulgate rules and regulations, under chapter 30A which, at a minimum, shall be consistent with the standards set forth in the 2009 National Association of Insurance Commissioners Long-Term Care Model Regulation, including standards for:  (i) full and fair disclosure, setting forth the manner, content and required disclosures for the sale of long-term care insurance policies and certificates;  (ii) policy definitions and provisions, terms of renewability, initial and subsequent conditions of eligibility, benefit triggers, home health and community care benefits, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, limitations, exceptions, reductions, elimination and probationary periods, requirements for replacement and unintentional lapse protection;  (iii) the promotion of premium adequacy and protections for the policyholder or certificate holder in the event of a substantial rate increase and disclosure;  (iv) the offer of inflation and nonforfeiture coverage, including rules for a contingent benefit upon lapse;  (v) marketing practices and suitability and producer professional education; and  (vi) filing requirements, reporting practices and requirements, reserve standards, independent review of benefit determinations and penalties.  (b) The division of insurance shall update, on a biennial basis, the consumer guide for long-term insurance. The division shall maintain a list of insurance companies selling long-term care insurance in the commonwealth and their Massachusetts rate increase history for the preceding 10 years on its website.  (c) The commissioner shall, in the commissioner's discretion and may, on motion of the attorney general, initiate a hearing on any long-term care insurance rate increase before its effective date after at least 10 days' notice.
MA Gen L ch 176u § 8 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176u - Long-Term Care Insurance|Section 8 - Penalties

Section 8. In addition to the penalties provided in chapters 175 and 176D, any insurer or insurance producer found to have violated any requirement of this chapter or any rules or regulations promulgated under this chapter relating to the regulation of long-term care insurance or the marketing of such insurance, shall be subject to a fine of up to 3 times the amount of any commissions paid for each policy involved in the violation or up to $10,000, whichever is greater.
MA Gen L ch 176u § 9 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176u - Long-Term Care Insurance|Section 9 - Scope of Chapter

Section 9. Nothing in this chapter shall supersede the obligations of entities subject to this chapter to comply with applicable insurance laws insofar as those laws do not conflict with this chapter, except that laws and regulations intended to apply to Medicare supplement insurance policies governed by chapter 176K of the General Laws shall not apply to long-term care insurance.
MA Gen L ch 176v § 2 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176v - Own Risk and Solvency Assessment|Section 2 - Risk Management Framework

Section 2. An insurer shall maintain a risk management framework to assist the insurer with identifying, assessing, monitoring, managing and reporting on its material and relevant risks. This requirement may be satisfied if the insurance group of which the insurer is a member maintains a risk management framework applicable to the operations of the insurer.
MA Gen L ch 176v § 3 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176v - Own Risk and Solvency Assessment|Section 3 - Orsa Requirements

Section 3. Subject to section 5, an insurer, or the insurance group of which the insurer is a member, shall regularly conduct an ORSA consistent with a process comparable to the ORSA guidance manual. The ORSA shall be conducted annually and at any time when there are significant changes to the risk profile of the insurer or the insurance group of which the insurer is a member.
MA Gen L ch 176v § 4 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176v - Own Risk and Solvency Assessment|Section 4 - Orsa Summary Report or Similar Report; Contents; Reports Submitted to Commissioner of Another State or Foreign Jurisdiction

Section 4. (a) Upon the request of the commissioner, and no more than annually, an insurer shall submit to the commissioner an ORSA summary report or any combination of reports that together contain the information described in the ORSA guidance manual, applicable to the insurer or the insurance group of which it is a member. Notwithstanding any request from the commissioner, if the insurer is a member of an insurance group, the insurer shall submit the report required by this subsection if the commissioner is the lead state commissioner of the insurance group as determined by the procedures within the financial analysis handbook adopted by the NAIC.  (b) The report required by subsection (a) shall include the attestation of the insurer or insurance group's chief risk officer or other executive with responsibility for the oversight of the insurer's enterprise risk management process that, to the best of their belief and knowledge, the insurer applies the enterprise risk management process described in the ORSA summary report and that a copy of the report has been provided to the insurer's board of directors or to the appropriate committee thereof.  (c) An insurer may comply with subsection (a) by providing the commissioner the most recent and substantially similar report provided by the insurer or another member of an insurance group of which the insurer is a member to the commissioner of another state or to a supervisor or regulator of a foreign jurisdiction if that report provides information that is comparable to the information described in the ORSA guidance manual. A report in a language other than English shall be accompanied by a translation of that report into English.
MA Gen L ch 176v § 6 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 176v - Own Risk and Solvency Assessment|Section 6 - Report to Be Consistent With Orsa Guidance Manual; Examination of Supporting Documents; Review

Section 6. (a) An ORSA summary report shall be prepared consistent with the ORSA guidance manual, subject to the requirements of this chapter. Documentation and supporting information shall be maintained and made available upon examination or upon request of the commissioner.  (b) The review of an ORSA summary report and any additional requests for information shall be made using procedures consistent with the analysis and examination of multi-state or global insurers and insurance groups.