reglab/housing_qa huggingface dataset:
MA Gen L ch 32a § 17b (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17b - Hospice Services for Commonwealth Employees Insured Under Group Insurance Commission

Section 17B. The commission shall provide to any active or retired employee of the commonwealth, who is insured under the group insurance commission, coverage for licensed hospice services to terminally ill patients with a life expectancy of six months or less, as set forth and regulated by the provisions of section fifty-seven D of chapter one hundred and eleven and as authorized by a duly licensed physician.
MA Gen L ch 32a § 17c (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17c - Required Coverage for Prenatal Care, Childbirth, and Postpartum Care

Section 17C. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for prenatal care, childbirth and postpartum care, with a minimum of forty-eight hours of in-patient care following a vaginal delivery and a minimum of ninety-six hours of in-patient care following a caesarean section for a mother and her newly born child. Any decision to shorten these minimum coverages shall be made by the attending physician in consultation with the mother. Any such decision shall be made in accordance with rules and regulations promulgated by the department of public health. Said regulations shall be relative to early discharge, defined as less than forty-eight hours for a vaginal delivery and ninety-six hours for a caesarean delivery and post-delivery care and shall include, but not be limited to, home visits, parent education, assistance and training in breast or bottle feeding and the performance of any necessary and appropriate clinical tests; provided, however, that the first home visit shall be conducted by a registered nurse, physician, or certified nurse midwife; and provided, further, that any subsequent home visit determined to be clinically necessary shall be provided by a licensed health care provider.  For the purposes of this section, attending physician shall include the attending obstetrician, pediatrician, or certified nurse midwife attending the mother and newly born child.  Any subscriber or member who is aggrieved by a denial of benefits to be provided under this section may appeal said denial in accordance with regulations of the department of public health.
MA Gen L ch 32a § 17d (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17d - Coverage for Bone Marrow Transplants

Section 17D. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for a bone marrow transplant for persons who have been diagnosed with breast cancer that has progressed to metastatic disease; provided, however, that said person shall meet the criteria established by the department of public health. The department of public health shall promulgate rules and regulations establishing criteria for eligibility for coverage hereunder which shall be consistent with medical research protocols reviewed and approved by the National Cancer Institute.
MA Gen L ch 32a § 17e (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17e - Scalp Hair Prostheses Necessary Due to Cancer or Leukemia Treatment

Section 17E. (a) For the purposes of this section, the following words shall have the following meanings:  ''Prosthesis'', an artificial appliance used to replace a lost natural structure; provided, however, that prosthesis shall include, but not be limited to, artificial arms, legs, breasts, scalp hair or glass eyes.  ''Scalp hair prosthesis'', an artificial substitute for scalp hair.  (b) The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission, if such group coverage provides for any other prosthesis, coverage for expenses for scalp hair prostheses worn for hair loss suffered as a result of the treatment of any form of cancer or leukemia; provided, however, that such coverage shall be subject to a written statement by the treating physician that the scalp hair prosthesis is medically necessary; and provided, further, that such coverage shall be subject to the same limitations and guidelines as other prostheses. Scalp hair prosthesis coverage pursuant to this section shall not exceed an amount of $350 per year.
MA Gen L ch 32a § 17f (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17f - Newborn Hearing Screening Test; Group Insurance Commission Coverage

Section 17F. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for the cost of a newborn hearing screening test to be performed before the newborn infant is discharged from the hospital or birthing center to the care of the parent or guardian or as provided by regulations of the department of public health. Nothing contained in this section shall be construed to abrogate any obligation to provide coverage for a hearing screening test or any other hearing screening test or audiological diagnostic procedure pursuant to any law or regulation of the commonwealth or of the United States or under any of the terms or provisions of any policy, contract or certification.
MA Gen L ch 32a § 17h (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17h - Coverage for Human Leukocyte or Histocompatibility Locus Antigen Testing

Section 17H. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for the cost of human leukocyte antigen testing or histocompatibility locus antigen testing that is necessary to establish bone marrow transplant donor suitability. The coverage shall cover the costs of testing for A, B or DR antigens, or any combination thereof, consistent with guidelines, criteria, rules or regulations established by the department of public health pursuant to section 218 of chapter 111.
MA Gen L ch 32a § 17i (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17i - Prosthetic Devices and Repairs; Group Insurance Commission Coverage

Section 17I. (a) The commission shall provide coverage for prosthetic devices and repairs to any active or retired employee of the commonwealth who is insured under the group insurance commission under the same terms and conditions that apply to other durable medical equipment covered under the policy, except as otherwise provided in this section.  (b) In this section, ''prosthetic device'' shall mean an artificial limb device to replace, in whole or in part, an arm or leg.  (c) Such coverage shall not impose any annual or lifetime dollar maximum on coverage for prosthetic devices other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy.  (d) Such coverage shall not apply amounts paid for prosthetic devices to any annual or lifetime dollar maximum applicable to other durable medical equipment covered under the policy other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the policy.  (e) Such coverage may include a reasonable coinsurance requirement for prosthetic devices and repairs, not to exceed 20 per cent of the allowable cost of the prosthetic device or repair, unless all covered benefits applying coinsurance under the plan do so at a higher amount. If the policy provides coverage for services from nonparticipating providers, the policy may include a reasonable coinsurance requirement for prosthetic devices and repairs, not to exceed 40 per cent of the allowable cost of the device or repair when obtained from a nonparticipating provider, unless all covered benefits applying coinsurance under the plan do so at a higher amount.  (f) Such coverage may require prior authorization as a condition of coverage for prosthetic devices.
MA Gen L ch 32a § 17j (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17j - Coverage for Children Under Age 18 for Cleft Lip and Cleft Palate

Section 17J. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for the cost of treating cleft lip and cleft palate for children under the age of 18 covered by that employee's health plan. The coverage shall include benefits for medical, dental, oral and facial surgery, surgical management and follow-up care by oral and plastic surgeons, orthodontic treatment and management, preventative and restorative dentistry to ensure good health and adequate dental structures for orthodontic treatment or prosthetic management therapy, speech therapy, audiology and nutrition services, if such services are prescribed by the treating physician or surgeon and such physician or surgeon certifies that such services are medically necessary and consequent to the treatment of the cleft lip, cleft palate or both. The coverage required by this section shall be subject to the terms and conditions applicable to other benefits. Payment for dental or orthodontic treatment not related to the management of the congenital conditions of cleft lip and cleft palate shall not be covered under this section.
MA Gen L ch 32a § 17k (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17k - Coverage for Orally Administered Anticancer Medications

Section 17K. Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission that provides coverage for cancer chemotherapy treatment shall provide coverage for prescribed, orally administered anticancer medications used to kill or slow the growth of cancerous cells on a basis not less favorable than intravenously administered or injected cancer medications that are covered as medical benefits. An increase in patient cost sharing for anticancer medications shall not be allowed to achieve compliance with this section.
MA Gen L ch 32a § 17l (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17l - Coverage for Abuse Deterrent Opioid Drug Products

Section 17L. Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission shall provide coverage for abuse deterrent opioid drug products listed on the formulary, compiled pursuant to subsection (b) of section 13 of chapter 17, on a basis not less favorable than non-abuse deterrent opioid drug products that are covered by the commission. An increase in patient cost sharing shall not be allowed to achieve compliance with this section.
MA Gen L ch 32a § 17m (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17m - Preauthorization for Substance Abuse Treatment Not to Be Required

Section 17M. For the purposes of this section the term ''substance abuse treatment'' shall include: early intervention services for substance use disorder treatment; a substance use disorder evaluation as defined in section 511/2 of chapter 111; outpatient services including medically assisted therapies; intensive outpatient and partial hospitalization services; residential or inpatient services, not covered under section 17N; and medically managed intensive inpatient services, not covered under said section 17N.  Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission shall not require a member to obtain a preauthorization for substance abuse treatment if the provider is certified or licensed by the department of public health.
MA Gen L ch 32a § 17n (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17n - Coverage for Medically Necessary Acute Treatment and Clinical Stabilization Services; Preauthorization Not to Be Required; Notice to Carrier of Admission and Initial Treatment Plan

Section 17N. For the purposes of this section the following terms shall have the following meanings, unless the context clearly requires otherwise:—  ''Acute treatment services'', 24–hour medically supervised addiction treatment for adults or adolescents provided in a medically managed or medically monitored inpatient facility, as defined by the department of public health, that provides evaluation and withdrawal management and which may include biopsychosocial assessment, individual and group counseling, psychoeducational groups and discharge planning.  ''Clinical stabilization services'', 24–hour clinically managed post detoxification treatment for adults or adolescents, as defined by the department of public health, usually following acute treatment services for substance abuse, which may include intensive education and counseling regarding the nature of addiction and its consequences, relapse prevention, outreach to families and significant others and aftercare planning, for individuals beginning to engage in recovery from addiction.  The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for medically necessary acute treatment services and medically necessary clinical stabilization services for up to a total of 14 days and shall not require preauthorization prior to obtaining such acute treatment services or clinical stabilization services; provided that, the facility shall provide the carrier both notification of admission and the initial treatment plan within 48 hours of admission; provided further, that utilization review procedures may be in initiated on day 7; and provided further, that the commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for, without preauthorization, substance use disorder evaluations ordered pursuant to section 511/2 of chapter 111.  Medical necessity shall be determined by the treating clinician in consultation with the patient and noted in the patient's medical record.
MA Gen L ch 32a § 17o (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17o - Coverage for Medical or Drug Treatments to Correct or Repair Disturbances of Body Composition Caused by HIV Associated Lipodystrophy Syndrome

[Text of section added by 2016, 233, Sec. 1. See also, Section 17O as added by 2016, 454, Sec. 1, below.]  Section 17O. Any coverage offered by the commission to an active or retired employee of the commonwealth insured under the group insurance commission shall provide coverage for medical or drug treatments to correct or repair disturbances of body composition caused by HIV associated lipodystrophy syndrome including, but not limited to, reconstructive surgery, such as suction assisted lipectomy, other restorative procedures and dermal injections or fillers for reversal of facial lipoatrophy syndrome. Coverage shall be subject to a statement from a treating provider that the treatment is necessary for correcting, repairing or ameliorating the effects of HIV associated lipodystrophy syndrome. The benefits in this section shall not be subject to any greater deductible, coinsurance, copayments or out-of-pocket limits than any other benefit provided by the commission.  Chapter 32A: Section 17O. Coverage for refills of prescription eye drops [Text of section added by 2016, 454, Sec. 1. See also, Section 17O added by 2016, 233, Sec. 1, above.]  Section 17O. Coverage offered by the commission to an active or retired employee of the commonwealth insured through the group insurance commission that provides coverage for prescription eye drops shall provide coverage for refills of prescription eye drops in accordance with the Medicare Part D guidelines on early refills of topical ophthalmic products when: (i) the prescribing health care practitioner indicates on the original prescription that additional quantities of the prescription eye drops are needed; (ii) the refill requested by the insured does not exceed the number of additional quantities indicated on the original prescription by the prescribing health care practitioner; and (iii) the prescription eye drops prescribed by the health care practitioner are a covered benefit under the policy or contract of the insured.
MA Gen L ch 32a § 17p (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17p - Filling of Remaining Portion of Prescription for Covered Drug That Is a Narcotic Substance Earlier Filled in Lesser Quantity

Section 17P. The commission shall provide, to an active or retired employee of the commonwealth who is insured under the group insurance commission, for any covered drug that is a narcotic substance contained in schedule II pursuant to chapter 94C and subject to cost sharing, that if a person receives a prescription filled in a lesser quantity pursuant to section 18 of said chapter 94C, that person shall not be subject to an additional payment obligation, including but not limited to co-payments, if that person fills the remaining portion of the prescription.
MA Gen L ch 32a § 17q (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17q - Pain Management Access Plan

Section 17Q. (a) The commission shall develop a plan to provide active or retired employees adequate coverage and access to a broad spectrum of pain management services, including, but not limited to, those that serve as alternatives to opioid prescribing, in accordance with guidelines developed by the division of insurance.  (b) The plan shall be subject to review by the division of insurance. In its review, the division shall consider the adequacy of access to a broad spectrum of pain management services and any carrier policies that may create unduly preferential coverage to prescribing opioids without other pain management modalities.  (c) The commission shall distribute educational materials to providers within their networks about the pain management access plan and make information about its plan publicly available on its website.
MA Gen L ch 32a § 17r (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 17r - Coverage for Treatment of Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections and Pediatric Acute-Onset Neuropsychiatric Syndrome

[Text of section effective as applied to contracts that take effect or are renewed on or after January 1, 2022. See 2020, 260, Sec. 74.]  Section 17R. The commission shall provide to any active or retired employee of the commonwealth who is insured under the group insurance commission coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome, including, but not limited to, the use of intravenous immunoglobulin therapy.
MA Gen L ch 32a § 18 (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title IV - Civil Service, Retirements and Pensions|Chapter 32a - Contributory Group General or Blanket Insurance for Persons in the Service of the Commonwealth|Section 18 - Medicare Health Benefits Supplement Plan, Mandatory Transfer; Payment of Penalty

Section 18. Notwithstanding any other provision of this chapter, all retirees, their spouses and dependents insured or eligible to be insured under sections five, ten B and twelve, if enrolled in medicare part A at no cost to the retiree, spouse or dependents, or eligible for coverage thereunder at no cost to the retiree, spouse or dependents, shall be required to transfer to a medicare health benefits supplement plan offered by the commission under section ten C or section fourteen; provided, that benefits under said plan and medicare part A and part B together shall be of comparable actuarial value to those under the retiree's existing coverage. Each retiree shall provide the commission, in such form as the commission shall prescribe, such information as is necessary to transfer to a medicare health benefits supplement plan. If a retiree does not submit the information required, he shall no longer be eligible for his existing health coverage. The commonwealth shall pay any medicare part B premium penalty assessed by the federal government on said retirees, spouses and dependents as a result of enrollment in medicare part B at the time of transfer into the medicare health benefits supplement plan.