reglab/housing_qa huggingface dataset:
MA Gen L ch 175 § 47d (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47d - Cardiac Rehabilitation Expense Benefits

Section 47D. Any blanket or general policy of insurance, except a blanket or general policy of insurance which provides supplemental coverage to medicare or other governmental programs, described in subdivision (A), (C) or (D) of section one hundred and ten which provides hospital expense and surgical expense insurance and which is issued or subsequently renewed by agreement between the insurer and the policy holder, within or without the commonwealth, during the period this provision is effective, or any policy of accident or sickness insurance as described in section one hundred and eight which provides hospital expense and surgical expense insurance, except a policy which provides supplemental coverage to medicare or other governmental programs, and which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policy holder in the commonwealth, during the period that this provision is effective, or any employees' health and welfare fund which provides hospital expense and surgical expense benefits and which is promulgated or renewed to any person or group of persons in the commonwealth, while this provision is effective, shall provide benefits for the expense of cardiac rehabilitation. Cardiac rehabilitation shall mean multidisciplinary, medically necessary treatment of persons with documented cardiovascular disease, which shall be provided in either a hospital or other setting and which shall meet standards promulgated by the commissioner of public health after reviewing proposals submitted by the Massachusetts Society for Cardiac Rehabilitation, Inc. and after notice and public hearing on the proposed standards. Such standards shall include, but not be limited to, outpatient treatment which is to be initiated within twenty-six weeks after the diagnosis of such disease.
MA Gen L ch 175 § 47e (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47e - Certified Nurse Midwife Services Benefits

Section 47E. Any blanket or general policy of insurance described in subdivision (A), (C), or (D) of section one hundred and ten which is issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, during the period this provision is effective, or any policy of accident and sickness insurance as described in section one hundred and eight which provides hospital expense and surgical expense insurance and which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policyholder in the commonwealth during the period that this provision is effective shall provide benefits for services of a certified nurse midwife; provided, however, that expenses for such services are reimbursed when such services are performed by any other duly licensed practitioner; and provided, further, that such services are within the lawful scope of practice for a certified nurse midwife.
MA Gen L ch 175 § 47g (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47g - Cytologic Screening and Mammographic Examination Expense Benefits

Section 47G. Any blanket or general policy of insurance described in subdivision (A), (C), or (D) of section one hundred and ten which is issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, during the period within which this premium is effective, or any policy of accident or sickness insurance as described in section one hundred and eight which provides hospital expense and surgical expense insurance and which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policyholder in the commonwealth, during the period within which this provision is effective, or any employers' health and welfare fund which provides hospital expense and surgical expense benefits and which is issued or renewed to any person or group of persons in the commonwealth, during the period within which this provision is effective, shall provide benefits for the expense of residents of the commonwealth covered under any such policy or plan for the expense of cytologic screening and mammographic examination. Said benefits shall be at least equal to the following minimum requirements: (a) in the case of benefits for cytologic screening, said benefits shall provide for an annual cytologic screening for women eighteen years of age and older; and (b), in the case of benefits for mammographic examination said benefits shall provide for a baseline mammogram for women between the ages of thirty-five and forty and for a mammogram on an annual basis for women forty years of age and older.
MA Gen L ch 175 § 47h (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47h - Infertility, Pregnancy-Related Benefits

Section 47H. Any blanket or general policy of insurance, except a blanket or general policy of insurance which provides supplemental coverage to medicare or other governmental programs, described in subdivisions (A), (C) or (D) of section one hundred and ten which provides hospital expense or surgical expense insurance which includes pregnancy-related benefits and which is issued or subsequently renewed by agreement between the insurer and the policyholder, within or without the commonwealth, while this provision is effective, or any policy of accident and sickness insurance as described in section one hundred and eight which provides hospital expense or surgical expense insurance which includes pregnancy-related benefits and which is delivered or issued for delivery or subsequently renewed by agreement between the insurer and the policyholder in the commonwealth while this provision is effective, or any employees' health and welfare fund which provides hospital expense and surgical expense benefits which includes pregnancy-related benefits and which is promulgated or renewed to any person or group of persons in the commonwealth while this provision is effective shall provide, to the same extent that benefits are provided for other pregnancy-related procedures, coverage for medically necessary expenses of diagnosis and treatment of infertility to persons residing within the commonwealth. For purposes of this section, ''infertility' shall mean the condition of an individual who is unable to conceive or produce conception during a period of 1 year if the female is age 35 or younger or during a period of 6 months if the female is over the age of 35. For purposes of meeting the criteria for infertility in this section, if a person conceives but is unable to carry that pregnancy to live birth, the period of time she attempted to conceive prior to achieving that pregnancy shall be included in the calculation of the 1 year or 6 month period, as applicable.
MA Gen L ch 175 § 47i (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47i - Nonprescription Enteral Formulas for Home Use

Section 47I. Any individual policy of accident and sickness insurance issued pursuant to section one hundred and eight, and any group blanket policy of accident and sickness insurance issued pursuant to section one hundred and ten, shall provide coverage for nonprescription enteral formulas for home use for which a physician has issued a written order and which are medically necessary for the treatment of malabsorption caused by Crohn's disease, ulcerative colitis, gastroesophageal reflux, gastrointestinal motility, chronic intestinal pseudo-obstruction, and inherited diseases of amino acids and organic acids. Coverage for inherited diseases of amino acids and organic acids shall include food products modified to be low protein in an amount not to exceed $5,000 annually for any insured individual.
MA Gen L ch 175 § 47j (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47j - Standardized Claim Form

Section 47J. The commissioner of insurance is hereby directed to produce a standardized claim form to be utilized by all health insurance companies licensed to do business in the commonwealth for billing purposes. Said form shall be made available to said companies no later than July first, nineteen hundred and ninety-three.
MA Gen L ch 175 § 47k (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47k - Off-Label Drug Use; Cancer Treatment

Section 47K. No individual policy of accident and sickness insurance issued pursuant to section one hundred and eight which provides coverage for prescription drugs, nor any group blanket policy of accident and sickness insurance issued pursuant to section one hundred and ten which provides coverage for prescription drugs, shall exclude coverage of any such drug used for the treatment of cancer on the grounds that the off-label use of the drug has not been approved by the United States Food and Drug Administration for that indication; provided, however, that such drug is recognized for treatment of such indication in one of the standard reference compendia, or in the medical literature, or by the commissioner under the provisions of section forty-seven L. Any coverage of a drug required by this section shall also include medically necessary services associated with the administration of the drug. This section shall not be construed to alter existing law with regard to provisions limiting the coverage of drugs that have not been fully licensed or approved by the United States Food and Drug Administration nor shall this section create an exclusionary presumption or inference concerning other appropriate medically accepted indications. This section shall not be construed to require coverage for any drug when the United States Food and Drug Administration has determined its use to be contraindicated for cancer. This section shall not be construed to require coverage for experimental drugs not otherwise approved for any indication by the United States Food and Drug Administration. For the purpose of this section, and section forty-seven L, the following words shall have the following meanings unless the context clearly requires otherwise:— ''Medical literature'', published scientific studies appearing in any peer-reviewed national professional journal. ''Off-label use'', a prescription drug used in the treatment of cancer which has been approved by the United States Food and Drug Administration and such drug is used for indications other than those approved by said Food and Drug Administration. ''Standard reference compendia'', (a) the United States Pharmacopoeia Drug Information; (b) the American Medical Association Drug Evaluations; or (c), the American Hospital Formulary Service Drug Information.
MA Gen L ch 175 § 47l (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47l - Off-Label Drug Use; Cancer; Review Panel

Section 47L. The commissioner shall establish a panel of six medical experts to review off-label uses, so-called, for prescription drugs for the treatment of cancer not included in any of the standard reference compendia or in the medical literature and to advise said commissioner in such instances whether a particular off-label use is medically appropriate. The panel shall make such recommendations from time to time and whenever a particular dispute about payment for such off-label use is referred to the panel by the commissioner. The members of said panel shall include: (a) three medical oncologists selected by the state medical oncology association, (b) a physician selected by the Massachusetts medical association, (c) a physician selected by a hospital and medical service corporation and (d), a physician selected by the Massachusetts association of health maintenance organizations from a member plan. The commissioner shall have the authority to direct any insurer to make payments, consistent with the recommendations of the panel, required by section forty-seven K, section eight N of chapter one hundred and seventy-six A, section four N of chapter one hundred and seventy-six B and section four E of chapter one hundred and seventy-six G.
MA Gen L ch 175 § 47n (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47n - Items Medically Necessary for Diagnosis and Treatment of Diabetes

Section 47N. An individual policy of accident and sickness insurance issued pursuant to section 108 which provides hospital expense and surgical expense insurance, except policies providing supplemental coverage to Medicare or other governmental programs, and any group blanket policy of accident and sickness insurance issued pursuant to section 110 which provides hospital expense and surgical expense insurance, except policies providing supplemental coverage to Medicare or other governmental programs, delivered, issued or renewed by agreement between the insurer and the policyholder, within or without the commonwealth, shall provide benefits for the following items if such items are within a category of benefits or services for which coverage is otherwise afforded by the policy, have been prescribed by a health care professional legally authorized to prescribe such items and if the items are medically necessary for the diagnosis or treatment of insulin-dependent, insulin-using, gestational and non-insulin-dependent diabetes: blood glucose monitors; blood glucose monitoring strips for home use; voice-synthesizers for blood glucose monitors for use by the legally blind; visual magnifying aids for use by the legally blind; urine glucose strips; ketone strips; lancets; insulin; insulin syringes; prescribed oral diabetes medications that influence blood sugar levels; laboratory tests, including glycosylated hemoglobin, or HbAlc, tests; urinary protein/microalbumin and lipid profiles; insulin pumps and insulin pump supplies; insulin pens, so-called; therapeutic/molded shoes and shoe inserts for people who have severe diabetic foot disease when the need for therapeutic shoes and inserts has been certified by the treating doctor and prescribed by a podiatrist or other qualified doctor and furnished by a podiatrist, orthotist, prosthetist or pedorthist; supplies and equipment approved by the Federal Drug Administration for the purposes for which they have been prescribed and diabetes outpatient self-management training and education, including medical nutrition therapy, when provided by a certified diabetes health care provider participating with the insurance contract or affiliated with a provider participating with the insurance contract. As used in this section, ''certified diabetes health care provider'' shall mean a licensed health care professional with expertise in diabetes, a registered dietician or a health care provider certified by the National Certification Board of Diabetes Educators as a certified diabetes educator. Nothing in this section shall be construed to require an insurance company to contract with a certified diabetes health care provider who is not already under contract with the insurance company. The benefits provided in this section shall meet all other terms and conditions within a policy. Coverage shall not be reduced or eliminated due to the requirements of this section.
MA Gen L ch 175 § 47o (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47o - HIV/AIDS Treatment; Insurance Coverage for Certain Off-Label Use of Prescription Drugs

Section 47O. No individual policy of accident and sickness insurance issued or renewed pursuant to section one hundred and eight, which provides coverage for prescription drugs, nor any group blanket policy of accident and sickness insurance issued pursuant to section one hundred and ten which provides coverage for prescription drugs, shall exclude coverage of any such drug for HIV/AIDS treatment on the grounds that the off-label use of the drug has not been approved by the federal food and drug administration for that indication, if such drug is recognized for treatment of such indication in one of the standard reference compendia, or in the medical literature, or by the commissioner under the provisions of section forty-seven P of this chapter. Any coverage of a drug required by this section shall also include medically necessary services associated with the administration of the drug. This section shall not be construed to alter existing law with regard to provisions limiting the coverage of drugs that have not been fully licensed or approved by the federal food and drug administration nor shall this section create an exclusionary presumption or inference concerning other appropriate medically accepted indications. This section shall not be construed to require coverage for any drug when the federal food and drug administration has determined its use to be contraindicated. This section shall not be construed to require coverage for experimental drugs not otherwise approved for any indication by the federal food and drug administration. For the purpose of this section, and section forty-seven P, the following words shall have the following meanings: ''Standard reference compendia'' means (a) the United States Pharmacopeia Drug Information; (b) the American Medical Association Drug Evaluations; or (c) the American Hospital Formulary Service Drug Information. ''Medical literature'' means published scientific studies published in any peer-reviewed national professional journal. ''HIV/AIDS'' means human immunodeficiency virus or acquired immunodeficiency syndrome. ''Off-label'' means a drug that has not been specifically approved by the Federal food and drug administration for HIV/AIDS treatment but is a drug approved for other indications by the Federal food and drug administration.
MA Gen L ch 175 § 47p (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47p - Off-Label Use of Prescription Drugs for HIV/AIDS Treatment; Advisory Panel

Section 47P. The commissioner shall establish an eleven member advisory panel to advise the commissioner on whether off-label uses for HIV/AIDS treatment not included in any of the standard reference compendia or in the medical literature are medically appropriate. The panel shall advise the commissioner whenever a dispute about coverage of such off-label prescription drugs prescribed by a physician is brought to the commissioner. This eleven member panel shall include: (a) three medical infectious disease specialists selected by the Massachusetts department of public health, (b) two physicians selected by the Massachusetts department of public health, (c) one physician representing a nonprofit hospital and medical service corporation, one physician representing health maintenance organizations, and one physician representing commercial insurers; (d) two consumers selected by the Massachusetts department of public health, and (e) one representative from an AIDS service organization or consumer advocacy group selected by the Massachusetts department of public health. After consulting with said advisory panel, the commissioner may direct an insurer to make payments required by section forty-seven O of chapter one hundred and seventy-five, section eight P of chapter one hundred and seventy-six A, section four O of chapter one hundred and seventy-six B, and section four F of chapter one hundred and seventy-six G.
MA Gen L ch 175 § 47q (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47q - Insurance Benefits for Services Rendered by Nurse Anesthetists and Nurse Practitioners

Section 47Q. All individual or group accident and health insurance policies and health service contracts delivered, issued or renewed by an insurer or nonprofit health service corporation which provide benefits to individual subscribers and members within the commonwealth or to all group members having a principal place of employment within the commonwealth shall provide benefits for services rendered by a certified registered nurse anesthetist or nurse practitioner designated as such certified registered nurse anesthetist or nurse practitioner by the board of registration in nursing pursuant to the provisions of section eighty B of chapter one hundred and twelve; provided, however, that the following conditions are met: (1) the service rendered is within the scope of the certified registered nurse anesthetist's license or the nurse practitioner's authorization to practice by the board of registration in nursing; and (2) the policy or contract currently provides benefits for identical services rendered by a provider of health care licensed by the commonwealth.
MA Gen L ch 175 § 47r (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47r - Accident and Sickness Insurance Benefits for Bone Marrow Transplants

Section 47R. Any individual policy of accident and sickness insurance issued pursuant to section one hundred and eight, and any group blanket policy of accident and sickness insurance issued pursuant to section one hundred and ten, shall provide coverage for a bone marrow transplant or transplants 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 175 § 47s (2021)
2021 Massachusetts General Laws|Part I - Administration of the Government|Title XXII - Corporations|Chapter 175 - Insurance|Section 47s - Accident and Sickness Insurance Benefits for Licensed Hospice Services

Section 47S. Any individual policy of accident and sickness insurance issued pursuant to section one hundred and eight, and any group blanket policy of accident and sickness insurance issued pursuant to section one hundred and ten, shall provide 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.