reglab/housing_qa huggingface dataset:
MS Code § 83-41-403 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 9 - Patient Protection Act of 1995|§ 83-41-403. Definitions

 As used in this article:   "Department" means the Mississippi Department of Insurance.   "Managed care plan" means a plan operated by a managed care entity as described in subparagraph (c) that provides for the financing and delivery of health care services to persons enrolled in such plan through:   Arrangements with selected providers to furnish health care services;   Explicit standards for the selection of participating providers;   Organizational arrangements for ongoing quality assurance, utilization review programs and dispute resolution; and   Financial incentives for persons enrolled in the plan to use the participating providers, products and procedures provided for by the plan.   "Managed care entity" includes a licensed insurance company, hospital or medical service plan, health maintenance organization (HMO), an employer or employee organization, or a managed care contractor as described in subparagraph (d) that operates a managed care plan.   "Managed care contractor" means a person or corporation that:   Establishes, operates or maintains a network of participating providers;   Conducts or arranges for utilization review activities; and   Contracts with an insurance company, a hospital or medical service plan, an employer or employee organization, or any other entity providing coverage for health care services to operate a managed care plan.   "Participating provider" means a physician, hospital, pharmacy, pharmacist, dentist, nurse, chiropractor, optometrist, or other provider of health care services licensed or certified by the state, that has entered into an agreement with a managed care entity to provide services, products or supplies to a patient enrolled in a managed care plan.
MS Code § 83-41-405 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 9 - Patient Protection Act of 1995|§ 83-41-405. Requirement of certification of managed care plans offered or provided to persons residing in Mississippi; termination of plans

 The department shall establish a process for the certification of managed care plans offered or provided to persons residing in Mississippi. No such plan shall be offered or provided to persons residing in this state unless it has been certified by the department. Any managed care plan certified by the department must be recertified annually, and the department shall establish procedures to ensure the continued compliance with the requirements of Section 83-41-409 through the recertification process. The department shall terminate the certificate of any managed care plan if such plan no longer meets the applicable requirements for certification. The department shall provide any such plan with an opportunity for a hearing on the proposed termination.
MS Code § 83-41-407 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 9 - Patient Protection Act of 1995|§ 83-41-407. Fees

 The department shall establish a fee to cover the costs of issuing and renewing the certifications authorized by this article and the fees shall be used solely for the administration of this article.
MS Code § 83-41-409 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 9 - Patient Protection Act of 1995|§ 83-41-409. Conditions for certification or recertification

 In order to be certified and recertified under this article, a managed care plan shall:   Provide enrollees or other applicants with written information on the terms and conditions of coverage in easily understandable language including, but not limited to, information on the following:   Coverage provisions, benefits, limitations, exclusions and restrictions on the use of any providers of care;   Summary of utilization review and quality assurance policies; and   Enrollee financial responsibility for copayments, deductibles and payments for out-of-plan services or supplies;   Demonstrate that its provider network has providers of sufficient number throughout the service area to assure reasonable access to care with minimum inconvenience by plan enrollees;   File a summary of the plan credentialing criteria and process and policies with the State Department of Insurance to be available upon request;   Provide a participating provider with a copy of his/her individual profile if economic or practice profiles, or both, are used in the credentialing process upon request;   When any provider application for participation is denied or contract is terminated, the reasons for denial or termination shall be reviewed by the managed care plan upon the request of the provider; and   Establish procedures to ensure that all applicable state and federal laws designed to protect the confidentiality of medical records are followed.
MS Code § 83-41-411 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 9 - Patient Protection Act of 1995|§ 83-41-411. Compliance with article by health maintenance organizations

 Health maintenance organizations must comply with the certification requirements in this article in addition to such other laws as might relate thereto.
MS Code § 83-41-413 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 9 - Patient Protection Act of 1995|§ 83-41-413. Regulations

 The department shall adopt regulations to implement the provisions of this article and may obtain any information from managed care plans that is necessary to determine if such plan should be certified or recertified.
MS Code § 83-41-415 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 9 - Patient Protection Act of 1995|§ 83-41-415. Applicability of Articles 7 and 9 to Division of Medicaid in Office of Governor

 Articles 7 and 9 do not apply to the Division of Medicaid in the Office of the Governor.
MS Code § 83-41-417 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 41 - Hospital and Medical Service Associations and Contracts|Article 9 - Patient Protection Act of 1995|§ 83-41-417. Geographic areas served; opportunity to apply for participation

 A health maintenance organization as defined in Section 83-41-303, and a managed care entity as defined in Section 83-41-403, shall establish procedures to give interested health care providers located in the geographic area served an opportunity to apply for participation.
MS Code § 83-51-1 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 51 - Dental Care Benefits|General Provisions|§ 83-51-1. Definitions

 As used in this chapter, the following words have the meanings ascribed herein unless the context clearly requires otherwise:   "Health insurance policy" means any individual, group, blanket or franchise insurance policy, insurance agreement or group hospital service contract which provides benefits for dental care expenses incurred as a result of an accident or sickness.   "Employee benefit plan" means any plan, fund or program heretofore or hereafter established or maintained by an employer or by an employee organization, or by both, to the extent that such plan, fund or program was established or is maintained for the purpose of providing for its participants or their beneficiaries, through the purchase of insurance or otherwise, dental care benefits in the event of accident or sickness.   "Dental care services" means those general and usual services furnished to any person for the purpose of preventing, alleviating, curing or healing human dental illness or injury as defined in Sections 73-9-1 through 73-9-65, Mississippi Code of 1972.   "Dentist" means any person who furnishes dental care services and who is licensed as a dentist by the State of Mississippi.   "Dental service contractor" means any person who accepts a prepayment from or for the benefit of any other person or group of persons as consideration for providing to such person or group of persons the opportunity to receive dental services at such times in the future as such services may be appropriate or required, but shall not be construed to include a dentist or professional dental corporation that accepts prepayment on a fee-for-service basis for providing specific dental services to individual patients for whom such services have been prediagnosed. Nothing in this paragraph (e) shall apply to a funded or self-funded trust qualified with the United States Department of Labor in accordance with Public Law 93-406, or the Division of Medicaid or any contractor of the division when providing services to eligible Medicaid beneficiaries.   "Participant" means a dentist who has contracted with a dental service contractor to accept from and to look solely to such contractor for payment for any health care services rendered to a subscriber, subject to any co-payment obligations included in the contract of the subscriber with the dental service contractor.   "Person" means an individual, insurer, association, organization, partnership, business, trust, except Employee Retirement Income Security Act (E.R.I.S.A.) trusts qualified with the United States Department of Labor under Public Law 93-406, corporation, or other legal entity.   "Subscriber" means any person by or for whom a dental service contractor is paid a periodic premium as prepayment for dental services to be rendered to him by a participant.   "Commissioner" means the Commissioner of Insurance of the State of Mississippi.
MS Code § 83-51-3 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 51 - Dental Care Benefits|General Provisions|§ 83-51-3. Provisions prohibited in health insurance policies and employee benefit plans

 No health insurance policy or employee benefit plan which is delivered, renewed, issued for delivery, or otherwise contracted for in this state shall:   Prevent any person who is a party to or beneficiary of any such health insurance policy or employee benefit plan from selecting the dentist of his choice to furnish the dental care services offered by such policy or plan, or interfere with such selection, provided the dentist selected is licensed to furnish such dental care services in this state;   Deny any dentist the right to participate as a contracting provider for such policy or plan, provided the dentist is licensed to furnish the dental care services offered by such policy or plan;   Authorize any person to regulate, interfere or intervene in any manner in the diagnosis or treatment rendered by a dentist to his patient for the purpose of preventing, alleviating, curing or healing dental illness or injury, provided such dentist practices within the scope of his license; or   Require that any dentist furnishing dental care services make or obtain dental x-rays or any other diagnostic aids for the purpose of preventing, alleviating, curing or healing dental illness or injury; provided, however, that nothing herein shall prohibit requests for existing dental x-rays or any other existing diagnostic aids for the purpose of determining benefits payable under a health insurance policy or employee benefit plan.   Nothing in this chapter shall prohibit the predetermination of benefits for dental care expenses prior to treatment by the attending dentist.
MS Code § 83-51-5 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 51 - Dental Care Benefits|General Provisions|§ 83-51-5. Disclosure requirements; payments to non-contracting providers

 Any health insurance policy or employee benefit plan which is delivered, renewed, issued for delivery, or otherwise contracted for in this state shall, to the extent that it provides benefits for dental care expenses:   Disclose, if applicable, that the benefit offered is limited to the least costly treatment;   Define and explain the standard upon which the payment of benefits or reimbursement for the cost of dental care services is based, such as "usual and customary," "reasonable and customary," "usual, customary and reasonable," or fees or words of similar import, or it shall specify in dollars and cents the amount of the payment or reimbursement for dental care services to be provided. Payment or reimbursement for a non-contracting provider dentist shall be the same as the payment or reimbursement for a contracting provider dentist; provided, however, that the health insurance policy or the employee benefit plan shall not be required to make payment or reimbursement in an amount which is greater than the amount specified or which is greater than the fee charged by the providing dentist for the dental care services rendered.
MS Code § 83-51-7 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 51 - Dental Care Benefits|General Provisions|§ 83-51-7. Provisions contrary to this chapter to be void

 Any provision in a health insurance policy or employee benefit plan which is delivered, renewed, issued for delivery, or otherwise contracted for in this state which is contrary to this chapter shall, to the extent of such conflict, be void.
MS Code § 83-51-9 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 51 - Dental Care Benefits|General Provisions|§ 83-51-9. Benefits not mandated

 The provisions of this chapter do not mandate that any type of benefits for dental care expenses be provided by a health insurance policy or an employee benefit plan.
MS Code § 83-51-11 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 51 - Dental Care Benefits|General Provisions|§ 83-51-11. Contracts between dentist and patient; authority of provider of health insurance policy or employee benefit plan

 Notwithstanding any other provision of this chapter:   A dentist may contract directly with a patient for the furnishing of dental care services to such patient as may be otherwise authorized by law;   Any person providing a health insurance policy or employee benefit plan, or an employer, or an employee organization may:   Make available to its insureds, beneficiaries, participants, employees or members information relating to dental care services by distributing factually accurate information regarding dental care services, rates, fees, location and hours of service, provided such distribution is made upon the request of any dentist licensed by the state; or   Establish an administrative mechanism which facilitates payment for dental care services by insureds, beneficiaries, participants, employees or members to the dentist of their choice; or   Pay or reimburse, on a non-discriminatory basis, its insureds, beneficiaries, participants, employees or members for the cost of dental care services rendered by the dentist of their choice.
MS Code § 83-51-13 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 51 - Dental Care Benefits|General Provisions|§ 83-51-13. Limitation of applicability of chapter

 The provisions of this chapter do not apply to Article 3, Chapter 41, Title 83, Mississippi Code of 1972, which provides for the organizing of nonprofit hospital, medical and surgical service corporations, and do not apply to the Nonprofit Dental Service Corporation Law or to employee benefit plans paid for completely by the employer covering the employee and his or her dependents.
MS Code § 83-51-31 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 51 - Dental Care Benefits|Prohibitions Against Certain Provisions In Contracts Between Certain Health Care Entities and Dentists|§ 83-51-31. Prohibition against contract between certain health care entities and dentists from requiring that dentist provide services to subscribers at fee established by health care entity unless services are covered services under subscriber agreement

 No contract between a health care entity that offers a dental plan or plans and a dentist for the provision of services to subscribers may require that a dentist provide services to his subscribers at a fee set by the health care entity unless the services are covered services under the applicable subscriber agreement. For the purposes of this section, "covered services" means services that are reimbursable under the applicable subscriber agreement, notwithstanding any deductibles, waiting periods or frequency limitations that may apply. For the purposes of this section, "dental plan" means any policy of insurance that is issued by a health care entity that provides for coverage of dental services not in connection with a medical plan.
MS Code § 83-71-1 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 71 - Unfair Discrimination Against Subjects of Abuse in Health, Life, and Disability Income Insurance|Discrimination Against Subjects of Abuse in Health Insurance|§ 83-71-1. Purpose

 The purpose of Sections 83-71-1 through 83-71-15 is to prohibit unfair discrimination by health carriers and insurance professionals on the basis of abuse status.Nothing in Sections 83-71-1 through 83-71-15 shall be construed to create or imply a private cause of action for a violation of Sections 83-71-1 through 83-71-15.
MS Code § 83-71-3 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 71 - Unfair Discrimination Against Subjects of Abuse in Health, Life, and Disability Income Insurance|Discrimination Against Subjects of Abuse in Health Insurance|§ 83-71-3. Applicability of Sections 83-71-1 through 83-71-15 to health carriers and insurance professionals issuing or renewing health insurance policies or certificates of health insurance in Mississippi

 Sections 83-71-1 through 83-71-15 apply to all health carriers and insurance professionals involved in issuing or renewing in this state a policy or certificate of health insurance.
MS Code § 83-71-9 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 71 - Unfair Discrimination Against Subjects of Abuse in Health, Life, and Disability Income Insurance|Discrimination Against Subjects of Abuse in Health Insurance|§ 83-71-9. Health carrier or insurance professional taking adverse action on the basis of a medical condition health carrier or insurance professional knows is abuse-related required to provide explanation for action

 A health carrier or insurance professional that takes an action that adversely affects an applicant or insured on the basis of a medical condition that the health carrier or insurance professional knows or has reason to know is abuse-related shall explain the reason for its action to the applicant or insured in writing and shall be able to demonstrate that its action, and any applicable plan provision:   Does not have the purpose or effect of treating abuse status as a medical condition or underwriting criterion;   Is not based upon any actual or perceived correlation between a medical condition and abuse;   Is otherwise permissible by law and applies in the same manner and to the same extent to all applicants and insureds with a similar medical condition without regard to whether the condition or claim is abuse-related; and   Except for claim actions, is based on a determination, made in conformance with sound actuarial principles and supported by reasonable statistical evidence, that there is a correlation between the medical condition and a material increase in insurance risk.
MS Code § 83-71-11 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 71 - Unfair Discrimination Against Subjects of Abuse in Health, Life, and Disability Income Insurance|Discrimination Against Subjects of Abuse in Health Insurance|§ 83-71-11. Health carriers to develop and adhere to written policies to protect the safety and privacy of subjects of abuse

 Health carriers shall develop and adhere to written policies specifying procedures to be followed by employees and by insurance professionals they contract with for the purpose of protecting the safety and privacy of a subject of abuse and shall otherwise implement the provisions of Sections 83-71-1 through 83-71-15 when taking an application, investigating a claim, pursuing subrogation or taking any other action relating to a policy or claim involving a subject of abuse. Insurers shall distribute their written policies to employees and insurance professionals.
MS Code § 83-71-13 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 71 - Unfair Discrimination Against Subjects of Abuse in Health, Life, and Disability Income Insurance|Discrimination Against Subjects of Abuse in Health Insurance|§ 83-71-13. Investigation of written, signed complaints; adjudicatory proceeding; penalties for violations of Sections 83-71-1 through 83-71-15

 The commissioner shall conduct a reasonable investigation based on a written and signed complaint received by the commissioner and shall issue a prompt determination as to whether a violation of Sections 83-71-1 through 83-71-15 may have occurred.If the commissioner finds from the investigation that a violation of Sections 83-71-1 through 83-71-15 may have occurred, the commissioner shall promptly begin an adjudicatory proceeding.The commissioner may address a violation through means appropriate to the nature and extent of the violation, which may include suspension or revocation of certificates of authority or licenses, imposition of civil penalties, issuance of cease and desist orders, injunctive relief, a requirement for restitution, referral to prosecutorial authorities or any combination of these.The powers and duties set forth in this section are in addition to all other authority of the commissioner.
MS Code § 83-71-15 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 71 - Unfair Discrimination Against Subjects of Abuse in Health, Life, and Disability Income Insurance|Discrimination Against Subjects of Abuse in Health Insurance|§ 83-71-15. Applicability of Sections 83-71-1 through 83-71-15 to certain health benefit plans and certain applications for coverage under health benefit plans

 Sections 83-71-1 through 83-71-15 apply to every health benefit plan or plan that is issued, reissued, renewed or continued on or after July 1, 2010, and to every application that is submitted on or after July 1, 2010, for coverage under a health benefit plan or plan.
MS Code § 83-71-51 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 71 - Unfair Discrimination Against Subjects of Abuse in Health, Life, and Disability Income Insurance|Discrimination Against Subjects of Abuse in Life Insurance|§ 83-71-51. Purpose

 The purpose of Sections 83-71-51 through 83-71-65 is to prohibit unfair discrimination by life insurers or insurance professionals on the basis of abuse status.Nothing in Sections 83-71-51 through 83-71-65 shall be construed to create or imply a private cause of action for a violation of Sections 83-71-51 through 83-71-65.
MS Code § 83-71-53 (2020)
2020 Mississippi Code|Title 83 - Insurance|Chapter 71 - Unfair Discrimination Against Subjects of Abuse in Health, Life, and Disability Income Insurance|Discrimination Against Subjects of Abuse in Life Insurance|§ 83-71-53. Applicability of Sections 83-71-51 through 83-71-65 to life insurers and insurance professionals issuing or renewing life insurance policies or certificates of life insurance in Mississippi

 Sections 83-71-51 through 83-71-65 apply to all life insurers and insurance professionals involved in issuing or renewing in this state a policy or certificate of life insurance.