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CORPORATIONS AND INSTITUTIONS FOR FINANCE AND INSURANCE : Chapter 48A

• 1 : Definitions; liability for medical services
• 2 : Nonprofit corporation; trustees and physicians; who may operate medical service plan; certificate of authority
• 2.1 : Medical service corporation merger procedure
• 3 : Issuance of certificate of authority; amendment; counties affected
• 4 : Corporate funds required
• 5 : Subscription contracts.
• 6 : Written contracts required; subscription certificates
• 6.1 : Elective surgery; definitions
• 6.10 : Eligibility for enrollment in medical service corporation
• 6.11 : Medical service corporation contract, exclusion, rates, terms based on genetic information prohibited.
• 6.2 : Second surgical opinion program
• 6.3 : Payment for second surgical opinion
• 6.4 : Third surgical opinion
• 6.5 : Second opinion exclusions
• 6.6 : Physicians furnishing opinion and performing surgical procedure; payment
• 6.7 : Application
• 6.8 : Medical service corporations to offer basic health care contracts
• 6.9 : Basic health care contract; provisions
• 7w : Medical service corporation to provide coverage for treatment of infertility.
• 7v : Coverage for hemophilia services by medical services corporation
• 7u : Medical service corporation to provide coverage for biologically-based mental illness.
• 7t : Coverage for certain dental procedures for the severely disabled or child age five or under by medical service corporation
• 7s : Coverage for treatment of domestic violence injuries by medical service corporation.
• 7r : Medical service corporation to cover certain audiology, speech-language pathology services.
• 7x : Medical service corporation to provide coverage for colorectal cancer screening.
• 7y : Medical service corporation prescription drug plans to cover certain infant formulas.
• 7z : Contract issued under C.17:48A-1 et seq. required to cover certain out-of-network services.
• 7aa : Medical service corporation to offer coverage for domestic partner.
• 7bb : Medical service corporation, coverage for prescription female contraceptives.
• 7cc : Medical service corporation to provide benefits for orthotic and prosthetic appliances.
• 7dd : Medical service corporation to provide coverage for hearing aids for certain persons aged 15 or younger.
• 7ee : Individual, group medical service corporation to provide installment payments to obstetrical provider for maternity services.
• 7ff : Medical service corporation to provide benefits for treatment of autism or other developmental disability.
• 7q : Coverage for treatment of inherited metabolic diseases by medical service corporation.
• 7p : Applicability of Health Care Quality Act
• 7o : Coverage for minimum inpatient care following mastectomy by individual, group medical service corporation
• 7 : Formal requirements for subscription certificates
• 7a : Treatment of alcoholism; benefits
• 7b : Reconstructive breast surgery; benefits
• 7c : Medical service contracts
• 7d : Medical service corporation insurance benefits for preexisting condition
• 7e : Medical service corporation to pay benefits for treatment of Wilm's tumor
• 7f : Medical service corporation contract, mammogram examination benefits.
• 7g : Medical service corporation, benefits for "off-label" drugs required
• 7h : Medical service corporation, benefits for health promotion
• 7i : Requirements for medical service corporation providing benefits for pharmacy services.
• 7j : Benefits for certain cancer treatments
• 7k : Coverage for birth and natal care; medical service corporation
• 7l : Coverage for diabetes treatment by individual, group medical service corporation
• 7m : Medical service corporation contract, Pap smear benefits
• 7n : Medical service corporation contract, prostate cancer testing
• 7.1 : Group contracts; issuance; description; benefits; employees defined.
• 7.10 : Coverage provided by medical service corporation for subscriber's child
• 7.11 : Requirements applicable to State Medicaid
• 7.12 : Medical service corporation to receive, transmit transactions electronically; standards.
• 7.13 : Coverage for certain dependents until age 31 by medical service corporation.
• 7.2 : Provisions applicable to group contracts
• 7.3 : Group contract form
• 7.4 : Participation agreements
• 7.5 : Schedule of rates
• 7.6 : Combined hospital-medical contract
• 7.7 : Review of determinations of commissioner of banking and insurance
• 7.8 : Review of practices, rules and procedures of medical service corporations
• 7.9 : Adjustment of rates; experience rating formula; approval
• 8 : Participating physicians; payments for medical services
• 9 : Filing form of subscription certificate, etc.; disapproval by commissioner
• 9.1 : Medical service corporation contract; compliance
• 9.2 : Filing of contract or related forms
• 9.3 : Contract forms; certification memorandum
• 10 : Schedule of rates; filing, disapproval
• 11 : Agreements with physicians; approval of payments; corporate records
• 12 : Expenditures in soliciting subscribers
• 13 : Administrative expenses
• 14 : Investments; surplus
• 15 : Statement of financial condition; inquiries by commissioner
• 16 : Failure to file statement or answer inquiries; penalty
• 17 : Examination of assets and affairs; assistants
• 18 : Expense of examination; gifts, etc., to departmental employees
• 19 : Exhibition of records and accounts; examinations under oath
• 21 : Fees
• 22 : Violations of chapter; penalty and recovery thereof; misdemeanors
• 23 : Grants for needy persons
• 24 : Corporation as charitable and benevolent institution; tax exemption
• 25 : Partial invalidity
• 26 : Podiatrist, services performed by.
• 27 : Bio-analytical laboratory, services performed by
• 28 : Dentists, services performed by
• 28.1 : Policies providing for reimbursement of services of dentist; additional applicable provisions
• 28.2 : Application of act to contracts with reservation of right to change premium
• 29 : Optometrist, services performed by
• 30 : Psychologist, services performed by
• 31 : Physical therapist, services performed by
• 32 : Chiropractors; authorization for payment for diagnostic X-rays; inclusion in act as physician licensed to practice medicine or surgery; liberal construction
• 33 : Chiropractors, services performed by
• 34 : Nurse-midwives, services performed by
• 35 : Services provided by registered professional nurse; benefits

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