Massachusetts · Regulations
958 CMR 3.00 — Health insurance consumer protection
49 sections
49 sections
- 958 CMR 3.001Scope and Purpose
- 958 CMR 3.020Definitions
- 958 CMR 3.100Clinical Decisions
- 958 CMR 3.101Carrier's Medical Necessity Guidelines
- 958 CMR 3.200Internal Inquiry Process
- 958 CMR 3.300Right to an Internal Grievance Process
- 958 CMR 3.301Information on Internal Grievance Process
- 958 CMR 3.302Form and Manner of Request
- 958 CMR 3.303Carrier and Utilization Review Organization Records of Grievances
- 958 CMR 3.304Carrier and Utilization Review Organization Acknowledgment of Internal Grievances
- 958 CMR 3.305Time Limits for Resolution of Non-expedited Internal Grievances
- 958 CMR 3.306Review of Internal Grievances
- 958 CMR 3.307Form of Written Resolution of the Internal Grievance
- 958 CMR 3.308Reconsideration of Carrier Decisions on Internal Grievances
- 958 CMR 3.309Expedited Internal Review of Adverse Determinations
- 958 CMR 3.310Right to Request a Conference
- 958 CMR 3.311Failure of Carrier to Meet Time Limits
- 958 CMR 3.312Coverage or Treatment Pending Resolution of Internal Grievance
- 958 CMR 3.313Confidentiality
- 958 CMR 3.314Internal Review Conference
- 958 CMR 3.401Expedited External Review
- 958 CMR 3.402Fees
- 958 CMR 3.403Consent to Release of Medical Information
- 958 CMR 3.404Form and Manner of Request for External Review
- 958 CMR 3.405Screening of Requests for External Review
- 958 CMR 3.406Requests Ineligible for External Review – Notification
- 958 CMR 3.407Assignment of External Reviews
- 958 CMR 3.408Notification of Assignment and Request for Information
- 958 CMR 3.409Medical Records and Information
- 958 CMR 3.410Review Panel
- 958 CMR 3.411Conflict of Interest
- 958 CMR 3.412Additional Medical or Other Information
- 958 CMR 3.413Informal Meeting
- 958 CMR 3.414Continuation of Services
- 958 CMR 3.415Decisions and Notice
- 958 CMR 3.416Confidentiality – External Review
- 958 CMR 3.417External Review Conference
- 958 CMR 3.500Disenrollment of Primary Care Provider
- 958 CMR 3.501Disenrollment of Providers of Care to Pregnant Women
- 958 CMR 3.502Disenrollment of Providers of Care to the Terminally Ill
- 958 CMR 3.503Coverage for the Newly Insured
- 958 CMR 3.504Carrier's Coverage Conditions
- 958 CMR 3.505Standing Referrals
- 958 CMR 3.506Specialty Care Not Requiring Prior Authorization
- 958 CMR 3.507Coverage of Pediatric Specialty Care
- 958 CMR 3.508Denial of Provider Application
- 958 CMR 3.509Provider Termination Without Cause Provisions
- 958 CMR 3.600Reporting Requirements
- 958 CMR 3.700Required Oral Interpretation and Written Translation Services