Scope and Purpose

958 CMR 3.000 applies to all carriers subject to the requirements of M.G.L. c. 176O. 958 CMR 3.000 establishes requirements for carriers in administering their internal grievance procedures and establishes the requirements for the conduct of external reviews of carriers' medical necessity adverse determinations. 958 CMR 3.000 also sets out requirements for continuity of care, referral to specialty care, and carrier reporting requirements. (Mass. Register #1494, 4/28/2023)