Massachusetts General Laws Part I. Administration of the Government (Ch. 1-182) Ch. 176G, § 11

Every health maintenance organization entering into a contract with the group insurance commission under chapter thirty-two A, or a county, city, town, or district under chapter thirty-two B, shall comply with the requirements applicable to health care organizations under said chapters thirty-two A and thirty-two B except that a health maintenance organization proposing to enter into direct contract may elect to have the group insurance commission, or the appropriate county, city, town or district, as the case may be, remit applicable monthly premium costs that would otherwise be payable to a carrier, directly to the health maintenance organization.