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34-23-113
Section 34-23-113 Cancellation of program; use of identity card after cancellation. (a) The
administrator of a program shall notify all pharmacies enrolled in the program of any cancellation
of coverage of benefits of any group enrolled in the program at least 30 days prior to the
effective date of such cancellation. (b) All persons enrolled in a program shall be notified
of its cancellation, and the administrator of the program shall make every reasonable effort
to gain possession of any plan identification cards such persons may have been issued pursuant
to the provisions of the program. (c) Any person who utilizes a program identification card
to obtain services from a pharmacy after having received notice of the cancellation of his
benefits shall be liable to the program administrator for all money paid by the program administrator
for any services received pursuant to the illegal use of the identification card. (Acts 1981,
No. 81-337, p. 477, §4.)...
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40-26B-70
Section 40-26B-70 Definitions. For purposes of this article, the following terms shall have
the following meanings: (1) ACCESS PAYMENT. A payment by the Medicaid program to an eligible
hospital for inpatient or outpatient hospital care, or both, provided to a Medicaid recipient.
(2) ALL PATIENT REFINED DIAGNOSIS-RELATED GROUP (APR-DRG). A statistical system of classifying
any non-Medicare inpatient stay into groups for the purposes of payment. (3) ALTERNATE CARE
PROVIDER. A contractor, other than a regional care organization, that agrees to provide a
comprehensive package of Medicaid benefits to Medicaid beneficiaries in a defined region of
the state pursuant to a risk contract. (4) CERTIFIED PUBLIC EXPENDITURE (CPE). A certification
in writing of the cost of providing medical care to Medicaid beneficiaries by publicly owned
hospitals and hospitals owned by a state agency or a state university plus the amount of uncompensated
care provided by publicly owned hospitals and hospitals...
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10A-2-8.50
Section 10A-2-8.50 Definitions. REPEALED IN THE 2019 REGULAR SESSION BY ACT 2019-94 EFFECTIVE
JANUARY 1, 2020. THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. In this division: (1) "Corporation"
includes any domestic or foreign predecessor entity of a corporation in a merger or other
transaction in which the predecessor's existence ceased upon consummation of the transaction.
(2) "Director" means an individual who is or was a director of a corporation or
an individual who, while a director of a corporation, is or was serving at the corporation's
request as a director, officer, partner, trustee, employee, or agent of another foreign or
domestic corporation, partnership, joint venture, trust, employee benefit plan, or other enterprise.
A director is considered to be serving an employee benefit plan at the corporation's request
if his or her duties to the corporation also impose duties on, or otherwise involve services
by, the director to the plan or to participants in or beneficiaries of the...
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27-49-4
Section 27-49-4 Obstetricians and gynecologists as primary care physicians; direct access to
obstetrician and gynecologist not used as primary care physicians. (a) Each health benefit
plan which is issued, delivered, issued for delivery, or renewed in this state on or after
October 1, 1996, shall allow obstetricians and gynecologists as primary care physicians. This
subsection shall not be construed to require an individual obstetrician or gynecologist to
accept primary care physician status if the obstetrician or gynecologist does not wish to
be designated as a primary care physician, nor to interfere with the credentialing and other
selection criteria usually applied by a health benefit plan with respect to other physicians
within its network. (b) For women not using an obstetrician or gynecologist as their primary
care physician, no health benefit plan which is issued, delivered, issued for delivery, or
renewed in this state on or after October 1, 1996, shall require as a condition...
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27-56-10
Section 27-56-10 Vision care providers - Contract requirements; rates; reimbursements; discounts.
(a) As used in this section, the following words shall have the following meanings: (1) CONTRACTUAL
DISCOUNT. A percentage reduction from a provider's usual and customary rate for covered services
and materials required under a participating provider agreement. (2) COVERED MATERIALS. Materials
for which reimbursement from the insurer or vision care plan is provided to a vision care
provider by an enrollee's plan contract, or for which a reimbursement would be available but
for the application of the enrollee's contractual limitations of deductibles, copayments,
or coinsurance. (3) COVERED SERVICES. Services for which reimbursement from the insurer or
vision care plan is provided to a vision care provider by an enrollee's plan contract, or
for which a reimbursement would be available but for the application of the enrollee's contractual
plan limitations of deductibles, copayments, or...
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11-91A-2
Section 11-91A-2 Local Government Health Insurance Board; governance and administration of
program. (a) The Local Government Health Insurance Board shall govern and administer the Local
Government Health Insurance Program currently governed and administered by the State Employees'
Insurance Board (SEIB) pursuant to Chapter 29 of Title 36. The transfer of the governance
and administration to the board shall take effect at 12:01 a.m. on January 1, 2015, and thereafter
the board shall take all control and responsibility for the program under procedures and authority
set out in this chapter. (b) The program governed and administered by the board shall provide
a reasonable relationship between the health care benefits to be included and the expected
health care expenses to be incurred by affected employees, retirees, and their dependents.
The board may establish a fully insured or self-insured health care plan for employees and
retirees as defined in this chapter and may adopt rules for the...
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11-98-5.2
Section 11-98-5.2 911 Fund. (a) Effective October 1, 2013, the 911 Fund shall be created as
an insured interest-bearing account into which the 911 Board shall deposit all revenues derived
from the service charge levied on voice communications service providers under this chapter
and all prepaid wireless 911 charges received from the department. The revenues deposited
into the 911 Fund shall not be monies or property of the state and shall not be subject to
appropriation by the Legislature. The 911 Board shall administer the fund and shall credit
the 911 Fund all revenues received. The fund and revenues generated by the fund may only be
used as provided in this chapter. (b) Effective October 1, 2013, there shall first be deducted,
no more than one time during each calendar month, from the total amount of the statewide 911
charges paid over to the 911 Board during such month, a sum not to exceed one percent of the
total amount, to be applied by the 911 Board exclusively for payment of...
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22-21-375
Section 22-21-375 Issuance of license; revocation; procedures for review and mediation of complaints.
(a) The Department of Insurance shall issue a license to each applicant upon payment of the
prescribed fees and upon being satisfied that: (1) The applicant has been organized in a bona
fide manner for the purpose of establishing, maintaining, and operating a dental service plan.
(2) Each contract executed, or proposed to be executed, by the applicant and a dentist obligates,
or will when executed obligate, such dentist to render the service or accept payment for the
service to which each subscriber may be entitled under the terms of the contract issued to
the subscriber. (3) Each contract issued, or proposed to be issued, to subscribers is in a
form approved by the department and that the rates charged, or proposed to be charged, for
each form of such contract and benefits to be provided pursuant thereto are fair and reasonable
and are actuarially sound. (4) No contributions to the...
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22-4-2
Section 22-4-2 Definitions. When used in this article, the following terms shall have the following
meanings, respectively, unless a different meaning clearly appears from the context: (1) STATE
BOARD OF HEALTH. The statutory agency of the State of Alabama operative in the field of general
health matters and performing the duties and exercising the powers as set forth in the statutory
provisions relating thereto. (2) STATEWIDE HEALTH COORDINATING COUNCIL. The advisory council
established pursuant to this article which shall advise the State Board of Health on matters
relating to health planning and resource development. (3) HEALTH SYSTEMS AGENCY. An entity
which is organized and operated under the provisions of Title XV of the Public Health Service
Act (42 U.S.C. §§ 3001 et seq.) and is responsible for the health planning and development
in a health service area designated by the Governor. (4) HEALTH SERVICE AREA. A geographical
area designated by the Governor as being appropriate...
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17-5-2
Section 17-5-2 Definitions. (a) For purposes of this chapter, the following terms shall have
the following meanings: (1) CANDIDATE. An individual who has done any of the following: a.
Taken the action necessary under the laws of the state to qualify himself or herself for nomination
or for election to any state office or local office or in the case of an independent seeking
ballot access, on the date when he or she files a petition with the judge of probate in the
case of county offices, with the appropriate qualifying municipal official in the case of
municipal offices, or the Secretary of State in all other cases. b. Received contributions
or made expenditures in excess of one thousand dollars ($1,000), or given his or her consent
for any other person or persons to receive contributions or make expenditures in excess of
one thousand dollars ($1,000), with a view to bringing about his or her nomination or election
to any state office or local office. (2) COMMISSION. The State Ethics...
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