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16-30A-6
Section 16-30A-6 Training and supervision of school employees becoming unlicensed medication
assistants. Notwithstanding any other provision of law, a licensed health care professional
may provide training and supervise school employees becoming unlicensed medication assistants
who may also be providing care and performing tasks pursuant to this chapter in the activities
set forth in Section 16-30A-5. (Act 2014-437, p. 1618, §6.)...
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27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive
denials, adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health
benefit plan that issues or renews any policy of accident or health insurance providing benefits
for medical or hospital expenses for its insured persons shall pay for services rendered by
Alabama health care providers within 45 calendar days upon receipt of a clean written claim
or 30 calendar days upon receipt of a clean electronic claim. If the insurer, health service
corporation, or health benefit plan is denying or pending the claim, the insurer, health service
corporation, or health benefit plan shall, within 45 calendar days for a written claim and
30 calendar days for an electronic claim, notify the health care provider or certificate holder
of the reason for denying or pending the claim and what, if any, additional information is
required to process the claim. Any undisputed portion of the claim...
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27-1-19
Section 27-1-19 Reimbursement of health care providers. (a) The insured, or health or
dental plan beneficiary may assign reimbursement for health or dental care services directly
to the provider of services. Health benefits include medical, pharmacy, podiatric, chiropractic,
optometric, durable medical equipment, and home care services. The company or agency, when
authorized by the insured, or health or dental plan beneficiary, shall pay directly to the
health care provider the amount of the claim, under the same criteria and payment schedule
that would have been reimbursed directly to the contract provider, and any applicable interest.
This amount only applies to assigned claims. Any company or agency making a payment to the
insured, or health or dental plan beneficiary, after the rights of reimbursement have been
assigned to the provider of services, shall be liable to the provider for the payment. If
the company or agency fails to reimburse the provider in accordance with the terms...
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16-30B-5
Section 16-30B-5 Liability of attending physician. An attending physician, as defined
in Section 22-8A-3, has no supervisory authority over the school's execution of the
Palliative and End of Life Individual Health Plan and shall be immune from civil liability
for any orders, acts, or omissions directly related to this chapter, including any vicarious
liability for the acts and omissions of school employees and officials in carrying out the
Palliative and End of Life Individual Health Plan. (Act 2018-460, §2.)...
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27-21B-10
Section 27-21B-10 Enforcement of health care coverage for certain employers. (a) In
any case in which a noncustodial parent is required by a court or administrative order to
provide health care coverage for such child and the employer of the noncustodial parent is
known to the Department of Human Resources, the department shall use the federally required
medical support notice to provide notice to the employer of the requirement for employer-based
health care coverage for the child through the parent of the child who has been ordered to
provide health care coverage for the child unless a court or administrative order stipulates
that alternative health care coverage to employer-based coverage is to be provided for a child
subject to a Title IV-D child support order. In the case of an employer entered in the directory
of new hires pursuant to Section 25-11-5, the department shall send the federal medical
support notice to any employer of a noncustodial parent subject to the order within...
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27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases
shall have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health.
(2) ENROLLEE. An individual who has contracted for or who participates in coverage under an
insurance policy, a health maintenance organization contract, a health service corporation
contract, an employee welfare benefit plan, a hospital or medical services plan, or any other
benefit program providing payment, reimbursement, or indemnification for health care costs
for the individual or the eligible dependents of the individual. (3) PROVIDER. A health care
provider duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system
for prospective and concurrent review of the necessity and appropriateness in the allocation
of health care resources and services given or proposed to be given to an individual within
this state. The term does not include elective requests for clarification of...
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27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this
section, the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS.
The design, implementation, and evaluation of environmental modifications, using behavioral
stimuli and consequences, to produce socially significant improvement in human behavior, including
the use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
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16-1-51.1
Section 16-1-51.1 Comprehensive model policy for supervision and monitoring of juvenile
sex offender students; educational placement of juvenile sex offenders. (a)(1) On or before
January 1, 2019, the State Board of Education shall develop a comprehensive model policy for
the supervision and monitoring of juvenile sex offender students, who have a low risk of re-offense
and are enrolled, attending class, and participating in school activities with the general
population of students. The purpose of the model policy is to provide a safe and secure environment
for all students and staff. The model policy shall be adopted by each local board of education
and implemented beginning with the 2020-2021 school year. The model policy, at a minimum,
shall contain all of the following components: a. Application to all school property and school-sponsored
functions including, but not limited to, classroom instructional time, assemblies, athletic
events, extracurricular activities, and school bus...
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22-6-233
Section 22-6-233 Legislative findings; certification of collaborators; powers of Medicaid
Agency; state action immunity. (a) The Legislature declares that collaboration among public
payers, private health carriers, third party purchasers, and providers to identify appropriate
service delivery systems and reimbursement methods in order to align incentives in support
of integrated and coordinated health care delivery is in the best interest of the public.
Collaboration pursuant to this article is to provide quality health care at the lowest possible
cost to Alabama citizens who are Medicaid eligible. The Legislature, therefore, declares that
this health care delivery system affirmatively contemplates the foreseeable displacement of
competition, such that any anti-competitive effect may be attributed to the state's policy
to displace competition in the delivery of a coordinated system of health care for the public
benefit. In furtherance of this goal, the Legislature declares its intent...
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27-21A-7
Section 27-21A-7 Evidence of coverage and charges for health care services. (a)(1) Every
enrollee residing in this state is entitled to an evidence of coverage. If the enrollee obtains
such coverage through an insurance policy or a contract issued by a health care service plan,
the insurer or the health care service plan shall issue the evidence of coverage. Otherwise,
the health maintenance organization shall issue the evidence of coverage. (2) No evidence
of coverage, or amendment thereto, shall be issued or delivered to any person in this state
until a copy of the basic form of the evidence of coverage, or amendment thereto, has been
filed with the commissioner and the State Health Officer, and approved by the commissioner.
(3) An evidence of coverage shall contain: a. No provisions or statements which encourage
misrepresentation, or which are untrue, misleading, or deceptive as defined in subsection
(a) of Section 27-21A-13; and b. A clear and concise statement, if a contract, or a...
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