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43-2-697
Section 43-2-697 Notice to Medicaid Agency of appointment as personal representative
or filing of petition under Section 43-2-692. (a) The personal representative, or person
filing to initiate a proceeding in accordance with the Alabama Small Estates Act, Division
10 of this article, shall give notice of his or her appointment, or the filing of a petition
in accordance with Section 43-2-692, to the Medicaid Agency. The notice shall include all
of the following information: (1) The full legal name of the deceased. (2) The date of birth
of the deceased. (3) The date of death of the deceased. (4) The Social Security number of
the deceased. (5) The marital status of the deceased at the time of death. (6) The name, address,
and phone number of the spouse of the deceased, if applicable. (7) The court in which a probate
estate has been opened. (8) The probate case number. (9) The date on which letters testamentary
or letters of administration were issued by the probate court. (10) The name,...
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22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance
procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for
Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid
region for at least one fully certified regional care organization to provide, pursuant to
a risk contract under which the Medicaid Agency makes a capitated payment, medical care to
Medicaid beneficiaries. However, the Medicaid Agency may enter into a contract pursuant to
this section only if, in the judgment of the Medicaid Agency, care of Medicaid beneficiaries
would be better, more efficient, and less costly than under the then existing care delivery
system. The Medicaid Agency may contract with more than one regional care organization in
a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments
for the regional care organization. (b) The Medicaid Agency shall...
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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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2-17-34
Section 2-17-34 Making, etc., of false statements or entries in reports, accounts, etc.; mutilation,
alteration, etc., of documentary evidence, etc. Any person, firm or corporation that shall
willfully make or cause to be made any false entry or statement of fact in any report required
to be made under this chapter, or that shall willfully make or cause to be made any false
entry in any account, record or memorandum kept by any person, firm or corporation subject
to this chapter or that shall willfully neglect or fail to make or to cause to be made full,
true and correct entries in such accounts, records or memoranda of all facts and transactions
appertaining to the business of such person, firm or corporation or that shall willfully remove
out of the jurisdiction of this state or willfully mutilate, alter or by any other means falsify
any documentary evidence of any such person, firm or corporation or that shall willfully refuse
to submit to the commissioner or to any of his...
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25-4-145
Section 25-4-145 Penalties; limitation of actions; collection of overpayments; waiver of overpayments.
(a) Penalties. (1) Whoever willfully makes a false statement or representation or who willfully
fails to disclose a material fact to obtain or increase any benefit or payment under this
chapter, or under an unemployment insurance law of any other state or government, either for
himself or herself or for any other person, whether such benefit or payment is actually received
or not, shall be guilty of an offense as follows and each such false statement or representation
shall constitute a separate and distinct offense: a. If the aggregate amount involved in the
offense exceeds two thousand five hundred dollars ($2,500) in value, that shall constitute
a Class B felony. b. If the aggregate amount involved in the offense exceeds five hundred
dollars ($500) but does not exceed two thousand five hundred dollars ($2,500), that shall
constitute a Class C felony. c. If the aggregate amount...
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41-5A-6
Section 41-5A-6 Chief examiner - Recovery audits for overpayments of state funds. (a) For the
purposes of this section, the following words have the following meanings: (1) CHIEF EXAMINER.
The Chief Examiner of Public Accounts. (2) OVERPAYMENT. Any payment in excess of amounts due
and includes failure to meet eligibility requirements, failure to identify third party liability
where applicable, any payment for an ineligible good or service, any payment for a good or
service not received, duplicate payments, invoice and pricing errors, failure to apply discounts,
rebates, or other allowances, failure to comply with contracts or purchasing agreements, or
both, failure to provide adequate documentation or necessary signatures, or both, on documents,
or any other inadvertent error resulting in overpayment. (3) RECOVERY AUDIT. A financial management
technique used to identify overpayments made by a state agency with respect to individuals,
vendors, service providers, and other entities in...
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18-4-5
Section 18-4-5 Additional payments - Dwelling occupied at least 180 days. (a) In addition to
payments otherwise authorized by this chapter, the state agency shall make an additional payment
not in excess of twenty-two thousand five hundred dollars ($22,500) to any displaced person
who is displaced from a dwelling actually owned and occupied by the displaced person for not
less than 180 days prior to the initiation of negotiations for the acquisition of the property.
The additional payment shall include the following: (1) The amount, if any, which, when added
to the acquisition cost of the dwelling acquired by the state agency, equals the reasonable
cost of a comparable replacement dwelling. (2) The amount, if any, which will compensate a
displaced person for any increased interest costs and other debt service costs which the displaced
person is required to pay for financing the acquisition of any comparable replacement dwelling.
The amount for any increased interest or debt service...
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40-26B-81
Section 40-26B-81 Medicaid hospital access payments. (a) If the Medicaid Agency begins making
payments pursuant to Article 9 of Chapter 6 of Title 22, on or before September 30, 2019,
to preserve and improve access to hospital services, for hospital inpatient and outpatient
services rendered on or after October 1, 2018, the agency shall consider the published inpatient
and outpatient rates as defined in Sections 40-26B-79 and 40-26B-80 as the minimum payment
allowed. (b) If the Medicaid Agency does not begin making payments pursuant to Article 9 of
Chapter 6 of Title 22, on or before September 30, 2019, the aggregate hospital access payment
amount is an amount equal to the upper payment limit, less total hospital base payments determined
under this article. All publicly, state-owned, and privately operated hospitals shall be eligible
for inpatient and outpatient hospital access payments for fiscal years 2020, 2021, and 2022,
as set forth in this article. (1) In addition to any other...
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45-37-171.44
Section 45-37-171.44 Ability to pay fees; increase in costs and fees; funding. No person shall
be denied any service because that person, or if a minor, the parent or legal guardian of
such person, is unable to pay the fee for such service established pursuant to this subpart.
The determination of a person's ability to pay shall be made in confidence and under circumstances
that will protect the dignity of the person receiving the service. Using any appropriate standards
of ability to pay for health care provided by the United States Government or any agency thereof,
the Jefferson County Board of Health may establish a sliding fee scale based on a person's
ability to pay. Any provision of this subpart to the contrary notwithstanding, this subpart
shall not be interpreted or applied to authorize any increase in the fees, if any, that any
person may be required to pay for any examination, treatment, vaccination, inoculation, or
other health care service of any kind that, as of September...
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15-20A-4
Section 15-20A-4 Definitions. For purposes of this chapter, the following words shall have
the following meanings: (1) ADULT SEX OFFENDER. A person convicted of a sex offense. (2) CHILD.
A person who has not attained the age of 12. (3) CHILDCARE FACILITY. A licensed child daycare
center, a licensed childcare facility, or any other childcare service that is exempt from
licensing pursuant to Section 38-7-3, if it is sufficiently conspicuous that a reasonable
person should know or recognize its location or its address has been provided to local law
enforcement. (4) CONVICTION. A verdict or finding of guilt as the result of a trial, a plea
of guilty, a plea of nolo contendere, or an Alford plea regardless of whether adjudication
was withheld. Conviction includes, but is not limited to, a conviction in a United States
territory, a conviction in a federal or military tribunal, including a court martial conducted
by the Armed Forces of the United States, a conviction for an offense committed...
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