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27-1-21
Section 27-1-21 Uniformity of limits applied to fulfillment of certain drug prescriptions.
(a) For the purposes of this section, the following words shall have the following meanings:
(1) ENROLLEE. A person enrolled in a health benefit plan. (2) HEALTH BENEFIT PLAN. Any individual
or group plan, policy, or contract for health care services issued, delivered, issued for
delivery, renewed in this state by a health care insurer, health maintenance organization,
accident and sickness insurer, fraternal benefit society, nonprofit hospital service corporation,
nonprofit medical service corporation, health care service plan, or any other person, firm,
corporation, joint venture, or other similar business entity that pays for, purchases, or
furnishes health care services to patients, insureds, or beneficiaries in this state. The
term includes, but is not limited to, entities created pursuant to Article 6 of Chapter 4
of Title 10. The term shall not include any collective bargaining agreement...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-21.htm - 3K - Match Info - Similar pages
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. ยงยง 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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-4-2.htm - 3K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-17.htm - 17K - Match Info - Similar pages
22-20-3
Section 22-20-3 Neonatal testing for certain diseases; rules and regulations for treatment
thereof. (a) It shall be the duty of the administrative officer or other persons in charge
of each institution caring for infants 28 days or less of age, or the physician attending
a newborn child or the person attending a newborn child that was not attended by a physician
to cause to have administered to every such infant or child in his care a reliable test for
hypothyroidism and a reliable test for phenylketonuria (PKU), such as the Guthrie test, or
any other test considered equally reliable by the State Board of Health and a reliable test
for sickle cell anemia, sickle cell trait, and/or abnormal hemoglobin and such other tests
relating to mental retardation or other heritable diseases and conditions as are designated
by the Board of Health. Provided, however, that the Board of Health shall designate only conditions
that are detectable by mass screening of newborn infants. Initial mass...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-20-3.htm - 2K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-233.htm - 6K - Match Info - Similar pages
22-21-351
Section 22-21-351 Legislative findings. The Legislature hereby finds and declares as follows:
(1) That in order to promote the public health of the people of the State of Alabama, the
Legislature enacted the enabling statute, whereunder, among other things: a. The several counties,
municipalities, and educational institutions of the state are effectively authorized to form
public corporations known as health care authorities, and b. Existing public hospital corporations
are authorized to reincorporate as health care authorities; (2) That all such health care
authorities are empowered under and pursuant to the enabling statute, among other things:
a. To own and operate public hospitals and other health care facilities; b. To furnish office
space to (among others) any nonhospital-based physician, dentist or other health care professional
for use in his private practice, subject to the conditions specified in the enabling statute;
and c. To appoint, employ, contract with, and provide for...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-351.htm - 2K - Match Info - Similar pages
22-6-163
Section 22-6-163 Legislative findings; rules; collaboration; approval of agreements and contracts;
state action immunity; confidentiality of records; additional duties. (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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-163.htm - 6K - Match Info - Similar pages
36-36-6
Section 36-36-6 Sources of funding; use of assets; distributions; modification and termination
of trusts; taxation; financial statement. (a) The sources of funding to the Alabama Retired
State Employees' Health Care Trust may be: (1) appropriations made by the Legislature; (2)
contributions by employees and retired employees; (3) employer contributions; (4) investment
income; (5) proceeds of any gifts, grants, or contributions; (6) transfers from the State
Employees' Insurance Fund; and (7) all other sources permitted by law. (b) The sources of
funding to the Alabama Retired Education Employees' Health Care Trust may be: (1) appropriations
made by the Legislature; (2) contributions by employees and retired employees; (3) employer
contributions; (4) investment income; (5) proceeds of any gifts, grants, or contributions;
(6) transfers from the Public Education Employees' Health Insurance Fund; and (7) all other
sources permitted by law. (c) The agreements creating the trusts shall be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-36-6.htm - 5K - Match Info - Similar pages
6-12-1
Section 6-12-1 Legislative findings. The Legislature of Alabama finds as follows: (1) Cigarette
smoking presents serious public health concerns to the state and to the citizens of the state.
The Surgeon General has determined that smoking causes lung cancer, heart disease, and other
serious diseases, and that there are hundreds of thousands of tobacco-related deaths in the
United States each year. These diseases most often do not appear until many years after the
person in question begins smoking. (2) Cigarette smoking also presents serious financial concerns
for the state. Under certain health care programs, the state may have a legal obligation to
provide medical assistance to eligible persons for health conditions associated with cigarette
smoking, and those persons may have a legal entitlement to receive such medical assistance.
(3) Under these programs, the state pays millions of dollars each year to provide medical
assistance for these persons for health conditions associated...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/6-12-1.htm - 2K - Match Info - Similar pages
27-21A-3
Section 27-21A-3 Issuance of certificate of authority. (a)(1) Upon receipt of an application
for issuance of a certificate of authority, the commissioner shall forthwith transmit copies
of such application and accompanying documents to the State Health Officer. (2) The State
Health Officer shall determine whether the applicant for a certificate of authority, with
respect to health care services to be furnished: a. Has demonstrated the willingness and potential
ability to assure that such health care services will be provided in a manner to assure both
availability and accessibility of adequate personnel and facilities and in a manner enhancing
availability, accessibility, and continuity of service; b. Has arrangements, established in
accordance with the regulations promulgated by the State Health Officer, for an on-going quality
assurance program concerning health care processes and outcomes; and c. Has a procedure, established
in accordance with regulations of the State Health...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-3.htm - 7K - Match Info - Similar pages
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