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27-1-16
Section 27-1-16 Standard health insurance claim form; electronic claims form; various claim
forms. (a)(1) The Commissioner of the Department of Insurance shall prescribe a standard health
insurance claim form to be used by all hospitals. The forms shall be prescribed in a format
which allows for the use of generally accepted diagnosis and treatment coding systems by providers
of health care and payors. The standard form shall be accepted and used by all insurers doing
business in the State of Alabama and by all state agencies which pay providers of health care
for hospital services. (2) The Commissioner of the Department of Insurance shall also prescribe
a format for all health insurance claims transmitted or submitted for payment by electronic
or electro-mechanical means. Such a format shall be used by all insurers doing business in
the State of Alabama and by all state agencies which pay providers of health care for hospital
services. (b) An advisory committee of five persons, two...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-16.htm - 3K - Match Info - Similar pages
27-21A-17
Section 27-21A-17 Suspension or revocation of certificate of authority. (a) The commissioner
in consultation with and with the approval of the State Health Officer, where necessary, may
suspend or revoke any certificate of authority issued to a health maintenance organization
under this chapter if he finds that any of the following conditions exist: (1) The health
maintenance organization is operating significantly in contravention of its basic organizational
document or in a manner contrary to that described in any other information submitted under
Section 27-21A-2, unless amendments to such submissions have been filed with the commissioner
and the State Health Officer and approved by the commissioner; (2) The health maintenance
organization issues evidence of coverage or uses a schedule of charges for health care services
which do not comply with requirements of Section 27-21A-7; (3) The health maintenance organization
does not provide or arrange for basic health care services; (4)...
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27-26-2
availability is limited and likely to become increasingly so, unless remedial legislation is
enacted. The Legislature further finds and declares that by reason of complicated and highly
technical medical concepts, and the existence of sophisticated medical techniques, decisions
with respect to optional procedures of diagnosis and treatment have become increasingly complex
and are necessarily made on the basis of professional judgment, on which opinions may and
often will reasonably vary. It is the purpose of this chapter to insure that the citizens
of the State of Alabama are able to receive necessary health services by providing an environment
in which the medical profession can be assured of medical liability insurance coverage and
be afforded reasonable protection against personal liability for consequences proximately
resulting from decisions with respect to diagnosis and treatment arrived at in the bona fide
exercise of professional judgment. (Acts 1975, No. 513, p. 1148, §2.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-26-2.htm - 1K - Match Info - Similar pages
27-48-3
Section 27-48-3 Prohibition against plan termination of services, reduction of capitation payment,
or other penalty for health care provider in compliance with chapter; prohibition against
financial encouragement of early discharge from postpartum care. No health benefit plan subject
to the provisions of this chapter shall terminate the services, reduce capitation payment,
or otherwise penalize an attending physician, certified nurse midwife, or other health care
provider who orders medical care consistent with this chapter. No health benefit plan shall
provide, directly or indirectly, any financial incentive or disincentive or grant or deny
any special favor or advantage of any kind or nature to any person to encourage or cause early
discharge of a hospital patient from postpartum care, excluding capitation or global fee arrangements.
Provided nothing contained in this chapter is intended to expand the list or designation of
covered providers as specified in any health benefit plan or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-48-3.htm - 1K - Match Info - Similar pages
27-56-5
Section 27-56-5 Third-party payment. (a) No insurance policy, plan, or contract providing for
third-party payment or prepayment of health or medical expenses that provides coverage for
eye care services shall be issued or renewed after August 1, 2001, unless such insurance policy,
plan, or contract does the following: (1) Provides a covered person direct access to any eye
care provider participating in, or otherwise eligible to provide services under, the policy,
plan, or contract for all eye care services covered under the policy, plan, or contract, without
any referral or preapproval requirement, including, but not limited to, the following services,
if covered: a. Medical treatment of glaucoma. b. Postoperative eye care. (2) Ensures that
any list of medical or health care providers participating in, or otherwise eligible to provide
services under, the policy, plan, or contract includes eye care providers to the same extent
that such list includes other medical or health care...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-56-5.htm - 1K - Match Info - Similar pages
38-9-4
Section 38-9-4 Arrangements for protective services; liability of department for protective
services; services to conform to wishes of person to be served; duty of department to ascertain
persons in need of care and protection. (a) Protective services may be arranged when an adult
person is in need of care and protection because of danger to his health or safety; provided,
that nothing in this chapter shall be construed to mean that the department is chargeable
for the cost of such care except where such care is specifically provided for by law or departmental
regulations and funding exists for such purpose. All protective services shall be in conformity
with the wishes of the person to be served unless the person is unable or unwilling to accept
such services, and if the person is unable or unwilling to accept such services, the court
may order such services. The department may be required to provide or arrange for services
only for persons it is equipped to serve and agrees to serve....
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/38-9-4.htm - 1K - Match Info - Similar pages
40-26B-2
Section 40-26B-2 Privilege tax upon providers of pharmaceutical services; exceptions. To provide
further for the availability of indigent health care, the operation of the Medicaid Program
and the maintenance and expansion of medical services thereunder, there is hereby levied and
shall be collected as provided in this article a privilege tax on the business activities
of every provider of pharmaceutical services to the citizens of Alabama, except for a pharmacy,
or portion thereof, serving hospital inpatients or pharmacies owned or operated by the State
of Alabama or an agency thereof. The privilege tax imposed by this article is in addition
to all other taxes of any kind now imposed by law, and shall be at the rate of 10 cents for
each prescription filled or refilled for a citizen of Alabama. (Acts 1991, No. 91-124, p.
148, §2; Act 2002-414, p. 1058, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-2.htm - 1K - Match Info - Similar pages
44-1-24
Section 44-1-24 Powers and duties of department generally. The Department of Youth Services
shall perform the following: (1) Provide services for youths who have run away from their
own communities in this state or from their home communities in other states to this state,
and provide such services, care, or cost for the youths as may be required pursuant to the
provisions of the Interstate Compact on Juveniles. (2) Provide for the expansion of local
detention care for youths alleged to be delinquent pending court hearing. (3) Secure the provision
of medical, hospital, psychiatric, surgical, or dental service, or payment of the cost of
such services, as may be needed for committed youths. (4) License and subsidize foster care
facilities or group homes for youths alleged to be delinquent pending hearing before a juvenile
court or adjudged delinquent following hearing, including detention, examination, study, care,
treatment, and training. (5) Establish, maintain, and subsidize programs...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/44-1-24.htm - 3K - Match Info - Similar pages
22-11A-60
by a rule adopted pursuant to the Alabama Administrative Procedure Act. (7) INVASIVE PROCEDURES.
(a) Those medical or surgical procedures characterized by the digital palpation of a needle
tip in a body cavity or by the simultaneous presence of the health care worker's fingers and
a needle or other sharp instrument or object in a poorly visualized or highly confined anatomic
site. (b) Invasive dental procedures shall include those that provide the opportunity for
an intraoral percutaneous injury to the dental health care worker and could result
in the blood of the health care worker coming in contact with the blood or mucous membrane
of the patient as adopted by the Board of Dental Examiners in rules developed pursuant to
Section 22-11A-70. (c) These procedures shall not include physical examinations; blood pressure
checks; eye examinations; phlebotomy; administering intramuscular, intradermal, or subcutaneous
injections; needle biopsies; needle aspirations; lumbar punctures;...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-11A-60.htm - 3K - Match Info - Similar pages
22-11D-8
Section 22-11D-8 Rules and regulations. (a) In accordance with the Alabama Administrative Procedure
Act, the board, with the advice and after approval of the council, shall promulgate rules
to implement and administer this chapter. Rules promulgated by the board may include, but
are not limited to, the following: (1) Criteria to ensure that severely injured or ill people
are promptly transported and treated at designated trauma centers appropriate to the severity
of the injury. Minimum criteria shall address emergency medical service trauma triage
and transportation guidelines as approved under the board's emergency medical services rules,
designation of health care facilities as trauma centers, interhospital transfers, and a trauma
system governance structure. (2) Standards for verification of trauma and health care center
status which assign level designations based on resources available within the facility. Standards
shall be based upon national guidelines, including, but not...
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