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27-19-53
Section 27-19-53 Standards for policy provisions; limitations of benefits. (a) The commissioner
shall issue reasonable regulations to establish specific standards for policy provisions of
Medicare supplement policies and certificates. The standards shall be in addition to and in
accordance with applicable laws of this state, including Article 1 and Chapter 20. No requirement
of this title relating to minimum required policy benefits, other than the minimum standards
contained in this article, shall apply to Medicare supplement policies and certificates. The
standards may cover but shall not be limited to the following: (1) Terms of renewability.
(2) Initial and subsequent conditions of eligibility. (3) Nonduplication of coverage. (4)
Probationary periods. (5) Benefit limitations, exceptions, and reductions. (6) Elimination
periods. (7) Requirements for replacement. (8) Recurrent conditions. (9) Definition of terms.
(b) The commissioner may issue reasonable regulations that specify...
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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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6-5-691
Section 6-5-691 Definitions. For the purposes of this article, the following terms shall have
the following meanings: (1) ASBESTOS ACTION. A civil action arising out of, based on, or related
to the health effects of exposure to asbestos and any derivative claim made by or on behalf
of a person exposed to asbestos or a representative, spouse, parent, child, or other relative
of that person. The term asbestos action does not include claims alleging ovarian cancer.
(2) ASBESTOS TRUST. A government-approved or court-approved trust, qualified settlement fund,
compensation fund, or claims facility that is created as a result of an administrative or
legal action, a court-approved bankruptcy, pursuant to 11 U.S.C. §524(g), 11 U.S.C. §1121(a),
or other applicable provision of law, that is intended, in whole or in part, to provide compensation
to claimants arising out of, based on, or related to the health effects of exposure to asbestos.
(3) TRUST CLAIM MATERIALS. A final executed proof of...
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20-3-2
Section 20-3-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) ASSISTED LIVING FACILITY. An institution or facility licensed as an assisted
living facility under regulations of the State Board of Health. (2) CHARITABLE CLINIC. The
term includes an established free medical clinic as defined in subdivision (1) of Section
6-5-662 and any community health center provided for under the federal Public Health Service
Law. (3) CHARITABLE PATIENT. For purposes of this chapter, the term shall not include patients
who are eligible to receive drugs under the Alabama Medicaid Program or under any other prescription
drug program funded in whole or in part by the state. (4) DRUGS. All medicinal substances
and preparations recognized by the United States Pharmacopoeia and National Formulary, or
any revision thereof, and all substances and preparations intended for external and internal
use in the cure, diagnosis, mitigation, treatment, or prevention of...
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27-21A-32
Section 27-21A-32 HMO enrollment requirements. (a) The state government, or any agency, board,
commission, institution, or political subdivision thereof, and any city or county, or board
of education, which offers its employees a health benefits plan may make available to and
inform its employees or members of the option to enroll in at least one health maintenance
organization holding a valid certificate of authority which provides health care services
in the geographic areas in which such employees or members reside. (b) The first time a health
maintenance organization is offered by an employer, either public or private, each covered
employee must make an affirmative written selection among the different alternatives included
in the health benefits plan. Thereafter, those who wish to change from one plan to another
will be allowed to do so annually, provided, that nothing in this section shall prevent any
health maintenance organization or insurer from requiring evidence of...
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27-51-1
Section 27-51-1 Payment for services of licensed physician assistant. (a) An insurance policy
or contract providing for third-party payment or prepayment of health or medical expenses
shall include a provision for the payment to a supervising physician for necessary medical
or surgical services that are provided by a licensed physician assistant practicing under
the supervision of the physician, and pursuant to the rules, regulations, and parameters for
physician assistants, if the policy or contract pays for the same care and treatment provided
by a licensed physician or doctor of osteopathy. (b) An insurance policy or contract subject
to this section shall not impose a practice or supervision restriction which is inconsistent
with or more restrictive than provided by law. (c) This section shall apply to services provided
under a policy or contract delivered, continued, or renewed in this state on or after August
1, 1997, and to any existing policy or contract, on the policy's or...
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27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following
meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological,
and psychosocial concepts, techniques, and processes necessary to maintain or develop functional
skills of clients, provided to individuals and groups for periods of more than two hours but
less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by
the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including
an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses,
issued by insurers, health maintenance organizations, preferred provider organizations, medical
service organizations, physician-hospital organizations, 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...
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22-50-17
Section 22-50-17 Operation of a facility for care or treatment of mental or emotional illness
or substance abuse, or services to persons with an intellectual disability. (a) No person,
partnership, corporation, or association of persons shall operate a facility or institution
for the care or treatment of any kind of mental or emotional illness or substance abuse or
for providing services to persons with an intellectual disability as defined in this chapter,
without being certified by the department or licensed by the State Board of Health; provided
that nothing in this section shall be construed so as to require a duly authorized physician,
psychiatrist, psychologist, social worker, licensed professional counselor operating under
the scope of his or her license, or Christian Science practitioner to obtain a license for
treatment of patients in his private office, unless he keeps two or more patients in his office
for continuous periods of 24 hours or more in one week, or that a church...
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22-6-122
Section 22-6-122 Medicaid Pharmacy and Therapeutics Committee - Classification and recommendation
of drugs; assurance of quality patient care; review of pharmaceutical products. (a) The Medicaid
Pharmacy and Therapeutics Committee shall review and recommend classes of drugs to the Medicaid
Commissioner for inclusion in the Medicaid Preferred Drug Plan. Class means a therapeutic
group of pharmaceutical agents approved by the FDA as defined by the American Hospital Formulary
Service. The classes of anti-retroviral and anti-psychotic drugs shall not be included in
the Medicaid Preferred Drug Plan. (b) The Medicaid Pharmacy and Therapeutics Committee shall
develop its preferred drug list recommendations by considering the clinical efficacy, safety,
and cost effectiveness of a product. Within each covered class, the committee shall review
and recommend drugs to the Medicaid Commissioner for inclusion on a preferred drug list. Generics
and over the counter drugs covered by Medicaid may be...
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36-29-1
Section 36-29-1 Definitions. When used in this chapter, the following terms shall have the
following meanings, respectively, unless the context clearly indicates otherwise: (1) BOARD.
The State Employees' Insurance Board. (2) CLASS. An employee or retiree shall be included
in one of the following classes: (i) active employee single, (ii) active employee family,
(iii) non-Medicare retiree single, (iv) non-Medicare retiree family, (v) Medicare retiree
single, (vi) Medicare retiree family, (vii) non-Medicare retiree with Medicare eligible dependent(s),
or (viii) Medicare retiree with non-Medicare dependent(s). (3) EMPLOYEE. A person who works
full time for the State of Alabama or for a county health department and who receives his
or her full compensation on a monthly basis through means of a state warrant drawn upon the
State Treasury or by check drawn by the Treasurer of the Alabama State Port Authority or by
check drawn by the treasurer of the Alabama state agency for surplus property...
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