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22-11B-3
Section 22-11B-3 Medicaid recipients deemed to have given consent to information release with
receipt of services. Medicaid recipients shall be deemed to have given their consent to the
release by the State Medicaid Agency of information to the State Board of Health or any other
health care provider by virtue of their receipt of Medicaid covered services. (Acts 1995,
No. 95-530, p. 1075, §3.)...
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34-23-183
Section 34-23-183 Application. This article shall apply to any audit of the records of a pharmacy
conducted by a managed care company, nonprofit hospital or medical service organization, health
benefit plan, third-party payor, pharmacy benefit manager, a health program administered by
a department of the state, except the Alabama Medicaid Agency, or any entity that represents
those companies, groups, or department. (Act 2012-306, p. 668, §4; Act 2018-457, §1.)...
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22-21-263
Section 22-21-263 New institutional health services subject to review. (a) All new institutional
health services which are subject to this article and which are proposed to be offered or
developed within the state shall be subject to review under this article. No institutional
health services which are subject to this article shall be permitted which are inconsistent
with the State Health Plan. For the purposes of this article, new institutional health services
shall include any of the following: (1) The construction, development, acquisition through
lease or purchase, or other establishment of a new health care facility or health maintenance
organization. A transaction involving the sale, lease, or other transfer or change of control
of an existing health care facility, existing health maintenance organization, or existing
institutional health service is not subject to certificate of need review or approval under
this article unless the transaction also involves implementing one or...
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22-6-227
Section 22-6-227 Quality assurance committee; reporting requirements. (a) The Medicaid Agency
shall create a quality assurance committee appointed by the Medicaid Commissioner to review
the care rendered through the integrated care networks. The members of the committee shall
serve two-year terms. The Medicaid Agency shall promulgate a rule establishing the membership
and criteria to serve on the quality assurance committee. (b) The Medicaid Agency shall continuously
evaluate the outcome and quality measures adopted by the committee pursuant to this section.
(c) The Medicaid Agency shall utilize available data systems for reporting outcome and quality
measures adopted by the committee and take actions to eliminate any redundant reporting or
reporting of limited value. (d) The Medicaid Agency shall publish the information collected
under this section at aggregate levels that do not disclose information otherwise protected
by law. The information published shall report all of the...
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27-21A-4
Section 27-21A-4 Powers of health maintenance organizations. (a) The powers of a health maintenance
organization include, but are not limited to the following: (1) The purchase, lease, construction,
renovation, operation, or maintenance of hospitals, medical facilities, or both, and their
ancillary equipment; (2) The making of loans other than in the ordinary course of business,
to providers under contract with it in furtherance of its program or the making of loans to
a corporation or corporations in which it owns a majority interest for the purpose of acquiring
or constructing medical facilities and hospitals or in furtherance of a program providing
health care services to enrollees. (3) The furnishing of health care services through providers
which are under contract with or employed by the health maintenance organization. (4) The
contracting with any person for the performance on its behalf of certain functions such as
marketing, enrollment, and administration. (5) The purchase,...
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34-19-21
Section 34-19-21 Coverage or reimbursement for services not required. Nothing contained in
this chapter shall be construed to create a requirement that any health benefit plan, group
insurance plan, policy, or contract for health care services that covers hospital, medical,
or surgical expenses, 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 group health care services to patients, insureds, or beneficiaries in this state,
including entities created pursuant to Article 6, commencing with Section 10A-20-6.01, of
Chapter 20, Title 10A, provide coverage or reimbursement for the services described or authorized
in this chapter. (Act 2017-383, §4.)...
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38-9C-5
Section 38-9C-5 Providers who contract with agencies or programs required to develop written
policies to ensure rights. All providers who contract or subcontract with any federal, state,
or local agency or program to provide services in the State of Alabama to persons with developmental
disabilities or traumatic brain injury in Alabama shall develop and implement written policies
and procedures to ensure the rights enumerated above are observed by the provider in discharging
its contractual or subcontractual duties and responsibilities. At a minimum, these policies
and procedures shall provide for the following: (1) Affirm and safeguard the rights stated
in this chapter. (2) Provide that prompt, reasonable action be taken to prevent the potential
for further abuse while an investigation is in process. (3) Provide for a prompt and thorough
investigation of all allegations of abuse, exploitation, or neglect by trained, experienced
personnel delegated with all necessary authority. (4)...
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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...
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22-7A-1
Section 22-7A-1 Physician agreements; dentist agreements. (a) For the purposes of this chapter,
the following words shall have the following meanings: (1) DENTIST. A person licensed to practice
dentistry in this state. (2) DENTIST AGREEMENT or AGREEMENT. A contract between a dentist
and a patient or his or her legal representative in which the dentist or the dentist's medical
practice agrees to provide dental services to the patient for an agreed upon fee and period
of time. (3) DENTIST PRACTICE. A dentist or a dental practice of a dentist that charges a
periodic fee for dental services and which does not bill a third party any additional fee
for services for patients covered under a dental agreement. The per visit charge of the practice
shall be less than the monthly equivalent of the periodic fee. (4) PHYSICIAN. A person licensed
to practice medicine in this state. (5) PHYSICIAN AGREEMENT or AGREEMENT. A contract between
a physician and a patient or his or her legal representative in...
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22-11B-1
Section 22-11B-1 Health care providers upon request required to give immunization status of
patients. (a) Notwithstanding any of the confidentiality provisions in Chapter 11A of this
title, or any other provisions of law, every public and private health care provider shall,
upon request of the persons or entities herein identified, provide information concerning
the immunization status of any patient in accordance with rules promulgated by the State Board
of Health to the following persons and entities: (1) Other public and private health care
providers. (2) Health care insurers of all descriptions. (3) The Alabama Medicaid Agency.
(4) Individuals and organizations with a need to verify the immunization status of persons
in their care, custody, or enrollment, including but not limited to, the chief executive officer,
or a designee of the officer, of a public or private day care center, school, or postsecondary
educational institution. (b) The authorization granted pursuant to this...
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