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22-6-154
Section 22-6-154 Quality assurance committee; collection and publication of information. (a)
The Medicaid Agency shall create a quality assurance committee appointed by the Medicaid Commissioner.
The members of the committee shall serve two-year terms. At least 60 percent of the members
shall be physicians who provide care to Medicaid beneficiaries served by a regional care organization.
In making appointments to the committee, the Medicaid Commissioner shall seek input from the
appropriate professional associations. (b) The committee shall identify objective outcome
and quality measures, including measures of outcome and quality for ambulatory care, inpatient
care, chemical dependency and mental health treatment, oral health care, and all other health
services provided by coordinated care organizations. Quality measures adopted by the committee
shall be consistent with existing state and national quality measures. The Medicaid Commissioner
shall incorporate these measures into...
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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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22-6-160
Section 22-6-160 Evaluation and report on long-term care system for Medicaid beneficiaries.
The Medicaid Agency shall decide which groups of Medicaid beneficiaries to include for coverage
by a regional care organization or alternate care provider. The Medicaid Agency, without the
approval of the Governor, shall not make a coverage decision that would affect Medicaid beneficiaries
who are directly served by another state agency. (Act 2013-261, p. 686, §11; Act 2015-322,
§1.)...
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22-6-220
Section 22-6-220 Definitions. For the purposes of this article, the following words shall have
the following meanings: (1) CAPITATION PAYMENT. A payment the state Medicaid Agency makes
periodically to the integrated care network on behalf of each recipient enrolled under a contract
for the provision of medical services pursuant to this article. (2) COLLABORATOR. A private
health carrier, third party purchaser, provider, health care center, health care facility,
state and local governmental entity, or other public payers, corporations, individuals, and
consumers who are expecting to collectively cooperate, negotiate, or contract with another
collaborator, or integrated care network in the health care system. (3) INTEGRATED CARE NETWORK.
One or more statewide organizations of health care providers, with offices in each regional
care organization region, that contracts with the Medicaid Agency to provide Medicaid benefits
to certain Medicaid beneficiaries as defined in subdivision (4) and...
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22-6-200
Section 22-6-200 Federal financial participation; contract for services. This article shall
be of no effect if federal financial participation under Title XIX of the Social Security
Act is not available to the Medicaid program for the purposes of this article at the approved
federal medical assistance percentage, established under Section 1905 of the Social Security
Act, for the applicable fiscal year, or in the event a contract for services between the PACE
program and the State of Alabama Medicaid Agency or Regional Care Organization is not executed
by September 30, 2014, and by the end of each subsequent state fiscal year thereafter. (Act
2014-126, p. 236, §11.)...
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27-1-17.1
Section 27-1-17.1 Payment of providers through electronic funds transfer methods. (a) As used
in this section, the following words shall have the following meanings: (1) ACH ELECTRONIC
FUNDS TRANSFER. An electronic funds transfer through the Health Insurance Portability and
Accountability Act (HIPPA) standard Automated Clearing House network. (2) COVERED HEALTH CARE
PROVIDER. A physician as defined in Section 34-24-50.1; a dentist as defined in Section 34-9-1;
a chiropractor as defined in Section 34-24-120; an individual engaged in the practice of optometry
as defined in Section 34-22-1; other licensed health care professionals as defined in Title
34; a hospital as defined in Section 22-21-20; and a health care facility, or other provider
who or that is accredited, licensed, or certified and who or that is performing within the
scope of that accreditation, license, or certification. (3) HEALTH INSURANCE PLAN. Any hospital
and medical expense incurred policy, health maintenance...
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12-15-314
Section 12-15-314 Dispositions for dependent children. (a) If a child is found to be dependent,
the juvenile court may make any of the following orders of disposition to protect the welfare
of the child: (1) Permit the child to remain with the parent, legal guardian, or other legal
custodian of the child, subject to conditions and limitations as the juvenile court may prescribe.
(2) Place the child under protective supervision under the Department of Human Resources.
(3) Transfer legal custody to any of the following: a. The Department of Human Resources.
b. A local public or private agency, organization, or facility willing and able to assume
the education, care, and maintenance of the child and which is licensed by the Department
of Human Resources or otherwise authorized by law to receive and provide care for the child.
c. A relative or other individual who, after study by the Department of Human Resources, is
found by the juvenile court to be qualified to receive and care for the...
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34-24-70
Section 34-24-70 Qualifications of applicants. (a) The following constitute the requirements
for the issuance of a certificate of qualification for a license to practice medicine in this
state: (1) MEDICAL EDUCATION REQUIREMENT. All applicants for a certificate of qualification
shall present a diploma or evidence of graduation from any of the following institutions:
a. A college of medicine or school of medicine accredited by the Liaison Committee on Medical
Education of the American Medical Association. b. A college of osteopathy accredited by the
American Osteopathic Association. c. A college of medicine or school of medicine not accredited
by the Liaison Committee on Medical Education which is approved by the Board of Medical Examiners.
The board may, within its discretion, withhold approval of any college of medicine not designated
in either a., or b., above which: 1. Has had its accreditation withdrawn by a national or
regional accreditation organization; or 2. Has had its...
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34-27B-11
Section 34-27B-11 Additional activities permitted under chapter. Nothing in this chapter shall
be construed as preventing or restricting the practice, services, or activities of any of
the following: (1) Any person who is licensed in Alabama or certified by an organization accredited
by the National Commission for Certifying Agencies and acceptable to the state from engaging
in the profession or occupation for which the person is licensed or certified. (2) Any person
employed by the United States government who provides respiratory therapy solely under the
direction or control of the United States government agency or organization. (3) Any person
receiving clinical training while pursuing a course of study leading to registry or certification
in a respiratory therapy educational program accredited by the Council on Allied Health Education
Programs in collaboration with the Committee on Accreditation for Respiratory Care or their
successor organizations. This person will be under direct...
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36-7-21
Section 36-7-21 Allowances of persons traveling in service of the state; travel authorization.
(a) Persons traveling in the service of the state or any of its departments, institutions,
boards, bureaus, commissions, councils, committees, or other agencies, outside the State of
Alabama, or within the State of Alabama for purposes of attending or assisting in hosting
a convention, conference, seminar, or other meeting of a state, regional, or national organization
of which the state or individual is a dues-paying member that is held within the state, shall
be allowed all of their actual and necessary expenses in addition to the actual expenses for
transportation. In-state travel authorized under this section is subject to the same documentation
requirements as out-of-state travel. (b) Except as provided in subsections (c), (d), (e),
and (f), any travel for which a traveler intends to seek reimbursement from the state under
this section shall be fully authorized in writing by the head of...
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