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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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