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27-1-19
Section 27-1-19 Reimbursement of health care providers. (a) The insured, or health or
dental plan beneficiary may assign reimbursement for health or dental care services directly
to the provider of services. Health benefits include medical, pharmacy, podiatric, chiropractic,
optometric, durable medical equipment, and home care services. The company or agency, when
authorized by the insured, or health or dental plan beneficiary, shall pay directly to the
health care provider the amount of the claim, under the same criteria and payment schedule
that would have been reimbursed directly to the contract provider, and any applicable interest.
This amount only applies to assigned claims. Any company or agency making a payment to the
insured, or health or dental plan beneficiary, after the rights of reimbursement have been
assigned to the provider of services, shall be liable to the provider for the payment. If
the company or agency fails to reimburse the provider in accordance with the terms...
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36-29-21
Section 36-29-21 Definitions. When used in this article, the following terms shall have
the following meanings, unless the context clearly indicates otherwise: (1) BOARD. The Flexible
Employees Benefits Board. (2) EMPLOYEE. A person who is employed by the State of Alabama,
its agencies, departments, or for a county health department, and who receives his compensation
through means of a state warrant drawn upon the State Treasury, or by check drawn by the Alabama
State Port Authority, or from the treasury of the Department of Mental Health, other than
those employees covered by the federal Railroad Retirement Act. Further, for the purposes
of long-term care insurance, this definition covers any person employed by a local government
in the State of Alabama. (3) INTERNAL REVENUE CODE. The Internal Revenue Code of 1986, as
amended. (4) PARTICIPATING EMPLOYEE. An employee who elects to participate in the flexible
benefit plan and meets the requirements set forth in said plan. (5) SALARY...
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22-13A-4
Section 22-13A-4 Establishment and promotion of program; duties of officer; strategies
for raising public awareness and educating consumers and professionals. (a) The State Department
of Health, hereinafter referred to as "the department," shall establish, promote,
and maintain an osteoporosis prevention and treatment education program in order to raise
public awareness, educate consumers, educate and train health professionals, teachers, and
human service providers, and for other purposes. (b) For purposes of administering this chapter,
the State Health Officer shall do all of the following: (1) Provide sufficient staff to implement
the Osteoporosis Prevention and Treatment Education Program. (2) Provide appropriate training
for staff of the Osteoporosis Prevention and Treatment Education Program. (3) Identify the
appropriate entities to carry out the program. (4) Base the program on the most up-to-date
scientific information and findings. (5) Work to improve the capacity of...
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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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22-21-311
Section 22-21-311 Definitions. (a) The following words and phrases used in this article,
and others evidently intended as the equivalent thereof, shall, in the absence of clear implication
herein otherwise, be given the following respective interpretations herein: (1) APPLICANT.
A natural person who files a written application with the governing body of a county, municipality,
or educational institution, or two or more thereof, in accordance with the provisions of Section
22-21-313. (2) AUTHORITY. A public corporation organized, and any public hospital corporation
reincorporated, pursuant to the provisions hereof. (3) AUTHORIZING RESOLUTION. The resolution
adopted by the governing body of an authorizing subdivision, in accordance with the provisions
of Section 22-21-313 or Section 22-21-341, that authorizes the incorporation
of an authority or the reincorporation of a public hospital corporation. (4) AUTHORIZING SUBDIVISION.
Each county, municipality, and educational institution with...
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22-21-318
Section 22-21-318 Powers of authority. (a) In addition to all other powers granted elsewhere
in this article, and subject to the express provisions of its certificate of incorporation,
an authority shall have the following powers, together with all powers incidental thereto
or necessary to the discharge thereof in corporate form: (1) To have succession by its corporate
name for the duration of time, which may be in perpetuity, specified in its certificate of
incorporation or until dissolved as provided in Section 22-21-339; (2) To sue and be
sued in its own name in civil suits and actions, and to defend suits and actions against it,
including suits and actions ex delicto and ex contractu, subject, however, to the provisions
of Chapter 93 of Title 11, which chapter is hereby made applicable to the authority; (3) To
adopt and make use of a corporate seal and to alter the same at pleasure; (4) To adopt, alter,
amend and repeal bylaws, regulations and rules, not inconsistent with the...
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27-1-4
Section 27-1-4 Applicability of title - Exemptions. This title shall not apply as to:
(1) Any fraternal or other organization or activity which is exempted from the provisions
of Chapter 34 under Section 27-34-5, except to the extent provided in such section;
(2) Nonprofit corporations for establishment of hospitalization plan under Section
10-4-100 et seq., except to the extent now or hereafter provided in such laws; (3) The insurance
department of a brotherhood or labor union, the members of which are subject to the act of
Congress known as the Railway Labor Act; or (4) The establishment, maintenance, administration,
and operation of any trust established pursuant to Section 22-21-240 by agreement of
any hospitals, other health care units or dental practitioners licensed as such by the State
of Alabama. (Acts 1971, No. 407, p. 707, §12; Acts 1977, No. 166, p. 226, §1; Acts 1978,
2nd Ex. Sess., No. 24, p. 1703, §1.)...
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41-5A-6
Section 41-5A-6 Chief examiner - Recovery audits for overpayments of state funds. (a)
For the purposes of this section, the following words have the following meanings:
(1) CHIEF EXAMINER. The Chief Examiner of Public Accounts. (2) OVERPAYMENT. Any payment in
excess of amounts due and includes failure to meet eligibility requirements, failure to identify
third party liability where applicable, any payment for an ineligible good or service, any
payment for a good or service not received, duplicate payments, invoice and pricing errors,
failure to apply discounts, rebates, or other allowances, failure to comply with contracts
or purchasing agreements, or both, failure to provide adequate documentation or necessary
signatures, or both, on documents, or any other inadvertent error resulting in overpayment.
(3) RECOVERY AUDIT. A financial management technique used to identify overpayments made by
a state agency with respect to individuals, vendors, service providers, and other entities
in...
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16-17A-18
Section 16-17A-18 Legislative findings. In support of and in furtherance of the powers
granted in Section 16-17A-8, the Legislature hereby finds and declares all of the following:
(1) Authorities organized under this chapter and its university affiliates are performing
essential public functions on behalf of the state, the sponsoring university, and other governmental
entities in the state. (2) The nature and scope of the powers conferred on authorities and
their university affiliates by this chapter are such as may compel each authority and each
university affiliate, in the course of exercising its powers or by virtue of such exercise
of such powers, to engage in activities itself or in collaboration with public or private
entities and individuals that may be characterized as anticompetitive or may result in the
acquisition or maintenance of monopoly power within the meaning of state and federal antitrust
laws or otherwise may have the effect of displacing competition in the provision...
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22-21-271
Section 22-21-271 Certificates of need - Application fees; appropriation of funds; disposition
of fees. (a) Each application for a certificate of need shall be accompanied by a fee of one
percent of the estimated cost of the proposed cost of the new Institutional Health Service,
or a maximum of twelve thousand dollars ($12,000) (indexed) per application. Provided, that
the application fee shall be three-fourths of one percent of the estimated cost of the proposed
new Institutional Health Service, or a maximum of eight thousand dollars ($8,000) if the applicant
has had an average daily census comprised of 50 percent or more Medicaid patients within the
last year prior to the filing of the application and a maximum of six thousand dollars ($6,000)
if a rural hospital applicant has had an average daily census comprised of 30 percent or more
Medicaid/Medicare patients within the last year prior to the filing of the application. The
minimum fee shall be set by the SHPDA. Fees shall be used...
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