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22-6-4.2
Section 22-6-4.2 Copayments for prescription drugs. (a) Medicaid eligible persons shall pay
the maximum allowable copayment under federal law or administrative regulation for each prescription
drug received under the Medicaid Program, except for designated exemptions. (b) Said maximum
allowable copayment shall be collected by the dispensing pharmacy and credited against the
Medicaid payment to the pharmacy for the drug. (c) Designated exemptions include prescriptions
for family planning drugs and those used in the treatment of persons participating in the
Medicaid Early and Periodic Screening, Diagnosis and Treatment Program. (d) The provisions
of this section shall not be effective if they are found by a court of competent jurisdiction
to contravene federal laws or federal administrative regulations applicable to the Medicaid
Program. (Acts 1980, No. 80-155, p. 226.)...
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20-2-212
Section 20-2-212 Controlled substances prescription database program; powers and duties of
department; trust fund; advisory committee; review committee. (a) The department may establish,
create, and maintain a controlled substances prescription database program. In order to carry
out its responsibilities under this article, the department is granted the following powers
and authority: (1) To adopt regulations, in accordance with the Alabama Administrative Procedure
Act, governing the establishment and operation of a controlled substances prescription database
program. (2) To receive and to expend for the purposes stated in this article funds in the
form of grants, donations, federal matching funds, interagency transfers, and appropriated
funds designated for the development, implementation, operation, and maintenance of the controlled
substances prescription database. The funds received pursuant to this subdivision shall be
deposited in a new fund that is established as a separate...
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20-2-214
Section 20-2-214 Limited access to database permitted for certain persons or entities. (a)
The following persons or entities shall be permitted access to the information in the controlled
substances database, subject to the limitations indicated below: (1) Authorized representatives
of the certifying boards; provided, however, that access shall be limited to information concerning
the licensees of the certifying board, however, authorized representatives from the Board
of Medical Examiners may access the database to inquire about certified registered nurse practitioners
(CRNPs), or certified nurse midwives (CNMs) that hold a Qualified Alabama Controlled Substances
Registration Certificate (QACSC). (2) A licensed practitioner approved by the department who
has authority to prescribe, dispense, or administer controlled substances. The licensed practitioner's
access shall be limited to information concerning himself or herself, registrants who possess
a Qualified Alabama Controlled...
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27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials,
adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit
plan that issues or renews any policy of accident or health insurance providing benefits for
medical or hospital expenses for its insured persons shall pay for services rendered by Alabama
health care providers within 45 calendar days upon receipt of a clean written claim or 30
calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation,
or health benefit plan is denying or pending the claim, the insurer, health service corporation,
or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar
days for an electronic claim, notify the health care provider or certificate holder of the
reason for denying or pending the claim and what, if any, additional information is required
to process the claim. Any undisputed portion of the claim...
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41-15B-2.2
Section 41-15B-2.2 Allocation of trust fund revenues. (a) For each fiscal year, beginning October
1, 1999, contingent upon the Children First Trust Fund receiving tobacco revenues and upon
appropriation by the Legislature, an amount of up to and including two hundred twenty-five
thousand dollars ($225,000), or equivalent percentage of the total fund, shall be designated
for the administration of the fund by the council and the Commissioner of Children's Affairs.
(b) For the each fiscal year, beginning October 1, 1999, contingent upon the Children First
Trust Fund receiving tobacco revenues, the remainder of the Children First Trust Fund, in
the amounts provided for in Section 41-15B-2.1, shall be allocated as follows: (1) Ten percent
of the fund shall be allocated to the Department of Public Health for distribution to one
or more of the following: a. The Children's Health Insurance Program. b. Programs for tobacco
control among children with the purpose being to reduce the consumption...
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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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20-2-213
Section 20-2-213 Reporting requirements. (a) Each of the entities designated in subsection
(b) shall report to the department, or to an entity designated by the department, controlled
substances prescription information as designated by regulation pertaining to all Class II,
Class III, Class IV, and Class V controlled substances in such manner as may be prescribed
by the department by regulation. (b) The following entities or practitioners are subject to
the reporting requirements of subsection (a): (1) Licensed pharmacies, not including pharmacies
of general and specialized hospitals, nursing homes, and any other health care facilities
which provide inpatient care, so long as the controlled substance is administered and used
by a patient on the premises of the facility. (2) Mail order pharmacies or pharmacy benefit
programs filling prescriptions for or dispensing controlled substances to residents of this
state. (3) Licensed physicians, dentists, podiatrists, or optometrists who...
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40-26B-26
Section 40-26B-26 Reduction of revenues; reimbursement computations; quality incentive program.
THIS SECTION WAS AMENDED BY ACT 2020-147 IN THE 2020 REGULAR SESSION, EFFECTIVE MAY 18, 2020.
THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. (a) No revenues resulting from the privilege assessment
established by this article and applied to increases in covered services or reimbursement
levels or other enhancements of the Medicaid program shall be subject to reduction or elimination
while the privilege assessment is in effect. (b) Every nursing facility participating in the
Medicaid program in the State of Alabama shall be reimbursed according to the reimbursement
methodology contained in Chapter 560-X-22 of the Alabama Medicaid Agency Administrative Code
(Supp. 12/31/95) on January 31, 1998, which methodology is incorporated by reference herein,
except that the following shall apply: (1) The ceiling for the operating cost center described
in Title 560-X-22-.06 (2)(a) of the Alabama Medicaid...
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38-1-7
Section 38-1-7 (Effective October 1, 2015 until September 30, 2017) Drug screening program.
(a) As used in this section, the following words shall have the following meanings: (1) DRUG.
Includes all of the following: a. A controlled substance for which a medical prescription
or other legal authorization is required for purchase or possession, including, but not limited
to: An amphetamine, a tetrahydrocannabinol, oxycodone, cocaine, phencyclidine (PCP), an opiate,
a barbiturate, a benzodiazepine, a methamphetamine, a propoxyphene, a tricyclic antidepressant,
or a metabolite of any of these substances. b. A drug whose manufacture, sale, use, or possession
is forbidden by law. (2) DRUG SCREENING. Any chemical, biological, or physical instrumental
analysis administered by a laboratory certified by the United States Department of Health
and Human Services or other licensing agency in this state for the purpose of determining
the presence or absence of a drug or its metabolites. (b) The...
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12-23-4
Section 12-23-4 Court referral officers or contracting entities; appointment; supervision by
Administrative Director of Courts and circuit judges; compensation; duties. (a) The Administrative
Director of Courts is authorized to appoint court referral officers or contract with individuals
or entities to provide alcohol and drug assessment for courts and to conduct the court referral
programs in each court jurisdiction of the state. Such appointments or contracts shall be
made or entered into with the advice of the presiding circuit judge. The Administrative Director
of Courts shall designate the locations where said court referral programs, court referral
officers or contracting entities or individuals shall serve, which designations may be changed
from time to time; provided, however, that all appointed court referral officers and approved
court referral programs shall serve at the pleasure of the Administrative Director of Courts.
Any individual or entity which contracts to conduct...
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