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22-6-6.1
Section 22-6-6.1 Assignment to state of recipients' rights to payments for medical care;
authorization to release needed information. (a) Every recipient of medical assistance under
the Alabama Medicaid Program shall be deemed to have made assignment to the State of Alabama
of any and all rights of his to medical support or payments for medical care from any person,
firm or corporation, together with the rights of any other individuals eligible for medical
assistance for whom he can legally make assignment. This assignment shall be effective to
the extent of the amount of medical assistance actually paid by the Medicaid Agency. The recipient
shall cooperate fully with the Medicaid Agency in its efforts to secure such rights, and shall
execute and deliver all instruments and papers needed by the Medicaid Agency in this regard.
(b) Every recipient of medical assistance under the Alabama Medicaid Program shall be deemed
to have authorized all third parties, including insurance companies...
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27-14-11.1
Section 27-14-11.1 Contents of policies - Denial or reduction of benefits due to Medicaid
eligibility void. (a) For purposes of this section, "private insurer" is
defined as any of the following: (1) Any commercial insurance company offering health or casualty
insurance to individuals or groups, including both experience-rated contracts and indemnity
contracts. (2) Any profit or nonprofit prepaid plan offering either medical services or full
or partial payment for the diagnosis or treatment of an injury, disease, or disability. (3)
Any organization administering health or casualty insurance plans for professional associations,
unions, fraternal groups, employer-employee benefit plans, and any similar organization offering
these payments or services, including self-insured and self-funded plans. (4) Any health insurer,
including group health plans, as defined in Section 607(1) of the Employee Retirement
Income Security Act of 1974, self-insured plans, service benefit plans, managed care...
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22-6-6
Section 22-6-6 Subrogation of state to rights of recipients of medical assistance under
program against persons, etc., causing injury, etc., thereto; manner of enforcement of rights
of state; effect of action by state or recipient against person, etc., causing injury, etc.,
upon rights of other; provision of written notice, etc., by recipients instituting civil actions
for damages. (a) If medical assistance is provided to a recipient under the Alabama Medicaid
Program for injuries, disease or sickness caused under circumstances creating a cause of action
in favor of the recipient against any person, firm or corporation, then the State of Alabama
shall be subrogated to such recipient's rights and shall be entitled to recover the proceeds
that may result from the exercise of any rights of recovery which the recipient may have against
any such person, firm or corporation to the extent of the actual amount of the medical assistance
payments made by the Alabama Medicaid Program. The...
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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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22-6-150
Section 22-6-150 Definitions. For the purposes of this article, the following words
shall have the following meanings: (1) ALTERNATE CARE PROVIDER. A contractor, other than a
regional care organization, that agrees to provide a comprehensive package of Medicaid benefits
to Medicaid beneficiaries in a defined region of the state pursuant to a risk contract. (2)
CAPITATION PAYMENT. A payment the state Medicaid Agency makes periodically to a contractor
on behalf of each recipient enrolled under a contract for the provision of medical services.
(3) CARE DELIVERY SYSTEM. The manner in which the benefits and services set forth in the state
Medicaid plan are provided to Medicaid beneficiaries. (4) 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...
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40-26B-70
Section 40-26B-70 Definitions. For purposes of this article, the following terms shall
have the following meanings: (1) ACCESS PAYMENT. A payment by the Medicaid program to an eligible
hospital for inpatient or outpatient hospital care, or both, provided to a Medicaid recipient.
(2) ALL PATIENT REFINED DIAGNOSIS-RELATED GROUP (APR-DRG). A statistical system of classifying
any non-Medicare inpatient stay into groups for the purposes of payment. (3) ALTERNATE CARE
PROVIDER. A contractor, other than a regional care organization, that agrees to provide a
comprehensive package of Medicaid benefits to Medicaid beneficiaries in a defined region of
the state pursuant to a risk contract. (4) CERTIFIED PUBLIC EXPENDITURE (CPE). A certification
in writing of the cost of providing medical care to Medicaid beneficiaries by publicly owned
hospitals and hospitals owned by a state agency or a state university plus the amount of uncompensated
care provided by publicly owned hospitals and hospitals...
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13A-9-150
Section 13A-9-150 Public assistance fraud; penalties. (a) For the purposes of this section,
public assistance means money or property provided directly or indirectly to eligible persons
through programs of the federal government, the state, or any political subdivision thereof,
including any program administered by a public housing authority. (b) It shall be unlawful
for an individual or business entity to knowingly do any of the following: (1) Fail, by false
statement, misrepresentation, impersonation, or other fraudulent means, to disclose a material
fact used in making a determination as to the qualification of the person to receive public
assistance. (2) Fail to disclose a change in circumstances in order to obtain or continue
to receive any public assistance to which he or she is not entitled or in an amount larger
than that to which he or she is entitled. (3) Aid and abet another person in the commission
of the prohibitions enumerated in subdivisions (1) and (2). (4) Use,...
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31-9-40
Section 31-9-40 Compact adopted and enacted. The Emergency Management Assistance Compact
is enacted into law and entered with all jurisdictions mutually adopting the compact in the
form substantially as follows: THE EMERGENCY MANAGEMENT ASSISTANCE COMPACT Article I - Purpose
and Authorities. This compact is made and entered into by and between the participating member
states which enact this compact, hereinafter called party states. For the purpose of this
agreement, the term "states" is taken to mean the several states, the Commonwealth
of Puerto Rico, the District of Columbia, and all U.S. territorial possessions. The purpose
of this compact is to provide for mutual assistance between the states entering into this
compact in managing any emergency or disaster that is duly declared by the governor of the
affected state or states, whether arising from natural disaster, technological hazard, man-made
disaster, civil emergency aspects of resources shortages, community disorders,...
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22-19-161
Section 22-19-161 Definitions. In this article: (1) "Adult" means an individual
who is at least 18 years of age. (2) "Agent" means an individual: (A) authorized
to make health care decisions on the principal's behalf by a power of attorney for health
care; or (B) expressly authorized to make an anatomical gift on the principal's behalf by
any other record signed by the principal. (3) "Anatomical gift" means a donation
of all or part of a human body to take effect after the donor's death for the purpose of transplantation,
therapy, research, or education. (4) "Coroner" means an elected or appointed official
who determines, with the assistance of other forensic scientists and investigators, the cause,
manner, and circumstances surrounding death. (5) "Decedent" means a deceased individual
whose body or part is or may be the source of an anatomical gift. The term includes a stillborn
infant and, subject to restrictions imposed by law other than this article, a fetus. (6) "Disinterested...
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16-33B-4
Section 16-33B-4 Basic powers and duties of the Alabama Commission on Higher Education
for the Alabama Guaranteed Student Loan Program. (a) Basic powers. The Alabama Commission
on Higher Education (ACHE) is authorized to administer the Alabama Guaranteed Student Loan
Program in accordance with the Federal Student Loan Law, and empowered to promulgate such
rules, regulations, policies, and procedures as may be reasonable and proper in order to carry
out the provisions and purposes of this chapter. Without limiting the generality of the foregoing,
the ACHE is authorized and empowered: (1) To establish regulations deemed necessary to comply
with federal regulations and legislation relative to guaranteed student loans and the Federal
Student Loan Law. (2) To establish eligibility criteria for participating postsecondary educational
institutions. (3) To establish reasonable eligibility criteria for the initial and continuing
participation of approved lenders in the student loan program. (4)...
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