27-1-10.1
Section 27-1-10.1 Insurance coverage for drugs to treat life-threatening illnesses. (a) The Legislature finds and declares the following: (1) The citizens of this state rely upon health insurance to cover the cost of obtaining health care and it is essential that the citizens' expectation that their health care costs will be paid by their insurance policies is not disappointed and that they obtain the coverage necessary and appropriate for their care within the terms of their insurance policies. (2) Some insurers deny payment for drugs that have been approved by the Federal Food and Drug Administration, hereafter referred to as FDA, when the drugs are used for indications other than those stated in the labelling approved by the FDA, off-label use, while other insurers with similar coverage terms do pay for off-label use. (3) Denial of payment for off-label use can interrupt or effectively deny access to necessary and appropriate treatment for a person being treated for a...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-10.1.htm - 6K - Match Info - Similar pages
34-22-83
Section 34-22-83 Telemedicine - Services; provider-patient relationship; standards of practice; confidentiality. (a) Telemedicine services provided at an established treatment site may be used for all patient visits, including initial evaluations to establish a proper doctor-patient relationship between a provider and a patient. (1) A provider shall be reasonably available onsite at the established medical site to assist with the provision of care. (2) A provider may delegate tasks and activities at an established treatment site to an assistant who is properly trained and supervised or directed. (b) A distant site provider who provides telemedicine services to a patient that is not present at an established treatment site shall ensure that a proper provider-patient relationship is established, which at a minimum includes all of the following: (1) Having had at least one face-to-face meeting at an established treatment site before engaging in telemedicine services. A face-to-face...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-22-83.htm - 3K - Match Info - Similar pages
34-9-6.1
Section 34-9-6.1 Mobile dental facilities or portable dental operations. (a) For purposes of this section, the following words have the following meanings: (1) DENTAL HOME. The dental home is the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care, delivered in a comprehensive, continuously accessible, coordinated, and family-centered way. (2) MOBILE DENTAL FACILITY. Any self-contained facility in which dentistry or dental hygiene is practiced which may be moved, towed, or transported from one location to another. (3) OPERATOR. A person licensed to practice dentistry in this state or an entity which is approved as tax exempt under Section 501(c)(3) of the Internal Revenue Code which employs dentists licensed in the state to operate a mobile dental facility or portable dental operation. (4) PORTABLE DENTAL OPERATION. The use of portable dental delivery equipment which is set up on site to provide dental services outside of a mobile...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-9-6.1.htm - 21K - Match Info - Similar pages
22-21-260
Section 22-21-260 Definitions. As used in this article, the following words and terms, and the plurals thereof, shall have the meanings ascribed to them in this section, unless otherwise required by their respective context: (1) ACQUISITION. Obtaining the legal equitable title to a freehold or leasehold estate or otherwise obtaining the substantial benefit of such titles or estates, whether by purchase, lease, loan or suffrage, gift, devise, legacy, settlement of a trust or means whatever, and shall include any act of acquisition. The term "acquisition" shall not mean or include any conveyance, or creation of any lien or security interest by mortgage, deed of trust, security agreement, or similar financing instrument, nor shall it mean or include any transfer of title or rights as a result of the foreclosure, or conveyance or transfer in lieu of the foreclosure, of any such mortgage, deed of trust, security agreement, or similar financing instrument, nor shall it mean or include any...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-260.htm - 11K - Match Info - Similar pages
27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological, and psychosocial concepts, techniques, and processes necessary to maintain or develop functional skills of clients, provided to individuals and groups for periods of more than two hours but less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses, issued by insurers, health maintenance organizations, preferred provider organizations, medical service organizations, physician-hospital organizations, or any other person, firm, corporation, joint venture, or other similar business entity that pays for, purchases, or furnishes health care services to patients, insureds, or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54-2.htm - 3K - Match Info - Similar pages
34-25A-4
Section 34-25A-4 Referral and consultation limits. (a) A licensed prosthetist, licensed orthotist, or licensed prosthetist/orthotist may provide services utilizing new prostheses or orthoses for which he or she is licensed and only under a written order from an authorized health care practitioner. A consultation with and periodic review by an authorized health care practitioner is not required for the evaluation, repair, adjusting, or servicing of a prosthesis by a licensed prosthetist, or licensed prosthetist/orthotist and for the evaluation, repair, adjusting, or servicing of an orthosis by a licensed orthotist, or licensed prosthetist/orthotist; nor is an order from an authorized health care practitioner required for maintenance or replacement of an orthosis or prosthesis to the level of its original prescription for an indefinite period of time if the original order remains appropriate for the patient's medical needs. (b) Prosthetists and orthotists must refer persons receiving...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-25A-4.htm - 2K - Match Info - Similar pages
22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid region for at least one fully certified regional care organization to provide, pursuant to a risk contract under which the Medicaid Agency makes a capitated payment, medical care to Medicaid beneficiaries. However, the Medicaid Agency may enter into a contract pursuant to this section only if, in the judgment of the Medicaid Agency, care of Medicaid beneficiaries would be better, more efficient, and less costly than under the then existing care delivery system. The Medicaid Agency may contract with more than one regional care organization in a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments for the regional care organization. (b) The Medicaid Agency shall...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-153.htm - 10K - Match Info - Similar pages
27-3A-5
Section 27-3A-5 Standards for utilization review agents. (a) Except as provided in subsection (b), all utilization review agents shall meet the following minimum standards: (1) Notification of a determination by the utilization review agent shall be mailed or otherwise communicated to the provider of record or the enrollee or other appropriate individual within two business days of the receipt of the request for determination and the receipt of all information necessary to complete the review. (2) Any determination by a utilization review agent as to the necessity or appropriateness of an admission, service, or procedure shall be reviewed by a physician or determined in accordance with standards or guidelines approved by a physician. (3) Any notification of determination not to certify an admission, service, or procedure shall include the principal reason for the determination and the procedures to initiate an appeal of the determination. (4) Utilization review agents shall maintain...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-3A-5.htm - 4K - Match Info - Similar pages
22-18-6
Section 22-18-6 Violations; good Samaritan provisions; scope of privilege; control of emergency scene; penalties. (a) It shall be a Class A misdemeanor for any person, firm, company, corporation, organization, facility, or agency to do any of the following: (1) Deliberately hinder, obstruct, or interfere with an officer, inspector, or duly authorized agent of the board while in the performance of official duties. (2) Deliberately hinder, obstruct, or interfere with any physician, licensed nurse, licensed EMSP, or emergency personnel exempt from licensure under this article while that individual is providing emergency care to a third person or while that individual is assisting at the scene of an emergency, directing traffic at the scene of an emergency, or managing or helping to manage the scene of an emergency. (3) Violate subsection (c) or (d). (4) Offer, provide, or perform, without a license or certificate to do so, an emergency medical service or other function which, under this...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-18-6.htm - 6K - Match Info - Similar pages
34-24-125
Section 34-24-125 Chiropractic agreements. (a) For the purposes of this section, the following words shall have the following meanings: (1) CHIROPRACTOR. A person licensed to practice chiropractic in this state. (2) CHIROPRACTIC AGREEMENT or AGREEMENT. A contract between a chiropractor and a patient or his or her legal representative in which the chiropractor or the chiropractor's chiropractic practice agrees to provide chiropractic services to the patient for an agreed upon fee and period of time. (3) CHIROPRACTIC PRACTICE. A chiropractor or a chiropractic practice of a chiropractor that charges a periodic fee for chiropractic services and which does not bill a third party any additional fee for services for patients covered under a chiropractic agreement. The per visit charge of the practice shall be less than the monthly equivalent of the periodic fee. (b) A chiropractic agreement is not insurance, may not be deemed an insurance arrangement, and is not subject to state insurance...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-24-125.htm - 4K - Match Info - Similar pages
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