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27-21A-3
Section 27-21A-3 Issuance of certificate of authority. (a)(1) Upon receipt of an application
for issuance of a certificate of authority, the commissioner shall forthwith transmit copies
of such application and accompanying documents to the State Health Officer. (2) The State
Health Officer shall determine whether the applicant for a certificate of authority, with
respect to health care services to be furnished: a. Has demonstrated the willingness and potential
ability to assure that such health care services will be provided in a manner to assure both
availability and accessibility of adequate personnel and facilities and in a manner enhancing
availability, accessibility, and continuity of service; b. Has arrangements, established in
accordance with the regulations promulgated by the State Health Officer, for an on-going quality
assurance program concerning health care processes and outcomes; and c. Has a procedure, established
in accordance with regulations of the State Health...
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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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11-91A-2
Section 11-91A-2 Local Government Health Insurance Board; governance and administration of
program. (a) The Local Government Health Insurance Board shall govern and administer the Local
Government Health Insurance Program currently governed and administered by the State Employees'
Insurance Board (SEIB) pursuant to Chapter 29 of Title 36. The transfer of the governance
and administration to the board shall take effect at 12:01 a.m. on January 1, 2015, and thereafter
the board shall take all control and responsibility for the program under procedures and authority
set out in this chapter. (b) The program governed and administered by the board shall provide
a reasonable relationship between the health care benefits to be included and the expected
health care expenses to be incurred by affected employees, retirees, and their dependents.
The board may establish a fully insured or self-insured health care plan for employees and
retirees as defined in this chapter and may adopt rules for the...
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34-21-1
Section 34-21-1 Definitions. For purposes of this chapter, the following terms shall have the
respective meanings ascribed by this section: (1) ADVISORY COUNCILS. Advisory councils provided
for under the terms of this chapter. (2) BOARD. The Board of Nursing created hereunder. (3)
COMPACT. The Enhanced Nurse Licensure Compact provided in Article 7. (4) COORDINATED LICENSE
INFORMATION SYSTEM. A licensing integrated database and process for collecting, storing, and
sharing nurse licensure and enforcement information that includes all licensed registered
nurses and licensed practical/vocational nurses. The system includes all disciplinary history
of each nurse, as administered by a nonprofit organization and controlled by licensing boards.
(5) LICENSED PRACTICAL NURSE. A person who is currently licensed to practice practical nursing.
For the purposes of the Enhanced Nurse Licensure Compact, practical nursing includes practice
as a licensed practical nurse, licensed vocational nurse, or...
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36-1A-5
Section 36-1A-5 Participation limited to voluntary, charitable, health and human care federations
and agencies with a substantial local presence. (a) Participation in the Alabama State Employee
Combined Charitable Campaign shall be limited to voluntary, charitable, health and human care
federations and agencies with a substantial local presence that provide or support direct
health and welfare services to individuals or their families and meet the criteria set forth
in this section. "Substantial local presence" is defined as a facility, staffed
by professionals or volunteers, available to provide its services and open at least 15 hours
a week. Such services must be available to state employees in the local campaign community,
unless they are rendered to needy persons overseas. Such services must directly benefit human
beings, whether children, youth, adults, the aged, the ill and infirm, or the mentally or
physically handicapped. Such services must consist of care, research, or...
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22-21-264
Section 22-21-264 Criteria for state agency review. The SHPDA, pursuant to the provisions of
Section 22-21-274, shall prescribe by rules and regulations the criteria and clarifying definitions
for reviews covered by this article. These criteria shall include at least the following:
(1) Consistency with the appropriate State Health Facility and services plans effective at
the time the application was received by the State Agency, which shall include the latest
approved revisions of the following plans: a. The most recent Alabama State Health Plan which
shall include updated inventories and separate bed need methodologies for inpatient rehabilitation
beds, inpatient psychiatric beds and inpatient/residential alcohol and drug abuse beds. b.
Alabama State Health Plan for services to the mentally ill. c. Alabama State Plan for rehabilitation
facilities. d. Alabama developmental disabilities plan. e. Alabama State alcoholism plan.
f. Such other State Plans as may from time to time be...
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38-12A-2
Section 38-12A-2 Enumeration of rights. The Department of Human Resources shall ensure that
each foster parent shall have all of the following rights: (1) The right to be treated with
dignity, respect, trust, value, and consideration as a primary provider of foster care and
a member of the professional team caring for foster children. (2) The right to receive information
concerning the rights enumerated in this section. (3) The right to a concise written explanation
of their role as foster parents in partnership with children and their families, the department,
and other providers, the role of the department, and the rights and role of the members of
the birth family of a child in foster care. (4) The right to training and support for the
purpose of improving skills in providing daily care and meeting the needs of the child in
foster care. (5) The right to training, consultation, and assistance in evaluating, identifying,
and accessing services to meet their needs related to their role...
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38-15-4
Section 38-15-4 Registration of certain youth residential institutions or organizations; staff
training plans; rights of children; licensing and inspection of food preparation areas; access
by law enforcement agencies. (a) Commencing on January 1, 2018, the department shall register
any religious, faith-based, or church nonprofit, other nonprofit, or for profit affiliated
youth residential facility, youth social rehabilitation facility, community treatment facility
for youths, youth transitional care facility, long term youth residential facility, private
alternative boarding school, private alternative outdoor program, and any organization entrusted
with the residential care of children in any organizational form or combination defined by
this section, whenever children are housed at the facility or location of the program for
a period of more than 24 hours. At a minimum, registered youth residential institution or
organization under this section shall do all of the following: (1) Be...
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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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34-23-184
Section 34-23-184 Audit procedures; report. (a) The entity conducting an audit shall follow
these procedures: (1) The pharmacy contract shall identify and describe in detail the audit
procedures. (2) The entity conducting the on-site audit shall give the pharmacy written notice
at least two weeks before conducting the initial on-site audit for each audit cycle. If the
pharmacy benefit manager does not include their auditing guidelines within their provider
manual, then the notice must include a documented checklist of all items being audited and
the manual, including the name, date, and edition or volume, applicable to the audit and auditing
guidelines. For on-site audits a pharmacy benefit manager shall also provide a list of material
that is copied or removed during the course of an audit to the pharmacy. The pharmacy benefit
manager may document this material on either a checklist or on an audit acknowledgement form.
The pharmacy shall produce any items during the course of the...
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