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27-21A-4
Section 27-21A-4 Powers of health maintenance organizations. (a) The powers of a health maintenance
organization include, but are not limited to the following: (1) The purchase, lease, construction,
renovation, operation, or maintenance of hospitals, medical facilities, or both, and their
ancillary equipment; (2) The making of loans other than in the ordinary course of business,
to providers under contract with it in furtherance of its program or the making of loans to
a corporation or corporations in which it owns a majority interest for the purpose of acquiring
or constructing medical facilities and hospitals or in furtherance of a program providing
health care services to enrollees. (3) The furnishing of health care services through providers
which are under contract with or employed by the health maintenance organization. (4) The
contracting with any person for the performance on its behalf of certain functions such as
marketing, enrollment, and administration. (5) The purchase,...
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27-58-4
Section 27-58-4 Benefits subject to annual deductible, coinsurance, exclusions, reductions,
etc. (a) The benefits provided in this chapter shall be subject to the same annual deductible
or coinsurance established for all covered benefits within a given policy. Private third party
payors may not reduce or eliminate coverage due to the requirements of this chapter. (b) A
health benefit plan subject to this chapter shall not terminate services, reduce capitation
payment, or otherwise penalize an attending physician or health care provider who orders medical
care consistent with this chapter. (c) Nothing in this chapter is intended to expand the list
of designations of covered providers as specified in any health benefit plan. (Act 2007-389,
p. 778, §4.)...
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27-57-5
Section 27-57-5 Coverage by participating providers; selection criteria and utilization protocols;
maximum benefits, exclusions, etc. (a) This chapter does not require and shall not be construed
to require the coverage of services of providers who are not designated as covered providers,
or who are not selected as a participating provider, by a group health benefit plan or insurer
having a participating network of service providers. Nothing in this chapter is intended to
expand the list or designation of participating providers as specified in any health benefit
plan. (b) Insurers or other issuers of any health benefit plan covered by this chapter shall
continue to be able to establish and apply selection criteria and utilization protocols for
health care providers including the designation of types of providers for which coverage is
provided as well as credentialing criteria used in the selection of providers. (c) A group
health benefit plan, policy, or contract that provides coverage...
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10A-20-6.02
Section 10A-20-6.02 Incorporation. (a) The incorporators of any corporation to be governed
by this article shall prepare and deliver to the Secretary of State for filing a certificate
of formation stating an intention to become a corporation, which certificate of formation
shall be signed by each of the incorporators and shall set forth: (1) The name of the proposed
corporation; (2) The objects and purposes for which the corporation is organized; (3) The
location of the principal office of the corporation in this state; and (4) The name and post
office address of each incorporator, not less than three in number. (b) The certificate of
formation may also contain any other provisions, not inconsistent with the provisions of this
article, which the incorporators may desire to insert for the regulation of the business or
affairs of the corporation or which would be permitted nonprofit corporations by the Alabama
Nonprofit Corporation Law. The filing of the certificate of formation shall be...
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22-6-221
Section 22-6-221 Service by integrated care network; board of directors. (a) An integrated
care network shall serve only Medicaid beneficiaries in providing medical care and services.
For the purposes of this article, a beneficiary cannot be a member of both an integrated care
network and a regional care organization. (b) An integrated care network shall provide required
medical care and services to Medicaid beneficiaries and may coordinate care provided by or
through an affiliation of other health care providers or other programs as the Medicaid Agency
shall determine. (c) Notwithstanding any other provision of law, the integrated care network
shall not be deemed an insurance company under state law. (d)(1) An integrated care network
shall have a governing board of directors composed of the following members: a. Twelve members
shall be persons representing risk bearing participants. A participant bears risk by contributing
cash, capital, or other assets to the integrated care network....
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36-36-8
Section 36-36-8 Liability of trustees. (a) A trustee shall not be: (1) personally liable for
any liability, loss, or expense suffered by the trust, unless such liability, loss, or expense
arises out of or results from the willful misconduct or intentional wrongdoing of such trustee;
(2) responsible for the adequacy of the trust to meet and discharge any obligation under the
relevant health care post-employment benefit plan; or (3) required to take action to enforce
the payment of any contribution or appropriation to the trust. (b) The trustees may be indemnified
by the trusts and from funds of the trusts against costs, liabilities, losses, damages, and
expenses, including their attorneys fees, as more fully provided in the respective trust agreements,
unless such cost, liability, loss, damage, or expense arises out of or results from the willful
misconduct or intentional wrongdoing of such trustee. (Act 2007-16, 1st Sp. Sess., p. 25,
§8.)...
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16-17A-2
university in the state or a university that operates a school of medicine. (2) AUTHORITY.
A public corporation organized pursuant to the provisions of this chapter. (3) BOARD. The
board of directors of an authority. (4) DIRECTOR. A member of the board of an authority. (5)
GOVERNMENTAL ENTITY. The state, a county, a municipality, or any department, agency, board,
or commission of the state, a county, or a municipality. (6) HEALTH CARE FACILITY. All property
or rights in property, real or personal, tangible or intangible, useful to an authority
in its operations, including without limitation, the following: a. Facilities necessary or
desirable to the operation of an academic medical center, one or more health sciences schools,
hospitals, public health care clinics, treatment centers, emergency facilities, outpatient
facilities, laboratories, service or support facilities, and any other facilities related
to the operation of any of the foregoing. b. Biomedical or public health...
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22-8B-3
employee, researcher, medical or nursing school faculty member, student, or employee, counselor,
social worker, or any professional, paraprofessional, or any other person who furnishes or
assists in the furnishing of health care services. (5) LIFE-SUSTAINING TREATMENT. Any medical
treatment, procedure, or intervention that, in the judgment of the attending physician, when
applied to the patient, would serve only to prolong the dying process where the patient has
a terminal illness or injury, or would serve only to maintain the patient in a condition
of permanent unconsciousness. These procedures include, but are not limited to, assisted ventilation,
cardiopulmonary resuscitation, renal dialysis, surgical procedures, blood transfusions, and
the administration of drugs and antibiotics. Life-sustaining treatment does not include the
administration of medication or the performance of any medical treatment where, in the opinion
of the attending physician, the medication or treatment...
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25-5-313
Section 25-5-313 Schedule of maximum fees. Within 60 days from May 19, 1992, the Workers' Compensation
Medical Services Board shall submit to the Governor an initial schedule of maximum fees for
medical services covered by this article, which schedule shall become effective immediately
upon submission to the Governor. The initial schedule of maximum fees shall be established
by the board in the manner prescribed in this section. The fee for each service in the schedule
shall be exactly equal to an amount derived by multiplying the preferred provider reimbursement
customarily paid on May 19, 1992, by the largest health care service plan incorporated pursuant
to Sections 10-4-100 to 10-4-115, inclusive, by a factor of 1.075, which product shall be
the maximum fee for each such service. In addition the board may submit to the Governor for
approval on or before January 31, 1993, a revised schedule of selected fees for medical services
covered by this article, which fees shall not exceed...
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22-21-324
Section 22-21-324 Use of proceeds. (a) The principal proceeds derived from any borrowing made
by an authority shall be used solely for the purpose or purposes for which such borrowing
was authorized to be made. If any securities are issued for the purpose of financing costs
of acquiring, constructing, improving, enlarging and equipping health care facilities, such
costs shall be deemed to include the following: (1) The cost of any land forming a part of
such health care facilities; (2) The cost of the labor, materials and supplies used in any
such construction, improvement or enlargement, including architectural and engineering fees
and the cost of preparing contract documents advertising for bids; (3) The purchase price
of, and the cost of installing, equipment for such health care facilities; (4) The cost of
landscaping the lands forming a part of such health care facilities and of constructing and
installing roads, sidewalks, curbs, gutters, utilities and parking places in...
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