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22-21-275
Section 22-21-275 Procedures for review of applications for certificates of need. The SHPDA,
pursuant to the provisions of Section 22-21-274, shall prescribe by rules and regulations
the procedures for review of applications for certificates of need and for issuance of certificates
of need. Rules and regulations governing review procedures shall include, but not necessarily
be limited to, the following: (1) Agreement with other review agencies for review procedures
consistent with this article and federal regulations. (2) Application procedures and forms
of the application necessary to elicit and provide all necessary information as required by
the review criteria. (3) Establishment of a project review period of 90 days from the date
the state agency determines that the application is complete and notification thereof is made
to the applicant. The rules and regulations may provide for a period of not more than 15 days
for determination of the completeness of the application,...
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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...
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27-19-103
would result in economies of acquisition or administration. 3. The benefits are reasonable
in relation to the premiums charged. (5) LONG-TERM CARE INSURANCE. Any insurance policy or
rider advertised, marketed, offered, or designed to provide coverage for not less than 12
consecutive months for each covered person on an expense incurred, indemnity, prepaid, or
other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic,
rehabilitative, maintenance, or personal care services, provided in a setting other
than an acute care unit of a hospital. This term includes group and individual annuities and
life insurance policies or riders that provide directly or that supplement long-term care
insurance. This term also includes a policy or rider that provides for payment of benefits
based upon cognitive impairment or the loss of functional capacity. The term shall also include
qualified long-term care insurance contracts. Long-term care insurance may be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-103.htm - 9K - 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...
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27-44-5
territories, or protectorates that do not have an association similar to the association created
by this chapter, shall be deemed residents of the state of domicile of the insurer that issued
the policies or contracts. (19) STATE. A state, the District of Columbia, Puerto Rico, and
a United States possession, territory, or protectorate. (20) STRUCTURED SETTLEMENT ANNUITY.
An annuity purchased in order to fund periodic payments for a plaintiff or other claimant
in payment for or with respect to personal injury suffered by the plaintiff
or other claimant. (21) SUPPLEMENTAL CONTRACT. A written agreement entered into for the distribution
of proceeds under a life, disability, or annuity policy or contract. (22) UNALLOCATED ANNUITY
CONTRACT. An annuity contract or group annuity certificate which is not issued to and owned
by an individual, except to the extent of any annuity benefits guaranteed to an individual
by an insurer under the contract or certificate. (Acts 1982, No. 82-561, p. 922,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-44-5.htm - 7K - Match Info - Similar pages
27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household
member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting
to cause or intentionally, knowingly, or recklessly causing another person, including a minor
child, bodily injury, severe emotional injury, or psychological trauma or conduct
which constitutes the crime of rape. b. Intentionally following another person, including
a minor child, without proper authority, under circumstances that place the person in reasonable
fear of bodily injury or physical harm. c. Subjecting another person, including a minor
child, to false imprisonment or kidnapping. d. Attempting to cause or intentionally, knowingly,
or recklessly causing damage to property to intimidate or attempt to control the behavior
of another person, including a minor child. e. Assault, child abuse, criminal...
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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...
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41-15B-2.2
5. Provision of other forensic services for children when requested by the council. b. The
Department of Forensic Sciences shall prepare an annual accounting of the distribution of
monies received and the effectiveness of programs implemented pursuant to this chapter and
shall file the accounting with the council before July 1. Sufficient safeguards shall be implemented
to ensure that the new monies increase and not supplant or decrease existing state support.
(12) One-half of one percent of the fund shall be allocated to the Department of Rehabilitation
Services for distribution to one or more of the following: a. Early intervention services
for children from birth through age three and services for children who have traumatic brain
injury. b. Child death review teams pursuant to Article 5 of Chapter 16 of Title 26.
The Department of Rehabilitation Services shall work in cooperation with the Department of
Public Health to administer this paragraph. (Act 99-390, p. 628, ยง3.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/41-15B-2.2.htm - 22K - Match Info - Similar pages
34-13A-2
offspring, or other family members. b. Discuss the features, natural history, means of diagnosis,
genetic and environmental factors, and management of risk for genetic or medical conditions
and diseases. c. Identify, recommend, and coordinate genetic tests and other genetic related
diagnostic studies as appropriate for the genetic assessment consistent with practice-based
competencies provided by the ACGC. d. Integrate genetic test results and other genetic-related
diagnostic studies with personal and family medical history to assess and communicate
risk factors for genetic or medical conditions and diseases. e. Explain the clinical implications
of genetic tests and other genetic-related diagnostic studies and their results. f. Evaluate
the responses of the client or family to the condition or risk of recurrence and provide client-centered
counseling and anticipatory guidance. g. Identify and utilize community resources that provide
medical, educational, financial, and psychosocial...
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22-27-48.1
Section 22-27-48.1 Approval process by local governing body for siting of new solid waste management
facility. (a) This section applies to the siting of any new solid waste management facility,
as defined in Section 22-27-2. (b) The governing body of a county or municipality shall make
a discretionary decision to approve or disapprove the siting of a new solid waste management
facility in accordance with this section. (c) Any person or entity seeking approval from the
governing body of a county or municipality for the siting of a new solid waste management
facility shall also submit to the governing body as part of its application, the application
fee required under subsection (d) of Section 22-27-48 and all of the following information:
(1) A written document addressing each of the criteria described in subsection (c) of Section
22-27-48. (2) The applicant's experience of owning or operating other solid waste facilities.
(3) Information relating to the applicant's financial resources,...
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