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20-2-213
Section 20-2-213 Reporting requirements. (a) Each of the entities designated in subsection
(b) shall report to the department, or to an entity designated by the department, controlled
substances prescription information as designated by regulation pertaining to all Class II,
Class III, Class IV, and Class V controlled substances in such manner as may be prescribed
by the department by regulation. (b) The following entities or practitioners are subject to
the reporting requirements of subsection (a): (1) Licensed pharmacies, not including pharmacies
of general and specialized hospitals, nursing homes, and any other health care facilities
which provide inpatient care, so long as the controlled substance is administered and used
by a patient on the premises of the facility. (2) Mail order pharmacies or pharmacy benefit
programs filling prescriptions for or dispensing controlled substances to residents of this
state. (3) Licensed physicians, dentists, podiatrists, or optometrists who...
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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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27-45-2
Section 27-45-2 Definitions. As used in this article, the following terms shall have
the respective meanings herein set forth, unless the context shall otherwise require: (1)
ALABAMA INSURANCE CODE. Title 27 of the Code of Alabama 1975. (2) INSURER. Such term shall
have the meaning ascribed in Section 27-1-2. (3) PERSON. Such term shall have the meaning
ascribed in Section 27-1-2. (4) COMMISSIONER and DEPARTMENT. Such terms, respectively,
shall have the meanings ascribed in Section 27-1-2. (5) CONTRACTUAL OBLIGATION. Any
obligation under covered policies or employee benefit plans. (6) COVERED POLICY OR PLAN. Any
policy, employee benefit plan, or contract within the scope of this article. (7) HEALTH INSURANCE
POLICY. Any individual, group, blanket, or franchise insurance policy, insurance agreement,
or group hospital service contract providing for pharmaceutical services, including without
limitation, prescription drugs, incurred as a result of accident or sickness, or to prevent
same....
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27-54-4
Section 27-54-4 Illnesses covered; requirements of benefit plans, etc. (a) All group
health benefit plans shall offer to provide, at a minimum, additional benefits according to
this chapter for a person receiving medical treatment for any of the following mental illnesses
diagnosed by an appropriately licensed provider. (1) Schizophrenia, schizophrenia form disorder,
schizo affective disorder. (2) Bipolar disorder. (3) Panic disorder. (4) Obsessive-compulsive
disorder. (5) Major depressive disorder. (6) Anxiety disorders. (7) Mood disorders. (8) Any
condition or disorder involving mental illness, excluding alcohol and substance abuse, that
falls under any of the diagnostic categories listed in the mental disorders section
of the International Classification of Disease, as periodically revised. (b) All group health
benefit plans, policies, contracts, and certificates executed, delivered, issued for delivery,
continue, or renewed in this state on or after January 1, 2001, shall offer, at...
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11-104-2
Section 11-104-2 Definitions. As used in this chapter, the following terms shall have
the following meanings: (1) DEPENDENTS. The spouse, children, or other dependents of the retired
employee, as defined by and covered under the documents governing the governmental entities'
benefit plans that provide post-employment benefits. (2) EMPLOYEE. Any person who is an employee
of any governmental entity located in the state who may become eligible for post-employment
benefits from the governmental entity. (3) EMPLOYER. Any governmental entity that sponsors,
in whole or in part, post-employment benefits. (4) FISCAL YEAR. The annual period at the end
of which a governmental entity determines its financial condition. (5) GASB. The Governmental
Accounting Standards Board. (6) GOVERNMENTAL ENTITY. Any political subdivision of the state,
any department, agency, board, commission, or authority of any such political subdivision,
or any public corporation, authority, agency, instrumentality, board,...
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27-1-16
Section 27-1-16 Standard health insurance claim form; electronic claims form; various
claim forms. (a)(1) The Commissioner of the Department of Insurance shall prescribe a standard
health insurance claim form to be used by all hospitals. The forms shall be prescribed in
a format which allows for the use of generally accepted diagnosis and treatment coding systems
by providers of health care and payors. The standard form shall be accepted and used by all
insurers doing business in the State of Alabama and by all state agencies which pay providers
of health care for hospital services. (2) The Commissioner of the Department of Insurance
shall also prescribe a format for all health insurance claims transmitted or submitted for
payment by electronic or electro-mechanical means. Such a format shall be used by all insurers
doing business in the State of Alabama and by all state agencies which pay providers of health
care for hospital services. (b) An advisory committee of five persons, two...
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20-2-190
Section 20-2-190 Penalties; sale of ephedrine, etc.; Alabama Drug Abuse Task Force.
(a) Any person who manufactures, sells, transfers, receives, or possesses a listed precursor
chemical violates this article if the person: (1) Knowingly fails to comply with the reporting
requirements of this article; (2) Knowingly makes a false statement in a report or record
required by this article or the rules adopted thereunder; (3) Is required by this article
to have a listed precursor chemical license or permit, and is a person as defined by this
article, and knowingly or deliberately fails to obtain such a license or permit. An offense
under this subsection shall constitute a Class C felony. (b) Notwithstanding the provisions
of Section 20-2-188, a person who possesses, sells, transfers, or otherwise furnishes
or attempts to solicit another or conspires to possess, sell, transfer, or otherwise furnish
a listed precursor chemical or a product containing a precursor chemical or ephedrine or...
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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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20-2-301
Section 20-2-301 Medication assisted treatment. (a)(1) For all patients receiving medication
assisted treatment, adequate billing records shall be maintained, in any format, for all patient
visits. Billing records shall be maintained for a period of three years from the date of the
patient's last treatment. Billing records shall be made for all methods of payment. Billing
records shall include, but not be limited to, information detailing all of the following:
a. The amount paid for services. b. Method of payment. c. Date of the delivery of services.
d. Date of payment. e. Description of services. (2) Records of all bank deposits of cash payments
for medication assisted treatment shall be maintained, in any format, for a period of three
years. (b) By January 1, 2020, the Alabama Board of Medical Examiners, in consultation with
the Public Health Officer of the Department of Public Health and the Alabama Department of
Mental Health shall adopt rules under the Alabama Administrative...
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25-5-331
Section 25-5-331 Definitions. As used in this article, the following words and terms
shall have meanings as follows: (1) ALCOHOL. Ethyl alcohol, hydrated oxide of ethyl, or spirits
of wine, from whatever source or by whatever process produced. (2) CHAIN OF CUSTODY. The methodology
of tracking specified materials, specimens, or substances for the purpose of maintaining control
and accountability from initial collection to final disposition for all of the materials,
specimens, or substances and providing for accountability at each stage in handling, testing,
and storing materials, specimens, or substances and reporting test results. (3) CONFIRMATION
TEST or CONFIRMED TEST. A second analytical procedure used to identify the presence of a specific
drug or metabolite in a specimen. The confirmation test shall be different in scientific principle
from that of the initial test procedure. The confirmation method shall be capable of providing
requisite specificity, sensitivity, and quantitative...
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