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27-21A-7
Section 27-21A-7 Evidence of coverage and charges for health care services. (a)(1) Every
enrollee residing in this state is entitled to an evidence of coverage. If the enrollee obtains
such coverage through an insurance policy or a contract issued by a health care service plan,
the insurer or the health care service plan shall issue the evidence of coverage. Otherwise,
the health maintenance organization shall issue the evidence of coverage. (2) No evidence
of coverage, or amendment thereto, shall be issued or delivered to any person in this state
until a copy of the basic form of the evidence of coverage, or amendment thereto, has been
filed with the commissioner and the State Health Officer, and approved by the commissioner.
(3) An evidence of coverage shall contain: a. No provisions or statements which encourage
misrepresentation, or which are untrue, misleading, or deceptive as defined in subsection
(a) of Section 27-21A-13; and b. A clear and concise statement, if a contract, or a...
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41-28-4
Section 41-28-4 Powers and duties of secretary. The secretary shall have all of the
following powers and duties: (1) Develop a comprehensive four-year strategic plan for the
state's information technology to include acquisition, management, and use of information
technology by state agencies. The plan shall be developed in conjunction with the planning
and budgeting processes for state agencies and may include review of state agencies' information
technology plans, capital budgets, and operating budgets as appropriate to accomplish the
goals of reducing redundant expenditures and maximizing the return on information technology
investments. The plan shall be updated annually and submitted to the Governor and shall be
presented during a public meeting to the Permanent Legislative Oversight Committee on Information
Technology. The plan shall further be coordinated with the Boards of Directors of the Alabama
Supercomputer Authority. (2) Collaborate and coordinate with the Division of Data...
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22-1-18
Section 22-1-18 Autism Spectrum Disorder coverage and reimbursement under Children's
Health Insurance Plan. In the administration of and provision of benefits for the Children's
Health Insurance Plan (ALL Kids), the Alabama Department of Public Health, on and after December
31, 2018, shall provide coverage and reimbursement for the treatment of Autism Spectrum Disorder
in the same manner and same levels as health benefit plans. (Act 2017-337, §2.)...
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27-57-2
Section 27-57-2 Coverage; applicability. (a) All group health benefit plans, policies,
contracts, and certificates executed, delivered, issued for delivery, continued, or renewed
in this state on or after August 1, 2004, shall offer, at the time of proposal, sale, or renewal
of a policy subject to this chapter, to include colorectal cancer examinations within the
coverage. Such offer of coverage shall include colorectal cancer examinations for covered
persons who are 50 years of age or older, or for covered persons who are less than 50 years
of age and at high risk for colorectal cancer according to current American Cancer Society
colorectal cancer screening guidelines. (b) This chapter shall apply to group accident and
sickness insurance policies issued by a fraternal benefit society, a nonprofit hospital service
corporation, a nonprofit medical service corporation, a group health care plan, a health maintenance
organization, or any similar entity. (Act 2004-502, p. 969, §2.)...
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27-48-2
Section 27-48-2 Coverage for medically necessary inpatient care for mother and newly
born child. (a) Every health benefit plan that provides maternity coverage shall provide coverage
for the following: (1) All medically necessary inpatient care for a mother and her newly born
child as determined by the woman's prenatal care physician, obstetrician-gynecologist, certified
nurse midwife, or the child's attending pediatrician and when consistent with the most recent
version of the "Guidelines for Perinatal Care" prepared by the American Academy
of Pediatrics and the American College of Obstetricians and Gynecologists, including the administration
of medical tests recommended by the American Academy of Pediatrics or the American College
of Obstetricians and Gynecologists or both on the admission and discharge of a mother and
the newborn child to determine whether additional medical care is needed for the mother or
newborn child or both. Included in medically necessary inpatient care is the...
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27-55-8
Section 27-55-8 Construction. This chapter does not and shall not be construed as creating
a private cause of action and does not and shall not require insurers, including any health
benefit plan, to extend coverage to any providers or type of providers for which coverage
is not specifically provided within the policy or certificate of insurance or health benefit
plan, or to add additional providers to existing networks, or to add any health care benefits.
(Act 2000-595, p. 1185, §8.)...
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27-58-2
Section 27-58-2 Coverage for annual screening. On and after October 1, 2007, each health
benefit plan shall offer, together with identification of associated costs, policies and contracts
including coverage for the annual screening for the early detection of prostate cancer in
men over age 40. (Act 2007-389, p. 778, §2.)...
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27-59-2
Section 27-59-2 Coverage offered for chiropractic. On and after October 1, 2008, each
health benefit plan shall offer, together with identification of associated costs, policies,
and contracts, coverage for chiropractic. (Act 2008-502, p. 1106, §2.)...
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22-5D-4
Section 22-5D-4 Coverage and costs. (a) This chapter does not expand the coverage required
of an insurer. (b) A health plan, third party administrator, or governmental agency is not
required to provide coverage for the cost of an investigational drug, biological product,
or device, or the cost of services related to the use of an investigational drug, biological
product, or device under this chapter. (c) This chapter does not require any governmental
agency to pay costs associated with the use, care, or treatment of a patient with an investigational
drug, biological product, or device. (d) This chapter does not require a hospital or other
health care facility to provide new or additional services, unless approved by the hospital
or facility. (Act 2015-320, §4.)...
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27-45-3
Section 27-45-3 Choice of pharmaceutical services; right to participate as contracting
provider. No health insurance policy or employee benefit plan which is delivered, renewed,
issued for delivery, or otherwise contracted for in this state shall: (1) Prevent any person
who is a party to or beneficiary of any such health insurance policy or employee benefit plan
from selecting the pharmacy or pharmacist of his choice to furnish the pharmaceutical services,
including without limitation, prescription drugs, offered by said policy or plan or interfere
with said selection provided the pharmacy or pharmacist is licensed to furnish such pharmaceutical
services in this state; or (2) Deny any pharmacy or pharmacist the right to participate as
a contracting provider for such policy or plan provided the pharmacist is licensed to furnish
pharmaceutical services, including without limitation, prescription drugs offered by said
policy or plan. (Acts 1988, No. 88-379, p. 565, §3.)...
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