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22-50-17
Section 22-50-17 Operation of a facility for care or treatment of mental or emotional illness
or substance abuse, or services to persons with an intellectual disability. (a) No person,
partnership, corporation, or association of persons shall operate a facility or institution
for the care or treatment of any kind of mental or emotional illness or substance abuse or
for providing services to persons with an intellectual disability as defined in this chapter,
without being certified by the department or licensed by the State Board of Health; provided
that nothing in this section shall be construed so as to require a duly authorized physician,
psychiatrist, psychologist, social worker, licensed professional counselor operating under
the scope of his or her license, or Christian Science practitioner to obtain a license for
treatment of patients in his private office, unless he keeps two or more patients in his office
for continuous periods of 24 hours or more in one week, or that a church...
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27-12A-2
Section 27-12A-2 Insurance fraud - definition. A person commits the crime of insurance fraud
if, knowingly and with intent to defraud, he or she commits, or conceals any material information
concerning, one or more of the following acts: (1) The solicitation or acceptance of new or
renewal insurance risks on behalf of an insurer, reinsurer, or other person engaged in the
transaction of the business of insurance, by a person who knows the insurer, reinsurer, or
other person responsible for the risk is financially unable to pay its claims at the time
of the transaction. (2) The removal, concealment, alteration, or destruction of the assets
or records relating to the transaction of the business of insurance of an insurer, reinsurer,
or other person engaged in the transaction of the business of insurance. This section does
not prohibit an insurer, reinsurer, or other person engaged in the transaction of the business
of insurance from destroying records or documents relating to the...
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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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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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-16.htm - 3K - Match Info - Similar pages
22-6-163
Section 22-6-163 Legislative findings; rules; collaboration; approval of agreements and contracts;
state action immunity; confidentiality of records; additional duties. (a) The Legislature
declares that collaboration among public payers, private health carriers, third party purchasers,
and providers to identify appropriate service delivery systems and reimbursement methods in
order to align incentives in support of integrated and coordinated health care delivery is
in the best interest of the public. Collaboration pursuant to this article is to provide quality
health care at the lowest possible cost to Alabama citizens who are Medicaid eligible. The
Legislature, therefore, declares that this health care delivery system affirmatively contemplates
the foreseeable displacement of competition, such that any anti-competitive effect may be
attributed to the state's policy to displace competition in the delivery of a coordinated
system of health care for the public benefit. In furtherance of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-163.htm - 6K - Match Info - Similar pages
22-6-233
Section 22-6-233 Legislative findings; certification of collaborators; powers of Medicaid Agency;
state action immunity. (a) The Legislature declares that collaboration among public payers,
private health carriers, third party purchasers, and providers to identify appropriate service
delivery systems and reimbursement methods in order to align incentives in support of integrated
and coordinated health care delivery is in the best interest of the public. Collaboration
pursuant to this article is to provide quality health care at the lowest possible cost to
Alabama citizens who are Medicaid eligible. The Legislature, therefore, declares that this
health care delivery system affirmatively contemplates the foreseeable displacement of competition,
such that any anti-competitive effect may be attributed to the state's policy to displace
competition in the delivery of a coordinated system of health care for the public benefit.
In furtherance of this goal, the Legislature declares its intent...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-233.htm - 6K - Match Info - Similar pages
25-5-293
Section 25-5-293 Duties of secretary; continuing education, accounting; recovery of expenses;
advisory committees; legislative intent regarding reimbursements. (a) The Secretary of the
Department of Labor may prescribe rules and regulations for the purpose of conducting continuing
education seminars for all personnel associated with workers' compensation claims and collect
registration fees in order to cover the related expenditures. The secretary may adopt rules
and regulations setting continuing education standards for workers' compensation claims personnel
employed by insurance companies and self-insured employers and groups. (b) The secretary shall
file annually with the Governor and the presiding officer of each house of the Legislature
a complete and detailed written report accounting for all funds received and disbursed during
the preceding fiscal year. The annual report shall be in the form and reported in the time
provided by law. (c) The secretary shall establish reasonable...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-293.htm - 11K - Match Info - Similar pages
27-15-52
Section 27-15-52 Definitions. The following terms shall have the following meanings: (1) COMMERCIALLY
REASONABLE EFFORT. The plans, processes, or procedures necessary to confirm the death of the
insured, contract owner or annuitant, or retained asset account holder against other available
records and information and, as applicable, to locate the beneficiary or beneficiaries or
other person entitled to payment pursuant to the terms of the policy or contract which have
been developed by each insurer and submitted to and approved by the department. (2) CONTRACT.
An annuity contract. The term contract shall not include an annuity used to fund an employment-based
retirement plan or program where the insurer is not committed by terms of the annuity contract
to pay death benefits to the beneficiaries of specific plan participants. (3) DEATH MASTER
FILE. The United States Social Security Administration's Death Master File or any other database
or service that is at least as comprehensive as...
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7-9A-309
Section 7-9A-309 Security interest perfected upon attachment. The following security interests
are perfected when they attach: (1) a purchase-money security interest in consumer goods,
except as otherwise provided in Section 7-9A-311(b) with respect to consumer goods that are
subject to a statute or treaty described in Section 7-9A-311(a); (2) an assignment of accounts
or payment intangibles which does not by itself or in conjunction with other assignments to
the same assignee transfer a significant part of the assignor's outstanding accounts or payment
intangibles; (3) a sale of a payment intangible; (4) a sale of a promissory note; (5) a security
interest created by the assignment of a health-care-insurance receivable to the provider of
the health-care goods or services; (6) a security interest arising under Section 7-2-401,
7-2-505, 7-2-711(3), or 7-2A-508(5), until the debtor obtains possession of the collateral;
(7) a security interest of a collecting bank arising under Section...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/7-9A-309.htm - 2K - Match Info - Similar pages
16-25A-6
Section 16-25A-6 Exclusions. Such health insurance shall not include the following: (1) Expenses
incurred by or on account of an individual prior to the effective date of the plan as to him;
(2) Hearing aids and examinations for the prescription or fitting thereof; (3) Cosmetic surgery
or treatment, except to the extent necessary for correction of damage caused by accidental
injury while covered by the plan or as a direct result of disease covered by the plan; (4)
Services received in a hospital owned or operated by the United States government for which
no charge is made; (5) Services received for injury or sickness due to war or any act of war,
whether declared or undeclared, which war or act of war shall have occurred after the effective
date of this plan; (6) Expenses for which the individual is not required to make payment;
(7) Expenses to the extent of benefits provided under any employer group plan other than this
plan in which the state participates in the cost thereof; (8)...
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