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34-23-181
Section 34-23-181 Definitions. The following words shall have the following meanings
as used in this article: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare
benefit plan, policy, or contract for health care services issued, delivered, issued for delivery,
or renewed in this state by a health care insurer, health maintenance organization, accident
and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, nonprofit
medical service corporation, health care service plan, or any other person, firm, corporation,
joint venture, or other similar business entity that pays for insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this article if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-23-181.htm - 3K - Match Info - Similar pages
34-9-43.2
Section 34-9-43.2 Legislative findings; rulemaking authority; liability; scope. (a)
The Legislature finds and declares all of the following: (1) The power to make rules regulating
the practice of dentistry and dental hygiene includes the power to prohibit unlicensed persons
from practicing dentistry and dental hygiene and the power to regulate how licensed persons
practice the same. (2) A primary goal of the provision of health care is to prioritize patient
health, safety, and welfare. (3) The board is in the best position to determine the dental
practices that affect and prioritize the health, safety, and welfare of the public. (4) It
is the intent of the Legislature in enacting this section to immunize the board, its
members, employees, and agents from liability under state and federal anti-trust laws for
the adoption of a rule that prioritizes patient health, safety, and welfare but appears to
have elements that appear anti-competitive or have an anti-competitive effect when the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-9-43.2.htm - 2K - Match Info - Similar pages
27-53-1
Section 27-53-1 Definitions. As used in this chapter, the following terms shall have
the following meanings: (1) GENETIC CHARACTERISTICS. A scientifically or medically identifiable
gene or chromosome, or alteration thereof, that is known to be a cause of a disease or disorder,
or determined to be associated with a statistically increased risk of development of a disease
or disorder. (2) GENETIC TEST. A pre-symptomatic laboratory test which is generally accepted
in the scientific and medical communities for the determination of the presence or absence
of the genetic characteristics that cause or are associated with risk of a disease or disorder.
(3) HEALTH BENEFIT PLAN. A health insurance policy, including a self-insured health plan,
that covers hospital, medical, or surgical expenses, health maintenance organizations, preferred
provider organizations, medical service organizations, physician-hospital organizations, or
any other person, firm, corporation, joint venture, or other similar...
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34-19-21
Section 34-19-21 Coverage or reimbursement for services not required. Nothing contained
in this chapter shall be construed to create a requirement that any health benefit plan, group
insurance plan, policy, or contract for health care services that covers hospital, medical,
or surgical expenses, health maintenance organizations, preferred provider organizations,
medical service organizations, physician-hospital organizations, or any other person, firm,
corporation, joint venture, or other similar business entity that pays for, purchases, or
furnishes group health care services to patients, insureds, or beneficiaries in this state,
including entities created pursuant to Article 6, commencing with Section 10A-20-6.01,
of Chapter 20, Title 10A, provide coverage or reimbursement for the services described or
authorized in this chapter. (Act 2017-383, §4.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-19-21.htm - 1K - Match Info - Similar pages
34-9-7
Section 34-9-7 Exemption of certain practices and operations. (a) Nothing in this chapter
shall apply to the following practices, acts, and operations: (1) The practice of his or her
profession by a physician or surgeon holding a certificate of qualification as a medical doctor
and licensed as such under the laws of this state, provided he or she shall not practice dentistry
as a specialty. (2) The practice of dentistry in the discharge of their official duties by
graduate dentists or dental surgeons in the United States Army, Navy, Air Force, or other
armed services, public health service including, but not limited to, a federally qualified
health center authorized and operating under Section 330 of the Public Health Service
Act (42 U.S.C. § 254B), provided, however, that such federally qualified health centers shall
register pursuant to Section 34-9-7.2 (provided further however, dentists, dental hygienists,
and other personnel employed by any public health service which performs...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-9-7.htm - 4K - Match Info - Similar pages
22-11A-60
Section 22-11A-60 Definitions. As used in this article, the following words shall have
the following meanings: (1) HEALTH CARE FACILITY. A hospital, nursing home, ambulatory surgical
center, outpatient surgical facility, ambulance service, rescue squad, paid fire department,
volunteer fire department, or any other clinic, office, or facility in which medical, dental,
nursing, or podiatric services are offered. (2) HEALTH CARE WORKER. Physicians, dentists,
nurses, respiratory therapists, phlebotomists, surgical technicians, physician assistants,
podiatrist, dialysis technicians, emergency medical technicians, paramedics, ambulance drivers,
dental hygienists, dental assistants, students in the healing arts, or any other individual
who provides or assists in the provision of medical, dental, or nursing services. (3) HEPATITIS
B VIRUS (HBV) INFECTION. The presence of the HBV as determined by the presence of hepatitis
B(e) antigen for six months or longer or by other means as determined by...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-11A-60.htm - 3K - Match Info - Similar pages
22-4-36
Section 22-4-36 Limits on information requested. The SHPDA may not request any information
from a health care reporter that requires the submission of proprietary or confidential matters,
such as negotiated discounts with specific insurers, health service corporations, or health
benefit plans. The SHPDA may not require any reporting that could be used to identify a patient
of a covered health care reporter. (Act 2015-471, §7.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-4-36.htm - 737 bytes - Match Info - Similar pages
25-5-290
Section 25-5-290 Ombudsman program, creation; purpose; members; notification of service;
benefit review conferences. (a) The Department of Industrial Relations shall establish an
Ombudsman Program to assist injured or disabled employees, persons claiming death benefits,
employers, and other persons in protecting their rights and obtaining information available
under the Workers' Compensation Law. (b) Providing that the employer and the employee agree
to participate in the benefit review conference, the ombudsmen shall meet with or otherwise
provide information to injured or disabled employees, investigate complaints, and communicate
with employers, insurance carriers, and health care providers on behalf of injured or disabled
employees. (c) Ombudsmen shall be Merit System employees and demonstrate familiarity with
the Workers' Compensation Law. An ombudsman shall not be an advocate for any person who shall
assist a claimant, employer, or other person in any proceeding beyond the...
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34-9-18
Section 34-9-18 Grounds for disciplinary action. (a) The board may invoke disciplinary
action as outlined in subsection (b) whenever it shall be established to the satisfaction
of the board, after a hearing as hereinafter provided, that any dentist or dental hygienist
has been guilty of the following: (1) Fraud, deceit, or misrepresentation in obtaining any
license, license certificate, annual registration certificate, money, or other thing of value.
(2) Gross immorality. (3) Is a menace to the public health or to patients or others by reason
of a disease. (4) Is an habitual user of intoxicants or drugs rendering him or her unfit for
the practice of dentistry or dental hygiene. (5) Has been convicted for violation of federal
or state narcotics or barbiturate laws. (6) Is guilty of negligence or gross negligence. a.
For the purposes of this subdivision, negligence is defined as the failure to do what a reasonably
prudent dentist or dental hygienist would have done under the same or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-9-18.htm - 9K - Match Info - Similar pages
35-11-371
Section 35-11-371 Perfection of lien. (a) For the purposes of this section, the
following terms shall have the following meanings: (1) HEALTH CARE PAYOR. A health care insurer,
health maintenance organization, or health care service plan organized under Article 6, Chapter
20, Title 10A, authorized to provide health care coverage in the state. (2) SATISFY THE CLAIM.
Receipt by the hospital of either of the following: a. Full payment for services as billed.
b. If the hospital has a contract with the injured person's health care payor, payment together
with all credits, discounts, and contractual adjustments that the patient's bill would be
entitled under the contract, including recoupments, between the hospital and the patient's
health care payor which extinguish the patient's obligation for the services rendered. (b)
Unless specifically contrary to any contractual agreement between the hospital and the injured
person's health care payor or unless contrary to any statute or governmental...
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