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27-21A-4
Section 27-21A-4 Powers of health maintenance organizations. (a) The powers of a health
maintenance organization include, but are not limited to the following: (1) The purchase,
lease, construction, renovation, operation, or maintenance of hospitals, medical facilities,
or both, and their ancillary equipment; (2) The making of loans other than in the ordinary
course of business, to providers under contract with it in furtherance of its program or the
making of loans to a corporation or corporations in which it owns a majority interest for
the purpose of acquiring or constructing medical facilities and hospitals or in furtherance
of a program providing health care services to enrollees. (3) The furnishing of health care
services through providers which are under contract with or employed by the health maintenance
organization. (4) The contracting with any person for the performance on its behalf of certain
functions such as marketing, enrollment, and administration. (5) The purchase,...
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22-21-263
Section 22-21-263 New institutional health services subject to review. (a) All new institutional
health services which are subject to this article and which are proposed to be offered or
developed within the state shall be subject to review under this article. No institutional
health services which are subject to this article shall be permitted which are inconsistent
with the State Health Plan. For the purposes of this article, new institutional health services
shall include any of the following: (1) The construction, development, acquisition through
lease or purchase, or other establishment of a new health care facility or health maintenance
organization. A transaction involving the sale, lease, or other transfer or change of control
of an existing health care facility, existing health maintenance organization, or existing
institutional health service is not subject to certificate of need review or approval under
this article unless the transaction also involves implementing one or...
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27-21A-23
Section 27-21A-23 Statutory construction and relationship to other laws. (a) Except
as otherwise provided in this chapter, provisions of the insurance law and provisions of health
care service plan laws shall not be applicable to any health maintenance organization granted
a certificate of authority under this chapter. This provision shall not apply to an insurer
or health care service plan licensed and regulated pursuant to the insurance law or the health
care service plan laws of this state except with respect to its health maintenance organization
activities authorized and regulated pursuant to this chapter. (b) Solicitation of enrollees
by a health maintenance organization granted a certificate of authority shall not be construed
to violate any provision of law relating to solicitation or advertising by health professionals.
(c) Any health maintenance organization authorized under this chapter shall not be deemed
to be practicing medicine and shall be exempt from the provisions of...
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22-11D-3
Section 22-11D-3 Establishment and operation of statewide trauma system. (a) The board,
in consultation with, and having solicited the advice of the council, shall establish and
maintain a statewide trauma system that shall include centralized dispatch for participating
trauma centers and emergency medical services. (b) The statewide trauma system shall become
operational within 12 months after the State Health Officer certifies to the Governor in writing
that the department has sufficient funds to finance its development, implementation, and operation.
(c) The board, in consultation with and having solicited the advice of the council, may establish
and maintain other coordinated statewide systems of emergency medical and hospital care for
other illnesses, such as stroke. Other statewide coordinated health care systems may be implemented
by the board as funds become available to the board. (Act 2007-299, p. 541, §3; Act 2012-526,
p. 1556, §1.)...
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27-21A-11
Section 27-21A-11 Investments. With the exception of investments made in accordance
with subdivisions (a)(1), (a)(2), (a)(5), and subsection (b) of Section 27-21A-4, the
funds of a health maintenance organization shall be invested only in securities or other investments
permitted by the laws of this state for the investment of assets constituting the legal reserves
of life insurance companies or such other securities or investments as the commissioner may
permit. (Acts 1986, No. 86-471, p. 854, §11.)...
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27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases
shall have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health.
(2) ENROLLEE. An individual who has contracted for or who participates in coverage under an
insurance policy, a health maintenance organization contract, a health service corporation
contract, an employee welfare benefit plan, a hospital or medical services plan, or any other
benefit program providing payment, reimbursement, or indemnification for health care costs
for the individual or the eligible dependents of the individual. (3) PROVIDER. A health care
provider duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system
for prospective and concurrent review of the necessity and appropriateness in the allocation
of health care resources and services given or proposed to be given to an individual within
this state. The term does not include elective requests for clarification of...
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27-21A-14
Section 27-21A-14 Regulation of producers. (a) Unless exempted pursuant to subsection
(c), health maintenance organizations in this state shall only solicit enrollees or otherwise
market their services through producers duly licensed in accordance with Chapters 7 and 8A
of this title. (b) The commissioner shall, after notice and hearing, promulgate such reasonable
rules and regulations as are necessary to provide for the licensing of producers. (c) The
commissioner may, by rule, exempt certain classes of persons from the requirement of obtaining
a license for either of the following reasons: (1) If the functions they perform do not require
special competence, trustworthiness, or the regulatory surveillance made possible by licensing.
(2) If other existing safeguards make regulation unnecessary. (d) Nothing in this section
shall be deemed to prohibit a health maintenance organization from advertising. (Acts 1986,
No. 86-471, p. 854, §14; Act 2001-702, p. 1509, §15.)...
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2-27-30
Section 2-27-30 Establishment and operation; policy committee and executive committee
therefor. The commissioner and state Department of Agriculture and Industries shall have authority
to provide for the establishment and operation of a laboratory to obtain reliable analysis
of raw and processed agricultural products, the materials used in production of agricultural
products for harmful pesticide residues for the protection of public health and interest,
to aid in developing and expanding markets for agricultural products, the protection and production
of fish and wildlife, and the use of recreational areas as related to pesticide residues.
In connection therewith, there shall be established a policy committee to be composed of the
following: (1) The Director, Alabama Cooperative Extension Service, who shall be chairman
of the committee; (2) The Commissioner of the Department of Agriculture and Industries; (3)
The Director, Alabama Experiment Station System; (4) The State Health...
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22-5C-2
Section 22-5C-2 State Advisory Council on Palliative Care and Quality of Life. (a) Not
later than November 23, 2015, the State Health Department shall establish a State Advisory
Council on Palliative Care and Quality of Life within the department. (b) The council membership
shall be appointed by the State Health Officer and shall include interdisciplinary palliative
care medical, nursing, social work, pharmacy, and spiritual professional expertise; patient
and family caregiver advocate representation, and any other relevant appointees the State
Health Officer determines appropriate. The State Health Officer shall consider the racial,
gender, geographic, urban/rural, and economic diversity of the state when appointing members.
Membership shall specifically include health professionals having palliative care work experience
or expertise in palliative care delivery models in a variety of inpatient, outpatient, and
community settings such as acute care, long-term care, and hospice and with...
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27-20A-2
Section 27-20A-2 Chapter applicable to group, etc., policies. No group, blanket, franchise,
or association health insurance policy providing coverage on an expense incurred basis, nor
group, blanket, franchise, or association service or indemnity type contract issued by a nonprofit
corporation, nor group-type self insurance plan providing protection, insurance, or indemnity
against hospital, medical, or surgical expenses, nor health maintenance organization plan
shall be issued, delivered, executed, or renewed in this state, or approved for issuance or
renewal in this state by the Commissioner of Insurance after 90 days beyond the effective
date of this chapter, unless such policy, contract, or plan, at the option of the policyholder
or sponsor, provides benefits to any insured, subscriber, or other person covered under the
policy, contract, or plan for expenses incurred in connection with the treatment of alcoholism
when such treatment is prescribed by a duly licensed doctor of...
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