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...
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6-5-543
Section 6-5-543 Damages against health care provider to be itemized; future damages over $150,000
to be paid by periodic payments over period of years; judgment to specify payment terms; requirement
to post security or provide evidence of insurance; future damages not to be reduced to present
value; attorney's fees; termination of periodic payments; contempt of court upon continuing
pattern of failure to make payments; modification of judgment; legislative intent. (a) In
any action for injury or damages whether in contract or in tort against a health care provider
based on a breach of the standard of care the damages assessed by the trier of fact shall
be itemized as follows: (1) Past damages, (2) Future damages, (3) Punitive damages. The trier
of fact shall not reduce any future damages to present value. If the trial court determines
that any one or more of the above categories is not recoverable in the action, that category
or categories shall be omitted from the itemization. (b)...
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27-1-21
Section 27-1-21 Uniformity of limits applied to fulfillment of certain drug prescriptions.
(a) For the purposes of this section, the following words shall have the following meanings:
(1) ENROLLEE. A person enrolled in a health benefit plan. (2) HEALTH BENEFIT PLAN. Any individual
or group plan, policy, or contract for health care services issued, delivered, issued for
delivery, 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, purchases, or
furnishes health care services to patients, insureds, or beneficiaries in this state. The
term includes, but is not limited to, entities created pursuant to Article 6 of Chapter 4
of Title 10. The term shall not include any collective bargaining agreement...
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27-27-16
Section 27-27-16 Domestic mutual insurers - Bond or deposit in lieu thereof. (a) Before soliciting
any applications for insurance required under Section 27-27-15, as qualification for the original
certificate of authority, the incorporators of the proposed mutual insurer shall file with
the commissioner a corporate surety bond in the penalty of $15,000.00 in favor of the State
of Alabama and for the use and benefit of the state and of applicant members and creditors
of the corporation. The bond shall be conditioned as follows: (1) Upon payment of any loss
suffered by applicants who have cancelled or lapsed existing insurance policies due to misrepresentation
by the incorporators or by persons soliciting such applications under authorization by the
corporation, to the effect that the making of such application for insurance and prepayment
of premiums in such proposed insurer provides insurance protection prior to issuance of a
certificate of authority to such insurer by the...
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22-21A-4
Section 22-21A-4 State control. Each member state, within its state, may suspend by legislation
the operation of all federal laws, rules, regulations, and orders regarding health care that
are inconsistent with the laws and regulations adopted by the member state pursuant to this
compact. Federal and state laws, rules, regulations, and orders regarding health care shall
remain in effect unless a member state expressly suspends them pursuant to its authority under
this compact. For any federal law, rule, regulation, or order that remains in effect in a
member state after the effective date, that member state shall be responsible for the associated
funding obligations in its state. (Act 2013-420, p. 1672, §4.)...
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22-6-154
Section 22-6-154 Quality assurance committee; collection and publication of information. (a)
The Medicaid Agency shall create a quality assurance committee appointed by the Medicaid Commissioner.
The members of the committee shall serve two-year terms. At least 60 percent of the members
shall be physicians who provide care to Medicaid beneficiaries served by a regional care organization.
In making appointments to the committee, the Medicaid Commissioner shall seek input from the
appropriate professional associations. (b) The committee shall identify objective outcome
and quality measures, including measures of outcome and quality for ambulatory care, inpatient
care, chemical dependency and mental health treatment, oral health care, and all other health
services provided by coordinated care organizations. Quality measures adopted by the committee
shall be consistent with existing state and national quality measures. The Medicaid Commissioner
shall incorporate these measures into...
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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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27-27-19
Section 27-27-19 Domestic mutual insurers - Failure to complete organization. If the proposed
domestic mutual insurer fails to complete its organization and to secure its original certificate
of authority within one year from, and after, date of its certificate of incorporation, the
corporation shall transact no further business, and the commissioner shall return, or cause
to be returned, to the persons entitled thereto all advance deposits or payments of premiums
held in trust under Section 27-27-18. (Acts 1971, No. 407, p. 707, §515.)...
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27-3-22
Section 27-3-22 Suspension or revocation of certificates - Order and notices. (a) Suspension
or revocation of an insurer's certificate of authority shall be by the commissioner's order
given to the insurer as provided by Section 27-2-18. The commissioner shall promptly also
give notice of such suspension or revocation to the insurer's agents in this state of record
in the commissioner's office. The insurer shall not solicit or write any new coverages in
this state during the period of any such suspension or revocation. (b) In his discretion,
the commissioner may cause notice of any such revocation to be published in one or more newspapers
of general circulation published in this state. (c) Upon revocation or suspension of the certificate
of authority of a surety insurer, the commissioner shall so notify each officer in this state
authorized to approve official bonds by circular letter stating the grounds of such suspension
or revocation. (Acts 1971, No. 407, p. 707, §67.)...
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27-50-6
Section 27-50-6 License suspension, etc. A license issued by the Department of Insurance to
an insurance company or a health maintenance organization shall be subject to suspension,
revocation, or imposition or other administrative penalty authorized by law, within the discretion
of the Commissioner of Insurance, for any violation of the provisions of this chapter. (Acts
1997, No. 97-414, p. 685, §6.)...
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