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20-2-190
Section 20-2-190 Penalties; sale of ephedrine, etc.; Alabama Drug Abuse Task Force. (a) Any
person who manufactures, sells, transfers, receives, or possesses a listed precursor chemical
violates this article if the person: (1) Knowingly fails to comply with the reporting requirements
of this article; (2) Knowingly makes a false statement in a report or record required by this
article or the rules adopted thereunder; (3) Is required by this article to have a listed
precursor chemical license or permit, and is a person as defined by this article, and knowingly
or deliberately fails to obtain such a license or permit. An offense under this subsection
shall constitute a Class C felony. (b) Notwithstanding the provisions of Section 20-2-188,
a person who possesses, sells, transfers, or otherwise furnishes or attempts to solicit another
or conspires to possess, sell, transfer, or otherwise furnish a listed precursor chemical
or a product containing a precursor chemical or ephedrine or...
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27-21A-16
Section 27-21A-16 Examination. (a) The commissioner may make an examination of the affairs
of any health maintenance organization and providers with whom such organization has contracts
or agreements as often as is reasonably necessary for the protection of the interests of the
people of this state, but not less frequently than once every three years. (b) The State Health
Officer may make an examination concerning health care service of any health maintenance organization
and providers with whom such organization has contracts, agreements, or other arrangements
as often as is reasonably necessary for the protection of the interests of the people of this
state, but not less frequently than once every three years. (c) Every health maintenance organization
shall submit its relevant books and records for such examinations and in every way facilitate
these examinations. For the purpose of examinations, the commissioner and the State Health
Officer may administer oaths to, and examine the...
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27-21A-31
Section 27-21A-31 Health maintenance organization advisory council. There shall be established
a three member HMO advisory council to advise and consult with the commissioner and the State
Health Officer in carrying out their duties under this chapter. The members of such advisory
body shall be appointed annually by the Alabama Association of Health Maintenance Organizations.
(Acts 1986, No. 86-471, p. 854, §31.)...
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27-21A-2
Section 27-21A-2 Establishment of health maintenance organizations. (a) Notwithstanding any
law of this state to the contrary, any person may apply to the commissioner for and obtain
a certificate of authority to establish and operate a health maintenance organization in compliance
with this chapter. No person shall establish or operate a health maintenance organization
in this state without obtaining a certificate of authority under this chapter. A foreign corporation
may qualify under this chapter, subject to its registration to do business in this state as
a foreign corporation under the provisions of Sections 10-2A-220, et seq. (b) Health maintenance
organizations licensed as of May 29, 1986, shall be issued a certificate of authority in accordance
with Section 27-21A-29. (c) Each application for a certificate of authority shall be verified
by an officer or authorized representative of the applicant, shall be in a form prescribed
by the commissioner, and shall set forth or be...
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27-21A-18
Section 27-21A-18 Rehabilitation, liquidation, or conservation of a health maintenance organization.
(a) Any rehabilitation, liquidation, or conservation of a health maintenance organization
shall be deemed to be the rehabilitation, liquidation, or conservation of an insurance company
and shall be conducted under the supervision of the commissioner pursuant to the law governing
the rehabilitation, liquidation, or conservation of insurance companies. The commissioner
may apply for an order directing him to rehabilitate, liquidate, or conserve a health maintenance
organization upon any one or more grounds set out in Section 27-32-6, or when in his opinion
the continued operation of the health maintenance organization would be hazardous either to
the enrollees or to the people of this state. Enrollees shall have the same priority in the
event of liquidation or rehabilitation as the law provides to policyholders of an insurer.
(b) A claim by a health care provider for an uncovered...
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27-21A-8
Section 27-21A-8 Reporting requirements. Every health maintenance organization shall annually,
on or before the first day of March, file a report verified by at least two principal officers
with the commissioner, with a copy to the State Health Officer, covering the preceding calendar
year. Such report shall be on forms prescribed by the commissioner, and shall include: (1)
A financial statement of the organization; (2) Any material changes in the information submitted
pursuant to subsection (c) of Section 27-21A-2; (3) The number of persons enrolled at the
beginning and end of the year; (4) A summary of information compiled pursuant to paragraph
(a)(2)c of Section 27-21A-3; (5) The amount of uncovered and covered expenditures that are
payable and more than 90 days past due; and (6) Such additional information or reports as
are deemed reasonably necessary and appropriate by the commissioner to enable him to carry
out his duties under this chapter. (Acts 1986, No. 86-471, p. 854, §8.)...
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27-49-5
Section 27-49-5 Penalties. Any violation of this chapter shall constitute grounds for suspension
or revocation of a license by the Department of Insurance issued to an insurance company or
health maintenance organization. (Acts 1996, No. 96-671, p. 1135, §5.)...
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27-21A-29
Section 27-21A-29 Existing health maintenance organizations. (a) Notwithstanding any other
provision of this chapter, any health maintenance organization licensed by the State Board
of Health and in operation on May 29, 1986, shall be granted a certificate of authority upon
payment of the application fee prescribed in Section 27-21A-21 and compliance with Section
27-21A-12. Nothing in this section shall prohibit any such health maintenance organization
from continuing to conduct business in this state until such certificate of authority is issued.
(b) Any health maintenance organization which was licensed in this state prior to January
1, 1986, may continue to operate under existing noncontractual provider arrangements (which
have been approved by the State Health Officer) for three years. (c) After issuance of a certificate
of authority in accordance with subsection (a) of this section, the commissioner may require
submission by the health maintenance organization of any additional...
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27-21A-20
Section 27-21A-20 Administrative procedures. (a) When the commissioner has cause to believe
that grounds for the denial of an application for a certificate of authority exist, or that
grounds for the suspension or revocation of a certificate of authority exist, he shall notify
the health maintenance organization and the State Health Officer in writing specifically stating
the grounds for denial, suspension, or revocation. If so requested in writing by the health
maintenance organization, the commissioner shall set a hearing on the matter within 30 days
of the receipt of such request. (b) The State Health Officer, or his designated representative,
shall be in attendance at the hearing and shall participate in the proceedings. The recommendation
and findings of the State Health Officer with respect to matters relating to the quality of
health care services provided in connection with any decision regarding denial, suspension,
or revocation of a certificate of authority, shall be...
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27-21A-1
Section 27-21A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively: (1) AGENT. A person who is appointed or employed by a health maintenance
organization and who engages in solicitation of membership in such organization. This definition
does not include a person enrolling members on behalf of an employer, union, or other organization.
(2) BASIC HEALTH CARE SERVICES. Emergency care, inpatient hospital and physician care, and
outpatient medical services. (3) COMMISSIONER. The Commissioner of Insurance. (4) ENROLLEE.
An individual who is enrolled in a health maintenance organization. (5) EVIDENCE OF COVERAGE.
Any certificate, agreement, or contract issued to an enrollee setting out the coverage to
which he is entitled. (6) HEALTH CARE SERVICES. Any services included in the furnishing to
any individual of medical or dental care, or hospitalization or incident to the furnishing
of such care or hospitalization, as well as the...
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