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27-3A-2
Section 27-3A-2 Purposes. The purposes of this chapter are to: (1) Promote the delivery of
quality health care in a cost-effective manner. (2) Assure that utilization review agents
adhere to reasonable standards for conducting utilization review. (3) Foster greater coordination
and cooperation between health care providers and utilization review agents. (4) Improve communications
and knowledge of benefit plan requirements among all parties concerned before expenses are
incurred. (5) Ensure that utilization review agents maintain the confidentiality of medical
records in accordance with applicable laws. (Acts 1994, 1st Ex. Sess., No. 94-786, p. 80,
ยง2.)...
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31-9-40
Section 31-9-40 Compact adopted and enacted. The Emergency Management Assistance Compact is
enacted into law and entered with all jurisdictions mutually adopting the compact in the form
substantially as follows: THE EMERGENCY MANAGEMENT ASSISTANCE COMPACT Article I - Purpose
and Authorities. This compact is made and entered into by and between the participating member
states which enact this compact, hereinafter called party states. For the purpose of this
agreement, the term "states" is taken to mean the several states, the Commonwealth
of Puerto Rico, the District of Columbia, and all U.S. territorial possessions. The purpose
of this compact is to provide for mutual assistance between the states entering into this
compact in managing any emergency or disaster that is duly declared by the governor of the
affected state or states, whether arising from natural disaster, technological hazard, man-made
disaster, civil emergency aspects of resources shortages, community disorders,...
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16-44B-1
Section 16-44B-1 Compact. ARTICLE I PURPOSE It is the purpose of this compact to remove barriers
to education success imposed on children of military families because of frequent moves and
deployment of their parents by: A. Facilitating the timely enrollment of children of military
families and ensuring that they are not placed at a disadvantage due to difficulty in the
transfer of education records from the previous school district(s) or variations in entrance/age
requirements. B. Facilitating the student placement process through which children of military
families are not disadvantaged by variations in attendance requirements, scheduling, sequencing,
grading, course content or assessment. C. Facilitating the qualification and eligibility for
enrollment, educational programs, and participation in extracurricular academic, athletic,
and social activities. D. Facilitating the on-time graduation of children of military families.
E. Providing for the promulgation and enforcement of...
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27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials,
adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit
plan that issues or renews any policy of accident or health insurance providing benefits for
medical or hospital expenses for its insured persons shall pay for services rendered by Alabama
health care providers within 45 calendar days upon receipt of a clean written claim or 30
calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation,
or health benefit plan is denying or pending the claim, the insurer, health service corporation,
or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar
days for an electronic claim, notify the health care provider or certificate holder of the
reason for denying or pending the claim and what, if any, additional information is required
to process the claim. Any undisputed portion of the claim...
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27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
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27-60-2
Section 27-60-2 Interstate Insurance Product Regulation Compact. The State of Alabama hereby
agrees to the following interstate compact known as the Interstate Insurance Product Regulation
Compact: ARTICLE I. PURPOSES. The purposes of this compact are, through means of joint and
cooperative action among the compacting states: 1. To promote and protect the interest of
consumers of individual and group annuity, life insurance, disability income, and long-term
care insurance products; 2. To develop uniform standards for insurance products covered under
the compact; 3. To establish a central clearinghouse to receive and provide prompt review
of insurance products covered under the compact and, in certain cases, advertisements related
thereto, submitted by insurers authorized to do business in one or more compacting states;
4. To give appropriate regulatory approval to those product filings and advertisements satisfying
the applicable uniform standard; 5. To improve coordination of...
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22-56-4
Section 22-56-4 Rights. (a) Consumers of mental health services have the same general rights
as other citizens of Alabama. These rights include but are not limited to the following: (1)
The right to exercise rights as a citizen of the United States and the State of Alabama. (2)
The right to be served through general services available to all citizens. (3) The right to
choose to live, work, be educated, and recreate with persons who do not have disabilities.
(4) The right to be presumed competent until a court of competent jurisdiction, abiding by
statutory and constitutional provisions, determines otherwise. (5) The right to vote and otherwise
participate in the political process. (6) The right to free exercise of religion. (7) The
right to own and possess real and personal property. Nothing in this section shall affect
existing laws pertaining to conveyance of real or personal property. (8) The right to make
contracts. (9) The right to obtain a driver's license on the same basis as...
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27-61-1
Section 27-61-1 Surplus Lines Insurance Multi-State Compliance Compact. The Surplus Lines Insurance
Multi-State Compliance Compact Act is enacted into law and entered into with all jurisdictions
mutually adopting the compact in the form substantially as follows: PREAMBLE WHEREAS, with
regard to Non-Admitted Insurance policies with risk exposures located in multiple states,
the 111th United States Congress has stipulated in Title V, Subtitle B, the Non-Admitted and
Reinsurance Reform Act of 2010, of the Dodd-Frank Wall Street Reform and Consumer Protection
Act, hereafter, the NRRA, that: (A) The placement of Non-Admitted Insurance shall be subject
to the statutory and regulatory requirements solely of the insured's Home State, and (B) Any
law, regulation, provision, or action of any State that applies or purports to apply to Non-Admitted
Insurance sold to, solicited by, or negotiated with an insured whose Home State is another
State shall be preempted with respect to such application;...
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27-3A-5
Section 27-3A-5 Standards for utilization review agents. (a) Except as provided in subsection
(b), all utilization review agents shall meet the following minimum standards: (1) Notification
of a determination by the utilization review agent shall be mailed or otherwise communicated
to the provider of record or the enrollee or other appropriate individual within two business
days of the receipt of the request for determination and the receipt of all information necessary
to complete the review. (2) Any determination by a utilization review agent as to the necessity
or appropriateness of an admission, service, or procedure shall be reviewed by a physician
or determined in accordance with standards or guidelines approved by a physician. (3) Any
notification of determination not to certify an admission, service, or procedure shall include
the principal reason for the determination and the procedures to initiate an appeal of the
determination. (4) Utilization review agents shall maintain...
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22-6-122
Section 22-6-122 Medicaid Pharmacy and Therapeutics Committee - Classification and recommendation
of drugs; assurance of quality patient care; review of pharmaceutical products. (a) The Medicaid
Pharmacy and Therapeutics Committee shall review and recommend classes of drugs to the Medicaid
Commissioner for inclusion in the Medicaid Preferred Drug Plan. Class means a therapeutic
group of pharmaceutical agents approved by the FDA as defined by the American Hospital Formulary
Service. The classes of anti-retroviral and anti-psychotic drugs shall not be included in
the Medicaid Preferred Drug Plan. (b) The Medicaid Pharmacy and Therapeutics Committee shall
develop its preferred drug list recommendations by considering the clinical efficacy, safety,
and cost effectiveness of a product. Within each covered class, the committee shall review
and recommend drugs to the Medicaid Commissioner for inclusion on a preferred drug list. Generics
and over the counter drugs covered by Medicaid may be...
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