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22-6-220
Section 22-6-220 Definitions. For the purposes of this article, the following words
shall have the following meanings: (1) CAPITATION PAYMENT. A payment the state Medicaid Agency
makes periodically to the integrated care network on behalf of each recipient enrolled under
a contract for the provision of medical services pursuant to this article. (2) COLLABORATOR.
A private health carrier, third party purchaser, provider, health care center, health care
facility, state and local governmental entity, or other public payers, corporations, individuals,
and consumers who are expecting to collectively cooperate, negotiate, or contract with another
collaborator, or integrated care network in the health care system. (3) INTEGRATED CARE NETWORK.
One or more statewide organizations of health care providers, with offices in each regional
care organization region, that contracts with the Medicaid Agency to provide Medicaid benefits
to certain Medicaid beneficiaries as defined in subdivision (4) and...
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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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22-21-20
Section 22-21-20 Definitions. For the purpose of this article, the following terms shall
have the meanings respectively ascribed to them by this section: (1) HOSPITALS. General
and specialized hospitals, including ancillary services; independent clinical laboratories;
rehabilitation centers; ambulatory surgical treatment facilities for patients not requiring
hospitalization; end stage renal disease treatment and transplant centers, including free-standing
hemodialysis units; abortion or reproductive health centers; hospices; health maintenance
organizations; and other related health care institutions when such institution is primarily
engaged in offering to the public generally, facilities and services for the diagnosis and/or
treatment of injury, deformity, disease, surgical or obstetrical care. Also included within
the term are long term care facilities such as, but not limited to, skilled nursing facilities,
intermediate care facilities, assisted living facilities, and specialty...
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27-50-3
Section 27-50-3 Health benefit plan. As used in this chapter, the term "health
benefit plan" has the following meaning: 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 business entity that
pays for, purchases, or furnishes health care services to patients, insureds, or beneficiaries
in this state. The term does not include accident-only, specified disease, individual hospital
indemnity, credit, dental-only, Medicare-supplement, long-term care, or disability income
insurance; coverage issued as a supplement to liability insurance, workers' compensation or
similar insurance; or automobile medical-payment insurance. For the purpose of this chapter,
a health benefit plan located or domiciled outside of the State of...
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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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29-2-106
Section 29-2-106 State Case Registry of Children in State Care. (a) The Department of
Human Resources, the Department of Mental Health, and the Department of Youth Services shall
create a joint project team to develop a requirements analysis and conceptual design for maintaining
a central repository of case information within 12 months of May 6, 1998, which shall be known
as the State Case Registry of Children in State Care and shall contain records with respect
to the following: (1) The number of children in state care. (2) The amount of funds expended
by federal, state, and local governments for maintenance payments on behalf of children in
state care. (3) The amount of funds expended by federal, state, and local governments for
payments on behalf of each child in state care and their natural parents or guardians. (4)
The types of services being offered to parents and their children in order to keep the family
together. (5) The number of children in foster care eligible for adoption,...
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27-58-1
Section 27-58-1 Definitions. As used in this chapter, the following terms shall have
the following meanings: (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 chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
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27-59-1
Section 27-59-1 Definitions. As used in this chapter, the following terms shall have
the following meanings: (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 chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
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27-1-22
Section 27-1-22 Uniform prescription drug information card or technology. (a) Every
health benefit plan that provides coverage for prescription drugs or devices, or administers
a plan, including, but not limited to, third party administrators for self-insured plans and
state administered plans, excluding the Alabama Medicaid Program, shall issue to its insureds
a card or other technology containing prescription drug information. The uniform prescription
drug information card or technology shall be in the format approved by the National Council
for Prescription Drug Programs (NCPDP) and shall include all of the required fields and conform
to the most recent pharmacy ID card or technology implementation guide produced by NCPDP or
conform to a national format acceptable to the Commissioner of Insurance. If a health care
plan includes a conditional or situational field, it shall conform to the most recent pharmacy
information card or technology implementation guide by the NCPDP or conform...
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27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household
member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting
to cause or intentionally, knowingly, or recklessly causing another person, including a minor
child, bodily injury, severe emotional injury, or psychological trauma or conduct which constitutes
the crime of rape. b. Intentionally following another person, including a minor child, without
proper authority, under circumstances that place the person in reasonable fear of bodily injury
or physical harm. c. Subjecting another person, including a minor child, to false imprisonment
or kidnapping. d. Attempting to cause or intentionally, knowingly, or recklessly causing damage
to property to intimidate or attempt to control the behavior of another person, including
a minor child. e. Assault, child abuse, criminal...
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