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27-21A-15
Section 27-21A-15 Powers of insurers and health care service plans. (a) An insurance company
licensed in this state, or a health care service plan authorized to do business in this state,
may either directly or through a subsidiary or affiliate organize and operate a health maintenance
organization under the provisions of this chapter. Notwithstanding any other law which may
be inconsistent herewith, any two or more such insurance companies, health care service plans,
or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance
organization. The business of insurance is deemed to include the providing of health care
by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.
(b) Notwithstanding any provision of insurance and health care service plan laws, Title 10,
Chapter 4, Article 6 and Title 27, an insurer or a health care service plan may contract with
a health maintenance organization to provide insurance or...
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34-23-183
Section 34-23-183 Application. This article shall apply to any audit of the records of a pharmacy
conducted by a managed care company, nonprofit hospital or medical service organization, health
benefit plan, third-party payor, pharmacy benefit manager, a health program administered by
a department of the state, except the Alabama Medicaid Agency, or any entity that represents
those companies, groups, or department. (Act 2012-306, p. 668, §4; Act 2018-457, §1.)...
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22-4-13
Section 22-4-13 Preparation, review, and revision of State Medical Facilities Plan. Upon the
adoption of federal regulations pursuant to Title XVI of the Public Health Service Act, the
State Board of Health is hereby authorized and required to prepare, review and revise, at
least annually, with such interim revisions as may become necessary, a Medical Facilities
Plan, which shall include all health care facilities defined in Section 22-4-2, shall divide
the State of Alabama into health service areas and, based on population and health facility
utilization statistics and such other criteria as the State Board of Health may direct, set
forth the need for health care facilities in such numbers and locations that all citizens
of the state shall have access to an integrated and interrelated system of health care. The
State Medical Facilities Plan shall consider the medical facilities plans of the health systems
agencies and shall be submitted to the Statewide Health Coordinating Council for...
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22-11A-63
Section 22-11A-63 Investigation by State Health Officer. (a) Upon notification of the existence
of an infected health care worker, the State Health Officer shall undertake an investigation
of the practice of the health care worker. In the investigation, the State Health Officer
shall seek advice of individuals and organizations deemed necessary. The investigation shall
determine if the infected health care worker performs invasive procedures. If the health care
worker is determined not to perform invasive procedures, no review panel shall be established,
no restrictions shall be placed on his or her practice, and all information obtained in the
investigation shall be confidential as provided for in Section 22-11A-69. If the infected
health care worker is determined to perform invasive procedures, the State Health Officer
shall cause an expert review panel to be formed. To the extent possible, the review shall
be conducted so that the identity of the health care worker shall not be...
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22-11D-4
Section 22-11D-4 Verification and certification of trauma or health care center status. (a)
With the advice of and after approval of the council, the board may adopt rules for verification
and certification of trauma or health care center status which assign level designations based
on resources available within the facility. Rules shall be based upon national guidelines,
including, but not limited to, those established by the American College of Surgeons, the
Joint Commission of Accreditation of Health Care Organizations, in Hospital and Pre-hospital
Resources for Optimal Care of the Injured Patient, and any published appendices thereto. Rules
specific to rural and urban areas shall be developed and adopted by rule of the board. (b)
Any medical facility that desires to be a designated trauma or other health care center shall
request a designation from the department whereby the medical facility agrees to maintain
a level of commitment and resources sufficient to meet the...
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22-21B-4
Section 22-21B-4 Participation in a health care service that violates the conscience of health
care provider; written objection; liability. (a) A health care provider has the right not
to participate, and no health care provider shall be required to participate, in a health
care service that violates his or her conscience when the health care provider has objected
in writing prior to being asked to provide such health care services. (b) When objecting in
writing in accordance with this chapter, no health care provider shall be civilly, criminally,
or administratively liable for declining to participate in a health care service that violates
his or her conscience except when failure to do so would immediately endanger the life of
a patient. (c) It shall be unlawful for any person, health care provider, health care institution,
public or private institution, public official, or any board which certifies competency in
medical or health care specialties to discriminate against any health...
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22-11A-60
Section 22-11A-60 Definitions. As used in this article, the following words shall have the
following meanings: (1) HEALTH CARE FACILITY. A hospital, nursing home, ambulatory surgical
center, outpatient surgical facility, ambulance service, rescue squad, paid fire department,
volunteer fire department, or any other clinic, office, or facility in which medical, dental,
nursing, or podiatric services are offered. (2) HEALTH CARE WORKER. Physicians, dentists,
nurses, respiratory therapists, phlebotomists, surgical technicians, physician assistants,
podiatrist, dialysis technicians, emergency medical technicians, paramedics, ambulance drivers,
dental hygienists, dental assistants, students in the healing arts, or any other individual
who provides or assists in the provision of medical, dental, or nursing services. (3) HEPATITIS
B VIRUS (HBV) INFECTION. The presence of the HBV as determined by the presence of hepatitis
B(e) antigen for six months or longer or by other means as determined by...
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27-56-2
Section 27-56-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) COVERED PERSON. Any individual, family, or family member on whose behalf third-party
payment or prepayment of health or medical expenses is provided under an insurance policy,
plan, or contract providing for third-party payment or prepayment of health care or medical
expenses. (2) EYE CARE PROVIDER. A licensed optometrist or a licensed ophthalmologist. (3)
INSURANCE POLICY, PLAN, OR CONTRACT PROVIDING FOR THIRD-PARTY PAYMENT OR PREPAYMENT OF HEALTH
OR MEDICAL EXPENSES. Includes an individual or group policy for accident or health insurance,
an individual or group hospital or health care service contract, an individual or group health
maintenance organization contract, an organized delivery system contract, or a preferred provider
organization contract, and any other similar policy, plan, or contract. This term shall not
include any employee welfare benefit plan, as defined...
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34-14C-5
Section 34-14C-5 Exemptions. The licensure requirements of this chapter do not apply to the
following entities or practitioners: (1) Home health agencies certified by the State of Alabama
to participate in the Medicare and Medicaid programs. (2) Hospital based home medical equipment
services, whether or not the services are provided through a separate corporation or other
business entity. (3) Health care practitioners legally eligible to order or prescribe home
medical equipment, or who use home medical equipment to treat patients in locations other
than the patient's residence, including, but not limited to, physicians, nurses, physical
therapists, respiratory therapists, speech therapists, occupational therapists, optometrists,
chiropractors, and podiatrists, except for those practitioners, other than a licensed physician
practicing medicine, who provide home medical equipment services in a patient's residence.
Nothing in this chapter shall be construed as prohibiting or restricting...
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22-11A-67
Section 22-11A-67 Records and information necessary to assist investigation. (a) Any health
care worker found to have HBV, HIV, or HCV, or other disease designated by the State Board
of Health and any health care facility at which an infected health care worker is employed
or practices shall make available to the State Board of Health, and to the expert review panel,
any and all patient medical records and other records requested by those groups, except that
records or documents greater than three years old shall not be provided. (b) The following
persons and facilities shall provide to the State Board of Health and the expert review panel
all requested documents or records three years old or less: (1) Any person having knowledge
of a health care worker diagnosed as infected with HIV, HBV, HCV, or other disease designated
by the State Board of Health. (2) The administrator of any health facility having knowledge
of a health care worker diagnosed as infected with HIV, HBV, HCV, or other...
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