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27-54-4
Section 27-54-4 Illnesses covered; requirements of benefit plans, etc. (a) All group health
benefit plans shall offer to provide, at a minimum, additional benefits according to this
chapter for a person receiving medical treatment for any of the following mental illnesses
diagnosed by an appropriately licensed provider. (1) Schizophrenia, schizophrenia form disorder,
schizo affective disorder. (2) Bipolar disorder. (3) Panic disorder. (4) Obsessive-compulsive
disorder. (5) Major depressive disorder. (6) Anxiety disorders. (7) Mood disorders. (8) Any
condition or disorder involving mental illness, excluding alcohol and substance abuse, that
falls under any of the diagnostic categories listed in the mental disorders section of the
International Classification of Disease, as periodically revised. (b) All group health benefit
plans, policies, contracts, and certificates executed, delivered, issued for delivery, continue,
or renewed in this state on or after January 1, 2001, shall offer, at...
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20-2-58
Section 20-2-58 Dispensing of controlled substances in Schedule II; maintenance of records
and inventories by registered pharmacies. (a) Except as otherwise provided in this section
or as otherwise provided by law, a pharmacist may dispense directly a controlled substance
in Schedule II only pursuant to a written prescription signed by the practitioner. Except
as provided in subsections (b) and (c), a prescription for a Schedule II controlled substance
may be transmitted by the practitioner or the agent of the practitioner to a pharmacy via
facsimile equipment; provided, the original written, signed prescription is presented to the
pharmacist for review prior to the actual dispensing of the controlled substance. (b) A prescription
written for a Schedule II narcotic substance to be compounded for the direct administration
to a patient by parenteral, intravenous, intramuscular, subcutaneous, or intraspinal infusion
may be transmitted by the practitioner or the agent of the practitioner...
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27-1-11
Section 27-1-11 Dentists and dental hygienists as "physicians" under health or accident
insurance policies. Whenever the terms "physician" and/or "doctor" are
used in any policy of health or accident insurance issued in this state or in any contract
for the provision of health care, services, or benefits issued by any health, medical or other
service corporation existing under, and by virtue of any laws of this state, said terms shall
include within their meaning those persons licensed under and in accordance with Chapter 9
of Title 34 in respect to any care, services, procedures, or benefits covered by said policy
of insurance or health care contract which the said persons are licensed to perform, any provisions
in any such policy of insurance or health care contract to the contrary notwithstanding. This
section shall be applicable to all policies in this state, regardless of date of issue, on
October 10, 1975. (Acts 1975, No. 1241, p. 2607, §1.)...
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27-54-5
Section 27-54-5 Implementation of coverage. (a) A group health benefit plan, policy, or contract
that provides coverage for the services to be offered pursuant to this chapter may contain
provisions for maximum benefits and coinsurance and limitations, deductibles, exclusions,
and utilization review protocols to the extent that these provisions are not inconsistent
with the requirements of this chapter. (b) The issuer of a group health benefit plan, policy,
or contract may either disclose the additional premium for such additional mental health benefits
to the prospective contract holder and allow the contract holder to elect such additional
benefits on an optional basis; or conform its policies, contracts, or certificates issued
on and after January 1, 2001, and adjust its premium costs to reflect the additional benefit
costs. (Act 2000-386, p. 605, §6.)...
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11-26-5
Section 11-26-5 Health and accident group to file bylaws and schedules with Insurance Commissioner;
group exempt from regulation and tax. Each health and accident self-insurance group established
under the provisions of this chapter shall file with the State Insurance Commissioner, a copy
of its bylaws and schedule of benefits and charges. Such group, however, shall be exempt from
regulation by the Department of Insurance of the State of Alabama and all premiums or charges
collected shall be exempt from insurance premium tax. (Acts 1981, No. 81-265, p. 348, §5.)...
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20-2-213
Section 20-2-213 Reporting requirements. (a) Each of the entities designated in subsection
(b) shall report to the department, or to an entity designated by the department, controlled
substances prescription information as designated by regulation pertaining to all Class II,
Class III, Class IV, and Class V controlled substances in such manner as may be prescribed
by the department by regulation. (b) The following entities or practitioners are subject to
the reporting requirements of subsection (a): (1) Licensed pharmacies, not including pharmacies
of general and specialized hospitals, nursing homes, and any other health care facilities
which provide inpatient care, so long as the controlled substance is administered and used
by a patient on the premises of the facility. (2) Mail order pharmacies or pharmacy benefit
programs filling prescriptions for or dispensing controlled substances to residents of this
state. (3) Licensed physicians, dentists, podiatrists, or optometrists who...
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27-45-2
Section 27-45-2 Definitions. As used in this article, the following terms shall have the respective
meanings herein set forth, unless the context shall otherwise require: (1) ALABAMA INSURANCE
CODE. Title 27 of the Code of Alabama 1975. (2) INSURER. Such term shall have the meaning
ascribed in Section 27-1-2. (3) PERSON. Such term shall have the meaning ascribed in Section
27-1-2. (4) COMMISSIONER and DEPARTMENT. Such terms, respectively, shall have the meanings
ascribed in Section 27-1-2. (5) CONTRACTUAL OBLIGATION. Any obligation under covered policies
or employee benefit plans. (6) COVERED POLICY OR PLAN. Any policy, employee benefit plan,
or contract within the scope of this article. (7) HEALTH INSURANCE POLICY. Any individual,
group, blanket, or franchise insurance policy, insurance agreement, or group hospital service
contract providing for pharmaceutical services, including without limitation, prescription
drugs, incurred as a result of accident or sickness, or to prevent same....
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27-54-6
Section 27-54-6 Cost report. Every issuer of a group health benefit plan subject to this chapter
shall provide a cost report for each calendar year to the Commissioner of Insurance no later
than April 30th of the following year. The report shall be in a form prescribed by the commissioner
and shall include certification of parity in mental health benefits and total annual costs
of mental health services relative to total health costs. The commissioner shall compile this
data for all health benefit plans in an annual report solely for the purpose of demonstrating
the health cost impact of the requirements of this chapter. (Act 2000-386, p. 605, §7.)...
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27-57-5
Section 27-57-5 Coverage by participating providers; selection criteria and utilization protocols;
maximum benefits, exclusions, etc. (a) This chapter does not require and shall not be construed
to require the coverage of services of providers who are not designated as covered providers,
or who are not selected as a participating provider, by a group health benefit plan or insurer
having a participating network of service providers. Nothing in this chapter is intended to
expand the list or designation of participating providers as specified in any health benefit
plan. (b) Insurers or other issuers of any health benefit plan covered by this chapter shall
continue to be able to establish and apply selection criteria and utilization protocols for
health care providers including the designation of types of providers for which coverage is
provided as well as credentialing criteria used in the selection of providers. (c) A group
health benefit plan, policy, or contract that provides coverage...
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27-58-4
Section 27-58-4 Benefits subject to annual deductible, coinsurance, exclusions, reductions,
etc. (a) The benefits provided in this chapter shall be subject to the same annual deductible
or coinsurance established for all covered benefits within a given policy. Private third party
payors may not reduce or eliminate coverage due to the requirements of this chapter. (b) A
health benefit plan subject to this chapter shall not terminate services, reduce capitation
payment, or otherwise penalize an attending physician or health care provider who orders medical
care consistent with this chapter. (c) Nothing in this chapter is intended to expand the list
of designations of covered providers as specified in any health benefit plan. (Act 2007-389,
p. 778, §4.)...
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