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27-51-1
Section 27-51-1 Payment for services of licensed physician assistant. (a) An insurance
policy or contract providing for third-party payment or prepayment of health or medical expenses
shall include a provision for the payment to a supervising physician for necessary medical
or surgical services that are provided by a licensed physician assistant practicing under
the supervision of the physician, and pursuant to the rules, regulations, and parameters for
physician assistants, if the policy or contract pays for the same care and treatment provided
by a licensed physician or doctor of osteopathy. (b) An insurance policy or contract subject
to this section shall not impose a practice or supervision restriction which is inconsistent
with or more restrictive than provided by law. (c) This section shall apply to services
provided under a policy or contract delivered, continued, or renewed in this state on or after
August 1, 1997, and to any existing policy or contract, on the policy's or...
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22-21B-3
Section 22-21B-3 Definitions. The following words and terms shall have the meanings
ascribed to them in this section, unless otherwise required by their respective context:
(1) CONSCIENCE. The religious, moral, or ethical principles held by a health care provider.
(2) DISCRIMINATION. Discrimination includes, but is not limited to: Hiring, termination, refusal
of staff privileges, refusal of board certification, demotion, loss of career specialty, reduction
of wages or benefits, adverse treatment in the terms and conditions of employment, refusal
to award any grant, contract, or other program, or refusal to provide residency training opportunities.
(3) HEALTH CARE PROVIDER. Any individual who may be asked to participate in any way in a health
care service, including, but not limited to: A physician, physician's assistant, nurse, nurse's
aide, medical assistant, hospital employee, clinic employee, nursing home employee, pharmacist,
researcher, medical or nursing school faculty, student,...
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22-18-50
Section 22-18-50 Enactment and text of Emergency Medical Services Personnel Licensure
Interstate Compact. The Emergency Medical Services Personnel Licensure Interstate Compact
is hereby enacted into law and entered into with all other jurisdictions legally joining therein
in form substantially as follows: SECTION 1. PURPOSE In order to protect the public
through verification of competency and ensure accountability for patient care related activities
all states license emergency medical services (EMS) personnel, such as emergency medical technicians
(EMTs), advanced EMTs and paramedics. This Compact is intended to facilitate the day to day
movement of EMS personnel across state boundaries in the performance of their EMS duties as
assigned by an appropriate authority and authorize state EMS offices to afford immediate legal
recognition to EMS personnel licensed in a member state. This Compact recognizes that states
have a vested interest in protecting the public's health and safety...
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27-49-3
Section 27-49-3 Definitions. As used in this chapter, the following terms shall have
the following meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, policy, or
contract for health care services issued, delivered, issued for delivery, 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, purchases, or furnishes health care services
to patients, insureds, or beneficiaries in this state. The term includes, but is not limited
to, entities created pursuant to Article 6 of Chapter 4 of Title 10. For the purposes of this
chapter, a health benefit plan located or domiciled outside of the State of Alabama is deemed
to be subject to the provisions of this chapter if it receives, processes,...
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27-19A-12
Section 27-19A-12 Dental services - Coverages; fees; exceptions. (a) As used in this
section, 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) COVERED SERVICES.
Dental care services for which a reimbursement is available under an enrollee's plan contract,
or for which a reimbursement would be available but for the application of contractual limitations
such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums,
frequency limitations, alternative benefit payments, or any other limitation. (3) DENTAL CARE
PROVIDER. A licensed dentist. (4) DENTAL PLAN. Includes any policy of insurance which is issued
by a health care service contractor which provides for coverage of...
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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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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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22-8B-3
Section 22-8B-3 Definitions. As used in this chapter, the following terms shall have
the following meanings: (1) AID IN DYING. The act of a person providing the means or manner
for another person to be able to commit suicide, with actual knowledge that the person deliberately
intends on committing suicide by that means or manner. (2) ARTIFICIALLY PROVIDED NUTRITIONAL
HYDRATION. A medical treatment consisting of the administration of food and water through
a tube or intravenous line, where the recipient is not required to chew or swallow voluntarily.
Artificially provided nutrition and hydration does not include assisted feeding, such as spoon
or bottle feeding. (3) DELIBERATELY. More than knowing the consequences of an act or action;
meaning to consider carefully; done on purpose; intentional; requiring premeditation; with
intent to cause the death of a person. (4) HEALTH CARE PROVIDER. Any individual who may be
asked to participate in any way in a health care service, including, but...
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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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22-6-163
Section 22-6-163 Legislative findings; rules; collaboration; approval of agreements
and contracts; state action immunity; confidentiality of records; additional duties. (a) The
Legislature declares that collaboration among public payers, private health carriers, third
party purchasers, and providers to identify appropriate service delivery systems and reimbursement
methods in order to align incentives in support of integrated and coordinated health care
delivery is in the best interest of the public. Collaboration pursuant to this article is
to provide quality health care at the lowest possible cost to Alabama citizens who are Medicaid
eligible. The Legislature, therefore, declares that this health care delivery system affirmatively
contemplates the foreseeable displacement of competition, such that any anti-competitive effect
may be attributed to the state's policy to displace competition in the delivery of a coordinated
system of health care for the public benefit. In furtherance of...
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