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26-23C-2
Section 26-23C-2 Legislative findings. (a) The Legislature of the State of Alabama finds all
of the following: (1) Under the Patient Protection and Affordable Care Act, P.L. 111-148,
federal tax dollars, via affordability credits, subsidies provided to individuals between
150-400 percent of the federal poverty level, are routed to exchange participating health
insurance plans, including plans that provide coverage for abortions. (2) Federal funding
of insurance plans that provide abortions is an unprecedented change in federal abortion funding
policy. The Hyde Amendment, as passed each year in the Labor Health and Human Services Appropriations
bill, and the Federal Employee Health Benefits Program, FEHBP, prohibit federal funds from
subsidizing health insurance plans that provide abortions. Under this new law, however, exchange
participating health insurance plans that provide abortions can receive federal funds. (3)
The provision of federal funding for health insurance plans that...
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36-29-19.2
Section 36-29-19.2 The State Employees' Insurance Board may offer supplemental coverage. The
board may no later than January 1, 2006, offer employees a supplemental coverage to other
employer group health insurance coverage. (1) For employees who have spouses with other employer
group health insurance coverage available to them through their employer, or previous employer,
the board may provide such employees with a supplemental coverage to the other employer group
health insurance coverage in lieu of coverage in the basic medical plan of the State Employees'
Health Insurance Plan. (2) An employer that provides its employees and their spouses with
other employer group health insurance coverage may not exclude an employee, as defined under
Section 36-29-1, or his or her spouse from coverage by application of a provision which does
not also apply on the same terms and conditions to other employees or their spouses. No provision
of this section requires an employer to amend its plan to...
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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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34-23-116
Section 34-23-116 Article not applicable to certain services. This article shall not apply
to any services rendered pursuant to provisions of the Alabama Medicaid Program, to the Public
Education Employees' Health Insurance Plan, or to any corporation organized under the provisions
of Title 10, Chapter 4, Article 6, for establishment and operation of health care service
plans. (Acts 1981, No. 81-337, p. 477, §7; Acts 1983, No. 83-637, p. 986, §§1, 2; Act 2012-478,
p. 1325, §1.)...
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16-25A-5.1
Section 16-25A-5.1 Supplemental policy to provide secondary coverage for employees. The board
may, no later than January 1, 2006, offer employees a supplemental policy that provides secondary
coverage to other employer group coverage. (1) For employees who have spouses with other employer
group health insurance coverage available to them through their employer or previous employer,
the board may provide such employees and retirees with a supplemental coverage policy to the
other employer group health insurance coverage in lieu of full basic medical plan coverage
through the plan. (2) An employer that provides its employees and their spouses with other
employer group health insurance coverage may not exclude an employee, as defined under Section
16-25A-1(1), or his or her spouse from coverage by application of a provision which does not
also apply on the same terms and conditions to other employees or their spouses. No provision
of this section requires an employer to amend its plan to...
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27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases shall
have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health. (2)
ENROLLEE. An individual who has contracted for or who participates in coverage under an insurance
policy, a health maintenance organization contract, a health service corporation contract,
an employee welfare benefit plan, a hospital or medical services plan, or any other benefit
program providing payment, reimbursement, or indemnification for health care costs for the
individual or the eligible dependents of the individual. (3) PROVIDER. A health care provider
duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system for prospective
and concurrent review of the necessity and appropriateness in the allocation of health care
resources and services given or proposed to be given to an individual within this state. The
term does not include elective requests for clarification of...
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36-29-6
Section 36-29-6 Authorization and execution of contracts; documentation of benefits. (a) The
board is hereby authorized to execute a contract or contracts to provide the plan determined
in accordance with the provisions of this chapter. Such contract or contracts may be executed
with one or more agencies or corporations licensed to transact or administer group health
insurance business in this state. All of the benefits to be provided under this chapter may
be included in one or more similar contracts issued by the same or different companies. (b)
Before entering into any contract or contracts authorized by subsection (a) of this section,
the board shall invite competitive bids from all qualified entities who may wish to administer
or offer plans for the health insurance coverage desired. The board shall award such contract
or contracts on a competitive basis as determined by the benefits afforded, administrative
costs, the costs to be incurred by employee, retiree, and employer, the...
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36-29-50
Section 36-29-50 High deductible health plan with a federally qualified health savings account.
(a) As used in this section, the following words shall have the following meanings: (1) HEALTH
SAVINGS ACCOUNT or HSA. A savings or other account meeting the requirements for favorable
tax treatment under 26 U.S.C. §223, as amended. (2) HIGH DEDUCTIBLE HEALTH PLAN or HDHP.
That term as defined in 26 U.S.C. §223(c)(2), as amended, and any regulations promulgated
thereunder. (3) PARTICIPANT. An eligible active or retired state employee and his or her dependents
as determined by the State Employees' Insurance Board. (b) The State Employees' Insurance
Board may offer a high deductible health plan with a federally qualified health savings account
(HDHP-HSA) to eligible active and retired state employees and their dependents. A retired
state employee eligible for or entitled to Medicare benefits under Title XVIII of the federal
Social Security Act is not eligible to participate in the HDHP-HSA....
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22-6-120
Section 22-6-120 Legislative findings. The Legislature finds the following: (1) The availability
of appropriate pharmaceutical benefits to every Alabama citizen is a critical component to
the overall health of its population. (2) Alabama should strive to provide appropriate, safe,
effective, and cost-efficient pharmaceutical care to those who depend on health benefits through
state funded programs. (3) The Alabama Medicaid Agency should endeavor to manage the Medicaid
Pharmacy Program utilizing clinical management tools in a manner to foster optimal health
outcomes at reasonable costs. (4) State Medicaid programs and private insurance plans across
the country utilize preferred drug lists as an effective way to foster and encourage clinically
appropriate and safe use of pharmaceuticals in a cost-effective manner. (5) Based on the proven
effectiveness of preferred drug programs to foster appropriate use of drugs, it is in the
best interests of Alabama and its citizens for the Alabama...
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27-21-1
Section 27-21-1 Purpose of chapter. The Legislature of Alabama takes cognizance of the existence
of many Alabama citizens who are unable to obtain adequate health care protection by reason
of economic, physical, or other related causes. It is the purpose of the Legislature to provide
adequate health care protection through this plan to those persons not otherwise able to obtain
such protection by insurance companies or voluntary association on a nonprofit basis. (Acts
1971, No. 501, p. 1218.)...
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