Code of Alabama

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27-52-30
Section 27-52-30 Consultation with State Board of Health. The commissioner shall consult with
the State Board of Health on all aspects related to the provision of medical services under
the Alabama Health Insurance Plan and the Alabama Small Employer Allocation Program established
under this chapter. All regulations, bylaws, policies, guidelines, or directives issued by
the commissioner applicable to the Alabama Health Insurance Plan and the Alabama Small Employer
Allocation Program pertaining to the delivery of medical services, including, but not limited
to, those items specified in subdivisions (8), (13), (14), (15) of Section 27-52-2 and Section
27-52-4, shall be promulgated with the concurrence of the State Board of Health. (Acts 1997,
No. 97-713, p. 1476, §9.)...
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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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22-7A-1
Section 22-7A-1 Physician agreements; dentist agreements. (a) For the purposes of this chapter,
the following words shall have the following meanings: (1) DENTIST. A person licensed to practice
dentistry in this state. (2) DENTIST AGREEMENT or AGREEMENT. A contract between a dentist
and a patient or his or her legal representative in which the dentist or the dentist's medical
practice agrees to provide dental services to the patient for an agreed upon fee and period
of time. (3) DENTIST PRACTICE. A dentist or a dental practice of a dentist that charges a
periodic fee for dental services and which does not bill a third party any additional fee
for services for patients covered under a dental agreement. The per visit charge of the practice
shall be less than the monthly equivalent of the periodic fee. (4) PHYSICIAN. A person licensed
to practice medicine in this state. (5) PHYSICIAN AGREEMENT or AGREEMENT. A contract between
a physician and a patient or his or her legal representative in...
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34-24-125
Section 34-24-125 Chiropractic agreements. (a) For the purposes of this section, the following
words shall have the following meanings: (1) CHIROPRACTOR. A person licensed to practice chiropractic
in this state. (2) CHIROPRACTIC AGREEMENT or AGREEMENT. A contract between a chiropractor
and a patient or his or her legal representative in which the chiropractor or the chiropractor's
chiropractic practice agrees to provide chiropractic services to the patient for an agreed
upon fee and period of time. (3) CHIROPRACTIC PRACTICE. A chiropractor or a chiropractic practice
of a chiropractor that charges a periodic fee for chiropractic services and which does not
bill a third party any additional fee for services for patients covered under a chiropractic
agreement. The per visit charge of the practice shall be less than the monthly equivalent
of the periodic fee. (b) A chiropractic agreement is not insurance, may not be deemed an insurance
arrangement, and is not subject to state insurance...
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27-44-5
territories, or protectorates that do not have an association similar to the association created
by this chapter, shall be deemed residents of the state of domicile of the insurer that issued
the policies or contracts. (19) STATE. A state, the District of Columbia, Puerto Rico, and
a United States possession, territory, or protectorate. (20) STRUCTURED SETTLEMENT ANNUITY.
An annuity purchased in order to fund periodic payments for a plaintiff or other claimant
in payment for or with respect to personal injury suffered by the plaintiff
or other claimant. (21) SUPPLEMENTAL CONTRACT. A written agreement entered into for the distribution
of proceeds under a life, disability, or annuity policy or contract. (22) UNALLOCATED ANNUITY
CONTRACT. An annuity contract or group annuity certificate which is not issued to and owned
by an individual, except to the extent of any annuity benefits guaranteed to an individual
by an insurer under the contract or certificate. (Acts 1982, No. 82-561, p. 922,...
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41-15B-2.2
5. Provision of other forensic services for children when requested by the council. b. The
Department of Forensic Sciences shall prepare an annual accounting of the distribution of
monies received and the effectiveness of programs implemented pursuant to this chapter and
shall file the accounting with the council before July 1. Sufficient safeguards shall be implemented
to ensure that the new monies increase and not supplant or decrease existing state support.
(12) One-half of one percent of the fund shall be allocated to the Department of Rehabilitation
Services for distribution to one or more of the following: a. Early intervention services
for children from birth through age three and services for children who have traumatic brain
injury. b. Child death review teams pursuant to Article 5 of Chapter 16 of Title 26.
The Department of Rehabilitation Services shall work in cooperation with the Department of
Public Health to administer this paragraph. (Act 99-390, p. 628, §3.)...
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27-19-103
would result in economies of acquisition or administration. 3. The benefits are reasonable
in relation to the premiums charged. (5) LONG-TERM CARE INSURANCE. Any insurance policy or
rider advertised, marketed, offered, or designed to provide coverage for not less than 12
consecutive months for each covered person on an expense incurred, indemnity, prepaid, or
other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic,
rehabilitative, maintenance, or personal care services, provided in a setting other
than an acute care unit of a hospital. This term includes group and individual annuities and
life insurance policies or riders that provide directly or that supplement long-term care
insurance. This term also includes a policy or rider that provides for payment of benefits
based upon cognitive impairment or the loss of functional capacity. The term shall also include
qualified long-term care insurance contracts. Long-term care insurance may be...
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16-44B-1
Commission may deem appropriate. The executive director shall serve as secretary to the Interstate
Commission, but shall not be a Member of the Interstate Commission. The executive director
shall hire and supervise such other persons as may be authorized by the Interstate Commission.
D. The Interstate Commission's executive director and its employees shall be immune from suit
and liability, either personally or in their official capacity, for a claim for damage to
or loss of property or personal injury or other civil liability caused or arising
out of or relating to an actual or alleged act, error, or omission that occurred, or that
such person had a reasonable basis for believing occurred, within the scope of Interstate
Commission employment, duties, or responsibilities; provided, that such person shall not be
protected from suit or liability for damage, loss, injury, or liability caused by the
intentional or willful and wanton misconduct of such person. 1. The liability of...
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36-29-3
Section 36-29-3 Factors to be considered by board in design of health insurance plan. The health
insurance plan provided for in this chapter shall be designed by the State Employees' Insurance
Board to provide a reasonable relationship between the hospital, surgical, and medical benefits
to be included and the expected hospital, surgical, and medical expenses to be incurred by
the affected employee and retiree and dependents and to include reasonable controls, which
may include, but are not limited to, deductible, copayment, coinsurance, and other cost containment
measures to prevent unnecessary utilization of the various hospital, surgical, and medical
services available and to provide reasonable assurance of stability in future years for the
plan. (Acts 1965, No. 833, p. 1564, §5; Act 2004-647, 1st Sp. Sess., p. 17, §1.)...
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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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