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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54A-2.htm - 10K - Match Info - Similar pages
27-1-20
Section 27-1-20 Patient Right to Know Act. (a) This section shall be known and may be cited as the "Patient Right to Know Act." (b) As used in this section, unless the context clearly indicates otherwise, the following words shall have the following meanings: (1) ENROLLEE. A person who purchases individual health care coverage or an employer who purchases a group health care plan. (2) PROVIDER. A physician, dentist, podiatrist, pharmacist, optometrist, psychologist, clinical social worker, advanced nurse practitioner, registered optician, licensed professional counselor, physical therapist, and chiropractor. (c)(1) All persons, firms, corporations, associations, health maintenance organizations, health insurance services, or preferred provider organizations, any employer-sponsored health benefit plan, or any similar organization or entity, providing health, accident, or dental insurance coverage, either directly or indirectly, shall provide an enrollee with a written description of the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-20.htm - 3K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19A-12.htm - 2K - Match Info - Similar pages
34-23-184
Section 34-23-184 Audit procedures; report. (a) The entity conducting an audit shall follow these procedures: (1) The pharmacy contract shall identify and describe in detail the audit procedures. (2) The entity conducting the on-site audit shall give the pharmacy written notice at least two weeks before conducting the initial on-site audit for each audit cycle. If the pharmacy benefit manager does not include their auditing guidelines within their provider manual, then the notice must include a documented checklist of all items being audited and the manual, including the name, date, and edition or volume, applicable to the audit and auditing guidelines. For on-site audits a pharmacy benefit manager shall also provide a list of material that is copied or removed during the course of an audit to the pharmacy. The pharmacy benefit manager may document this material on either a checklist or on an audit acknowledgement form. The pharmacy shall produce any items during the course of the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-23-184.htm - 9K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-103.htm - 9K - Match Info - Similar pages
38-15-4
for youths, youth transitional care facility, long term youth residential facility, private alternative boarding school, private alternative outdoor program, and any organization entrusted with the residential care of children in any organizational form or combination defined by this section shall be afforded the following rights and any other rights adopted by the department through rule, which shall be publicly posted and accessible to youth: a. To be afforded dignity in his or her personal relationships with staff, youth, and other persons. b. To live in a safe, healthy, and comfortable environment where he or she is treated with respect. c. To be free from physical, sexual, emotional, or other abuse or corporal punishment. d. To be granted a reasonable level of personal privacy in accommodations, personal care and assistance, and visits. e. To confidential care of his or her records and personal information, and to approve release of those records prior to the release of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/38-15-4.htm - 13K - Match Info - Similar pages
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,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-44-5.htm - 7K - Match Info - Similar pages
26-1A-404
regarding provision, withholding, or withdrawal of life-sustaining treatment and artificially provided nutrition and hydration but only a. if specifically authorized to do so in the durable power of attorney, b. if the substantive provisions of the durable power of attorney are in substantial compliance and if the durable power of attorney is executed and accepted in substantially the same form as set forth in the Alabama Natural Death Act, and c. in instances of terminal illness or injury or permanent unconsciousness, if the authority is implemented in the manner permitted under the Alabama Natural Death Act. All durable powers of attorney executed prior to January 1, 2012, shall be effective to the extent specifically provided therein notwithstanding the provisions of this subsection. The decisions made by the attorney in fact shall be implemented in accordance with the same procedures set forth in the Alabama Natural Death Act for health care proxies. (3) Any authority...
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26-1-2
regarding provision, withholding, or withdrawal of life-sustaining treatment and artificially provided nutrition and hydration but only a. if specifically authorized to do so in the durable power of attorney, b. if the substantive provisions of the durable power of attorney are in substantial compliance and if the durable power of attorney is executed and accepted in substantially the same form as set forth in the Alabama Natural Death Act, and c. in instances of terminal illness or injury or permanent unconsciousness, if the authority is implemented in the manner permitted under the Alabama Natural Death Act. All durable powers of attorney executed prior to May 8, 1997, shall be effective to the extent specifically provided therein notwithstanding the provisions of this subsection. The decisions made by the attorney in fact shall be implemented in accordance with the same procedures set forth in the Alabama Natural Death Act for health care proxies. (3) Any authority granted...
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25-14-9
Section 25-14-9 Written contract; rights and duties of clients; employees, and professional employer organizations. (a) All professional employer organization arrangements shall have a written contract between the client and the professional employer organization recognizing the rights, responsibilities, and duties of each party. The contract shall disclose to the client the services to be rendered by the professional employer organization, including the total administrative fees charged for professional employer organization services, the respective rights and obligations of the parties, and shall provide the following: (1) The professional employer organization reserves a right of direction and control over contract employees and exercises that right in the context of the need to do so according to the terms and conditions of the professional employment agreement. The client, however, as an employer, may retain sufficient direction and control over covered employees necessary to...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-14-9.htm - 12K - Match Info - Similar pages
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