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34-23-181
Section 34-23-181 Definitions. The following words shall have the following meanings as used
in this article: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare benefit
plan, policy, or contract for health care services issued, delivered, issued for delivery,
or 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 insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this article if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or...
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22-13A-5
Section 22-13A-5 Needs assessment; list of services and providers. (a) The department shall
conduct a needs assessment to identify any or all of the following: (1) Research being conducted
within the state. (2) Available technical assistance and educational materials and programs
nationwide. (3) The level of public and professional awareness about osteoporosis. (4) The
needs of osteoporosis patients, their families, and caregivers. (5) Needs of health care providers,
including physicians, nurses, managed care organizations, and other health care providers.
(6) The services available to the osteoporosis patient. (7) Existence of osteoporosis treatment
programs. (8) Existence of osteoporosis support groups. (9) Existence of rehabilitation services.
(10) The number and location of bone density testing equipment. (b) Based on the needs assessment,
the department shall develop and maintain a list of osteoporosis-related services and osteoporosis
health care providers with specialization in...
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27-21A-23
Section 27-21A-23 Statutory construction and relationship to other laws. (a) Except as otherwise
provided in this chapter, provisions of the insurance law and provisions of health care service
plan laws shall not be applicable to any health maintenance organization granted a certificate
of authority under this chapter. This provision shall not apply to an insurer or health care
service plan licensed and regulated pursuant to the insurance law or the health care service
plan laws of this state except with respect to its health maintenance organization activities
authorized and regulated pursuant to this chapter. (b) Solicitation of enrollees by a health
maintenance organization granted a certificate of authority shall not be construed to violate
any provision of law relating to solicitation or advertising by health professionals. (c)
Any health maintenance organization authorized under this chapter shall not be deemed to be
practicing medicine and shall be exempt from the provisions of...
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27-26-2
Section 27-26-2 Purpose of chapter. It is hereby declared by the Legislature of the State of
Alabama that the availability of medical liability insurance at reasonable rates for the medical
profession, medical institutions, and other health care providers is essential to provide
adequate health services to the people of Alabama, and without such insurance, medical services
by the medical profession may be curtailed, and that while the need for such insurance is
increasing, availability is limited and likely to become increasingly so, unless remedial
legislation is enacted. The Legislature further finds and declares that by reason of complicated
and highly technical medical concepts, and the existence of sophisticated medical techniques,
decisions with respect to optional procedures of diagnosis and treatment have become increasingly
complex and are necessarily made on the basis of professional judgment, on which opinions
may and often will reasonably vary. It is the purpose of this...
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27-58-1
Section 27-58-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare benefit
plan, policy, or contract for health care services issued, delivered, issued for delivery,
or 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 insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
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34-14C-5
Section 34-14C-5 Exemptions. The licensure requirements of this chapter do not apply to the
following entities or practitioners: (1) Home health agencies certified by the State of Alabama
to participate in the Medicare and Medicaid programs. (2) Hospital based home medical equipment
services, whether or not the services are provided through a separate corporation or other
business entity. (3) Health care practitioners legally eligible to order or prescribe home
medical equipment, or who use home medical equipment to treat patients in locations other
than the patient's residence, including, but not limited to, physicians, nurses, physical
therapists, respiratory therapists, speech therapists, occupational therapists, optometrists,
chiropractors, and podiatrists, except for those practitioners, other than a licensed physician
practicing medicine, who provide home medical equipment services in a patient's residence.
Nothing in this chapter shall be construed as prohibiting or restricting...
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22-11A-60
Section 22-11A-60 Definitions. As used in this article, the following words shall have the
following meanings: (1) HEALTH CARE FACILITY. A hospital, nursing home, ambulatory surgical
center, outpatient surgical facility, ambulance service, rescue squad, paid fire department,
volunteer fire department, or any other clinic, office, or facility in which medical, dental,
nursing, or podiatric services are offered. (2) HEALTH CARE WORKER. Physicians, dentists,
nurses, respiratory therapists, phlebotomists, surgical technicians, physician assistants,
podiatrist, dialysis technicians, emergency medical technicians, paramedics, ambulance drivers,
dental hygienists, dental assistants, students in the healing arts, or any other individual
who provides or assists in the provision of medical, dental, or nursing services. (3) HEPATITIS
B VIRUS (HBV) INFECTION. The presence of the HBV as determined by the presence of hepatitis
B(e) antigen for six months or longer or by other means as determined by...
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22-11D-10
Section 22-11D-10 Statewide Health System Fund. (a) The Statewide Health System Fund is created.
The department shall distribute funding allocated to the department for the purpose of creating,
administering, maintaining, or enhancing the statewide health system. The department may apply
for, receive, and accept gifts and other payments, including property and services, for the
fund from any governmental or other public or private entity or person and may utilize the
fund for activities related to the design, administration, operation, maintenance, or enhancement
of the statewide health system. (b) The methodology of distribution of funds and allocation
of funds shall be established by the council and subsequently adopted by the board pursuant
to the Administrative Procedure Act. Fund allocation to health care centers shall be based
upon the designated level of health care and the number of qualified patients directed through
the health care centers, as defined by the rules of the...
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27-50-3
Section 27-50-3 Health benefit plan. As used in this chapter, the term "health benefit
plan" has the following meaning: A health insurance policy, including a self-insured
health plan, that covers hospital, medical, or surgical expenses, health maintenance organizations,
preferred provider organizations, medical service organizations, physician-hospital organizations,
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 does not include accident-only, specified disease, individual hospital
indemnity, credit, dental-only, Medicare-supplement, long-term care, or disability income
insurance; coverage issued as a supplement to liability insurance, workers' compensation or
similar insurance; or automobile medical-payment insurance. For the purpose of this chapter,
a health benefit plan located or domiciled outside of the State of...
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27-56-7
Section 27-56-7 Applicability to certain providers. (a) This chapter does not require and shall
not be construed to require any insurance policy, plan, or contract to provide health care
coverage for eye care. The provisions of this chapter are applicable only to those insurance
policies, plans, or contracts which provide coverage for eye care. (b) Insurers or other issuers
of any insurance policy, plan, or contract which provides coverage for eye care shall continue
to be able to establish and apply selection criteria and utilization protocols for health
care providers as well as credentialing criteria used in the selection of providers. (c) This
chapter does not require and shall not be construed to require the coverage of eye care services
by providers who are not designated as covered providers, or who are not selected as participating
providers, by an insurance policy, plan, or contract, or the issuer thereof having a participating
network of service providers. Provided, however,...
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