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27-1-19
Section 27-1-19 Reimbursement of health care providers. (a) The insured, or health or dental
plan beneficiary may assign reimbursement for health or dental care services directly to the
provider of services. Health benefits include medical, pharmacy, podiatric, chiropractic,
optometric, durable medical equipment, and home care services. The company or agency, when
authorized by the insured, or health or dental plan beneficiary, shall pay directly to the
health care provider the amount of the claim, under the same criteria and payment schedule
that would have been reimbursed directly to the contract provider, and any applicable interest.
This amount only applies to assigned claims. Any company or agency making a payment to the
insured, or health or dental plan beneficiary, after the rights of reimbursement have been
assigned to the provider of services, shall be liable to the provider for the payment. If
the company or agency fails to reimburse the provider in accordance with the terms...
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27-1-4
Section 27-1-4 Applicability of title - Exemptions. This title shall not apply as to: (1) Any
fraternal or other organization or activity which is exempted from the provisions of Chapter
34 under Section 27-34-5, except to the extent provided in such section; (2) Nonprofit corporations
for establishment of hospitalization plan under Section 10-4-100 et seq., except to the extent
now or hereafter provided in such laws; (3) The insurance department of a brotherhood or labor
union, the members of which are subject to the act of Congress known as the Railway Labor
Act; or (4) The establishment, maintenance, administration, and operation of any trust established
pursuant to Section 22-21-240 by agreement of any hospitals, other health care units or dental
practitioners licensed as such by the State of Alabama. (Acts 1971, No. 407, p. 707, §12;
Acts 1977, No. 166, p. 226, §1; Acts 1978, 2nd Ex. Sess., No. 24, p. 1703, §1.)...
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27-19A-7
Section 27-19A-7 Contracting directly with patient; distribution of information about policy
or plan; payment and reimbursement procedures. The provisions of this chapter do not prohibit
the following conduct and shall be construed to provide that: (1) A dentist may contract directly
with a patient for the furnishing of dental care services to said patient as may be otherwise
authorized by law; (2) Any person providing a health insurance policy or employee benefit
plan, or an employer, or an employee organization may: a. Make available to its insureds,
beneficiaries, participants, employees, or members information relating to dental care services
by the distribution of factually accurate information regarding dental care services, rates,
fees, location, and hours of service, provided such distribution is made upon the request
of any dentist licensed by this state; or b. Establish an administrative mechanism which facilitates
payment for dental care services by insureds, beneficiaries,...
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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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34-9-7
Section 34-9-7 Exemption of certain practices and operations. (a) Nothing in this chapter shall
apply to the following practices, acts, and operations: (1) The practice of his or her profession
by a physician or surgeon holding a certificate of qualification as a medical doctor and licensed
as such under the laws of this state, provided he or she shall not practice dentistry as a
specialty. (2) The practice of dentistry in the discharge of their official duties by graduate
dentists or dental surgeons in the United States Army, Navy, Air Force, or other armed services,
public health service including, but not limited to, a federally qualified health center authorized
and operating under Section 330 of the Public Health Service Act (42 U.S.C. § 254B), provided,
however, that such federally qualified health centers shall register pursuant to Section 34-9-7.2
(provided further however, dentists, dental hygienists, and other personnel employed by any
public health service which performs...
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38-9-2
Section 38-9-2 Definitions. For the purposes of this chapter, the following terms shall have
the following meanings: (1) ABUSE. The infliction of physical pain, injury, or the
willful deprivation by a caregiver or other person of services necessary to maintain mental
and physical health. (2) ADULT IN NEED OF PROTECTIVE SERVICES. A person 18 years of age or
older whose behavior indicates that he or she is mentally incapable of adequately caring for
himself or herself and his or her interests without serious consequences to himself or herself
or others, or who, because of physical or mental impairment, is unable to protect himself
or herself from abuse, neglect, exploitation, sexual abuse, or emotional abuse by others,
and who has no guardian, relative, or other appropriate person able, willing, and available
to assume the kind and degree of protection and supervision required under the circumstances.
(3) CAREGIVER. An individual who has the responsibility for the care of a protected...
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22-21-265
Section 22-21-265 Certificates of need - Required for new institutional health service. (a)
On or after July 30, 1979, no person to which this article applies shall acquire, construct,
or operate a new institutional health service, as defined in this article, or furnish or offer,
or purport to furnish a new institutional health service, as defined in this article, or make
an arrangement or commitment for financing the offering of a new institutional health service,
unless the person shall first obtain from the SHPDA a certificate of need therefor. Notwithstanding
any provisions of this article to the contrary, those facilities and distinct units operated
by the Department of Mental Health, and those facilities and distinct units operating under
contract or subcontract with the Department of Mental Health where the contract constitutes
the primary source of income to the facility, shall not be required to obtain a certificate
of need under this article. (b) Notwithstanding all other...
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27-19A-3
the dentist is licensed to furnish such dental care services in this state; (2) Deny any dentist
the right to participate as a contracting provider for such policy or plan provided the dentist
is licensed to furnish the dental care services offered by said policy or plan; (3) Authorize
any person to regulate, interfere, or intervene in any manner in the diagnosis or treatment
rendered by a dentist to his patient for the purpose of preventing, alleviating, curing, or
healing dental illness or injury provided said dentist practices within the scope of
his license; or (4) Require that any dentist furnishing dental care services must make or
obtain dental X rays or any other diagnostic aids for the purpose of preventing, alleviating,
curing, or healing dental illness or injury; provided, however, that nothing herein
shall prohibit requests for existing dental X rays or any other existing diagnostic aids for
the purpose of determining benefits payable under a health insurance policy or...
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34-17A-3
Section 34-17A-3 Definitions. As used in this chapter, the following words have the following
meanings: (1) ADVERTISE. The issuing or causing to be distributed any card, sign, or device
to any person; or the causing, permitting, or allowing any sign or marking on or in any building,
radio or television, transmission or broadcast, or advertising by any media or other means
designed to secure public attention. (2) BOARD. The Alabama Board of Examiners in Marriage
and Family Therapy. (3) MARRIAGE AND FAMILY THERAPIST. A person to whom a valid, current license
has been issued pursuant to this chapter. (4) PERSON. Any individual, firm, corporation, partnership,
organization, political body, or other entity. (5) PRACTICE OF MARRIAGE AND FAMILY THERAPY.
The process of providing professional marriage and family therapy to individuals, couples,
and families, either alone or in a group. The practice of marriage and family therapy utilizes
established principles that recognize the interrelated...
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34-29-61
VETERINARIAN. A person who is validly and currently licensed to practice veterinary medicine
in Alabama. (13) LICENSED VETERINARY TECHNICIAN. A person who is validly and currently licensed
to practice as a veterinary technician in Alabama. (14) PERSON. Any individual, firm, partnership,
association, joint venture, cooperative, or corporation or any other group or combination
acting in concert; and whether or not acting as a principal, trustee, fiduciary, receiver,
or as any kind of legal or personal representative, or as the successor in interest,
assigning agent, factor, servant, employee, director, officer, or any other representative
of such person. (15) PRACTICE OF VETERINARY MEDICINE: a. To diagnose, treat, correct, change,
relieve, or prevent animal disease, deformity, defect, injury, or other physical or
mental condition; including the prescription or administration of any drug, medicine, biologic,
apparatus, application, anesthesia, or other therapeutic or diagnostic...
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