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16-25A-7
Section 16-25A-7 Authorization and execution of contracts; evidence of coverage; denial of
claims. (a) The board is hereby authorized to execute a contract or contracts to provide for
the benefits or the administration of the plan determined in accordance with the provisions
of this article. 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 article may be included in one or more similar contracts
issued by the same or different companies. The board is further authorized to develop a plan
whereby it may become self-insured upon its finding that such arrangement would be financially
advantageous to the state and plan participants. (b) Before entering into any contract or
contracts authorized by subsection (a), the board shall invite competitive bids from all qualified
entities who may wish to administer or offer plans for the...
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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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27-21A-1
Section 27-21A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively: (1) AGENT. A person who is appointed or employed by a health maintenance
organization and who engages in solicitation of membership in such organization. This definition
does not include a person enrolling members on behalf of an employer, union, or other organization.
(2) BASIC HEALTH CARE SERVICES. Emergency care, inpatient hospital and physician care, and
outpatient medical services. (3) COMMISSIONER. The Commissioner of Insurance. (4) ENROLLEE.
An individual who is enrolled in a health maintenance organization. (5) EVIDENCE OF COVERAGE.
Any certificate, agreement, or contract issued to an enrollee setting out the coverage to
which he is entitled. (6) HEALTH CARE SERVICES. Any services included in the furnishing to
any individual of medical or dental care, or hospitalization or incident to the furnishing
of such care or hospitalization, as well as the...
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22-11A-118
Section 22-11A-118 Health Care Data Advisory Council. (a) There is established the Health Care
Data Advisory Council to assist in developing regulations and standards necessary to implement
the provisions of this article, to review and serve as consultants to the board on matters
related to any reports or publications prior to a report or publication release and to serve
as consultants to the board on matters relating to the protection, collection, and dissemination
of health care facility acquired infection data. (b) The council shall consist of 18 members
and be constituted in the following manner: (1) Six hospital members to be appointed by the
Alabama Hospital Association, two of which shall be infection control professionals. (2) Three
members to be appointed by the Medical Association of the State of Alabama. (3) Two members
to be appointed by the Business Council of Alabama, at least one of whom represents a small
business, all of whom are purchasers of health care, and none of...
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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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22-21B-3
Section 22-21B-3 Definitions. The following words and terms shall have the meanings ascribed
to them in this section, unless otherwise required by their respective context: (1) CONSCIENCE.
The religious, moral, or ethical principles held by a health care provider. (2) DISCRIMINATION.
Discrimination includes, but is not limited to: Hiring, termination, refusal of staff privileges,
refusal of board certification, demotion, loss of career specialty, reduction of wages or
benefits, adverse treatment in the terms and conditions of employment, refusal to award any
grant, contract, or other program, or refusal to provide residency training opportunities.
(3) HEALTH CARE PROVIDER. Any individual who may be asked to participate in any way in a health
care service, including, but not limited to: A physician, physician's assistant, nurse, nurse's
aide, medical assistant, hospital employee, clinic employee, nursing home employee, pharmacist,
researcher, medical or nursing school faculty, student,...
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34-24-75.1
Section 34-24-75.1 Certificate and limited license under Retired Senior Volunteer Program.
(a) The State Board of Medical Examiners may, at its discretion and subject to the rules and
regulations promulgated by the board, issue a certificate of qualification in behalf of physicians
meeting the requirements for participation in the Retired Senior Volunteer Program. The Retired
Senior Volunteer Program is created for the purpose of permitting doctors of medicine and
doctors of osteopathy who are fully retired from the active practice of medicine to obtain
a limited license without cost which would permit the provision of outpatient health care
services at established free clinics operated pursuant to the Volunteer Medical Professional
Act, Section 6-5-660, et seq. Physicians having certificates issued under this section must
perform no fewer than 100 hours of voluntary service annually and must limit their practice
to the confines of an established free medical clinic, as that term is...
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34-27B-2
Section 34-27B-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) BOARD. The Alabama State Board of Respiratory Therapy. (2) DIRECT CLINICAL SUPERVISION.
A situation where a licensed respiratory therapist or physician is available for the purpose
of communication, consultation, and assistance. (3) HEALTHCARE FACILITY. The definition shall
be the same as in Section 22-21-260. (4) MEDICALLY APPROVED PROTOCOL. A detailed plan for
taking specific diagnostic or treatment actions, or both, authorized by the treating physician
of the patient, all of which actions shall be: a. In a hospital or other inpatient health
care facility, approved by the supervising physician of the respiratory therapist or in an
outpatient treatment setting approved by the supervising physician of the respiratory therapist.
b. Except in cases of medical emergency, instituted following an evaluation of the patient
by a physician or otherwise directed by the supervising...
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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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11-91A-7
Section 11-91A-7 Jurisdiction of board; funding; powers of board. The board shall have full,
complete, and exclusive jurisdiction over the program and shall allocate funds from its treasury
for the fulfillment and accomplishment of its duties and responsibilities in a manner as may
be necessary and appropriate to carry out the purposes of this chapter. The board shall have
the general powers and authority granted under the laws of this state for health insurers,
and in addition thereto, the specific authority to do all of the following: (a) Subject to
compliance with Section 11-91A-8 where applicable, execute a contract or contracts to provide
for the administration of the program in accordance with this chapter. The contract or contracts
may be executed with one or more agencies or corporations licensed to transact or administer
group health care business in this state with similar plans of the state for the joint performance
of common administrative functions. (b) Establish, and...
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