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36-29A-4
Section 36-29A-4 Workers' Compensation Law not applicable. Except as provided herein,
the program implemented pursuant to this chapter is not governed by or subject to the provisions
of Act 92-537, or its successor, otherwise known as the Alabama Workers' Compensation Law
or any similar law. Payments made to physicians licensed to practice medicine for services
to injured employees shall be in accordance with the schedule of maximum fees as established
under Section 25-5-313, or as otherwise permitted under Section 25-5-314. All
undisputed medical reimbursements or payments shall be made within twenty five (25) working
days of receipt of claims in the form specified in Section 25-5-3. There shall be added
to any undisputed medical invoice which is not paid within twenty five (25) working days an
amount equal to ten (10) percent of the unpaid balance. Any regulation, policy, or program
directive for the conduct of utilization review, bill screenings, and medical necessity determinations...
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45-37-123.01
Section 45-37-123.01 Definitions. For the purposes of this part, the following terms
shall have the following meanings: (1) ACT. The act adding this part, to be called the General
Retirement System for Employees of Jefferson County Act. (2) ACTIVE MEMBER. An individual
who currently is employed by the county or other entities set forth in subdivision (20) and
is making employee contributions to the system. (3) ACTUARIAL EQUIVALENT. Effective July 30,
1984, or such other dates as set forth in Exhibit A, which is maintained in the office of
the pension board, a form of benefit differing in time, period, or manner of payment from
a specific benefit provided under the plan but having the same value when computed using the
mortality tables, the interest rate, and any other assumptions last adopted by the pension
board, which assumptions shall clearly preclude any discretion in the determination of the
amount of a member's benefit. (4) ACTUARIAL GAIN. As defined in Section...
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25-5-313
Section 25-5-313 Schedule of maximum fees. Within 60 days from May 19, 1992, the Workers'
Compensation Medical Services Board shall submit to the Governor an initial schedule of maximum
fees for medical services covered by this article, which schedule shall become effective immediately
upon submission to the Governor. The initial schedule of maximum fees shall be established
by the board in the manner prescribed in this section. The fee for each service in
the schedule shall be exactly equal to an amount derived by multiplying the preferred provider
reimbursement customarily paid on May 19, 1992, by the largest health care service plan incorporated
pursuant to Sections 10-4-100 to 10-4-115, inclusive, by a factor of 1.075, which product
shall be the maximum fee for each such service. In addition the board may submit to the Governor
for approval on or before January 31, 1993, a revised schedule of selected fees for medical
services covered by this article, which fees shall not exceed...
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25-5-1
Section 25-5-1 Definitions. Throughout this chapter, the following words and phrases
as used therein shall be considered to have the following meanings, respectively, unless the
context shall clearly indicate a different meaning in the connection used: (1) COMPENSATION.
The money benefits to be paid on account of injury or death, as provided in Articles 3 and
4. The recovery which an employee may receive by action at law under Article 2 of this chapter
is termed "recovery of civil damages," as provided for in Sections 25-5-31 and 25-5-34.
"Compensation" does not include medical and surgical treatment and attention, medicine,
medical and surgical supplies, and crutches and apparatus furnished an employee on account
of an injury. (2) CHILD or CHILDREN. The terms include posthumous children and all other children
entitled by law to inherit as children of the deceased; stepchildren who were members of the
family of the deceased, at the time of the accident, and were dependent upon him or...
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31-9-10
Section 31-9-10 Local emergency management organizations; emergency powers of political
subdivisions. (a) Each political subdivision of this state is hereby authorized and directed
to establish a local organization for emergency management in accordance with the state emergency
management plan and program and may confer or authorize the conferring, upon members of the
auxiliary police, the powers of peace officers, subject to such restrictions as shall be imposed.
The governing body of the political subdivision is authorized to appoint a director, who shall
have direct responsibility for the organization, administration, and operation of such local
organization for emergency management, subject to the direction and control of such governing
body. Each local organization for emergency management shall perform emergency management
functions within the territorial limits of the political subdivision within which it is organized,
and, in addition, shall conduct such functions outside of...
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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...
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27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household
member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting
to cause or intentionally, knowingly, or recklessly causing another person, including a minor
child, bodily injury, severe emotional injury, or psychological trauma or conduct which constitutes
the crime of rape. b. Intentionally following another person, including a minor child, without
proper authority, under circumstances that place the person in reasonable fear of bodily injury
or physical harm. c. Subjecting another person, including a minor child, to false imprisonment
or kidnapping. d. Attempting to cause or intentionally, knowingly, or recklessly causing damage
to property to intimidate or attempt to control the behavior of another person, including
a minor child. e. Assault, child abuse, criminal...
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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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13A-9-150
Section 13A-9-150 Public assistance fraud; penalties. (a) For the purposes of this section,
public assistance means money or property provided directly or indirectly to eligible persons
through programs of the federal government, the state, or any political subdivision thereof,
including any program administered by a public housing authority. (b) It shall be unlawful
for an individual or business entity to knowingly do any of the following: (1) Fail, by false
statement, misrepresentation, impersonation, or other fraudulent means, to disclose a material
fact used in making a determination as to the qualification of the person to receive public
assistance. (2) Fail to disclose a change in circumstances in order to obtain or continue
to receive any public assistance to which he or she is not entitled or in an amount larger
than that to which he or she is entitled. (3) Aid and abet another person in the commission
of the prohibitions enumerated in subdivisions (1) and (2). (4) Use,...
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27-1-22
Section 27-1-22 Uniform prescription drug information card or technology. (a) Every
health benefit plan that provides coverage for prescription drugs or devices, or administers
a plan, including, but not limited to, third party administrators for self-insured plans and
state administered plans, excluding the Alabama Medicaid Program, shall issue to its insureds
a card or other technology containing prescription drug information. The uniform prescription
drug information card or technology shall be in the format approved by the National Council
for Prescription Drug Programs (NCPDP) and shall include all of the required fields and conform
to the most recent pharmacy ID card or technology implementation guide produced by NCPDP or
conform to a national format acceptable to the Commissioner of Insurance. If a health care
plan includes a conditional or situational field, it shall conform to the most recent pharmacy
information card or technology implementation guide by the NCPDP or conform...
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