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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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22-8A-9
Section 22-8A-9 Withholding or withdrawal of treatment, etc., not suicide; execution of advance
directive not to affect sale, etc., of life or health insurance nor be condition for receipt
of treatment, etc.; provisions of chapter cumulative. (a) The withholding or withdrawal of
life-sustaining treatment or artificially provided nutrition and hydration from a patient
in accordance with the provisions of this chapter shall not, for any purpose, constitute a
suicide and shall not constitute assisting suicide. (b) The making of an advance directive
for health care pursuant to this chapter shall not affect in any manner the sale, procurement,
or issuance of any policy of life or health insurance, nor shall it be deemed to modify the
terms of an existing policy of life or health insurance. No policy of life or health insurance
shall be legally impaired or invalidated in any manner by the withholding or withdrawal of
life-sustaining treatment or artificially provided nutrition and hydration...
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11-91A-2
Section 11-91A-2 Local Government Health Insurance Board; governance and administration of
program. (a) The Local Government Health Insurance Board shall govern and administer the Local
Government Health Insurance Program currently governed and administered by the State Employees'
Insurance Board (SEIB) pursuant to Chapter 29 of Title 36. The transfer of the governance
and administration to the board shall take effect at 12:01 a.m. on January 1, 2015, and thereafter
the board shall take all control and responsibility for the program under procedures and authority
set out in this chapter. (b) The program governed and administered by the board shall provide
a reasonable relationship between the health care benefits to be included and the expected
health care expenses to be incurred by affected employees, retirees, and their dependents.
The board may establish a fully insured or self-insured health care plan for employees and
retirees as defined in this chapter and may adopt rules for the...
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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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27-7-1
with or offering advice directly to a purchaser or prospective purchaser of a particular contract
of insurance concerning any of the substantive benefits, terms, or conditions of the contract,
provided that the person engaged in that act either sells insurance or obtains insurance from
insurers for purchasers. (17) PERSON. An individual or a business entity. (18) PROPERTY LINES
OF AUTHORITY. Any one or more of the following lines as defined in Section 27-7-14.1: Property;
casualty; and personal lines. (19) SELL. To exchange a contract of insurance by any
means, for money or its equivalent, on behalf of an insurance company. (20) SERVICE REPRESENTATIVE.
A natural person, other than an officer, manager, or managing general agent of the insurer,
employed on salary or at an hourly rate by an insurer, managing general agent, or a captive
producer to work for, with or through producers in selling, soliciting, or negotiating insurance
in the insurer or in the insurers represented by the...
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16-6D-6
Section 16-6D-6 Innovation plan. (a) The innovation plan of a local school system shall include,
at a minimum, all of the following: (1) The school year that the local school system expects
the school flexibility contract to begin. (2) The list of state laws, regulations, and policies,
including rules, regulations, and policies promulgated by the State Board of Education and
the State Department of Education, that the local school system is seeking to waive in its
school flexibility contract. (3) A list of schools included in the innovation plan of the
local school system. (b) A local school system is accountable to the state for the performance
of all schools in its system, including innovative schools, under state and federal accountability
requirements. (c) A local school system may not, pursuant to this chapter, waive requirements
imposed by federal law, requirements related to the health and safety of students or employees,
requirements imposed by ethics laws, requirements imposed...
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27-19A-2
of this chapter. (7) HEALTH INSURANCE POLICY. Any individual, group, blanket, or franchise
insurance policy, insurance agreement, or group hospital service contract providing benefits
for dental care expenses incurred as a result of an accident or sickness. (8) EMPLOYEE BENEFIT
PLAN. Any plan, fund, or program heretofore or hereafter established or maintained by an employer
or by an employee organization, or by both, to the extent that such plan, fund, or program
was established or is maintained for the purpose of providing for its participants or their
beneficiaries, through the purchase of insurance or otherwise, dental care benefits in the
event of accident or sickness. (9) DENTAL CARE SERVICES. Any services furnished to any person
for the purpose of preventing, alleviating, curing, or healing human dental illness or injury.
(10) DENTIST. Any person who furnishes dental care services and who is licensed as a dentist
by the State of Alabama. (Acts 1984, No. 84-411, p. 960, ยง2.)...
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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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34-25A-3
and require the generation of an image, form, or mold that replicates the patient's body or
body segment and involves the rectification of dimensions, contours, and volumes to achieve
proper fit, comfort, and function for that specific patient. Except for the treatment of scoliosis,
orthosis does not include prefabricated or direct-formed orthotic devices, as defined in this
subdivision and does not include any of the following items: Commercially available knee orthoses
used following injury or surgery; upper extremity adaptive equipment; finger splints;
leather wrist gauntlets; face masks used following burns; wheelchair seating that is an integral
part of the wheelchair and not worn by the patient independent of the wheelchair; fabric or
elastic supports; corsets; arch supports, also known as non-custom or prefabricated orthotics;
low-temperature formed plastic splints; trusses; elastic hose; canes; crutches; cervical collars;
dental appliances, and other similar devices as...
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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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