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27-26-5
Section 27-26-5 Reports of judgments and settlements; confidentiality; penalty. (a) Any insurance
company which sells medical liability insurance to Alabama physicians or their professional
corporations or professional associations, or to hospitals or other health care providers
shall be required to report to the state licensing agency which issues the license of the
physician, hospital, or other health care provider any final judgment or any settlement in
or out of court resulting from a claim or action for damages for personal injuries caused
by an error, omission, or negligence in the performance of professional services with or without
consent rendered by its policyholder within 30 days after entry of a judgment in court or
agreement to settle a claim in or out of court. (b) The report rendered to the appropriate
state agency shall consist of the name of the policyholder, or if the policyholder is a professional
corporation or professional association, the name of the physician or...
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22-21-351
Section 22-21-351 Legislative findings. The Legislature hereby finds and declares as follows:
(1) That in order to promote the public health of the people of the State of Alabama, the
Legislature enacted the enabling statute, whereunder, among other things: a. The several counties,
municipalities, and educational institutions of the state are effectively authorized to form
public corporations known as health care authorities, and b. Existing public hospital corporations
are authorized to reincorporate as health care authorities; (2) That all such health care
authorities are empowered under and pursuant to the enabling statute, among other things:
a. To own and operate public hospitals and other health care facilities; b. To furnish office
space to (among others) any nonhospital-based physician, dentist or other health care professional
for use in his private practice, subject to the conditions specified in the enabling statute;
and c. To appoint, employ, contract with, and provide for...
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27-21A-16
Section 27-21A-16 Examination. (a) The commissioner may make an examination of the affairs
of any health maintenance organization and providers with whom such organization has contracts
or agreements as often as is reasonably necessary for the protection of the interests of the
people of this state, but not less frequently than once every three years. (b) The State Health
Officer may make an examination concerning health care service of any health maintenance organization
and providers with whom such organization has contracts, agreements, or other arrangements
as often as is reasonably necessary for the protection of the interests of the people of this
state, but not less frequently than once every three years. (c) Every health maintenance organization
shall submit its relevant books and records for such examinations and in every way facilitate
these examinations. For the purpose of examinations, the commissioner and the State Health
Officer may administer oaths to, and examine the...
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27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following
meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological,
and psychosocial concepts, techniques, and processes necessary to maintain or develop functional
skills of clients, provided to individuals and groups for periods of more than two hours but
less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by
the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including
an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses,
issued by insurers, 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...
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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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45-37-171.44
Section 45-37-171.44 Ability to pay fees; increase in costs and fees; funding. No person shall
be denied any service because that person, or if a minor, the parent or legal guardian of
such person, is unable to pay the fee for such service established pursuant to this subpart.
The determination of a person's ability to pay shall be made in confidence and under circumstances
that will protect the dignity of the person receiving the service. Using any appropriate standards
of ability to pay for health care provided by the United States Government or any agency thereof,
the Jefferson County Board of Health may establish a sliding fee scale based on a person's
ability to pay. Any provision of this subpart to the contrary notwithstanding, this subpart
shall not be interpreted or applied to authorize any increase in the fees, if any, that any
person may be required to pay for any examination, treatment, vaccination, inoculation, or
other health care service of any kind that, as of September...
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27-1-16
Section 27-1-16 Standard health insurance claim form; electronic claims form; various claim
forms. (a)(1) The Commissioner of the Department of Insurance shall prescribe a standard health
insurance claim form to be used by all hospitals. The forms shall be prescribed in a format
which allows for the use of generally accepted diagnosis and treatment coding systems by providers
of health care and payors. The standard form shall be accepted and used by all insurers doing
business in the State of Alabama and by all state agencies which pay providers of health care
for hospital services. (2) The Commissioner of the Department of Insurance shall also prescribe
a format for all health insurance claims transmitted or submitted for payment by electronic
or electro-mechanical means. Such a format shall be used by all insurers doing business in
the State of Alabama and by all state agencies which pay providers of health care for hospital
services. (b) An advisory committee of five persons, two...
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27-1-21
Section 27-1-21 Uniformity of limits applied to fulfillment of certain drug prescriptions.
(a) For the purposes of this section, the following words shall have the following meanings:
(1) ENROLLEE. A person enrolled in a health benefit plan. (2) HEALTH BENEFIT PLAN. Any individual
or group plan, policy, or contract for health care services issued, delivered, issued for
delivery, 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, purchases, or
furnishes health care services to patients, insureds, or beneficiaries in this state. The
term includes, but is not limited to, entities created pursuant to Article 6 of Chapter 4
of Title 10. The term shall not include any collective bargaining agreement...
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11-50B-4
Section 11-50B-4 Municipal authority to furnish cable service; rules and regulations. Notwithstanding
any other provision of this chapter, so long as a municipality has by virtue of the provisions
of any franchise, jurisdiction, authority, or a right, to approve or disapprove the subscriber
rates, fees, or charges of private providers of cable service furnishing cable service to
subscribers in the municipality and has not either relinquished the same, or adopted procedures
pursuant to which private providers of cable service are permitted to increase or decrease
their rates to subscribers upon not less than 30 days notice freely, so long as the rates
charged subscribers reflect all direct costs and indirect costs of providing the cable service,
neither the municipality nor any municipal instrumentality whose organization the municipality
has authorized, may exercise the authority to furnish cable service granted elsewhere in this
chapter. Notwithstanding the foregoing, nothing...
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27-56-4
Section 27-56-4 Prohibited activities. An insurance policy, plan, or contract providing for
third-party payment or prepayment of health or medical expenses shall not do any of the following:
(1) Impose a practice restriction for optometrists which is inconsistent with or more restrictive
than provided by law. (2) Discriminate between classes of eye care providers with respect
to any covered service which falls within the scope of the eye care provider's license. (3)
Require an eye care provider to hold hospital privileges as a condition of participation in
or receiving payment from the policy, plan, or contract. (4) Impose any restriction not required
by law based on the eye care provider's professional degree. (5) Discriminate between eye
care providers in connection with the amount of reimbursement for the provision of the same
services. (6) Require an eye care provider to purchase or maintain a minimum quantity or minimum
dollar amount of a specified brand of ophthalmic materials as...
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