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27-57-5
Section 27-57-5 Coverage by participating providers; selection criteria and utilization protocols;
maximum benefits, exclusions, etc. (a) This chapter does not require and shall not be construed
to require the coverage of services of providers who are not designated as covered providers,
or who are not selected as a participating provider, by a group health benefit plan or insurer
having a participating network of service providers. Nothing in this chapter is intended to
expand the list or designation of participating providers as specified in any health benefit
plan. (b) Insurers or other issuers of any health benefit plan covered by this chapter shall
continue to be able to establish and apply selection criteria and utilization protocols for
health care providers including the designation of types of providers for which coverage is
provided as well as credentialing criteria used in the selection of providers. (c) A group
health benefit plan, policy, or contract that provides coverage...
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22-6-221
Section 22-6-221 Service by integrated care network; board of directors. (a) An integrated
care network shall serve only Medicaid beneficiaries in providing medical care and services.
For the purposes of this article, a beneficiary cannot be a member of both an integrated care
network and a regional care organization. (b) An integrated care network shall provide required
medical care and services to Medicaid beneficiaries and may coordinate care provided by or
through an affiliation of other health care providers or other programs as the Medicaid Agency
shall determine. (c) Notwithstanding any other provision of law, the integrated care network
shall not be deemed an insurance company under state law. (d)(1) An integrated care network
shall have a governing board of directors composed of the following members: a. Twelve members
shall be persons representing risk bearing participants. A participant bears risk by contributing
cash, capital, or other assets to the integrated care network....
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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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27-21A-4
Section 27-21A-4 Powers of health maintenance organizations. (a) The powers of a health maintenance
organization include, but are not limited to the following: (1) The purchase, lease, construction,
renovation, operation, or maintenance of hospitals, medical facilities, or both, and their
ancillary equipment; (2) The making of loans other than in the ordinary course of business,
to providers under contract with it in furtherance of its program or the making of loans to
a corporation or corporations in which it owns a majority interest for the purpose of acquiring
or constructing medical facilities and hospitals or in furtherance of a program providing
health care services to enrollees. (3) The furnishing of health care services through providers
which are under contract with or employed by the health maintenance organization. (4) The
contracting with any person for the performance on its behalf of certain functions such as
marketing, enrollment, and administration. (5) The purchase,...
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34-21-120
Section 34-21-120 Findings; purpose. (a) The party states find and declare all of the following:
(1) The health and safety of the public are affected by the degree of compliance with and
the effectiveness of enforcement activities related to state nurse licensure laws. (2) Violations
of nurse licensure and other laws regulating the practice of nursing may result in injury
or harm to the public. (3) The expanded mobility of nurses and the use of advanced communication
technologies as part of a national health care delivery system requires greater coordination
and cooperation among states in the areas of nurse licensure and regulation. (4) New practice
modalities and technology make compliance with individual state nurse licensure laws difficult
and complex. (5) Uniformity of nurse licensure requirements throughout the states promotes
public safety and public health benefits. (b) The general purpose of this compact is to achieve
all of the following: (1) Facilitate the responsibility of...
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22-13A-3
Section 22-13A-3 Purposes of chapter. The purposes of this chapter are as follows: (1) To create
and foster a multi-generational, statewide program to promote public awareness and knowledge
about the causes of osteoporosis, personal risk factors, the value of prevention and early
detection, and the options available for treatment. (2) To facilitate and enhance knowledge
and understanding of osteoporosis by disseminating educational materials, information about
research results, services, and strategies for prevention and treatment to patients, health
professionals, and the public. (3) To utilize educational and training resources and services
that have been developed by organizations with appropriate expertise and knowledge of osteoporosis
and to use available technical assistance. (4) To evaluate existing osteoporosis services
in the community and assess the need for improving the quality and accessibility of community-based
services. (5) To provide easy access to clear, complete, and...
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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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27-14-11.1
Section 27-14-11.1 Contents of policies - Denial or reduction of benefits due to Medicaid eligibility
void. (a) For purposes of this section, "private insurer" is defined as any of the
following: (1) Any commercial insurance company offering health or casualty insurance to individuals
or groups, including both experience-rated contracts and indemnity contracts. (2) Any profit
or nonprofit prepaid plan offering either medical services or full or partial payment for
the diagnosis or treatment of an injury, disease, or disability. (3) Any organization administering
health or casualty insurance plans for professional associations, unions, fraternal groups,
employer-employee benefit plans, and any similar organization offering these payments or services,
including self-insured and self-funded plans. (4) Any health insurer, including group health
plans, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974,
self-insured plans, service benefit plans, managed care...
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38-15-2
Section 38-15-2 Legislative findings. The Legislature finds that there is a substantial need
to protect children and youth from abuse and neglect by persons entrusted with their physical
custody, and from persons or organizations that advertise, hold themselves out, or lead others
to believe that they will provide them with health, therapeutic, rehabilitative, or disciplinary
services, and from persons employed or exercising authority over them, and who they depend
upon to provide the basic necessities of life. The Legislature further finds that abuse and
neglect often take the form of the withholding of the basic necessities of life, including
food, water, shelter, clothing, and health care through an affirmative act or omission. It
is the intent of the Legislature to implement a baseline of registration and regulation requirements
for religious, faith-based, or church nonprofit, other nonprofit, and for profit affiliated
youth residential facilities and institutions that have...
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45-16-140.01
Section 45-16-140.01 Legislative findings. The Legislature declares that the Coffee County
fire departments, emergency medical service squads contracted in writing with the Coffee County
Commission, and the Coffee County Volunteer Firefighters Association that receive funds pursuant
to this article are organizations which are public in nature, as they protect the health,
safety, and welfare of the citizens of the county. (Act 2010-110, §2; 2010-130, §2.)...
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