|
22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance
procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for
Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid
region for at least one fully certified regional care organization to provide, pursuant to
a risk contract under which the Medicaid Agency makes a capitated payment, medical care to
Medicaid beneficiaries. However, the Medicaid Agency may enter into a contract pursuant to
this section only if, in the judgment of the Medicaid Agency, care of Medicaid beneficiaries
would be better, more efficient, and less costly than under the then existing care delivery
system. The Medicaid Agency may contract with more than one regional care organization in
a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments
for the regional care organization. (b) The Medicaid Agency shall...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-153.htm - 10K - Match Info - Similar pages
27-19-103
Section 27-19-103 Definitions. Unless the context requires otherwise, the definitions in this
section apply throughout this article. (1) APPLICANT. In the case of: a. An individual long-term
care insurance policy, the person who seeks to contract for benefits. b. A group long-term
care insurance policy, the proposed certificate holder. (2) CERTIFICATE. Any certificate issued
under a group long-term care insurance policy, which policy has been delivered or issued for
delivery in this state. (3) COMMISSIONER. The Alabama Commissioner of Insurance. (4) GROUP
LONG-TERM CARE INSURANCE. A long-term care insurance policy which is delivered or issued for
delivery in this state and issued to any of the following: a. One or more employers or labor
organizations, or to a trust or to the trustees of a fund established by one or more employers
or labor organizations, or a combination thereof, for employees or former employees or a combination
thereof, or for members or former members or a...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-103.htm - 9K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54-2.htm - 3K - Match Info - Similar pages
22-18-6
Section 22-18-6 Violations; good Samaritan provisions; scope of privilege; control of emergency
scene; penalties. (a) It shall be a Class A misdemeanor for any person, firm, company, corporation,
organization, facility, or agency to do any of the following: (1) Deliberately hinder, obstruct,
or interfere with an officer, inspector, or duly authorized agent of the board while in the
performance of official duties. (2) Deliberately hinder, obstruct, or interfere with any physician,
licensed nurse, licensed EMSP, or emergency personnel exempt from licensure under this article
while that individual is providing emergency care to a third person or while that individual
is assisting at the scene of an emergency, directing traffic at the scene of an emergency,
or managing or helping to manage the scene of an emergency. (3) Violate subsection (c) or
(d). (4) Offer, provide, or perform, without a license or certificate to do so, an emergency
medical service or other function which, under this...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-18-6.htm - 6K - Match Info - Similar pages
27-20A-1
Section 27-20A-1 Definitions. The following words and phrases used in this chapter, and others
evidently intended as the equivalent thereof, shall, in the absence of clear implication otherwise,
be given the following respective interpretations herein: (1) ALCOHOLISM. A chronic disorder
or illness in which the individual is unable, for psychological or physical reasons, or both,
to refrain from the frequent consumption of alcohol in quantities sufficient to produce intoxication
and, ultimately, injury to health and effective functioning. (2) DETOXIFICATION. Supervised
physical withdrawal from alcohol. (3) INPATIENT TREATMENT FOR ALCOHOLISM. Care provided in
a licensed hospital and is normally limited to detoxification where severe medical or psychiatric
complications are present or may be anticipated. (4) SHORT TERM RESIDENTIAL ALCOHOLISM TREATMENT
FACILITY. A state certified facility which provides structured programs of intensive treatment
services for people addicted to alcohol....
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-20A-1.htm - 1K - Match Info - Similar pages
22-21-264
Section 22-21-264 Criteria for state agency review. The SHPDA, pursuant to the provisions of
Section 22-21-274, shall prescribe by rules and regulations the criteria and clarifying definitions
for reviews covered by this article. These criteria shall include at least the following:
(1) Consistency with the appropriate State Health Facility and services plans effective at
the time the application was received by the State Agency, which shall include the latest
approved revisions of the following plans: a. The most recent Alabama State Health Plan which
shall include updated inventories and separate bed need methodologies for inpatient rehabilitation
beds, inpatient psychiatric beds and inpatient/residential alcohol and drug abuse beds. b.
Alabama State Health Plan for services to the mentally ill. c. Alabama State Plan for rehabilitation
facilities. d. Alabama developmental disabilities plan. e. Alabama State alcoholism plan.
f. Such other State Plans as may from time to time be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-264.htm - 4K - Match Info - Similar pages
22-5A-4
Section 22-5A-4 Selection of community ombudsmen; training; certification; duties; area plan
to describe program; notification of department as to prospective ombudsmen; advisory committee
on program. (a) Each area agency on aging funded by the department shall select at least one
community ombudsman in each planning and service area established according to regulations
issued pursuant to the Older Americans Act of 1965, as amended. The community ombudsman shall
be an employee or contractual employee of the area agency on aging and shall certify to having
no association with any health care facility or provider for reward or profit. (b) The duties
of each community ombudsman shall be as follows: (1) To receive, investigate, respond to,
and attempt informally to resolve complaints made by or on behalf of recipients; (2) To report
immediately instances of fraud, abuse, neglect, or exploitation to the department of pensions
and security for investigation and follow-up pursuant to Chapter...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-5A-4.htm - 4K - Match Info - Similar pages
27-51-1
Section 27-51-1 Payment for services of licensed physician assistant. (a) An insurance policy
or contract providing for third-party payment or prepayment of health or medical expenses
shall include a provision for the payment to a supervising physician for necessary medical
or surgical services that are provided by a licensed physician assistant practicing under
the supervision of the physician, and pursuant to the rules, regulations, and parameters for
physician assistants, if the policy or contract pays for the same care and treatment provided
by a licensed physician or doctor of osteopathy. (b) An insurance policy or contract subject
to this section shall not impose a practice or supervision restriction which is inconsistent
with or more restrictive than provided by law. (c) This section shall apply to services provided
under a policy or contract delivered, continued, or renewed in this state on or after August
1, 1997, and to any existing policy or contract, on the policy's or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-51-1.htm - 2K - Match Info - Similar pages
26-1A-404
Section 26-1A-404 Health care powers of attorney executed on or after January 1, 2012. (a)
This section applies to a power of attorney for health care decisions executed on or after
January 1, 2012. (b) A durable power of attorney is a power of attorney by which a principal
designates another his or her attorney in fact or agent in writing and the writing contains
the words "This power of attorney shall not be affected by disability, incompetency,
or incapacity of the principal" or "This power of attorney shall become effective
upon the disability, incompetency, or incapacity of the principal" or similar words showing
the intent of the principal that the authority conferred shall be exercisable notwithstanding
the principal's subsequent disability, incompetency, or incapacity. (c)(1) A principal may
designate under a durable power of attorney an individual who shall be empowered to make health
care decisions on behalf of the principal, in the manner set forth in the Natural Death Act,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/26-1A-404.htm - 8K - Match Info - Similar pages
14-14-2
Section 14-14-2 Definitions. For purposes of this chapter, the following words shall have the
following meanings: (1) COMMISSIONER. The Commissioner of the Department of Corrections. (2)
DEPARTMENT. The Department of Corrections. (3) GERIATRIC INMATE. A person 55 years of age
or older convicted in this state of a non-capital felony offense and sentenced to the penitentiary,
who suffers from a chronic life-threatening infirmity, life-threatening illness, or chronic
debilitating disease related to aging, who poses a low risk to the community, and who does
not constitute a danger to himself or herself or society. (4) PERMANENTLY INCAPACITATED INMATE.
A state inmate who possesses a permanent, irreversible physical or mental health condition
that prevents him or her from being able to perpetrate a violent physical action upon another
person or self or initiate or participate in a criminal act. The medical or mental health
treatment or need for assistance of such individual must require...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/14-14-2.htm - 2K - Match Info - Similar pages
|