|
22-6-120
Section 22-6-120 Legislative findings. The Legislature finds the following: (1) The availability
of appropriate pharmaceutical benefits to every Alabama citizen is a critical component to
the overall health of its population. (2) Alabama should strive to provide appropriate, safe,
effective, and cost-efficient pharmaceutical care to those who depend on health benefits through
state funded programs. (3) The Alabama Medicaid Agency should endeavor to manage the Medicaid
Pharmacy Program utilizing clinical management tools in a manner to foster optimal health
outcomes at reasonable costs. (4) State Medicaid programs and private insurance plans across
the country utilize preferred drug lists as an effective way to foster and encourage clinically
appropriate and safe use of pharmaceuticals in a cost-effective manner. (5) Based on the proven
effectiveness of preferred drug programs to foster appropriate use of drugs, it is in the
best interests of Alabama and its citizens for the Alabama...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-120.htm - 1K - Match Info - Similar pages
22-6-122
Section 22-6-122 Medicaid Pharmacy and Therapeutics Committee - Classification and recommendation
of drugs; assurance of quality patient care; review of pharmaceutical products. (a) The Medicaid
Pharmacy and Therapeutics Committee shall review and recommend classes of drugs to the Medicaid
Commissioner for inclusion in the Medicaid Preferred Drug Plan. Class means a therapeutic
group of pharmaceutical agents approved by the FDA as defined by the American Hospital Formulary
Service. The classes of anti-retroviral and anti-psychotic drugs shall not be included in
the Medicaid Preferred Drug Plan. (b) The Medicaid Pharmacy and Therapeutics Committee shall
develop its preferred drug list recommendations by considering the clinical efficacy, safety,
and cost effectiveness of a product. Within each covered class, the committee shall review
and recommend drugs to the Medicaid Commissioner for inclusion on a preferred drug list. Generics
and over the counter drugs covered by Medicaid may be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-122.htm - 4K - Match Info - Similar pages
25-5-293
Section 25-5-293 Duties of secretary; continuing education, accounting; recovery of expenses;
advisory committees; legislative intent regarding reimbursements. (a) The Secretary of the
Department of Labor may prescribe rules and regulations for the purpose of conducting continuing
education seminars for all personnel associated with workers' compensation claims and collect
registration fees in order to cover the related expenditures. The secretary may adopt rules
and regulations setting continuing education standards for workers' compensation claims personnel
employed by insurance companies and self-insured employers and groups. (b) The secretary shall
file annually with the Governor and the presiding officer of each house of the Legislature
a complete and detailed written report accounting for all funds received and disbursed during
the preceding fiscal year. The annual report shall be in the form and reported in the time
provided by law. (c) The secretary shall establish reasonable...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-293.htm - 11K - Match Info - Similar pages
12-15-315
Section 12-15-315 Permanency hearing for Department of Human Resources cases only. (a) Within
12 months of the date a child is removed from the home and placed in out-of-home care, and
not less frequently than every 12 months thereafter during the continuation of the child in
out-of-home care, the juvenile court shall hold a permanency hearing. The Department of Human
Resources shall present to the juvenile court at the hearing a permanent plan for the child.
The juvenile court shall consult with the child, in an age-appropriate manner, regarding the
permanency plan and any transition plan to independent living. If a permanent plan is not
presented to the juvenile court at this hearing, there shall be a rebuttable presumption that
the child should be returned home. This provision is intended to ensure that a permanent plan
is prepared by the Department of Human Resources and presented to the juvenile court within
12 months of the placement of any child in foster care and no less...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/12-15-315.htm - 7K - Match Info - Similar pages
22-6-123
Section 22-6-123 Considerations for inclusions on preferred drug list; review; adoption of
list. (a) Drugs will be considered for the Medicaid preferred drug list based on clinical
efficacy, side effect profiles, appropriate usage, and cost effectiveness. (b) The Medicaid
Pharmacy and Therapeutics Committee shall perform a thorough review of relevant clinical and
medical considerations, including, but not limited to: Medicaid Drug Utilization Review (DUR)
data; Surveillance Utilization Review (SUR) data; potential abuse, misuse, or inappropriate
use in prescribing and/or dispensing patterns; inconsistency with FDA approved labeling, inconsistency
with uses recognized in the American Hospital Formulary Service Drug Information, and the
American Medical Association Drug Evaluations, or the U.S. Pharmacopoeia Dispensing Information.
(c) The Medicaid Pharmacy and Therapeutics Committee shall recommend and the Medicaid Agency
shall adopt an initial Medicaid preferred drug list not later...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-123.htm - 2K - Match Info - Similar pages
22-6-163
Section 22-6-163 Legislative findings; rules; collaboration; approval of agreements and contracts;
state action immunity; confidentiality of records; additional duties. (a) The Legislature
declares that collaboration among public payers, private health carriers, third party purchasers,
and providers to identify appropriate service delivery systems and reimbursement methods in
order to align incentives in support of integrated and coordinated health care delivery is
in the best interest of the public. Collaboration pursuant to this article is to provide quality
health care at the lowest possible cost to Alabama citizens who are Medicaid eligible. The
Legislature, therefore, declares that this health care delivery system affirmatively contemplates
the foreseeable displacement of competition, such that any anti-competitive effect may be
attributed to the state's policy to displace competition in the delivery of a coordinated
system of health care for the public benefit. In furtherance of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-163.htm - 6K - Match Info - Similar pages
22-6-233
Section 22-6-233 Legislative findings; certification of collaborators; powers of Medicaid Agency;
state action immunity. (a) The Legislature declares that collaboration among public payers,
private health carriers, third party purchasers, and providers to identify appropriate service
delivery systems and reimbursement methods in order to align incentives in support of integrated
and coordinated health care delivery is in the best interest of the public. Collaboration
pursuant to this article is to provide quality health care at the lowest possible cost to
Alabama citizens who are Medicaid eligible. The Legislature, therefore, declares that this
health care delivery system affirmatively contemplates the foreseeable displacement of competition,
such that any anti-competitive effect may be attributed to the state's policy to displace
competition in the delivery of a coordinated system of health care for the public benefit.
In furtherance of this goal, the Legislature declares its intent...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-233.htm - 6K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-22.htm - 3K - Match Info - Similar pages
40-26B-26
Section 40-26B-26 Reduction of revenues; reimbursement computations; quality incentive program.
THIS SECTION WAS AMENDED BY ACT 2020-147 IN THE 2020 REGULAR SESSION, EFFECTIVE MAY 18, 2020.
THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. (a) No revenues resulting from the privilege assessment
established by this article and applied to increases in covered services or reimbursement
levels or other enhancements of the Medicaid program shall be subject to reduction or elimination
while the privilege assessment is in effect. (b) Every nursing facility participating in the
Medicaid program in the State of Alabama shall be reimbursed according to the reimbursement
methodology contained in Chapter 560-X-22 of the Alabama Medicaid Agency Administrative Code
(Supp. 12/31/95) on January 31, 1998, which methodology is incorporated by reference herein,
except that the following shall apply: (1) The ceiling for the operating cost center described
in Title 560-X-22-.06 (2)(a) of the Alabama Medicaid...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-26.htm - 8K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/11-91A-2.htm - 5K - Match Info - Similar pages
|