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22-6-160
Section 22-6-160 Evaluation and report on long-term care system for Medicaid beneficiaries.
The Medicaid Agency shall decide which groups of Medicaid beneficiaries to include for coverage
by a regional care organization or alternate care provider. The Medicaid Agency, without the
approval of the Governor, shall not make a coverage decision that would affect Medicaid beneficiaries
who are directly served by another state agency. (Act 2013-261, p. 686, §11; Act 2015-322,
§1.)...
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40-26B-70
Section 40-26B-70 Definitions. For purposes of this article, the following terms shall have
the following meanings: (1) ACCESS PAYMENT. A payment by the Medicaid program to an eligible
hospital for inpatient or outpatient hospital care, or both, provided to a Medicaid recipient.
(2) ALL PATIENT REFINED DIAGNOSIS-RELATED GROUP (APR-DRG). A statistical system of classifying
any non-Medicare inpatient stay into groups for the purposes of payment. (3) ALTERNATE CARE
PROVIDER. A contractor, other than a regional care organization, that agrees to provide a
comprehensive package of Medicaid benefits to Medicaid beneficiaries in a defined region of
the state pursuant to a risk contract. (4) CERTIFIED PUBLIC EXPENDITURE (CPE). A certification
in writing of the cost of providing medical care to Medicaid beneficiaries by publicly owned
hospitals and hospitals owned by a state agency or a state university plus the amount of uncompensated
care provided by publicly owned hospitals and hospitals...
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22-6-222
Section 22-6-222 Citizens' advisory committee. There shall be a citizens' advisory committee
constituted to advise the integrated care network on ways the integrated care network may
be more efficient in providing quality care to Medicaid beneficiaries. In addition, the advisory
committee shall carry out other functions and duties assigned to it by the integrated care
network and approved by the Medicaid Agency. The committee shall meet all of the following
criteria: (1) Be selected in a method established by the organization seeking to become an
integrated care network, or established by an integrated care network, and approved by the
Medicaid Agency. (2) At least 20 percent of its members shall be Medicaid beneficiaries or
sponsors of Medicaid beneficiaries or, if the organization has been certified as an integrated
care network, at least 20 percent of its members shall be Medicaid beneficiaries enrolled
in the integrated care network, or their sponsor. (3) Include members who are...
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40-26B-82
Section 40-26B-82 Effectiveness and cessation. (a) The assessment imposed under this article
shall not take effect or shall cease to be imposed and any moneys remaining in the Hospital
Assessment Account in the Alabama Medicaid Program Trust Fund shall be refunded to hospitals
in proportion to the amounts paid by them if any of the following occur: (1) Expenditures
for hospital inpatient and outpatient services paid for by the Alabama Medicaid Program for
fiscal years 2020, 2021, and 2022, are less than the amount paid during fiscal year 2017.
Reimbursement rates under this article for fiscal years 2020, 2021, and 2022, are less than
the rates approved by CMS in Sections 40-26B-79 and 40-26B-80. (2) The Medicaid Agency makes
changes in its rules that reduce hospital inpatient payment rates, outpatient payment rates,
or adjustment payments, including any cost settlement protocol, that were in effect on September
30, 2019. (3) The inpatient or outpatient hospital access payments required...
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22-6-220
Section 22-6-220 Definitions. For the purposes of this article, the following words shall have
the following meanings: (1) CAPITATION PAYMENT. A payment the state Medicaid Agency makes
periodically to the integrated care network on behalf of each recipient enrolled under a contract
for the provision of medical services pursuant to this article. (2) COLLABORATOR. A private
health carrier, third party purchaser, provider, health care center, health care facility,
state and local governmental entity, or other public payers, corporations, individuals, and
consumers who are expecting to collectively cooperate, negotiate, or contract with another
collaborator, or integrated care network in the health care system. (3) INTEGRATED CARE NETWORK.
One or more statewide organizations of health care providers, with offices in each regional
care organization region, that contracts with the Medicaid Agency to provide Medicaid benefits
to certain Medicaid beneficiaries as defined in subdivision (4) and...
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22-11A-118
Section 22-11A-118 Health Care Data Advisory Council. (a) There is established the Health Care
Data Advisory Council to assist in developing regulations and standards necessary to implement
the provisions of this article, to review and serve as consultants to the board on matters
related to any reports or publications prior to a report or publication release and to serve
as consultants to the board on matters relating to the protection, collection, and dissemination
of health care facility acquired infection data. (b) The council shall consist of 18 members
and be constituted in the following manner: (1) Six hospital members to be appointed by the
Alabama Hospital Association, two of which shall be infection control professionals. (2) Three
members to be appointed by the Medical Association of the State of Alabama. (3) Two members
to be appointed by the Business Council of Alabama, at least one of whom represents a small
business, all of whom are purchasers of health care, and none of...
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27-1-17.1
Section 27-1-17.1 Payment of providers through electronic funds transfer methods. (a) As used
in this section, the following words shall have the following meanings: (1) ACH ELECTRONIC
FUNDS TRANSFER. An electronic funds transfer through the Health Insurance Portability and
Accountability Act (HIPPA) standard Automated Clearing House network. (2) COVERED HEALTH CARE
PROVIDER. A physician as defined in Section 34-24-50.1; a dentist as defined in Section 34-9-1;
a chiropractor as defined in Section 34-24-120; an individual engaged in the practice of optometry
as defined in Section 34-22-1; other licensed health care professionals as defined in Title
34; a hospital as defined in Section 22-21-20; and a health care facility, or other provider
who or that is accredited, licensed, or certified and who or that is performing within the
scope of that accreditation, license, or certification. (3) HEALTH INSURANCE PLAN. Any hospital
and medical expense incurred policy, health maintenance...
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41-23-195
Section 41-23-195 Advisory committee - Membership. (a) There is created the Alabama Public
Transportation Fund Advisory Committee for the purpose of advising the director and staff
of the department with respect to the administration of the trust fund; provided, however,
all decisionmaking authority remains with the department. (b) The advisory committee shall
consist of the following members: (1) A member of the House of Representatives appointed by
the Speaker of the House of Representatives. (2) A member of the Senate appointed by the President
Pro Tempore of the Senate. (3) The Lieutenant Governor or his or her designee. (4) A representative
of the American Association of Retired Persons (AARP) appointed by AARP Alabama. (5) A representative
of the Department of Senior Services appointed by that department. (6) A representative of
the Alabama Association of Regional Councils appointed by that organization. (7) A representative
of the Community Action Association of Alabama...
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41-29-333
Section 41-29-333 Alabama Office of Apprenticeship - Powers and duties; Alabama Committee on
Credentialing and Career Pathways. (a) The Alabama Office of Apprenticeship, with the advice
and consent of the Alabama Apprenticeship Council, shall develop a nationally recognized state
apprenticeship completion credential, as described in 29 C.F.R. §29.5, for completing a registered
or industry-recognized apprenticeship program registered with the Alabama Office of Apprenticeship.
(b) The Alabama Office of Apprenticeship may certify industry-recognized apprenticeships,
registered with the Alabama Office of Apprenticeship, as eligible training providers for the
purpose of the federal Workforce Innovation and Opportunity Act, P.L. 113-128, and may deliver
services to registered apprenticeship participants with qualifying training accounts under
Title I of the federal Workforce Innovation and Opportunity Act, P.L. 113-128, through the
eligible training provider list of each regional workforce...
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10A-20-6.04
Section 10A-20-6.04 Board of directors. The property and business of the corporation shall
be managed by a board of directors with the powers and authority necessary or incidental to
the purposes of the corporation. The board shall be composed of not less than 15 nor more
than 27 directors. Public directors, who shall reflect the social, economic, and geographic
characteristics of the population served by the corporation, shall constitute at least a majority
of the board. Providers of health care and their representatives may also serve on the board,
but in no event may constitute a majority thereof. Persons who derive income from the delivery
or administration of health care or services shall not be eligible to serve as public directors.
The bylaws of the corporation shall contain a provision requiring the board: (1) To establish
a procedure for the disclosure of and the determination of whether a person is a provider
or a representative of a provider of health care and possible...
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