38-9C-5
Section 38-9C-5 Providers who contract with agencies or programs required to develop written
policies to ensure rights. All providers who contract or subcontract with any federal, state,
or local agency or program to provide services in the State of Alabama to persons with developmental
disabilities or traumatic brain injury in Alabama shall develop and implement written policies
and procedures to ensure the rights enumerated above are observed by the provider in discharging
its contractual or subcontractual duties and responsibilities. At a minimum, these policies
and procedures shall provide for the following: (1) Affirm and safeguard the rights stated
in this chapter. (2) Provide that prompt, reasonable action be taken to prevent the potential
for further abuse while an investigation is in process. (3) Provide for a prompt and thorough
investigation of all allegations of abuse, exploitation, or neglect by trained, experienced
personnel delegated with all necessary authority. (4)...
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6-5-548
Section 6-5-548 Burden of proof; reasonable care as similarly situated health care provider;
no evidence admitted of medical liability insurance. (a) In any action for injury or damages
or wrongful death, whether in contract or in tort, against a health care provider for breach
of the standard of care, the plaintiff shall have the burden of proving by substantial evidence
that the health care provider failed to exercise such reasonable care, skill, and diligence
as other similarly situated health care providers in the same general line of practice ordinarily
have and exercise in a like case. (b) Notwithstanding any provision of the Alabama Rules of
Evidence to the contrary, if the health care provider whose breach of the standard of care
is claimed to have created the cause of action is not certified by an appropriate American
board as being a specialist, is not trained and experienced in a medical specialty, or does
not hold himself or herself out as a specialist, a "similarly...
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22-21-293
Section 22-21-293 Financial responsibility for out-of-county indigent patients treated at a
regional referral hospital. Ultimate financial responsibility for treatment received at a
regional referral hospital by a certified indigent patient, who is a resident of the State
of Alabama but is not a resident of the county in which the regional referral hospital is
located, shall be the obligation of the county of which the certified indigent patient is
a resident. A county's annual financial responsibility for each of its resident certified
indigent patients receiving treatment at a regional referral hospital shall be limited to
payment for 30 days or the number of days of services allowed per annum for the care of Medicaid
patients through the State Medicaid Program at the time of the patient's hospitalization,
whichever shall be less, at the per diem reimbursement rate currently in effect for the regional
referral hospital under the medical assistance program for the needy under Title...
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26-10D-5
Section 26-10D-5 State prohibited from discriminating against child care service providers
under certain conditions. (a) The state may not refuse to license or otherwise discriminate
or take an adverse action against any child placing agency that is licensed by or required
to be licensed by the state for child placing services on the basis that the child placing
agency declines to make, provide, facilitate, or refer for a placement in a manner that conflicts
with, or under circumstances that conflict with, the sincerely held religious beliefs of the
child placing agency provided the agency is otherwise in compliance with the requirements
of the Alabama Child Care Act of 1971, Chapter 7, Title 38, and the Minimum Standards for
Child Placing Agencies. (b) If a child placing agency under subsection (a) declines to make,
provide, facilitate, or refer for a child placement, the decision of the child placing agency
may not limit the ability of another child placing agency to make, provide,...
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41-22-4
Section 41-22-4 Adoption by agencies of rules governing organization, practice, etc.; public
access to rules, orders, etc.; effect of rules, orders, etc., not made available to public.
(a) In addition to the other rulemaking requirements imposed by law, each agency shall: (1)
Adopt as a rule a description of its organization, stating the general course and method of
its operations and the methods whereby the public may obtain information or make submissions
or requests; (2) Adopt rules of practice setting forth the nature and requirements of all
formal and informal procedures available, including a description of all forms and instructions
used by the agency; (3) Make available for public inspection and copying, at cost, all rules
and all other written statements of policy or interpretations formulated, adopted or used
by the agency in the discharge of its functions; (4) Make available for public inspection
and copying, at cost, and index by name and subject all final orders,...
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41-5A-6
Section 41-5A-6 Chief examiner - Recovery audits for overpayments of state funds. (a) For the
purposes of this section, the following words have the following meanings: (1) CHIEF EXAMINER.
The Chief Examiner of Public Accounts. (2) OVERPAYMENT. Any payment in excess of amounts due
and includes failure to meet eligibility requirements, failure to identify third party liability
where applicable, any payment for an ineligible good or service, any payment for a good or
service not received, duplicate payments, invoice and pricing errors, failure to apply discounts,
rebates, or other allowances, failure to comply with contracts or purchasing agreements, or
both, failure to provide adequate documentation or necessary signatures, or both, on documents,
or any other inadvertent error resulting in overpayment. (3) RECOVERY AUDIT. A financial management
technique used to identify overpayments made by a state agency with respect to individuals,
vendors, service providers, and other entities in...
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22-21-275
Section 22-21-275 Procedures for review of applications for certificates of need. The SHPDA,
pursuant to the provisions of Section 22-21-274, shall prescribe by rules and regulations
the procedures for review of applications for certificates of need and for issuance of certificates
of need. Rules and regulations governing review procedures shall include, but not necessarily
be limited to, the following: (1) Agreement with other review agencies for review procedures
consistent with this article and federal regulations. (2) Application procedures and forms
of the application necessary to elicit and provide all necessary information as required by
the review criteria. (3) Establishment of a project review period of 90 days from the date
the state agency determines that the application is complete and notification thereof is made
to the applicant. The rules and regulations may provide for a period of not more than 15 days
for determination of the completeness of the application,...
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27-21A-15
Section 27-21A-15 Powers of insurers and health care service plans. (a) An insurance company
licensed in this state, or a health care service plan authorized to do business in this state,
may either directly or through a subsidiary or affiliate organize and operate a health maintenance
organization under the provisions of this chapter. Notwithstanding any other law which may
be inconsistent herewith, any two or more such insurance companies, health care service plans,
or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance
organization. The business of insurance is deemed to include the providing of health care
by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.
(b) Notwithstanding any provision of insurance and health care service plan laws, Title 10,
Chapter 4, Article 6 and Title 27, an insurer or a health care service plan may contract with
a health maintenance organization to provide insurance or...
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31-9B-3
Section 31-9B-3 Providing of information; requirements for emergency and disaster planning
provisions; immunity. (a) All appropriate agencies and community-based service providers,
including, but not limited to, home health care providers, hospices, community mental health
centers, and related facilities, but not including health care facilities which provide inpatient
care to include general and specialized hospitals including ancillary services, skilled nursing
facilities, intermediate care facilities, or any assisted living facility, shall provide information
on the number of individuals with medical needs and shall assist the State Health Department
in the establishment of programs to increase the awareness of medical needs shelters, and
in educating clients and sponsors or caregivers about the procedures that may be necessary
for their safety during disasters. (b) State agencies that regulate or contract with providers
of services, or both, for persons with disabilities or...
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34-23-183
Section 34-23-183 Application. This article shall apply to any audit of the records of a pharmacy
conducted by a managed care company, nonprofit hospital or medical service organization, health
benefit plan, third-party payor, pharmacy benefit manager, a health program administered by
a department of the state, except the Alabama Medicaid Agency, or any entity that represents
those companies, groups, or department. (Act 2012-306, p. 668, §4; Act 2018-457, §1.)...

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