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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...
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27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases shall
have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health. (2)
ENROLLEE. An individual who has contracted for or who participates in coverage under an insurance
policy, a health maintenance organization contract, a health service corporation contract,
an employee welfare benefit plan, a hospital or medical services plan, or any other benefit
program providing payment, reimbursement, or indemnification for health care costs for the
individual or the eligible dependents of the individual. (3) PROVIDER. A health care provider
duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system for prospective
and concurrent review of the necessity and appropriateness in the allocation of health care
resources and services given or proposed to be given to an individual within this state. The
term does not include elective requests for clarification of...
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27-56-10
Section 27-56-10 Vision care providers - Contract requirements; rates; reimbursements; discounts.
(a) As used in this section, the following words shall have the following meanings: (1) CONTRACTUAL
DISCOUNT. A percentage reduction from a provider's usual and customary rate for covered services
and materials required under a participating provider agreement. (2) COVERED MATERIALS. Materials
for which reimbursement from the insurer or vision care plan is provided to a vision care
provider by an enrollee's plan contract, or for which a reimbursement would be available but
for the application of the enrollee's contractual limitations of deductibles, copayments,
or coinsurance. (3) COVERED SERVICES. Services for which reimbursement from the insurer or
vision care plan is provided to a vision care provider by an enrollee's plan contract, or
for which a reimbursement would be available but for the application of the enrollee's contractual
plan limitations of deductibles, copayments, or...
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38-9D-3
Section 38-9D-3 Alabama Interagency Council for the Prevention of Elder Abuse. There is created
the Alabama Interagency Council for the Prevention of Elder Abuse. The members of the council
shall include, but not be limited to, the following: (1) The chief executive officer, or his
or her designee, of each of the following participating agencies and organizations: a. The
Alabama 911 Network. b. The Administrative Office of Courts. c. The Attorney General. d. The
Banking Department. e. The Coalition Against Domestic Violence. f. The Crime Victims Compensation
Commission. g. The Department of Forensic Sciences. h. The Department of Human Resources.
i. The Department of Insurance. j. The Department of Mental Health. k. The Department of Public
Health. l. The Alabama State Law Enforcement Agency. m. The Department of Senior Services.
n. The Department of Veterans Affairs. o. The Governor's Office of Faith Based Initiatives
and Community Service. p. The Medicaid Agency. q. The Office of...
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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...
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22-21-260
Section 22-21-260 Definitions. As used in this article, the following words and terms, and
the plurals thereof, shall have the meanings ascribed to them in this section, unless otherwise
required by their respective context: (1) ACQUISITION. Obtaining the legal equitable title
to a freehold or leasehold estate or otherwise obtaining the substantial benefit of such titles
or estates, whether by purchase, lease, loan or suffrage, gift, devise, legacy, settlement
of a trust or means whatever, and shall include any act of acquisition. The term "acquisition"
shall not mean or include any conveyance, or creation of any lien or security interest by
mortgage, deed of trust, security agreement, or similar financing instrument, nor shall it
mean or include any transfer of title or rights as a result of the foreclosure, or conveyance
or transfer in lieu of the foreclosure, of any such mortgage, deed of trust, security agreement,
or similar financing instrument, nor shall it mean or include any...
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27-52-2
Section 27-52-2 Authority. The plan shall have the general powers and authority granted under
the laws of this state to health insurers and in addition thereto, the specific authority
to do all of the following: (1) Enter into contracts as are necessary or proper to carry out
the provisions and purposes of this article, including the authority, with the approval of
the commissioner, to enter into contracts with similar plans of other states for the joint
performance of common administrative functions, or with persons or other organizations for
the performance of administrative functions. (2) Sue or be sued, including taking any legal
actions necessary or proper to recover or collect assessments due the plan. (3) Take legal
action as necessary to do any of the following: a. To avoid the payment of improper claims
against the plan or the coverage provided by or through the plan. b. To recover any amounts
erroneously or improperly paid by the plan. c. To recover any amounts paid by the...
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11-95-7
Section 11-95-7 Powers of corporation. In addition to all other powers granted elsewhere in
this chapter, a corporation shall have the following powers, together with all powers incidental
thereto or necessary to the discharge thereof in corporate form: (1) To have succession by
its corporate name for the duration of time (which may be perpetuity, subject to the provisions
of Section 11-95-19) specified in its certificate of incorporation; (2) To sue and be sued
in its own name in civil suits and actions, and to defend suits against it; (3) To adopt and
make use of a corporate seal and to alter the same at pleasure; (4) To adopt and alter bylaws
for the regulation and conduct of its affairs and business; (5) To acquire, construct, equip,
enlarge, improve, maintain, and operate hospital facilities in the authorizing county and
to do all things necessary to that end; (6) To receive, acquire, take and hold, whether by
purchase, gift, lease, devise, or otherwise, real and personal property...
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34-9-6.1
Section 34-9-6.1 Mobile dental facilities or portable dental operations. (a) For purposes of
this section, the following words have the following meanings: (1) DENTAL HOME. The dental
home is the ongoing relationship between the dentist and the patient, inclusive of all aspects
of oral health care, delivered in a comprehensive, continuously accessible, coordinated, and
family-centered way. (2) MOBILE DENTAL FACILITY. Any self-contained facility in which dentistry
or dental hygiene is practiced which may be moved, towed, or transported from one location
to another. (3) OPERATOR. A person licensed to practice dentistry in this state or an entity
which is approved as tax exempt under Section 501(c)(3) of the Internal Revenue Code which
employs dentists licensed in the state to operate a mobile dental facility or portable dental
operation. (4) PORTABLE DENTAL OPERATION. The use of portable dental delivery equipment which
is set up on site to provide dental services outside of a mobile...
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21-3A-3
Section 21-3A-3 Definitions. The following words and phrases used in this chapter have the
following respective meanings unless the context clearly indicates otherwise: (1) COUNCIL.
The Interagency Coordinating Council as established in Section 21-3A-4. (2) EARLY INTERVENTION
SERVICES. Any developmental services that: a. Are provided under public supervision. b. Are
designed to meet the developmental needs of each eligible child and the needs of the family
related to enhancing the development of the child. c. Are selected in collaboration with the
parents. d. Are provided by qualified personnel as determined by the personnel standards of
the state, the standards of the early intervention program, and the regulations. e. Are provided
in conformity with an individualized family service plan. f. Meet the requirements of Public
Law 99-457 as amended (20 U.S.C. ยงยง1471 to 1485, inclusive), and the early intervention
standards of the State of Alabama. g. Are provided, to the extent...
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