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22-6-6.1
Section 22-6-6.1 Assignment to state of recipients' rights to payments for medical care; authorization
to release needed information. (a) Every recipient of medical assistance under the Alabama
Medicaid Program shall be deemed to have made assignment to the State of Alabama of any and
all rights of his to medical support or payments for medical care from any person, firm or
corporation, together with the rights of any other individuals eligible for medical assistance
for whom he can legally make assignment. This assignment shall be effective to the extent
of the amount of medical assistance actually paid by the Medicaid Agency. The recipient shall
cooperate fully with the Medicaid Agency in its efforts to secure such rights, and shall execute
and deliver all instruments and papers needed by the Medicaid Agency in this regard. (b) Every
recipient of medical assistance under the Alabama Medicaid Program shall be deemed to have
authorized all third parties, including insurance companies...
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27-14-11.1
Section 27-14-11.1 Contents of policies - Denial or reduction of benefits due to Medicaid eligibility
void. (a) For purposes of this section, "private insurer" is defined as any of the
following: (1) Any commercial insurance company offering health or casualty insurance to individuals
or groups, including both experience-rated contracts and indemnity contracts. (2) Any profit
or nonprofit prepaid plan offering either medical services or full or partial payment for
the diagnosis or treatment of an injury, disease, or disability. (3) Any organization administering
health or casualty insurance plans for professional associations, unions, fraternal groups,
employer-employee benefit plans, and any similar organization offering these payments or services,
including self-insured and self-funded plans. (4) Any health insurer, including group health
plans, as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974,
self-insured plans, service benefit plans, managed care...
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22-6-6
Section 22-6-6 Subrogation of state to rights of recipients of medical assistance under program
against persons, etc., causing injury, etc., thereto; manner of enforcement of rights of state;
effect of action by state or recipient against person, etc., causing injury, etc., upon rights
of other; provision of written notice, etc., by recipients instituting civil actions for damages.
(a) If medical assistance is provided to a recipient under the Alabama Medicaid Program for
injuries, disease or sickness caused under circumstances creating a cause of action in favor
of the recipient against any person, firm or corporation, then the State of Alabama shall
be subrogated to such recipient's rights and shall be entitled to recover the proceeds that
may result from the exercise of any rights of recovery which the recipient may have against
any such person, firm or corporation to the extent of the actual amount of the medical assistance
payments made by the Alabama Medicaid Program. The...
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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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22-6-150
Section 22-6-150 Definitions. For the purposes of this article, the following words shall have
the following meanings: (1) 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. (2) CAPITATION
PAYMENT. A payment the state Medicaid Agency makes periodically to a contractor on behalf
of each recipient enrolled under a contract for the provision of medical services. (3) CARE
DELIVERY SYSTEM. The manner in which the benefits and services set forth in the state Medicaid
plan are provided to Medicaid beneficiaries. (4) 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...
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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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13A-9-150
Section 13A-9-150 Public assistance fraud; penalties. (a) For the purposes of this section,
public assistance means money or property provided directly or indirectly to eligible persons
through programs of the federal government, the state, or any political subdivision thereof,
including any program administered by a public housing authority. (b) It shall be unlawful
for an individual or business entity to knowingly do any of the following: (1) Fail, by false
statement, misrepresentation, impersonation, or other fraudulent means, to disclose a material
fact used in making a determination as to the qualification of the person to receive public
assistance. (2) Fail to disclose a change in circumstances in order to obtain or continue
to receive any public assistance to which he or she is not entitled or in an amount larger
than that to which he or she is entitled. (3) Aid and abet another person in the commission
of the prohibitions enumerated in subdivisions (1) and (2). (4) Use,...
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31-9-40
Section 31-9-40 Compact adopted and enacted. The Emergency Management Assistance Compact is
enacted into law and entered with all jurisdictions mutually adopting the compact in the form
substantially as follows: THE EMERGENCY MANAGEMENT ASSISTANCE COMPACT Article I - Purpose
and Authorities. This compact is made and entered into by and between the participating member
states which enact this compact, hereinafter called party states. For the purpose of this
agreement, the term "states" is taken to mean the several states, the Commonwealth
of Puerto Rico, the District of Columbia, and all U.S. territorial possessions. The purpose
of this compact is to provide for mutual assistance between the states entering into this
compact in managing any emergency or disaster that is duly declared by the governor of the
affected state or states, whether arising from natural disaster, technological hazard, man-made
disaster, civil emergency aspects of resources shortages, community disorders,...
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22-19-161
Section 22-19-161 Definitions. In this article: (1) "Adult" means an individual who
is at least 18 years of age. (2) "Agent" means an individual: (A) authorized to
make health care decisions on the principal's behalf by a power of attorney for health care;
or (B) expressly authorized to make an anatomical gift on the principal's behalf by any other
record signed by the principal. (3) "Anatomical gift" means a donation of all or
part of a human body to take effect after the donor's death for the purpose of transplantation,
therapy, research, or education. (4) "Coroner" means an elected or appointed official
who determines, with the assistance of other forensic scientists and investigators, the cause,
manner, and circumstances surrounding death. (5) "Decedent" means a deceased individual
whose body or part is or may be the source of an anatomical gift. The term includes a stillborn
infant and, subject to restrictions imposed by law other than this article, a fetus. (6) "Disinterested...
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16-33B-4
Section 16-33B-4 Basic powers and duties of the Alabama Commission on Higher Education for
the Alabama Guaranteed Student Loan Program. (a) Basic powers. The Alabama Commission on Higher
Education (ACHE) is authorized to administer the Alabama Guaranteed Student Loan Program in
accordance with the Federal Student Loan Law, and empowered to promulgate such rules, regulations,
policies, and procedures as may be reasonable and proper in order to carry out the provisions
and purposes of this chapter. Without limiting the generality of the foregoing, the ACHE is
authorized and empowered: (1) To establish regulations deemed necessary to comply with federal
regulations and legislation relative to guaranteed student loans and the Federal Student Loan
Law. (2) To establish eligibility criteria for participating postsecondary educational institutions.
(3) To establish reasonable eligibility criteria for the initial and continuing participation
of approved lenders in the student loan program. (4)...
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