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27-21A-1
Section 27-21A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively: (1) AGENT. A person who is appointed or employed by a health maintenance
organization and who engages in solicitation of membership in such organization. This definition
does not include a person enrolling members on behalf of an employer, union, or other organization.
(2) BASIC HEALTH CARE SERVICES. Emergency care, inpatient hospital and physician care, and
outpatient medical services. (3) COMMISSIONER. The Commissioner of Insurance. (4) ENROLLEE.
An individual who is enrolled in a health maintenance organization. (5) EVIDENCE OF COVERAGE.
Any certificate, agreement, or contract issued to an enrollee setting out the coverage to
which he is entitled. (6) HEALTH CARE SERVICES. Any services included in the furnishing to
any individual of medical or dental care, or hospitalization or incident to the furnishing
of such care or hospitalization, as well as the...
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27-50-3
Section 27-50-3 Health benefit plan. As used in this chapter, the term "health benefit
plan" has the following meaning: A health insurance policy, including a self-insured
health plan, that covers hospital, medical, or surgical expenses, health maintenance organizations,
preferred provider organizations, medical service organizations, physician-hospital organizations,
or any other person, firm, corporation, joint venture, or other similar business entity that
pays for, purchases, or furnishes health care services to patients, insureds, or beneficiaries
in this state. The term does not include accident-only, specified disease, individual hospital
indemnity, credit, dental-only, Medicare-supplement, long-term care, or disability income
insurance; coverage issued as a supplement to liability insurance, workers' compensation or
similar insurance; or automobile medical-payment insurance. For the purpose of this chapter,
a health benefit plan located or domiciled outside of the State of...
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14-14-5
Section 14-14-5 Medical release application; eligibility factors; revocation; notice. (a) An
inmate, or any concerned person, including, but not limited to, the inmate's attorney, family,
physician, or an employee or official of the department may initiate consideration for medical
furlough by submitting to the department an initial medical release application form along
with supporting documentation. (b)(1) The initial application form shall include the report
of a physician or physicians employed by the department or its health care provider and a
notarized report of at least one other duly licensed physician who is board certified in the
field of medicine for which the inmate is seeking a medical furlough and who is not an employee
of the department. These reports shall each be of the opinion that the inmate is either terminally
ill, permanently incapacitated, or that the inmate suffers from a chronic infirmity, illness,
or disease related to aging. (2) The commissioner shall...
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22-11A-4
Section 22-11A-4 Certain records to be provided to State Health Officer or Bureau of Clinical
Laboratories. (a) For purposes of this article, the following terms have the following meanings:
(1) CLINICAL MATERIALS. Either of the following: a. A clinical isolate that contains or that
may contain an infectious agent of public health importance. b. Material that contains or
that may contain an infectious agent of public health importance, if an isolate is not available,
in the following order of preference: 1. A patient specimen. 2. Nucleic acid. 3. Other laboratory
material. (2) PROVIDER OF MEDICAL SERVICES. A physician, hospital, laboratory, or other medical
facility or medical professional that renders medical care relating to treatment of possible
or confirmed cases of public health importance. (b) A provider of medical services that is
currently rendering or that has rendered treatment, care, diagnostic services, or laboratory
services to any person suspected of having a notifiable...
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6-5-333
Section 6-5-333 Dentists, chiropractors, and physicians serving on utilization and quality
control committees, peer review committees, or professional standards review committees; consultants
thereto and employees thereof; dental, chiropractic and medical societies and associations;
appeal to Alabama Dental Association; confidentiality. (a) Any dentist, chiropractor, or physician
licensed to practice medicine in Alabama who serves on a peer review or a utilization and
quality control committee or professional standards review committee or a similar committee
or a committee of similar purpose or any dentist, physician, chiropractor, or individual who
serves as a consultant or employee to one of said committees established either by a dental
society or dental association or by a chiropractic society or chiropractic association or
by a state medical association or county medical society to review any aspect of dental care,
chiropractic care, or medical care at the request of a government...
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27-51-1
Section 27-51-1 Payment for services of licensed physician assistant. (a) An insurance policy
or contract providing for third-party payment or prepayment of health or medical expenses
shall include a provision for the payment to a supervising physician for necessary medical
or surgical services that are provided by a licensed physician assistant practicing under
the supervision of the physician, and pursuant to the rules, regulations, and parameters for
physician assistants, if the policy or contract pays for the same care and treatment provided
by a licensed physician or doctor of osteopathy. (b) An insurance policy or contract subject
to this section shall not impose a practice or supervision restriction which is inconsistent
with or more restrictive than provided by law. (c) This section shall apply to services provided
under a policy or contract delivered, continued, or renewed in this state on or after August
1, 1997, and to any existing policy or contract, on the policy's or...
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27-53-1
Section 27-53-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) GENETIC CHARACTERISTICS. A scientifically or medically identifiable gene or
chromosome, or alteration thereof, that is known to be a cause of a disease or disorder, or
determined to be associated with a statistically increased risk of development of a disease
or disorder. (2) GENETIC TEST. A pre-symptomatic laboratory test which is generally accepted
in the scientific and medical communities for the determination of the presence or absence
of the genetic characteristics that cause or are associated with risk of a disease or disorder.
(3) HEALTH BENEFIT PLAN. A health insurance policy, including a self-insured health plan,
that covers hospital, medical, or surgical expenses, health maintenance organizations, preferred
provider organizations, medical service organizations, physician-hospital organizations, or
any other person, firm, corporation, joint venture, or other similar...
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27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials,
adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit
plan that issues or renews any policy of accident or health insurance providing benefits for
medical or hospital expenses for its insured persons shall pay for services rendered by Alabama
health care providers within 45 calendar days upon receipt of a clean written claim or 30
calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation,
or health benefit plan is denying or pending the claim, the insurer, health service corporation,
or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar
days for an electronic claim, notify the health care provider or certificate holder of the
reason for denying or pending the claim and what, if any, additional information is required
to process the claim. Any undisputed portion of the claim...
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22-1-16
Section 22-1-16 Prescribing, dispensing, and administering auto-injectable epinephrine; liability;
reports; rulemaking authority. (a) As used in this section, the following words shall have
the following meanings: (1) ADMINISTER. The direct application of an epinephrine auto-injector
to the body of an individual. (2) AUTHORIZED ENTITY. Any entity or organization other than
a K-12 public school subject to Section 16-1-48, in connection with or at which allergens
capable of causing anaphylaxis may be present, including, but not limited to, recreation camps,
colleges and universities, day care facilities, youth sport leagues, amusement parks, restaurants,
places of employment, and sports arenas. (3) EPINEPHRINE AUTO-INJECTOR. A single-use device
used for the automatic injection of a premeasured dose of epinephrine into the human body.
(4) MEDICAL PRACTITIONER. A physician or other individual licensed under Title 34 authorized
to treat, use, or prescribe medicine and drugs for sick and...
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22-18-1
Section 22-18-1 Definitions. For the purposes of this article, the following terms shall have
the meanings respectively ascribed to them by this section: (1) ADVANCED EMERGENCY MEDICAL
TECHNICIAN. Any person 18 years of age or older who satisfies all of the following: a. Has
successfully completed the advanced emergency medical technician course of instruction, or
its equivalent, as approved by the State Board of Health. b. Has passed the state Advanced
EMT examination, as well as having met the requirements for becoming a licensed emergency
medical technician. c. Has been granted a license by the State Board of Health. (2) ADVANCED
LIFE SUPPORT (ALS). The treatment of potentially life-threatening medical emergencies through
the use of invasive medical techniques specified as advanced life support techniques by the
Board of Health, which ordinarily would be performed or provided by licensed physicians, but
which may be performed by emergency medical service personnel during emergencies...
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