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22-8A-15
Section 22-8A-15 THIS SECTION WAS ASSIGNED BY THE CODE COMMISSIONER IN THE 2018 REGULAR SESSION,
EFFECTIVE MARCH 28, 2018. THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. (a) The representative
of a qualified minor may execute a directive with respect to the extent of medical treatment,
medication, and other interventions available to provide palliative and supportive care to
the qualified minor by completing and signing an Order for PPEL Care form. Once completed
and signed by the representative, the attending physician may complete and sign the executed
directive and enter the directive into the medical record of the qualified minor. Once properly
entered and received into the medical record, the directive is deemed a valid Order for PPEL
Care; provided, however, it is the intent of this section to recognize the desires as reflected
in communications, including verbal or written statements, of a qualified minor and of the
representative of a qualified minor with respect to the extent of...
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34-14C-5
Section 34-14C-5 Exemptions. The licensure requirements of this chapter do not apply to the
following entities or practitioners: (1) Home health agencies certified by the State of Alabama
to participate in the Medicare and Medicaid programs. (2) Hospital based home medical equipment
services, whether or not the services are provided through a separate corporation or other
business entity. (3) Health care practitioners legally eligible to order or prescribe home
medical equipment, or who use home medical equipment to treat patients in locations other
than the patient's residence, including, but not limited to, physicians, nurses, physical
therapists, respiratory therapists, speech therapists, occupational therapists, optometrists,
chiropractors, and podiatrists, except for those practitioners, other than a licensed physician
practicing medicine, who provide home medical equipment services in a patient's residence.
Nothing in this chapter shall be construed as prohibiting or restricting...
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22-6-151
Section 22-6-151 Regional care organizations; governing board of directors; citizen's advisory
committee; solvency and financial requirements; reporting; provider standards committee. (a)
A regional care organization shall serve only Medicaid beneficiaries in providing medical
care and services. (b) Notwithstanding any other provision of law, a regional care organization
shall not be deemed an insurance company under state law. (c)(1) A regional care organization
and an organization with probationary regional care organization certification shall have
a governing board of directors composed of the following members: a. Twelve members shall
be persons representing risk-bearing participants in the regional care organization or organization
with probationary certification. A participant bears risk by contributing cash, capital, or
other assets to the regional care organization. A participant also bears risk by contracting
with the regional care organization to treat Medicaid beneficiaries...
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22-5A-6
Section 22-5A-6 Procedures for resolving complaints. (a) A community ombudsman's access to
any health care facility shall be limited to standard operating hours unless prior arrangements
with the operator of the facility has been made. If the complaint involves more than one provider
or alleges to involve more than one provider, the ombudsman shall investigate all providers.
(b) Any complaint requiring remedial action and deemed valid by the ombudsman shall be identified
and brought to the attention of the administrator or provider involved and followed up in
writing within a reasonable time. Upon receipt of such document, the administrator or provider,
in coordination with the ombudsman, shall establish a course of appropriate remedial action.
If the remedial action is not forthcoming within a reasonable time, the ombudsman must refer
the case to the State Ombudsman who may take any one or more of the following actions: (1)
Allow more time if the State Ombudsman has reason to believe...
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25-5-313
Section 25-5-313 Schedule of maximum fees. Within 60 days from May 19, 1992, the Workers' Compensation
Medical Services Board shall submit to the Governor an initial schedule of maximum fees for
medical services covered by this article, which schedule shall become effective immediately
upon submission to the Governor. The initial schedule of maximum fees shall be established
by the board in the manner prescribed in this section. The fee for each service in the schedule
shall be exactly equal to an amount derived by multiplying the preferred provider reimbursement
customarily paid on May 19, 1992, by the largest health care service plan incorporated pursuant
to Sections 10-4-100 to 10-4-115, inclusive, by a factor of 1.075, which product shall be
the maximum fee for each such service. In addition the board may submit to the Governor for
approval on or before January 31, 1993, a revised schedule of selected fees for medical services
covered by this article, which fees shall not exceed...
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27-3A-5
Section 27-3A-5 Standards for utilization review agents. (a) Except as provided in subsection
(b), all utilization review agents shall meet the following minimum standards: (1) Notification
of a determination by the utilization review agent shall be mailed or otherwise communicated
to the provider of record or the enrollee or other appropriate individual within two business
days of the receipt of the request for determination and the receipt of all information necessary
to complete the review. (2) Any determination by a utilization review agent as to the necessity
or appropriateness of an admission, service, or procedure shall be reviewed by a physician
or determined in accordance with standards or guidelines approved by a physician. (3) Any
notification of determination not to certify an admission, service, or procedure shall include
the principal reason for the determination and the procedures to initiate an appeal of the
determination. (4) Utilization review agents shall maintain...
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16-30B-3
Section 16-30B-3 Rulemaking authority; school nurse requirements; training guidelines. (a)
The State Board of Education shall adopt rules regarding the administration of Palliative
and End of Life Individual Health Plans in the school setting; provided, however, the board
may not propose rules without approval from the task force created pursuant to Section 16-30B-6.
For purposes of this subsection, approval requires an affirmative vote from at least three-fifths
of the task force members. The rules shall include, but are not limited to, the contents of
a plan and procedures for the execution and termination of a plan. The final rules shall be
certified to the Legislative Services Agency not later than June 1, 2019. (b) A Palliative
and End of Life Individual Health Plan administered under this chapter shall be developed
by the school nurse, in conjunction with the representative of the qualified minor. (c) A
plan shall include an Order for Pediatric Palliative and End of Life Care...
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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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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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34-27B-11
Section 34-27B-11 Additional activities permitted under chapter. Nothing in this chapter shall
be construed as preventing or restricting the practice, services, or activities of any of
the following: (1) Any person who is licensed in Alabama or certified by an organization accredited
by the National Commission for Certifying Agencies and acceptable to the state from engaging
in the profession or occupation for which the person is licensed or certified. (2) Any person
employed by the United States government who provides respiratory therapy solely under the
direction or control of the United States government agency or organization. (3) Any person
receiving clinical training while pursuing a course of study leading to registry or certification
in a respiratory therapy educational program accredited by the Council on Allied Health Education
Programs in collaboration with the Committee on Accreditation for Respiratory Care or their
successor organizations. This person will be under direct...
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