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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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12-23A-2
Section 12-23A-2 Definitions. As used in this chapter, the following words shall have the following
meanings: (1) ADVISORY COMMITTEE. A local committee which may consist of the following members
or their designees: a. The drug court judge, who shall serve as chair. b. The district attorney.
c. The public defender or a member of the criminal defense bar. d. The drug court coordinator.
e. The court clerk. f. A community corrections or court referral officer, or both. g. A pretrial
services provider. h. A law enforcement officer. i. Substance abuse treatment providers. j.
Any other person the chair deems appropriate. (2) ASSESSMENT. A diagnostic evaluation for
placement in a treatment program which shall be performed in accordance with criteria certified
by the Department of Mental Health, Substance Abuse Services Division. (3) CHARGE. As defined
in Section 12-25-32(13). (4) CONTINUUM OF CARE. A seamless and coordinated course of substance
abuse education and treatment designed to meet...
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22-18-6
Section 22-18-6 Violations; good Samaritan provisions; scope of privilege; control of emergency
scene; penalties. (a) It shall be a Class A misdemeanor for any person, firm, company, corporation,
organization, facility, or agency to do any of the following: (1) Deliberately hinder, obstruct,
or interfere with an officer, inspector, or duly authorized agent of the board while in the
performance of official duties. (2) Deliberately hinder, obstruct, or interfere with any physician,
licensed nurse, licensed EMSP, or emergency personnel exempt from licensure under this article
while that individual is providing emergency care to a third person or while that individual
is assisting at the scene of an emergency, directing traffic at the scene of an emergency,
or managing or helping to manage the scene of an emergency. (3) Violate subsection (c) or
(d). (4) Offer, provide, or perform, without a license or certificate to do so, an emergency
medical service or other function which, under this...
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22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance
procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for
Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid
region for at least one fully certified regional care organization to provide, pursuant to
a risk contract under which the Medicaid Agency makes a capitated payment, medical care to
Medicaid beneficiaries. However, the Medicaid Agency may enter into a contract pursuant to
this section only if, in the judgment of the Medicaid Agency, care of Medicaid beneficiaries
would be better, more efficient, and less costly than under the then existing care delivery
system. The Medicaid Agency may contract with more than one regional care organization in
a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments
for the regional care organization. (b) The Medicaid Agency shall...
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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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27-19A-3
Section 27-19A-3 Prohibited provisions. No health insurance policy or employee benefit plan
which is delivered, renewed, issued for delivery, or otherwise contracted for in this state
shall: (1) Prevent any person who is a party to or beneficiary of any such health insurance
policy or employee benefit plan from selecting the dentist of his choice to furnish the dental
care services offered by said policy or plan or interfere with said selection provided the
dentist is licensed to furnish such dental care services in this state; (2) Deny any dentist
the right to participate as a contracting provider for such policy or plan provided the dentist
is licensed to furnish the dental care services offered by said policy or plan; (3) Authorize
any person to regulate, interfere, or intervene in any manner in the diagnosis or treatment
rendered by a dentist to his patient for the purpose of preventing, alleviating, curing, or
healing dental illness or injury provided said dentist practices within...
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34-22-81
Section 34-22-81 Definitions. For the purposes of this article, the following terms shall have
the following meanings: (1) BOARD. The Alabama Board of Optometry created pursuant to Section
34-22-40. (2) DISTANT SITE PROVIDER. The provider providing the telemedicine service from
a site other than the patient's current location. A distant site provider shall hold an active
Alabama license pursuant to Section 34-22-20 or Section 34-22-21. (3) ESTABLISHED TREATMENT
SITE. A location where a patient shall present to seek optometric care where there is an optometrist
present and sufficient technology and equipment to allow for an adequate physical evaluation
as appropriate for the patient's presenting complaint. The term requires an optometrist-patient
relationship. A patient's private home is not considered an established treatment site. (4)
FACE-TO-FACE VISIT. An evaluation performed on a patient where both the provider and patient
are at the same physical location or where the patient is...
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34-22-82
Section 34-22-82 Telemedicine - Protocols; privacy practices. (a) A provider who uses telemedicine
in his or her practice shall adopt protocols to prevent fraud and abuse through the use of
telemedicine. (b)(1) Privacy practices. a. A provider that communicates with patients by electronic
communications other than telephone or facsimile shall provide patients with written notification
of the provider's privacy practices before evaluation or treatment. b. The notice of privacy
practices shall include language that is consistent with federal standards under 45 CFR Parts
160 and 164 relating to privacy of individually identifiable health information. c. A provider
shall make a good faith effort to obtain the patient's written acknowledgment of the notice.
(2) Limitations of telemedicine. A provider who uses telemedicine services, before providing
services, shall give each patient notice regarding telemedicine services, including the risks
and benefits of being treated via telemedicine,...
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13A-12-214.2
Section 13A-12-214.2 (Repealed effective July 1, 2020) Possession and use of cannabidiol. (a)
This section shall be known and may be cited as "Carly's Law." (b) As used in this
section, the following words shall have the following meanings: (1) AUTHORIZED BY THE UAB
DEPARTMENT. Authorized by the UAB Department means that Cannabidiol (CBD) has been prescribed
by a health care practitioner employed by or on behalf of the UAB Department. (2) CANNABIDIOL
(CBD). [13956-29-1]. A (nonpsychoactive) cannabinoid found in the plant Cannabis sativa L.
or any other preparation thereof that is essentially free from plant material, and has a THC
level of no more than 3 percent. Also known as (synonyms): 2-[(1R,6R)-3-Methyl-6-(1-methylethenyl)-2-cyclohexen-1-yl]-5-pentyl-1,3-benzenediol;
trans-(-)-2-p-mentha-1,8-dien-3-yl-5-pentylresorcinol; (-)-Cannabidiol; (-)-trans-Cannabidiol;
Cannabidiol (7CI); D1(2)-trans-Cannabidiol. (3) DEBILITATING EPILEPTIC CONDITION. Epilepsy
or other neurological disorder,...
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26-16-91
Section 26-16-91 Definitions. The following words and phrases have the following meanings unless
the context clearly indicates otherwise: (1) AUTOPSY. An external and internal examination,
medical history, and record review. (2) CHILD. A person who has not yet reached his or her
eighteenth birthday. (3) CHILD DEATHS TO BE REVIEWED. Those deaths which are unexpected or
unexplained. (4) COMMUNITY. The people and area within the local team jurisdiction. (5) COUNTY.
The county in which a deceased child resided prior to his or her death. (6) INVESTIGATION.
In the context of child death, includes all of the following: a. A postmortem examination
which may be limited to an external examination or may include an autopsy. b. An inquiry by
law enforcement agencies having jurisdiction into the circumstances of the death, including
a scene investigation and interview with the child's parents, guardians, or caretakers and
the person who reported the child's death. c. A review of information...
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