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34-39-3
Section 34-39-3 Definitions. In this chapter, the following terms shall have the respective
meanings provided in this section unless the context clearly requires a different meaning:
(1) ASSOCIATION. The Alabama Occupational Therapy Association. (2) BOARD. The Alabama State
Board of Occupational Therapy. (3) LICENSE. A valid and current certificate of registration
issued by the Alabama State Board of Occupational Therapy. (4) OCCUPATIONAL THERAPY. a. The
practice of occupational therapy means the therapeutic use of occupations, including everyday
life activities with individuals, groups, populations, or organizations to support participation,
performance, and function in roles and situations in home, school, workplace, community, and
other settings. Occupational therapy services are provided for habilitation, rehabilitation,
and the promotion of health and wellness to those who have or are at risk for developing an
illness, injury, disease, disorder, condition, impairment, disability,...
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27-1-16
Section 27-1-16 Standard health insurance claim form; electronic claims form; various claim
forms. (a)(1) The Commissioner of the Department of Insurance shall prescribe a standard health
insurance claim form to be used by all hospitals. The forms shall be prescribed in a format
which allows for the use of generally accepted diagnosis and treatment coding systems by providers
of health care and payors. The standard form shall be accepted and used by all insurers doing
business in the State of Alabama and by all state agencies which pay providers of health care
for hospital services. (2) The Commissioner of the Department of Insurance shall also prescribe
a format for all health insurance claims transmitted or submitted for payment by electronic
or electro-mechanical means. Such a format shall be used by all insurers doing business in
the State of Alabama and by all state agencies which pay providers of health care for hospital
services. (b) An advisory committee of five persons, two...
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34-23-1
Section 34-23-1 Definitions. For the purpose of this chapter, the following words and phrases
shall have the following meanings: (1) ASSOCIATION. The Alabama Pharmacy Association. (2)
BIOLOGICAL PRODUCT. Has the same meaning as the term as defined in 42 U.S.C. ยง262. (3) BOARD
or STATE BOARD. The Alabama State Board of Pharmacy. (4) CHEMICAL. Any substance of a medicinal
nature, whether simple or compound, obtained through the process of the science and art of
chemistry, whether of organic or inorganic origin. (5) DISPENSE. To sell, distribute, administer,
leave with, give away, dispose of, deliver, or supply a drug or medicine to the ultimate user
or his or her agent. (6) DRUGS. All medicinal substances, preparations, and devices recognized
by the United States Pharmacopoeia and National Formulary, or any revision thereof, and all
substances and preparations intended for external and internal use in the cure, diagnosis,
mitigation, treatment, or prevention of disease in man or animal...
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34-25A-4
Section 34-25A-4 Referral and consultation limits. (a) A licensed prosthetist, licensed orthotist,
or licensed prosthetist/orthotist may provide services utilizing new prostheses or orthoses
for which he or she is licensed and only under a written order from an authorized health care
practitioner. A consultation with and periodic review by an authorized health care practitioner
is not required for the evaluation, repair, adjusting, or servicing of a prosthesis by a licensed
prosthetist, or licensed prosthetist/orthotist and for the evaluation, repair, adjusting,
or servicing of an orthosis by a licensed orthotist, or licensed prosthetist/orthotist; nor
is an order from an authorized health care practitioner required for maintenance or replacement
of an orthosis or prosthesis to the level of its original prescription for an indefinite period
of time if the original order remains appropriate for the patient's medical needs. (b) Prosthetists
and orthotists must refer persons receiving...
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34-25A-3
Section 34-25A-3 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) ACCREDITED FACILITY. A facility where prosthetic, orthotic, prosthetic and orthotic,
or pedorthic care is provided to patients needing such care and has met the requirements of
the board for such designation. The board shall require that all accredited facilities meet
the requirements of a national certifying board, recognized by the state board in prosthetics,
orthotics, and pedorthics accredited by the National Commission for Certifying Agencies (NCCA)
in the discipline or disciplines for which the application is made and meet any other requirements
of the board. The requirements may include custom and non-custom items the board may determine
are necessary to perform quality care and are typical in the course of business. (2) ACCREDITED
PEDORTHIC FACILITY. A facility where pedorthic care may be provided that has met the requirements
of the board for such designation. An...
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27-48-3
Section 27-48-3 Prohibition against plan termination of services, reduction of capitation payment,
or other penalty for health care provider in compliance with chapter; prohibition against
financial encouragement of early discharge from postpartum care. No health benefit plan subject
to the provisions of this chapter shall terminate the services, reduce capitation payment,
or otherwise penalize an attending physician, certified nurse midwife, or other health care
provider who orders medical care consistent with this chapter. No health benefit plan shall
provide, directly or indirectly, any financial incentive or disincentive or grant or deny
any special favor or advantage of any kind or nature to any person to encourage or cause early
discharge of a hospital patient from postpartum care, excluding capitation or global fee arrangements.
Provided nothing contained in this chapter is intended to expand the list or designation of
covered providers as specified in any health benefit plan or...
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34-21-81
Section 34-21-81 Definitions. As used in this article, the following terms shall have the following
meanings: (1) BOARD OF MEDICAL EXAMINERS. The State Board of Medical Examiners established
pursuant to Section 34-24-53. (2) BOARD OF NURSING. The Board of Nursing established under
Section 34-21-2. (3) ADVANCED PRACTICE NURSE. A registered nurse that has gained additional
knowledge and skills through successful completion of an organized program of nursing education
that prepares nurses for advanced practice roles and has been certified by the Board of Nursing
to engage in the practice of advanced practice nursing. There shall be four categories of
advanced practice nurses: Certified registered nurse practitioners (CRNP), certified nurse
midwives (CNM), certified registered nurse anesthetists (CRNA), and clinical nurse specialists
(CNS). Certified registered nurse practitioners and certified nurse midwives are subject to
collaborative practice agreements with an Alabama physician....
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27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
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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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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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