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27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases shall
have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health. (2)
ENROLLEE. An individual who has contracted for or who participates in coverage under an insurance
policy, a health maintenance organization contract, a health service corporation contract,
an employee welfare benefit plan, a hospital or medical services plan, or any other benefit
program providing payment, reimbursement, or indemnification for health care costs for the
individual or the eligible dependents of the individual. (3) PROVIDER. A health care provider
duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system for prospective
and concurrent review of the necessity and appropriateness in the allocation of health care
resources and services given or proposed to be given to an individual within this state. The
term does not include elective requests for clarification of...
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35-11-371
Section 35-11-371 Perfection of lien. (a) For the purposes of this section, the following terms
shall have the following meanings: (1) HEALTH CARE PAYOR. A health care insurer, health maintenance
organization, or health care service plan organized under Article 6, Chapter 20, Title 10A,
authorized to provide health care coverage in the state. (2) SATISFY THE CLAIM. Receipt by
the hospital of either of the following: a. Full payment for services as billed. b. If the
hospital has a contract with the injured person's health care payor, payment together with
all credits, discounts, and contractual adjustments that the patient's bill would be entitled
under the contract, including recoupments, between the hospital and the patient's health care
payor which extinguish the patient's obligation for the services rendered. (b) Unless specifically
contrary to any contractual agreement between the hospital and the injured person's health
care payor or unless contrary to any statute or governmental...
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26-16-70
Section 26-16-70 Membership; eligibility. (a) For purposes of this section, the following terms
have the following meanings: (1) FORENSIC INTERVIEW. The same meaning as in Section 12-15-301.
(2) LOCAL LAW ENFORCEMENT AGENCIES. The police department for the municipality and the sheriff's
department for the county in which a child advocacy center is located. (3) MENTAL HEALTH PROFESSIONAL.
An individual holding a master's or higher degree in social work, mental health counseling,
or other social work related or mental health counseling related field of study, and who has
received special training regarding child maltreatment and child trauma. (b) In order to become
eligible for a full membership in the Alabama Network of Children's Advocacy Centers, Incorporated,
child advocacy centers in this state shall: (1) Incorporate as a nonprofit agency under the
requirements of Section 10A-3-1.01 et seq. (2) Utilize a neutral, child-focused facility where
forensic interviews, conducted jointly by...
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38-9C-5
Section 38-9C-5 Providers who contract with agencies or programs required to develop written
policies to ensure rights. All providers who contract or subcontract with any federal, state,
or local agency or program to provide services in the State of Alabama to persons with developmental
disabilities or traumatic brain injury in Alabama shall develop and implement written policies
and procedures to ensure the rights enumerated above are observed by the provider in discharging
its contractual or subcontractual duties and responsibilities. At a minimum, these policies
and procedures shall provide for the following: (1) Affirm and safeguard the rights stated
in this chapter. (2) Provide that prompt, reasonable action be taken to prevent the potential
for further abuse while an investigation is in process. (3) Provide for a prompt and thorough
investigation of all allegations of abuse, exploitation, or neglect by trained, experienced
personnel delegated with all necessary authority. (4)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/38-9C-5.htm - 2K - Match Info - Similar pages
12-15-127
Section 12-15-127 Release, delivery to detention or shelter care facility, medical facility
of children taken into custody generally. (a) A person taking a child into custody without
an order of the juvenile court shall, with all possible speed, and in accordance with this
chapter and the rules of court pursuant thereto: (1) Release the child to the parents, legal
guardian, or legal custodian of the child or other suitable person able to provide supervision
and care for the child and issue verbal counsel and warning as may be appropriate. (2) Release
the child to the parents, legal guardian, or legal custodian of the child upon his or her
promise to bring the child before the juvenile court when requested, unless the placement
of the child in detention or shelter care appears required. If a parent, legal guardian, or
other legal custodian fails, when requested, to bring the child before the juvenile court
as provided in this section, the juvenile court may issue an order directing that...
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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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26-10-22
Section 26-10-22 Definitions. As used in this article, the following words shall have the following
meanings unless the context indicates otherwise: (1) ADOPTION SUBSIDY. A money payment, services,
deferred payment, or any combination thereof that is provided to a child with special needs
or circumstances after submission of an application to the department. (2) AGENCY. The department
or a child welfare agency which is authorized in its license issued by the department to place
children for adoption. (3) APPLICATION. The submission to the department of a complete application
as defined by the department with documentation of the child's special needs. (4) CHILD. An
individual under 19 years of age, or an individual 19 or 20 years of age and eligible for
Title IV-E Federal Funding, who is: a. in the care or custody, or both, of the department,
or a public or voluntary licensed child-placing agency, b. legally free for adoption and c.
in special need or circumstances because he or she is...
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27-21A-17
Section 27-21A-17 Suspension or revocation of certificate of authority. (a) The commissioner
in consultation with and with the approval of the State Health Officer, where necessary, may
suspend or revoke any certificate of authority issued to a health maintenance organization
under this chapter if he finds that any of the following conditions exist: (1) The health
maintenance organization is operating significantly in contravention of its basic organizational
document or in a manner contrary to that described in any other information submitted under
Section 27-21A-2, unless amendments to such submissions have been filed with the commissioner
and the State Health Officer and approved by the commissioner; (2) The health maintenance
organization issues evidence of coverage or uses a schedule of charges for health care services
which do not comply with requirements of Section 27-21A-7; (3) The health maintenance organization
does not provide or arrange for basic health care services; (4)...
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27-54-4
Section 27-54-4 Illnesses covered; requirements of benefit plans, etc. (a) All group health
benefit plans shall offer to provide, at a minimum, additional benefits according to this
chapter for a person receiving medical treatment for any of the following mental illnesses
diagnosed by an appropriately licensed provider. (1) Schizophrenia, schizophrenia form disorder,
schizo affective disorder. (2) Bipolar disorder. (3) Panic disorder. (4) Obsessive-compulsive
disorder. (5) Major depressive disorder. (6) Anxiety disorders. (7) Mood disorders. (8) Any
condition or disorder involving mental illness, excluding alcohol and substance abuse, that
falls under any of the diagnostic categories listed in the mental disorders section of the
International Classification of Disease, as periodically revised. (b) All group health benefit
plans, policies, contracts, and certificates executed, delivered, issued for delivery, continue,
or renewed in this state on or after January 1, 2001, shall offer, at...
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31-9-3
Section 31-9-3 Definitions. As used in this article, these terms shall have the following meanings:
(1) EMERGENCY MANAGEMENT. The preparation for and the carrying out of all emergency functions,
other than functions for which military forces or other federal agencies are primarily responsible,
to prevent, minimize, and repair injury and damage resulting from disasters caused by enemy
attack, sabotage, or other hostile action, or by fire, flood, earthquake, or other natural
cause. These functions include, without limitation, fire-fighting services; police services;
medical and health services; rescue, engineering, air raid warning services; communications;
radiological, chemical, and other special weapons of defense; evacuation of persons from stricken
areas; emergency welfare services (civilian war aid); emergency transportation; plant protection;
temporary restoration of public utility services; and other functions related to civilian
protection, together with all other activities...
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