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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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6-5-549.1
Section 6-5-549.1 Limits of liability insurance coverage in legal action against health care
providers; testimony of health care providers as specialists. (a) This section and Sections
6-5-548 and 6-5-549 shall be known and may be cited as "The Alabama Medical Liability
Act of 1996." (b) The Legislature of the State of Alabama finds and declares that a crisis
continues to threaten the delivery and availability of medical services to the people of Alabama
and the health and safety of the citizens of this state are in jeopardy as a result of this
crisis. In accordance with the previous declarations of the Legislature of Alabama in Sections
6-5-480 to 6-5-488, inclusive, 27-26-1 to 27-26-4, inclusive, and 27-26-20 to 27-26-43, inclusive,
and Sections 6-5-540 to 6-5-552, inclusive, it is the declared intent of this Legislature
to ensure that quality medical services continue to be available at reasonable costs to the
citizens of the State of Alabama. The continuing and ever increasing...
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16-25A-5
Section 16-25A-5 Authorization for health insurance plan; election of optional or supplemental
coverage. (a) The board is hereby empowered and authorized to establish a fully insured or
self-insured health insurance plan for employees and, under certain conditions, retired employees
and to adopt and promulgate rules and regulations for the administration of such plan subject
to such limitations as may be contained in this article. Such plan may provide for group hospitalization,
surgical, medical, cancer, cash indemnity, and dental insurance against the financial costs
of hospitalization, surgical, and medical treatment and care and may also include, among other
things, prescribed drugs, medicines, prosthetic appliances, hospital inpatient and outpatient
service benefits, and hospital/medical expenses indemnity benefits, including major medical
benefits or such other coverage or benefits as may be deemed appropriate and desirable by
the board, within the limits of such funds as may be...
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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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6-5-546
Section 6-5-546 Venue of actions; transfer. In any action for injury or damages or wrongful
death whether in contract or in tort against a health care provider based on a breach of the
standard of care, the action must be brought in the county wherein the act or omission constituting
the alleged breach of the standard of care by the defendant actually occurred. If plaintiff
alleges that plaintiff's injuries or plaintiff's decedent's death resulted from acts or omissions
which took place in more than one county within the State of Alabama, the action must be brought
in the county wherein the plaintiff resided at the time of the act or omission, if the action
is one for personal injuries, or wherein the plaintiff's decedent resided at the time of the
act or omission if the action is one for wrongful death. If at any time prior to the commencement
of the trial of the action it is shown that the plaintiff's injuries or plaintiff's decedent's
death did not result from acts or omissions...
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22-6-226
Section 22-6-226 Review and approval of contracts; rules governing operation of integrated
care networks. (a) All provider contracts of an organization granted final certification as
an integrated care network shall be subject to review and approval of the Medicaid Agency.
(b)(1) If a provider is dissatisfied with any term or provision of the agreement or contract
offered by an integrated care network, the provider shall: a. Seek redress with the integrated
care network. In providing redress, an integrated care network shall afford the provider a
review by a panel composed of a representative of an integrated care network, the same type
of provider, and a representative of the citizens' advisory board appointed by the chair of
the advisory board. b. After seeking redress with an integrated care network, a provider or
an integrated care network who remains dissatisfied may request a review of such disputed
term or provision by the Medicaid Agency. The Medicaid Agency shall have 10 days...
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27-45-20
Section 27-45-20 No agreement for services until written verification of registration obtained.
No insurance company, health maintenance organization (HMO), employer or organization offering
a pharmaceutical prescription program to their employees or members in Alabama, shall enter
into an agreement for services until they have obtained written verification that the provider
pharmacies are registered with the Alabama State Board of Pharmacy. Such verification must
be filed with the Alabama Department of Insurance within 10 days of initiating such agreement.
Said department shall provide a copy of the verification to the Alabama State Board of Pharmacy.
Failure to comply with such verification requirement shall result in a fine to the sponsor
of such prescription program, of $100.00 per day, from the date that such agreement was signed
until such verification requirement is satisfied. (Acts 1991, No. 91-595, p. 1098, §1.)...
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27-48-1
Section 27-48-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. A health insurance policy 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. For
the purpose of this chapter, a health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to the provisions of this chapter if it receives, processes,
adjudicates, pays, or denies claims for health care services submitted by or on behalf of
the State of Alabama or who receive health care services in the State of Alabama. The term
includes, but is not limited to, entities created pursuant to Article 6 of...
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27-50-5
Section 27-50-5 Penalties for compliance with article - Prohibited. (a) No health benefit plan
subject to the provisions of this chapter shall terminate the services, reduce capitation
payment, or otherwise penalize an attending physician or other health care provider who orders
medical care consistent with this chapter. (b) Nothing in this chapter is intended to expand
the list or designation of covered providers as specified in any health benefit plan. (Acts
1997, No. 97-414, p. 685, §5.)...
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22-11B-3
Section 22-11B-3 Medicaid recipients deemed to have given consent to information release with
receipt of services. Medicaid recipients shall be deemed to have given their consent to the
release by the State Medicaid Agency of information to the State Board of Health or any other
health care provider by virtue of their receipt of Medicaid covered services. (Acts 1995,
No. 95-530, p. 1075, §3.)...
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