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22-21-263
Section 22-21-263 New institutional health services subject to review. (a) All new institutional
health services which are subject to this article and which are proposed to be offered or
developed within the state shall be subject to review under this article. No institutional
health services which are subject to this article shall be permitted which are inconsistent
with the State Health Plan. For the purposes of this article, new institutional health services
shall include any of the following: (1) The construction, development, acquisition through
lease or purchase, or other establishment of a new health care facility or health maintenance
organization. A transaction involving the sale, lease, or other transfer or change of control
of an existing health care facility, existing health maintenance organization, or existing
institutional health service is not subject to certificate of need review or approval under
this article unless the transaction also involves implementing one or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-263.htm - 6K - Match Info - Similar pages
27-21A-28
Section 27-21A-28 Taxes. Health maintenance organizations doing business in this state shall
be subject to and pay the annual premium tax to be paid by health insurers on health insurance
premiums. The same taxes and filing requirements applicable to health insurers under this
title, shall apply to and shall be imposed upon each health insurance organization licensed
under the provisions of this chapter; and the organization shall also be entitled to the same
tax deductions, reductions, abatements, and credits that health insurers are entitled to receive.
(Acts 1986, No. 86-471, p. 854, §28; Acts 1993, No. 93-679, p. 1291, §9; Acts 1997, No.
97-227, p. 372, §1.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-28.htm - 988 bytes - Match Info - Similar pages
27-21A-32
Section 27-21A-32 HMO enrollment requirements. (a) The state government, or any agency, board,
commission, institution, or political subdivision thereof, and any city or county, or board
of education, which offers its employees a health benefits plan may make available to and
inform its employees or members of the option to enroll in at least one health maintenance
organization holding a valid certificate of authority which provides health care services
in the geographic areas in which such employees or members reside. (b) The first time a health
maintenance organization is offered by an employer, either public or private, each covered
employee must make an affirmative written selection among the different alternatives included
in the health benefits plan. Thereafter, those who wish to change from one plan to another
will be allowed to do so annually, provided, that nothing in this section shall prevent any
health maintenance organization or insurer from requiring evidence of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-32.htm - 2K - Match Info - Similar pages
27-52-3
Section 27-52-3 Additional powers; guidelines. (a) The commissioner shall, by regulation, establish
additional powers and duties of the plan and may adopt such rules as are necessary and proper
to implement this article. For the purpose of this section, the term "insurer" means
any entity covered by the Health Insurance Portability Act, including, but not limited to,
as the terms are defined in the Health Insurance Portability Act, a health insurance issuer,
a health maintenance organization and, notwithstanding Section 10-4-115, any health benefit
plan. In the case of a self-funded health benefit plan operating through a third party administrator,
the third party administrator shall be the insurer for the purpose of this section. The commissioner
may, by regulation, define health insurance premiums consistent with the purpose of this section.
(b) The regulations shall set forth coverage eligibility criteria consistent with the requirements
of Health Insurance Portability and...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-52-3.htm - 2K - Match Info - Similar pages
40-26B-76
Section 40-26B-76 Notice of assessment. (a)(1) The department shall send a notice of assessment
to each privately operated hospital informing the hospital of the assessment rate, the hospital's
net patient revenue calculation, and the estimated assessment amount owed by the hospital
for the applicable fiscal year. (2) Annual notices of assessment shall be sent at least 30
days before the due date for the first quarterly assessment payment of each fiscal year. (b)(1)
The privately operated hospital shall have 30 days from the date of its receipt of a notice
of assessment to review and verify the assessment rate, the hospital's net patient revenue
calculation, and the estimated assessment amount. (2) If a privately operated hospital disputes
the hospital's net patient revenue calculation and the estimated assessment amount, the hospital
shall notify the department of the disputed amounts within 15 business days of notification
of the assessment by the department. The hospital and the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-76.htm - 4K - Match Info - Similar pages
16-25A-17.1
Section 16-25A-17.1 Assistance to low income employees and retirees. The board shall provide
assistance to low income employees and retirees who meet the federal poverty levels defined
in this section, effective October 1, 2005, and for each fiscal year thereafter. (1) For employees
and retirees who contribute to the cost of their health insurance premium and with annual
income (determined as provided below on an aggregate basis for an employee or retiree and
spouse) equal to or below 300 percent of the federal poverty level, the employee or retiree
contribution shall be reduced as follows: a. For employees or retirees with annual income
equal to or less than 100 percent of the federal poverty level, the employee contribution
will be calculated using 50 percent of the applicable premium. b. For employees or retirees
with annual income equal to or less than 150 percent of the federal poverty level, but more
than 100 percent of the federal poverty level, the employee contribution will be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-17.1.htm - 3K - Match Info - Similar pages
36-29-19.4
Section 36-29-19.4 Assistance to low income employees and retirees. The board shall provide
assistance to low income employees and retirees who meet the federal poverty levels defined
in this section, effective October 1, 2005, and for each fiscal year thereafter. (1) For employees
and retirees who contribute to the cost of their health insurance premium and with annual
income (determined as provided below on an aggregate basis for an employee or retiree and
spouse) equal to or below 300 percent of the federal poverty level, the employee or retiree
contribution shall be reduced as follows: a. For employees or retirees with annual income
equal to or less than 100 percent of the federal poverty level, the employee contribution
will be calculated using 50 percent of the applicable premium. b. For employees or retirees
with annual income equal to or less than 150 percent of the federal poverty level, but more
than 100 percent of the federal poverty level, the employee contribution shall be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-19.4.htm - 3K - Match Info - Similar pages
22-13A-2
Section 22-13A-2 Legislative findings. (a) The Legislature finds all of the following: (1)
Osteoporosis, a bone-thinning disease, is a major public health problem that poses a threat
to the health and quality of life to as many as 25 million Americans. (2) The 1.5 million
fractures each year that result from osteoporosis cause pain, disability, immobility and social
isolation, affecting quality of life and threatening the ability of people to live independently.
(3) Because osteoporosis progresses silently and without sensation over many years, and many
cases remain undiagnosed, the first symptom of the disease is often a fracture, typically
of the hip, spine, or wrist. (4) One of two women and one of five men will suffer an osteoporotic
fracture in their lifetime. (5) A woman's risk of hip fracture is equal to her combined risk
of breast, uterine, and ovarian cancer. (6) The annual direct and indirect costs of osteoporosis
to the health care system are estimated to be as high as...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-13A-2.htm - 2K - Match Info - Similar pages
27-1-19
Section 27-1-19 Reimbursement of health care providers. (a) The insured, or health or dental
plan beneficiary may assign reimbursement for health or dental care services directly to the
provider of services. Health benefits include medical, pharmacy, podiatric, chiropractic,
optometric, durable medical equipment, and home care services. The company or agency, when
authorized by the insured, or health or dental plan beneficiary, shall pay directly to the
health care provider the amount of the claim, under the same criteria and payment schedule
that would have been reimbursed directly to the contract provider, and any applicable interest.
This amount only applies to assigned claims. Any company or agency making a payment to the
insured, or health or dental plan beneficiary, after the rights of reimbursement have been
assigned to the provider of services, shall be liable to the provider for the payment. If
the company or agency fails to reimburse the provider in accordance with the terms...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-19.htm - 2K - Match Info - Similar pages
10A-20-6.13
Section 10A-20-6.13 Deposit of securities with State Treasurer. Every health care service corporation
shall deposit with, and thereafter maintain on deposit with, the Treasurer of the State of
Alabama bonds of the United States government or of the State of Alabama, or of any subdivision
thereof, or first mortgages on real estate situated in Alabama securing an indebtedness not
in excess of 50 percent of the appraised value thereof, subject to the approval of the Commissioner
of Insurance, in an amount to be determined as of the first day of January of each year as
follows: (1) Every company whose gross annual premium receipts from business done within this
state for the preceding year ending December 31 are less than fifty thousand dollars ($50,000)
shall so deposit and maintain securities of par and market value not less than five thousand
dollars ($5,000); (2) Every company whose gross annual premium receipts so computed are in
excess of fifty thousand dollars ($50,000) and less...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/10A-20-6.13.htm - 2K - Match Info - Similar pages
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