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34-19-21
Section 34-19-21 Coverage or reimbursement for services not required. Nothing contained in
this chapter shall be construed to create a requirement that any health benefit plan, group
insurance plan, policy, or contract for health care services 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 group health care services to patients, insureds, or beneficiaries in this state,
including entities created pursuant to Article 6, commencing with Section 10A-20-6.01, of
Chapter 20, Title 10A, provide coverage or reimbursement for the services described or authorized
in this chapter. (Act 2017-383, ยง4.)...
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36-1-6.1
Section 36-1-6.1 Professional liability coverage for state employees or agents; duties of Finance
Director; self-insurance; costs of insurance. (a) The various state agencies, departments,
boards, or commissions shall determine and report their needs for liability coverage to the
Finance Director, the Insurance Commissioner, and the Attorney General. The Finance Director,
with the advice of the Insurance Commissioner and Attorney General, shall then determine the
type of blanket policy needed to provide basic coverage for deaths, injuries, or damages arising
out of the negligent or wrongful acts or omissions committed by state employees or agents
of the state, including retired licensed physicians and dentists while they are voluntarily
serving at free health care clinics and individuals serving as foster parents licensed or
approved by the Department of Human Resources to maintain homes for a child or children under
the supervision of the department or serving as adult foster care...
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22-1-14
Section 22-1-14 Licensure Freedom Act. (a) State licensure requirements for physicians, chiropractors,
optometrists, and dentists in this state shall be granted based on demonstrated skill and
academic competence. Licensure approval for physicians, chiropractors, optometrists, and dentists
in this state may not be conditioned upon or related to participation in any public or private
health insurance plan, public health care system, public service initiative, or emergency
room coverage. (b) The licensure of dentists, osteopaths, chiropractors, optometrists, and
physicians shall be conducted exclusively pursuant to Chapter 9 of Title 34; Division 1, commencing
with Section 34-24-50, of Article 3 of Chapter 24 of Title 34; Article 4, commencing with
Section 34-24-120, of Chapter 24 of Title 34; Chapter 22 of Title 34; and Division 1, commencing
with Section 34-24-310, of Article 8 of Title 34, respectively. (c) Physician or optometric
licensure shall not be conditioned upon or related to...
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27-21A-10
Section 27-21A-10 Complaint system. (a)(1) Every health maintenance organization shall establish
and maintain a complaint system which has been approved by the commissioner, after consultation
with the State Health Officer, to provide reasonable procedures for the resolution of written
complaints initiated by enrollees. (2) Each health maintenance organization shall submit to
the commissioner and the State Health Officer an annual report in a form prescribed by the
commissioner, after consultation with the State Health Officer, which shall include: a. A
description of the procedures of such complaint system; b. The total number of complaints
handled through such complaint system and a compilation of causes underlying the complaints
filed; and c. The number, amount, and disposition of malpractice claims and other claims relating
to the service or care rendered by the health maintenance organization made by enrollees of
the organization that were settled during the year by the health...
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27-21A-23
Section 27-21A-23 Statutory construction and relationship to other laws. (a) Except as otherwise
provided in this chapter, provisions of the insurance law and provisions of health care service
plan laws shall not be applicable to any health maintenance organization granted a certificate
of authority under this chapter. This provision shall not apply to an insurer or health care
service plan licensed and regulated pursuant to the insurance law or the health care service
plan laws of this state except with respect to its health maintenance organization activities
authorized and regulated pursuant to this chapter. (b) Solicitation of enrollees by a health
maintenance organization granted a certificate of authority shall not be construed to violate
any provision of law relating to solicitation or advertising by health professionals. (c)
Any health maintenance organization authorized under this chapter shall not be deemed to be
practicing medicine and shall be exempt from the provisions of...
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27-2B-2
Section 27-2B-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ADJUSTED RBC REPORT. An RBC report which has been adjusted by the commissioner
in accordance with subsection (e) of Section 27-2B-3. (2) CORRECTIVE ORDER. An order issued
by the commissioner specifying corrective actions which the commissioner has determined are
required. (3) DOMESTIC INSURER. Any insurer domiciled in this state. (4) FOREIGN INSURER.
Any insurer which is licensed to do business in this state but not domiciled in this state.
(5) FRATERNAL BENEFIT SOCIETY. Any insurer licensed under Chapter 34. (6) HEALTH ORGANIZATION.
Any health care service plan, health maintenance organization, limited health service organization,
dental services corporation, or other managed care organization licensed under this title.
This term does not include any life and disability insurer or property and casualty insurer.
(7) INSURER. As defined in Section 27-1-2, including, without...
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27-21A-18
Section 27-21A-18 Rehabilitation, liquidation, or conservation of a health maintenance organization.
(a) Any rehabilitation, liquidation, or conservation of a health maintenance organization
shall be deemed to be the rehabilitation, liquidation, or conservation of an insurance company
and shall be conducted under the supervision of the commissioner pursuant to the law governing
the rehabilitation, liquidation, or conservation of insurance companies. The commissioner
may apply for an order directing him to rehabilitate, liquidate, or conserve a health maintenance
organization upon any one or more grounds set out in Section 27-32-6, or when in his opinion
the continued operation of the health maintenance organization would be hazardous either to
the enrollees or to the people of this state. Enrollees shall have the same priority in the
event of liquidation or rehabilitation as the law provides to policyholders of an insurer.
(b) A claim by a health care provider for an uncovered...
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22-6-233
Section 22-6-233 Legislative findings; certification of collaborators; powers of Medicaid Agency;
state action immunity. (a) The Legislature declares that collaboration among public payers,
private health carriers, third party purchasers, and providers to identify appropriate service
delivery systems and reimbursement methods in order to align incentives in support of integrated
and coordinated health care delivery is in the best interest of the public. Collaboration
pursuant to this article is to provide quality health care at the lowest possible cost to
Alabama citizens who are Medicaid eligible. The Legislature, therefore, declares that this
health care delivery system affirmatively contemplates the foreseeable displacement of competition,
such that any anti-competitive effect may be attributed to the state's policy to displace
competition in the delivery of a coordinated system of health care for the public benefit.
In furtherance of this goal, the Legislature declares its intent...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-233.htm - 6K - Match Info - Similar pages
27-19-38
Section 27-19-38 Coverage of newly born children in health insurance policies. (a) All individual
and group health insurance policies providing coverage on an expense-incurred basis and individual
and group service or indemnity type contracts issued by a nonprofit service corporation which
provide coverage for a family member of the insured or subscriber shall, as to such family
members' coverage, also provide that the health insurance benefits applicable for children
shall be payable with respect to a newly born child of the insured or subscriber from the
moment of birth. (b) The coverage for newly born children shall consist of coverage of injury
or sickness including the necessary care and treatment of medically diagnosed congenital defects
and birth abnormalities, but need not include benefits for routine well-baby care. (c) The
requirements of this section shall apply to all insurance policies and subscriber contracts
renewed, delivered, or issued for delivery in this state, 60...
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27-21A-4
Section 27-21A-4 Powers of health maintenance organizations. (a) The powers of a health maintenance
organization include, but are not limited to the following: (1) The purchase, lease, construction,
renovation, operation, or maintenance of hospitals, medical facilities, or both, and their
ancillary equipment; (2) The making of loans other than in the ordinary course of business,
to providers under contract with it in furtherance of its program or the making of loans to
a corporation or corporations in which it owns a majority interest for the purpose of acquiring
or constructing medical facilities and hospitals or in furtherance of a program providing
health care services to enrollees. (3) The furnishing of health care services through providers
which are under contract with or employed by the health maintenance organization. (4) The
contracting with any person for the performance on its behalf of certain functions such as
marketing, enrollment, and administration. (5) The purchase,...
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