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27-20A-2
Section 27-20A-2 Chapter applicable to group, etc., policies. No group, blanket, franchise,
or association health insurance policy providing coverage on an expense incurred basis, nor
group, blanket, franchise, or association service or indemnity type contract issued by a nonprofit
corporation, nor group-type self insurance plan providing protection, insurance, or indemnity
against hospital, medical, or surgical expenses, nor health maintenance organization plan
shall be issued, delivered, executed, or renewed in this state, or approved for issuance or
renewal in this state by the Commissioner of Insurance after 90 days beyond the effective
date of this chapter, unless such policy, contract, or plan, at the option of the policyholder
or sponsor, provides benefits to any insured, subscriber, or other person covered under the
policy, contract, or plan for expenses incurred in connection with the treatment of alcoholism
when such treatment is prescribed by a duly licensed doctor of...
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27-57-2
Section 27-57-2 Coverage; applicability. (a) All group health benefit plans, policies, contracts,
and certificates executed, delivered, issued for delivery, continued, or renewed in this state
on or after August 1, 2004, shall offer, at the time of proposal, sale, or renewal of a policy
subject to this chapter, to include colorectal cancer examinations within the coverage. Such
offer of coverage shall include colorectal cancer examinations for covered persons who are
50 years of age or older, or for covered persons who are less than 50 years of age and at
high risk for colorectal cancer according to current American Cancer Society colorectal cancer
screening guidelines. (b) This chapter shall apply to group accident and sickness insurance
policies issued by a fraternal benefit society, a nonprofit hospital service corporation,
a nonprofit medical service corporation, a group health care plan, a health maintenance organization,
or any similar entity. (Act 2004-502, p. 969, ยง2.)...
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6-5-540
Section 6-5-540 Legislative intent. It is hereby declared by the Legislature of the State of
Alabama that a crisis threatens the delivery of medical services to the people of Alabama
and the health and safety of the citizens of this state are in jeopardy. In accordance with
the previous declaration of Legislature contained in Act 513 of the Regular Session of the
1975 Alabama Legislature it is the declared intent of this Legislature to insure that quality
medical services continue to be available at reasonable costs to the citizens of the State
of Alabama. This Legislature finds and declares that the increasing threat of legal actions
for alleged medical injury causes and contributes to an increase in health care costs and
places a heavy burden upon those who can least afford such increases, and that the threat
of such actions contributes to expensive medical procedures to be performed by physicians
and other health care providers which otherwise would not be considered necessary, and...
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27-3A-5
Section 27-3A-5 Standards for utilization review agents. (a) Except as provided in subsection
(b), all utilization review agents shall meet the following minimum standards: (1) Notification
of a determination by the utilization review agent shall be mailed or otherwise communicated
to the provider of record or the enrollee or other appropriate individual within two business
days of the receipt of the request for determination and the receipt of all information necessary
to complete the review. (2) Any determination by a utilization review agent as to the necessity
or appropriateness of an admission, service, or procedure shall be reviewed by a physician
or determined in accordance with standards or guidelines approved by a physician. (3) Any
notification of determination not to certify an admission, service, or procedure shall include
the principal reason for the determination and the procedures to initiate an appeal of the
determination. (4) Utilization review agents shall maintain...
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22-21-371
Section 22-21-371 Individual, group, blanket or franchise contracts authorized; certificates
of coverage; filing and approval of contracts and certificates; requirements; grounds for
disapproval. (a) Dental service plan contracts may be written on individual, group, blanket
or franchise basis. Each contractual obligation for such dental service(s) must be evidenced
by a contract. Each person covered under a group contract must be issued a certificate of
coverage. (b) No contract or certificate of dental service benefits may be issued in this
state unless a copy of the form has been filed and approved by the commissioner. (c) The commissioner
may not approve any form that does not meet the following requirements: (1) Contracts must
contain a list and description of the dental service payments promised or the dental work
for which expenses are to be reimbursed, and any limits on the amounts to be paid or reimbursed;
(2) Contracts and certificates must indicate the name of the dental...
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22-50-17
Section 22-50-17 Operation of a facility for care or treatment of mental or emotional illness
or substance abuse, or services to persons with an intellectual disability. (a) No person,
partnership, corporation, or association of persons shall operate a facility or institution
for the care or treatment of any kind of mental or emotional illness or substance abuse or
for providing services to persons with an intellectual disability as defined in this chapter,
without being certified by the department or licensed by the State Board of Health; provided
that nothing in this section shall be construed so as to require a duly authorized physician,
psychiatrist, psychologist, social worker, licensed professional counselor operating under
the scope of his or her license, or Christian Science practitioner to obtain a license for
treatment of patients in his private office, unless he keeps two or more patients in his office
for continuous periods of 24 hours or more in one week, or that a church...
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34-19-16
Section 34-19-16 Where care may be performed; required forms an duties of licensed midwife.
(a) A licensed midwife may provide midwifery care in the setting of the client's choice, except
a hospital. (b) A licensed midwife shall ensure that the client has signed a midwife disclosure
form provided by the board indicating receipt of a written statement that includes all of
the following information: (1) A description of the licensed midwife's education, training,
and experience in midwifery. (2) Antepartum, intrapartum, and postpartum conditions requiring
medical referral, transfer of care, and transport to a hospital. (3) A plan for medical referral,
transfer of care, and transport of the client or newborn or both when indicated by specific
antepartum, intrapartum, or postpartum conditions. (4) Instructions for filing a complaint
against a licensed midwife. (5) A statement that the licensed midwife must comply with the
federal Health Insurance Portability and Accountability Act. (6) The...
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16-17A-2
Section 16-17A-2 Definitions. For purposes of this chapter, the following terms shall have
the following meanings: (1) ACADEMIC MEDICAL CENTER. The teaching, research, and clinical
facilities provided, established, or operated by a constitutionally created public university
in the state or a university that operates a school of medicine. (2) AUTHORITY. A public corporation
organized pursuant to the provisions of this chapter. (3) BOARD. The board of directors of
an authority. (4) DIRECTOR. A member of the board of an authority. (5) GOVERNMENTAL ENTITY.
The state, a county, a municipality, or any department, agency, board, or commission of the
state, a county, or a municipality. (6) HEALTH CARE FACILITY. All property or rights in property,
real or personal, tangible or intangible, useful to an authority in its operations, including
without limitation, the following: a. Facilities necessary or desirable to the operation of
an academic medical center, one or more health sciences schools,...
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27-43-10
Section 27-43-10 Types of legal expense insurance; policy and certificate forms; issuance of
policies and certificates. (a) Legal expense insurance may be written as individual, group,
blanket, or franchise insurance. Each contractual obligation for legal expense insurance must
be evidenced by a policy. Each person insured under a group policy must be issued a certificate
of coverage. (b) No policy or certificate of legal expense insurance may be issued in this
state unless a copy of the form has been filed and approved by the commissioner. (c) The commissioner
may not approve any form that does not meet the following requirements: (1) Policies must
contain a list and description of the legal service payments promised or the legal matters
for which expenses are to be reimbursed and any limits on the amounts to be paid or reimbursed;
(2) Policies and certificates must indicate the name of the insurer and the full address of
its principal place of business; (3) Certificates issued under...
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33-1-5.2
Section 33-1-5.2 Life and health insurance for certain salaried officers and employees of state
docks. (a) The Alabama State Port Authority is hereby authorized to provide and establish
a plan of life and health insurance for the salaried officers and employees of Alabama state
docks who work full time for the Alabama state docks and receive their compensation on a bi-weekly
basis and also a plan of health insurance for the spouses and dependent children of such officers
and employees and to pay the costs and premiums of such life and health insurance from the
revenues of the Alabama State Port Authority. (b) Such health insurance plan may provide for
group hospitalization, surgical, medical and dental insurance against the financial costs
of hospitalization, surgical, medical and dental treatment and care, and may also include,
among other things, prescribed drugs, medicines, prosthetic appliances, hospital in-patient
and out-patient service benefits, including major medical benefits,...
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