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27-21A-29
Section 27-21A-29 Existing health maintenance organizations. (a) Notwithstanding any other
provision of this chapter, any health maintenance organization licensed by the State Board
of Health and in operation on May 29, 1986, shall be granted a certificate of authority upon
payment of the application fee prescribed in Section 27-21A-21 and compliance with Section
27-21A-12. Nothing in this section shall prohibit any such health maintenance organization
from continuing to conduct business in this state until such certificate of authority is issued.
(b) Any health maintenance organization which was licensed in this state prior to January
1, 1986, may continue to operate under existing noncontractual provider arrangements (which
have been approved by the State Health Officer) for three years. (c) After issuance of a certificate
of authority in accordance with subsection (a) of this section, the commissioner may require
submission by the health maintenance organization of any additional...
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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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27-21A-3
Section 27-21A-3 Issuance of certificate of authority. (a)(1) Upon receipt of an application
for issuance of a certificate of authority, the commissioner shall forthwith transmit copies
of such application and accompanying documents to the State Health Officer. (2) The State
Health Officer shall determine whether the applicant for a certificate of authority, with
respect to health care services to be furnished: a. Has demonstrated the willingness and potential
ability to assure that such health care services will be provided in a manner to assure both
availability and accessibility of adequate personnel and facilities and in a manner enhancing
availability, accessibility, and continuity of service; b. Has arrangements, established in
accordance with the regulations promulgated by the State Health Officer, for an on-going quality
assurance program concerning health care processes and outcomes; and c. Has a procedure, established
in accordance with regulations of the State Health...
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22-1-16
Section 22-1-16 Prescribing, dispensing, and administering auto-injectable epinephrine; liability;
reports; rulemaking authority. (a) As used in this section, the following words shall have
the following meanings: (1) ADMINISTER. The direct application of an epinephrine auto-injector
to the body of an individual. (2) AUTHORIZED ENTITY. Any entity or organization other than
a K-12 public school subject to Section 16-1-48, in connection with or at which allergens
capable of causing anaphylaxis may be present, including, but not limited to, recreation camps,
colleges and universities, day care facilities, youth sport leagues, amusement parks, restaurants,
places of employment, and sports arenas. (3) EPINEPHRINE AUTO-INJECTOR. A single-use device
used for the automatic injection of a premeasured dose of epinephrine into the human body.
(4) MEDICAL PRACTITIONER. A physician or other individual licensed under Title 34 authorized
to treat, use, or prescribe medicine and drugs for sick and...
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34-13-1
Section 34-13-1 Definitions. (a) For purposes of this chapter, the following terms shall have
the following meanings: (1) ACCREDITED SCHOOL or COLLEGE OF MORTUARY SCIENCE. A school or
college approved by the Alabama Board of Funeral Service and which maintains a course of instruction
of not less than 48 calendar weeks or four academic quarters or college terms and which gives
a course of instruction in the fundamental subjects including, but not limited to, the following:
a. Mortuary management and administration. b. Legal medicine and toxicology as it pertains
to funeral directing. c. Public health, hygiene, and sanitary science. d. Mortuary science,
to include embalming technique, in all its aspects; chemistry of embalming, color harmony;
discoloration, its causes, effects, and treatment; treatment of special cases; restorative
art; funeral management; and professional ethics. e. Anatomy and physiology. f. Chemistry,
organic and inorganic. g. Pathology. h. Bacteriology. i. Sanitation...
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27-21A-2
Section 27-21A-2 Establishment of health maintenance organizations. (a) Notwithstanding any
law of this state to the contrary, any person may apply to the commissioner for and obtain
a certificate of authority to establish and operate a health maintenance organization in compliance
with this chapter. No person shall establish or operate a health maintenance organization
in this state without obtaining a certificate of authority under this chapter. A foreign corporation
may qualify under this chapter, subject to its registration to do business in this state as
a foreign corporation under the provisions of Sections 10-2A-220, et seq. (b) Health maintenance
organizations licensed as of May 29, 1986, shall be issued a certificate of authority in accordance
with Section 27-21A-29. (c) Each application for a certificate of authority shall be verified
by an officer or authorized representative of the applicant, shall be in a form prescribed
by the commissioner, and shall set forth or be...
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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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27-21A-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...
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27-21A-1
Section 27-21A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively: (1) AGENT. A person who is appointed or employed by a health maintenance
organization and who engages in solicitation of membership in such organization. This definition
does not include a person enrolling members on behalf of an employer, union, or other organization.
(2) BASIC HEALTH CARE SERVICES. Emergency care, inpatient hospital and physician care, and
outpatient medical services. (3) COMMISSIONER. The Commissioner of Insurance. (4) ENROLLEE.
An individual who is enrolled in a health maintenance organization. (5) EVIDENCE OF COVERAGE.
Any certificate, agreement, or contract issued to an enrollee setting out the coverage to
which he is entitled. (6) HEALTH CARE SERVICES. Any services included in the furnishing to
any individual of medical or dental care, or hospitalization or incident to the furnishing
of such care or hospitalization, as well as the...
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27-21A-13
Section 27-21A-13 Prohibited practices. (a) No health maintenance organization, or representative
thereof, may cause or knowingly permit the use of advertising which is untrue or misleading,
solicitation which is untrue or misleading, or any form or evidence of coverage which is deceptive.
For purposes of this chapter: (1) A statement or item of information shall be deemed to be
untrue if it does not conform to fact in any respect which is or may be significant to an
enrollee of, or person considering enrollment with a health maintenance organization; (2)
A statement or item of information shall be deemed to be misleading, whether or not it may
be literally untrue, if, in the total context in which such statement is made or such item
of information is communicated, such statement or item of information may be reasonably understood
by a reasonable person, not possessing special knowledge regarding health care coverage, as
indicating any benefit or advantage or the absence of any...
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