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27-49-3
Section 27-49-3 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, policy, or contract for health
care services issued, delivered, issued for delivery, renewed in this state by a health care
insurer, health maintenance organization, accident and sickness insurer, fraternal benefit
society, nonprofit hospital service corporation, nonprofit medical service corporation, health
care service plan, 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 includes, but is not limited to, entities created
pursuant to Article 6 of Chapter 4 of Title 10. For the purposes 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,...
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27-59-1
Section 27-59-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare benefit
plan, policy, or contract for health care services issued, delivered, issued for delivery,
or renewed in this state by a health care insurer, health maintenance organization, accident
and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, nonprofit
medical service corporation, health care service plan, or any other person, firm, corporation,
joint venture, or other similar business entity that pays for insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
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27-58-1
Section 27-58-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare benefit
plan, policy, or contract for health care services issued, delivered, issued for delivery,
or renewed in this state by a health care insurer, health maintenance organization, accident
and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, nonprofit
medical service corporation, health care service plan, or any other person, firm, corporation,
joint venture, or other similar business entity that pays for insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this chapter if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or on...
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27-1-21
Section 27-1-21 Uniformity of limits applied to fulfillment of certain drug prescriptions.
(a) For the purposes of this section, the following words shall have the following meanings:
(1) ENROLLEE. A person enrolled in a health benefit plan. (2) HEALTH BENEFIT PLAN. Any individual
or group plan, policy, or contract for health care services issued, delivered, issued for
delivery, renewed in this state by a health care insurer, health maintenance organization,
accident and sickness insurer, fraternal benefit society, nonprofit hospital service corporation,
nonprofit medical service corporation, health care service plan, 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 includes, but is not limited to, entities created pursuant to Article 6 of Chapter 4
of Title 10. The term shall not include any collective bargaining agreement...
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34-8A-3
Section 34-8A-3 Construction and application of chapter. (a) Nothing in this chapter shall
be construed to apply to any of the following: (1) The activities, services, and use of an
official title on the part of a person employed as a counselor by any federal, state, county,
or municipal agency; public or private educational institution; medical personnel in a clinic
or hospital that is certified by the Alabama Department of Public Health or any successor
to such department or that is accredited by the Joint Commission on Accreditation of Health
Care Organizations or any successor to such commission; law practice; or licensed private
employment agencies, provided such persons are performing counseling or counseling-related
activities within the scope of their employment. (2) The activities and services of a student,
intern, or trainee in counseling pursuing a course of study in counseling in a regionally
accredited institution of higher learning or training institution, if these...
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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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22-11D-5
Section 22-11D-5 Establishment of council; composition; meetings. (a) There is established
the Statewide Trauma and Health Care Center Advisory Council to assist in developing regulations
and standards necessary to implement this chapter and to serve as consultants to the board
on matters related to the statewide trauma system and other health care centers. (b) The council
shall consist of 11 members and be constituted in the following manner: (1) Four representatives
of hospitals, who shall be appointed by the Board of Trustees of the Alabama Hospital Association.
Two of the appointees shall be from hospitals located in urban areas and two shall be from
hospitals located in rural areas of the state. At least two of the appointees shall be from
hospitals that will be designated as trauma centers after the statewide trauma system is established.
(2) Four representatives who shall be licensed physicians, appointed by the Medical Association
of the State of Alabama. (3) One representative...
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20-3-2
Section 20-3-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) ASSISTED LIVING FACILITY. An institution or facility licensed as an assisted
living facility under regulations of the State Board of Health. (2) CHARITABLE CLINIC. The
term includes an established free medical clinic as defined in subdivision (1) of Section
6-5-662 and any community health center provided for under the federal Public Health Service
Law. (3) CHARITABLE PATIENT. For purposes of this chapter, the term shall not include patients
who are eligible to receive drugs under the Alabama Medicaid Program or under any other prescription
drug program funded in whole or in part by the state. (4) DRUGS. All medicinal substances
and preparations recognized by the United States Pharmacopoeia and National Formulary, or
any revision thereof, and all substances and preparations intended for external and internal
use in the cure, diagnosis, mitigation, treatment, or prevention of...
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22-11D-2
Section 22-11D-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) BOARD. The State Board of Health. (2) COMMUNICATIONS SYSTEM. A radio and land
line network complying with the board's rules and which provides rapid public access, coordinated
central dispatching of services, and coordination of personnel, equipment, and facilities
in the trauma and health system. (3) COUNCIL. The Statewide Trauma and Health System Advisory
Council. (4) DEPARTMENT. The Alabama Department of Public Health. (5) DESIGNATION. A formal
determination by the department that a hospital is capable of providing designated trauma
or other specific health care as authorized by this chapter. (6) EMERGENCY MEDICAL SERVICE.
The organization responding to a perceived individual's need for immediate medical care in
order to prevent loss of life or aggravation of physiological or psychological illness or
injury. (7) HEALTH CARE CENTER. A hospital that voluntarily...
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27-19-52
Section 27-19-52 Definitions. For purposes of this article, the following terms shall have
the meaning indicated herein: (1) APPLICANT. Includes either of the following: a. In the case
of an individual Medicare supplement policy or subscriber contract, the person who seeks to
contract for insurance benefits. b. In the case of a group Medicare supplement policy or subscriber
contract, the proposed certificate holder. (2) CERTIFICATE. Any certificate issued under a
group Medicare supplement policy, which policy has been delivered or issued for delivery in
this state. (3) CERTIFICATE FORM. The form on which the certificate is delivered or issued
for delivery by the issuer. (4) ISSUER. Insurance companies, fraternal benefit societies,
health care service plans, health maintenance organizations, and any other entity delivering
or issuing for delivery in this state Medicare supplement policies or certificates. (5) MEDICARE.
The "Health Insurance for the Aged Act," Title XVIII of the Social...
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