Code of Alabama

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22-5A-6
Section 22-5A-6 Procedures for resolving complaints. (a) A community ombudsman's access to
any health care facility shall be limited to standard operating hours unless prior arrangements
with the operator of the facility has been made. If the complaint involves more than one provider
or alleges to involve more than one provider, the ombudsman shall investigate all providers.
(b) Any complaint requiring remedial action and deemed valid by the ombudsman shall be identified
and brought to the attention of the administrator or provider involved and followed up in
writing within a reasonable time. Upon receipt of such document, the administrator or provider,
in coordination with the ombudsman, shall establish a course of appropriate remedial action.
If the remedial action is not forthcoming within a reasonable time, the ombudsman must refer
the case to the State Ombudsman who may take any one or more of the following actions: (1)
Allow more time if the State Ombudsman has reason to believe...
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27-44-5
Section 27-44-5 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively, unless the context clearly indicates otherwise: (1) ACCOUNT. Either
of the three accounts created under Section 27-44-6. (2) ASSOCIATION. The Alabama Life and
Disability Insurance Guaranty Association created under Section 27-44-6. (3) AUTHORIZED ASSESSMENT
or the term AUTHORIZED when used in the context of assessments. A resolution by the board
of directors has been passed whereby an assessment will be called immediately or in the future
from member insurers for a specified amount. An assessment is authorized when the resolution
is passed. (4) BENEFIT PLAN. A specific employee, union, or association of natural persons
benefit plan. (5) CALLED ASSESSMENT or the term CALLED when used in the context of assessments.
A notice that has been issued by the association to member insurers requiring that an authorized
assessment be paid within the time frame set forth within...
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31-9B-3
Section 31-9B-3 Providing of information; requirements for emergency and disaster planning
provisions; immunity. (a) All appropriate agencies and community-based service providers,
including, but not limited to, home health care providers, hospices, community mental health
centers, and related facilities, but not including health care facilities which provide inpatient
care to include general and specialized hospitals including ancillary services, skilled nursing
facilities, intermediate care facilities, or any assisted living facility, shall provide information
on the number of individuals with medical needs and shall assist the State Health Department
in the establishment of programs to increase the awareness of medical needs shelters, and
in educating clients and sponsors or caregivers about the procedures that may be necessary
for their safety during disasters. (b) State agencies that regulate or contract with providers
of services, or both, for persons with disabilities or...
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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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34-23-1
Section 34-23-1 Definitions. For the purpose of this chapter, the following words and phrases
shall have the following meanings: (1) ASSOCIATION. The Alabama Pharmacy Association. (2)
BIOLOGICAL PRODUCT. Has the same meaning as the term as defined in 42 U.S.C. ยง262. (3) BOARD
or STATE BOARD. The Alabama State Board of Pharmacy. (4) CHEMICAL. Any substance of a medicinal
nature, whether simple or compound, obtained through the process of the science and art of
chemistry, whether of organic or inorganic origin. (5) DISPENSE. To sell, distribute, administer,
leave with, give away, dispose of, deliver, or supply a drug or medicine to the ultimate user
or his or her agent. (6) DRUGS. All medicinal substances, preparations, and devices 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 disease in man or animal...
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38-9A-2
Section 38-9A-2 Individual and Family Support Program. (a) The Individual and Family Support
Program is created and shall be administered through a system of regional support councils
and their affiliated community councils and a state council. One regional support council
is created and incorporated as a private nonprofit corporation in each of the mental retardation
regions as defined by the Department of Mental Health. The regional support councils and their
affiliated community councils may receive and accept funds, real estate, and other items of
value from state agencies and other organizations, and enter into any necessary agreements
and contracts for the purposes of implementing this chapter. Councils may employ adequate
staff personnel including a state coordinator to implement the program. If staff personnel
are employed through a fiscal agent or other entity apart from the council, a memorandum of
understanding which defines the roles and responsibilities of the staff shall...
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27-54-4
Section 27-54-4 Illnesses covered; requirements of benefit plans, etc. (a) All group health
benefit plans shall offer to provide, at a minimum, additional benefits according to this
chapter for a person receiving medical treatment for any of the following mental illnesses
diagnosed by an appropriately licensed provider. (1) Schizophrenia, schizophrenia form disorder,
schizo affective disorder. (2) Bipolar disorder. (3) Panic disorder. (4) Obsessive-compulsive
disorder. (5) Major depressive disorder. (6) Anxiety disorders. (7) Mood disorders. (8) Any
condition or disorder involving mental illness, excluding alcohol and substance abuse, that
falls under any of the diagnostic categories listed in the mental disorders section of the
International Classification of Disease, as periodically revised. (b) All group health benefit
plans, policies, contracts, and certificates executed, delivered, issued for delivery, continue,
or renewed in this state on or after January 1, 2001, shall offer, at...
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22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance
procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for
Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid
region for at least one fully certified regional care organization to provide, pursuant to
a risk contract under which the Medicaid Agency makes a capitated payment, medical care to
Medicaid beneficiaries. However, the Medicaid Agency may enter into a contract pursuant to
this section only if, in the judgment of the Medicaid Agency, care of Medicaid beneficiaries
would be better, more efficient, and less costly than under the then existing care delivery
system. The Medicaid Agency may contract with more than one regional care organization in
a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments
for the regional care organization. (b) The Medicaid Agency shall...
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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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34-23-74
Section 34-23-74 Hospitals and related institutions; automated dispensing systems. (a) Except
as otherwise provided in subsection (b), every pharmacy located in a hospital, skilled nursing
home, or other related institution in this state shall be under the supervision of a licensed
pharmacist. In general hospitals, skilled nursing homes, and extended care facilities not
operating a pharmacy, the drug or medicine room shall be under the direct supervision and
direction of a consulting pharmacist or a member of the medical staff who shall be a licensed
practitioner of medicine. In nursing homes which are not classified by the State Board of
Health as skilled nursing homes, maternity homes, homes for the aged, domiciliary institutions,
and all related institutions except those operated by and in conjunction with a licensed hospital,
medicines or drugs bearing the wording on the label "caution, federal law prohibits dispensing
without prescription" or similar wording that causes the...
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