|
27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases shall
have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health. (2)
ENROLLEE. An individual who has contracted for or who participates in coverage under an insurance
policy, a health maintenance organization contract, a health service corporation contract,
an employee welfare benefit plan, a hospital or medical services plan, or any other benefit
program providing payment, reimbursement, or indemnification for health care costs for the
individual or the eligible dependents of the individual. (3) PROVIDER. A health care provider
duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system for prospective
and concurrent review of the necessity and appropriateness in the allocation of health care
resources and services given or proposed to be given to an individual within this state. The
term does not include elective requests for clarification of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-3A-3.htm - 3K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-2B-2.htm - 4K - Match Info - Similar pages
27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following
meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological,
and psychosocial concepts, techniques, and processes necessary to maintain or develop functional
skills of clients, provided to individuals and groups for periods of more than two hours but
less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by
the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including
an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses,
issued by insurers, 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 health
care services to patients, insureds, or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-54-2.htm - 3K - Match Info - Similar pages
27-50-3
Section 27-50-3 Health benefit plan. As used in this chapter, the term "health benefit
plan" has the following meaning: A health insurance policy, including a self-insured
health plan, 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 health care services to patients, insureds, or beneficiaries
in this state. The term does not include accident-only, specified disease, individual hospital
indemnity, credit, dental-only, Medicare-supplement, long-term care, or disability income
insurance; coverage issued as a supplement to liability insurance, workers' compensation or
similar insurance; or automobile medical-payment insurance. For the purpose of this chapter,
a health benefit plan located or domiciled outside of the State of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-50-3.htm - 1K - Match Info - Similar pages
27-57-1
Section 27-57-1 Definitions. As used in this chapter, the following words and terms shall have
the following meanings: (1) COLORECTAL CANCER EXAMINATIONS. Examinations and laboratory tests
specified in current American Cancer Society guidelines for colorectal cancer screening of
asymptomatic individuals. (2) HEALTH BENEFIT PLAN. A group health insurance policy 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 health care services to patients, insureds, or beneficiaries in this
state. 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 this chapter if it receives, processes,
adjudicates, pays, or denies claims for health care services submitted...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-57-1.htm - 1K - Match Info - Similar pages
27-19A-7
Section 27-19A-7 Contracting directly with patient; distribution of information about policy
or plan; payment and reimbursement procedures. The provisions of this chapter do not prohibit
the following conduct and shall be construed to provide that: (1) A dentist may contract directly
with a patient for the furnishing of dental care services to said patient as may be otherwise
authorized by law; (2) Any person providing a health insurance policy or employee benefit
plan, or an employer, or an employee organization may: a. Make available to its insureds,
beneficiaries, participants, employees, or members information relating to dental care services
by the distribution of factually accurate information regarding dental care services, rates,
fees, location, and hours of service, provided such distribution is made upon the request
of any dentist licensed by this state; or b. Establish an administrative mechanism which facilitates
payment for dental care services by insureds, beneficiaries,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19A-7.htm - 1K - Match Info - Similar pages
22-8A-9
Section 22-8A-9 Withholding or withdrawal of treatment, etc., not suicide; execution of advance
directive not to affect sale, etc., of life or health insurance nor be condition for receipt
of treatment, etc.; provisions of chapter cumulative. (a) The withholding or withdrawal of
life-sustaining treatment or artificially provided nutrition and hydration from a patient
in accordance with the provisions of this chapter shall not, for any purpose, constitute a
suicide and shall not constitute assisting suicide. (b) The making of an advance directive
for health care pursuant to this chapter shall not affect in any manner the sale, procurement,
or issuance of any policy of life or health insurance, nor shall it be deemed to modify the
terms of an existing policy of life or health insurance. No policy of life or health insurance
shall be legally impaired or invalidated in any manner by the withholding or withdrawal of
life-sustaining treatment or artificially provided nutrition and hydration...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-8A-9.htm - 2K - Match Info - Similar pages
27-53-1
Section 27-53-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) GENETIC CHARACTERISTICS. A scientifically or medically identifiable gene or
chromosome, or alteration thereof, that is known to be a cause of a disease or disorder, or
determined to be associated with a statistically increased risk of development of a disease
or disorder. (2) GENETIC TEST. A pre-symptomatic laboratory test which is generally accepted
in the scientific and medical communities for the determination of the presence or absence
of the genetic characteristics that cause or are associated with risk of a disease or disorder.
(3) HEALTH BENEFIT PLAN. A health insurance policy, including a self-insured health plan,
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-53-1.htm - 1K - Match Info - Similar pages
27-1-22
Section 27-1-22 Uniform prescription drug information card or technology. (a) Every health
benefit plan that provides coverage for prescription drugs or devices, or administers a plan,
including, but not limited to, third party administrators for self-insured plans and state
administered plans, excluding the Alabama Medicaid Program, shall issue to its insureds a
card or other technology containing prescription drug information. The uniform prescription
drug information card or technology shall be in the format approved by the National Council
for Prescription Drug Programs (NCPDP) and shall include all of the required fields and conform
to the most recent pharmacy ID card or technology implementation guide produced by NCPDP or
conform to a national format acceptable to the Commissioner of Insurance. If a health care
plan includes a conditional or situational field, it shall conform to the most recent pharmacy
information card or technology implementation guide by the NCPDP or conform...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-22.htm - 3K - Match Info - Similar pages
27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following
meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household
member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting
to cause or intentionally, knowingly, or recklessly causing another person, including a minor
child, bodily injury, severe emotional injury, or psychological trauma or conduct which constitutes
the crime of rape. b. Intentionally following another person, including a minor child, without
proper authority, under circumstances that place the person in reasonable fear of bodily injury
or physical harm. c. Subjecting another person, including a minor child, to false imprisonment
or kidnapping. d. Attempting to cause or intentionally, knowingly, or recklessly causing damage
to property to intimidate or attempt to control the behavior of another person, including
a minor child. e. Assault, child abuse, criminal...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-55-2.htm - 5K - Match Info - Similar pages
|