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27-1-19
Section 27-1-19 Reimbursement of health care providers. (a) The insured, or health or dental
plan beneficiary may assign reimbursement for health or dental care services directly to the
provider of services. Health benefits include medical, pharmacy, podiatric, chiropractic,
optometric, durable medical equipment, and home care services. The company or agency, when
authorized by the insured, or health or dental plan beneficiary, shall pay directly to the
health care provider the amount of the claim, under the same criteria and payment schedule
that would have been reimbursed directly to the contract provider, and any applicable interest.
This amount only applies to assigned claims. Any company or agency making a payment to the
insured, or health or dental plan beneficiary, after the rights of reimbursement have been
assigned to the provider of services, shall be liable to the provider for the payment. If
the company or agency fails to reimburse the provider in accordance with the terms...
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34-21-81
Section 34-21-81 Definitions. As used in this article, the following terms shall have the following
meanings: (1) BOARD OF MEDICAL EXAMINERS. The State Board of Medical Examiners established
pursuant to Section 34-24-53. (2) BOARD OF NURSING. The Board of Nursing established under
Section 34-21-2. (3) ADVANCED PRACTICE NURSE. A registered nurse that has gained additional
knowledge and skills through successful completion of an organized program of nursing education
that prepares nurses for advanced practice roles and has been certified by the Board of Nursing
to engage in the practice of advanced practice nursing. There shall be four categories of
advanced practice nurses: Certified registered nurse practitioners (CRNP), certified nurse
midwives (CNM), certified registered nurse anesthetists (CRNA), and clinical nurse specialists
(CNS). Certified registered nurse practitioners and certified nurse midwives are subject to
collaborative practice agreements with an Alabama physician....
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27-1-17
Section 27-1-17 Limitation periods for payment of claims; overdue claims; retroactive denials,
adjustments, etc.; penalties. (a) Each insurer, health service corporation, and health benefit
plan that issues or renews any policy of accident or health insurance providing benefits for
medical or hospital expenses for its insured persons shall pay for services rendered by Alabama
health care providers within 45 calendar days upon receipt of a clean written claim or 30
calendar days upon receipt of a clean electronic claim. If the insurer, health service corporation,
or health benefit plan is denying or pending the claim, the insurer, health service corporation,
or health benefit plan shall, within 45 calendar days for a written claim and 30 calendar
days for an electronic claim, notify the health care provider or certificate holder of the
reason for denying or pending the claim and what, if any, additional information is required
to process the claim. Any undisputed portion of the claim...
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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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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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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...
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34-23-90
Section 34-23-90 Authority; composition. (a) The Alabama State Board of Pharmacy is vested
with the authority to carry out the purposes of and enforce this chapter. The board shall
consist of five members who are citizens of this state. The members of the board shall be
licensed pharmacists who have been licensed in this state for a minimum of five years and
who are actively engaged in the practice of pharmacy or pharmacy administration, or both.
(b) Three members shall be appointed by the Governor. Of the three appointed members, one
member shall be engaged in the practice of pharmacy or pharmacy administration, or both, in
a hospital, one in an independent pharmacy, and one in a chain pharmacy. On or before August
1, 1996, and each five years thereafter, or whenever a vacancy occurs in the designated position
for hospital pharmacists, the Alabama Society of Health System Pharmacists, or its successor
organization, shall submit a list of three nominees to the Governor. On or before...
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34-25A-3
Section 34-25A-3 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) ACCREDITED FACILITY. A facility where prosthetic, orthotic, prosthetic and orthotic,
or pedorthic care is provided to patients needing such care and has met the requirements of
the board for such designation. The board shall require that all accredited facilities meet
the requirements of a national certifying board, recognized by the state board in prosthetics,
orthotics, and pedorthics accredited by the National Commission for Certifying Agencies (NCCA)
in the discipline or disciplines for which the application is made and meet any other requirements
of the board. The requirements may include custom and non-custom items the board may determine
are necessary to perform quality care and are typical in the course of business. (2) ACCREDITED
PEDORTHIC FACILITY. A facility where pedorthic care may be provided that has met the requirements
of the board for such designation. An...
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12-15-208
Section 12-15-208 Facilities to be used for detention or shelter care of children generally;
when child may be detained in jail or other facility for detention of adults; notification
of juvenile court, when child received at facility for detention of adult offenders or persons
charged with crimes; development of statewide system; Department of Youth Services to subsidize
detention in regional facilities, may contract for detention; transfer of child to detention
facility, when case transferred from juvenile court for criminal prosecution. (a) Persons
who shall not be detained or confined in secure custody include all of the following: (1)
STATUS OFFENDERS. Effective October 1, 2009, status offenders, as defined in this article,
shall not be detained or confined in secure custody, except that a status offender who is
charged with or who commits a violation of a valid court order may be detained in secure custody
in a juvenile detention facility for up to 72 hours in any six-month...
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27-31A-2
Section 27-31A-2 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively, unless the context clearly indicates otherwise: (1) COMMISSIONER.
The Insurance Commissioner of this state or the commissioner, director, or superintendent
of insurance in any other state. (2) COMPLETED OPERATIONS LIABILITY. Liability arising out
of the installation, maintenance, or repair of any product at a site which is not owned or
controlled by either of the following: a. Any person who performs that work. b. Any person
who hires an independent contractor to perform that work, but shall include liability for
activities which are completed or abandoned before the date of the occurrence giving rise
to the liability. (3) DOMICILE. For purposes of determining the state in which a purchasing
group is domiciled: a. For a corporation, the state in which the purchasing group is incorporated.
b. For an unincorporated entity, the state of its principal place of...
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