|
27-19A-12
Section 27-19A-12 Dental services - Coverages; fees; exceptions. (a) As used in this section,
the following terms shall have the following meanings: (1) COVERED PERSON. Any individual,
family, or family member on whose behalf third-party payment or prepayment of health or medical
expenses is provided under an insurance policy, plan, or contract providing for third-party
payment or prepayment of health care or medical expenses. (2) COVERED SERVICES. Dental care
services for which a reimbursement is available under an enrollee's plan contract, or for
which a reimbursement would be available but for the application of contractual limitations
such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums,
frequency limitations, alternative benefit payments, or any other limitation. (3) DENTAL CARE
PROVIDER. A licensed dentist. (4) DENTAL PLAN. Includes any policy of insurance which is issued
by a health care service contractor which provides for coverage of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19A-12.htm - 2K - Match Info - Similar pages
27-55-3
Section 27-55-3 Prohibited practices; disclosure of information. (a) No insurer may: (1) Deny,
refuse to issue, renew, or reissue, cancel, or otherwise terminate, restrict, or exclude coverage
on an insurance policy or health benefit plan on the basis of an applicant's or insured's
abuse status, or on the basis of any association, relationship, or assistance to a subject
of abuse. (2) Exclude or limit coverage for a loss, deny benefits, or deny a claim on the
basis of the insured's abuse status, or on the basis of any association, relationship, or
assistance to a subject of abuse, except as otherwise permitted or required by the laws of
this state relating to acts of abuse committed by a life insurance beneficiary. Notwithstanding
anything to the contrary in this section, a liability insurer may include policy provisions
providing that a payment required by this subsection may be denied or, if paid, recovered
by the insurer from the insured, if the claim arose out of an act of abuse by...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-55-3.htm - 8K - Match Info - Similar pages
34-23-150
Section 34-23-150 Definitions. As used in this article, the following terms shall have the
following meanings: (1) BOARD. The Alabama State Board of Pharmacy. (2) COMPONENT. Any ingredient
used in the compounding of a drug product. (3) COMPOUNDING. The preparation, mixing, assembling,
packaging, and labeling of a drug or device as the result of a licensed practitioner's prescription
drug order or initiative based on the practitioner/patient/pharmacist relationship in the
course of professional practice. a. Compounding may also be for the purpose of, or as incident
to, research, teaching, or chemical analysis. b. Compounding includes the preparation of drugs
or devices in anticipation of prescription drug orders based on routine, regularly observed
prescribing patterns. c. Reconstitution of commercial products is not considered compounding
for purposes of this article. (4) COMPOUNDED OVER THE COUNTER (OTC) PRODUCTS. A medical product
that is prepared, packaged, and labeled in a pharmacy...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-23-150.htm - 2K - Match Info - Similar pages
16-25A-8
Section 16-25A-8 Funding of health insurance plan; participation; Public Education Employees'
Health Insurance Fund. (a) The Public Education Employees' Health Insurance Board is hereby
authorized to provide under the contract or contracts entered into under the provisions of
this article an insurance benefit plan for each covered employee and, under certain conditions,
retired employees; the cost of such plan may be funded in part or in full through monthly
premiums per active employee from the same source of funds as those used for the payment of
salaries of active members and in part from other funds. (b) On or before January 1 next preceding
each regular meeting of the Legislature, the board shall certify to the Governor and to the
Legislature the amount or amounts necessary to fund coverage for benefits authorized by this
article for the following fiscal year for employees and for retired employees as a monthly
premium per active member per month. The Legislature shall set the...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-8.htm - 6K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/34-23-1.htm - 10K - Match Info - Similar pages
27-56-2
Section 27-56-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) COVERED PERSON. Any individual, family, or family member on whose behalf third-party
payment or prepayment of health or medical expenses is provided under an insurance policy,
plan, or contract providing for third-party payment or prepayment of health care or medical
expenses. (2) EYE CARE PROVIDER. A licensed optometrist or a licensed ophthalmologist. (3)
INSURANCE POLICY, PLAN, OR CONTRACT PROVIDING FOR THIRD-PARTY PAYMENT OR PREPAYMENT OF HEALTH
OR MEDICAL EXPENSES. Includes an individual or group policy for accident or health insurance,
an individual or group hospital or health care service contract, an individual or group health
maintenance organization contract, an organized delivery system contract, or a preferred provider
organization contract, and any other similar policy, plan, or contract. This term shall not
include any employee welfare benefit plan, as defined...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-56-2.htm - 1K - Match Info - Similar pages
20-2-214
Section 20-2-214 Limited access to database permitted for certain persons or entities. (a)
The following persons or entities shall be permitted access to the information in the controlled
substances database, subject to the limitations indicated below: (1) Authorized representatives
of the certifying boards; provided, however, that access shall be limited to information concerning
the licensees of the certifying board, however, authorized representatives from the Board
of Medical Examiners may access the database to inquire about certified registered nurse practitioners
(CRNPs), or certified nurse midwives (CNMs) that hold a Qualified Alabama Controlled Substances
Registration Certificate (QACSC). (2) A licensed practitioner approved by the department who
has authority to prescribe, dispense, or administer controlled substances. The licensed practitioner's
access shall be limited to information concerning himself or herself, registrants who possess
a Qualified Alabama Controlled...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/20-2-214.htm - 6K - Match Info - Similar pages
27-48-3
Section 27-48-3 Prohibition against plan termination of services, reduction of capitation payment,
or other penalty for health care provider in compliance with chapter; prohibition against
financial encouragement of early discharge from postpartum care. No health benefit plan subject
to the provisions of this chapter shall terminate the services, reduce capitation payment,
or otherwise penalize an attending physician, certified nurse midwife, or other health care
provider who orders medical care consistent with this chapter. No health benefit plan shall
provide, directly or indirectly, any financial incentive or disincentive or grant or deny
any special favor or advantage of any kind or nature to any person to encourage or cause early
discharge of a hospital patient from postpartum care, excluding capitation or global fee arrangements.
Provided nothing contained in this chapter is intended to expand the list or designation of
covered providers as specified in any health benefit plan or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-48-3.htm - 1K - Match Info - Similar pages
16-25A-1
Section 16-25A-1 Definitions. When used in this article, the following terms shall have the
following meanings, respectively, unless the context clearly indicates otherwise: (1) EMPLOYEE.
Any person covered by the Public Education Employees' Health Insurance Plan pursuant to Section
16-25A-11 or person who is employed full-time in any public institution of education within
the State of Alabama which provides instruction at any combination of grades K through 14,
exclusively, under the auspices of the State Board of Education or the Alabama Institute for
Deaf and Blind; provided, any person employed part-time by any public institution of education
within the State of Alabama which provides instruction at any combination of grades K through
14, exclusively, under the auspices of the State Board of Education or the Alabama Institute
for Deaf and Blind, shall be included in the definition of employee if such person shall agree
to have deducted from his or her compensation a pro rata...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-25A-1.htm - 6K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-13.htm - 3K - Match Info - Similar pages
|