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22-10B-5
Section 22-10B-5 Sickle cell services. The sickle cell services shall include all of the following:
(1) Public and professional health education which shall be provided by persons specially
trained for the task. (2) Screening of all newborns within a designated area for sickle cell
disease by accurate laboratory techniques. (3) Genetic counseling and decision-making counseling
which shall be offered to all parents of infants who are affected with Sickle Cell Disease
and to those parents and patients at risk of having other children affected with this disease.
(4) Medical referral and follow-up which shall consist of a prompt definitive diagnosis of
patients found to have medically significant hemoglobin and the medical management of painful
episodes, infections, and other complications which shall be provided by physicians and other
medical professionals. (5) Psychosocial support services which shall be provided to help patients
affected with Sickle Cell Disease to live a happy and...
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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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22-10A-2
Section 22-10A-2 Diagnostic facilities, genetic counseling and prenatal testing for genetic
disorders at University of Alabama in Birmingham and University of South Alabama. (a) The
University of Alabama in Birmingham, through its laboratory of medical genetics, and the University
of South Alabama shall expand their respective medical genetics programs to provide diagnostic
facilities, genetic counseling and prenatal testing for genetic disorders. (b) Each shall:
(1) Develop an education program designed to educate physicians and the public concerning
genetic disorders and the availability of this program. (2) Assure that genetic counseling
is available to those Alabama families who need it. This will include those families who have
a member with a birth defect, mental retardation, or other handicapping disorder due to genetic
factors as well as families identified by screening to be at increased risk for having a child
with one of these problems. (3) Formulate a graduated fee...
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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...
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22-2-10
Section 22-2-10 Council on Dental Health, Council on Animal and Environmental Health, Council
on Prevention of Disease and Medical Care and Council on Health Costs, Administration and
Organization - Chairmen; vacancies; meetings; quorum; compensation. Each such council shall
select from among its members, by majority vote, a chairman; and the chairman of each such
council, by virtue of his selection as chairman, shall be a member of the State Committee
of Public Health with full voting privileges, rights and responsibilities of membership. As
each term expires on each council, the designated association or person responsible for the
original appointment shall fill the vacancy for a five-year term. Appointees who serve less
than five-year terms shall be eligible for reappointment for only one five-year term. A council
member who ceases to be a member of the appointing authority or who no longer is a resident
of the State of Alabama shall automatically cease to be a member of the council...
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27-58-4
Section 27-58-4 Benefits subject to annual deductible, coinsurance, exclusions, reductions,
etc. (a) The benefits provided in this chapter shall be subject to the same annual deductible
or coinsurance established for all covered benefits within a given policy. Private third party
payors may not reduce or eliminate coverage due to the requirements of this chapter. (b) A
health benefit plan subject to this chapter shall not terminate services, reduce capitation
payment, or otherwise penalize an attending physician or health care provider who orders medical
care consistent with this chapter. (c) Nothing in this chapter is intended to expand the list
of designations of covered providers as specified in any health benefit plan. (Act 2007-389,
p. 778, §4.)...
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27-59-3
Section 27-59-3 Implementation of coverage. (a) The benefits provided in this chapter shall
be subject to the same annual deductible or co-insurance established for all covered benefits
within a given policy. Private third party payors may not reduce or eliminate coverage due
to the requirements of this chapter. (b) A health benefit plan subject to this chapter may
not terminate services, reduce capitation payment, or otherwise penalize an attending physician
or health care provider who orders medical care consistent with this chapter. (c) Nothing
in this chapter is intended to expand the list of designations of covered providers as specified
in any health benefit plan. (Act 2008-502, p. 1106, §3.)...
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27-50-5
Section 27-50-5 Penalties for compliance with article - Prohibited. (a) No health benefit plan
subject to the provisions of this chapter shall terminate the services, reduce capitation
payment, or otherwise penalize an attending physician or other health care provider who orders
medical care consistent with this chapter. (b) Nothing in this chapter is intended to expand
the list or designation of covered providers as specified in any health benefit plan. (Acts
1997, No. 97-414, p. 685, §5.)...
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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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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...
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