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27-54A-2
Section 27-54A-2 Treatment under certain policies and contracts. (a) As used in this section,
the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design,
implementation, and evaluation of environmental modifications, using behavioral stimuli and
consequences, to produce socially significant improvement in human behavior, including the
use of direct observation, measurement, and functional analysis of the relationship between
environment and behavior. (2) AUTISM SPECTRUM DISORDER. Any of the pervasive developmental
disorders or autism spectrum disorders as defined by the most recent edition of the Diagnostic
and Statistical Manual of Mental Disorders (DSM) or the edition that was in effect at the
time of diagnosis. (3) BEHAVIORAL HEALTH TREATMENT. Counseling and treatment programs, including
applied behavior analysis that are both of the following: a. Necessary to develop, maintain,
or restore, to the maximum extent practicable, the functioning of an...
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27-1-20
Section 27-1-20 Patient Right to Know Act. (a) This section shall be known and may be cited
as the "Patient Right to Know Act." (b) As used in this section, unless the context
clearly indicates otherwise, the following words shall have the following meanings: (1) ENROLLEE.
A person who purchases individual health care coverage or an employer who purchases a group
health care plan. (2) PROVIDER. A physician, dentist, podiatrist, pharmacist, optometrist,
psychologist, clinical social worker, advanced nurse practitioner, registered optician, licensed
professional counselor, physical therapist, and chiropractor. (c)(1) All persons, firms, corporations,
associations, health maintenance organizations, health insurance services, or preferred provider
organizations, any employer-sponsored health benefit plan, or any similar organization or
entity, providing health, accident, or dental insurance coverage, either directly or indirectly,
shall provide an enrollee with a written description of the...
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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...
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34-23-184
Section 34-23-184 Audit procedures; report. (a) The entity conducting an audit shall follow
these procedures: (1) The pharmacy contract shall identify and describe in detail the audit
procedures. (2) The entity conducting the on-site audit shall give the pharmacy written notice
at least two weeks before conducting the initial on-site audit for each audit cycle. If the
pharmacy benefit manager does not include their auditing guidelines within their provider
manual, then the notice must include a documented checklist of all items being audited and
the manual, including the name, date, and edition or volume, applicable to the audit and auditing
guidelines. For on-site audits a pharmacy benefit manager shall also provide a list of material
that is copied or removed during the course of an audit to the pharmacy. The pharmacy benefit
manager may document this material on either a checklist or on an audit acknowledgement form.
The pharmacy shall produce any items during the course of the...
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27-19-103
Section 27-19-103 Definitions. Unless the context requires otherwise, the definitions in this
section apply throughout this article. (1) APPLICANT. In the case of: a. An individual long-term
care insurance policy, the person who seeks to contract for benefits. b. A group long-term
care insurance policy, the proposed certificate holder. (2) CERTIFICATE. Any certificate issued
under a group long-term care insurance policy, which policy has been delivered or issued for
delivery in this state. (3) COMMISSIONER. The Alabama Commissioner of Insurance. (4) GROUP
LONG-TERM CARE INSURANCE. A long-term care insurance policy which is delivered or issued for
delivery in this state and issued to any of the following: a. One or more employers or labor
organizations, or to a trust or to the trustees of a fund established by one or more employers
or labor organizations, or a combination thereof, for employees or former employees or a combination
thereof, or for members or former members or a...
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38-15-4
Section 38-15-4 Registration of certain youth residential institutions or organizations; staff
training plans; rights of children; licensing and inspection of food preparation areas; access
by law enforcement agencies. (a) Commencing on January 1, 2018, the department shall register
any religious, faith-based, or church nonprofit, other nonprofit, or for profit affiliated
youth residential facility, youth social rehabilitation facility, community treatment facility
for youths, youth transitional care facility, long term youth residential facility, private
alternative boarding school, private alternative outdoor program, and any organization entrusted
with the residential care of children in any organizational form or combination defined by
this section, whenever children are housed at the facility or location of the program for
a period of more than 24 hours. At a minimum, registered youth residential institution or
organization under this section shall do all of the following: (1) Be...
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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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26-1A-404
Section 26-1A-404 Health care powers of attorney executed on or after January 1, 2012. (a)
This section applies to a power of attorney for health care decisions executed on or after
January 1, 2012. (b) A durable power of attorney is a power of attorney by which a principal
designates another his or her attorney in fact or agent in writing and the writing contains
the words "This power of attorney shall not be affected by disability, incompetency,
or incapacity of the principal" or "This power of attorney shall become effective
upon the disability, incompetency, or incapacity of the principal" or similar words showing
the intent of the principal that the authority conferred shall be exercisable notwithstanding
the principal's subsequent disability, incompetency, or incapacity. (c)(1) A principal may
designate under a durable power of attorney an individual who shall be empowered to make health
care decisions on behalf of the principal, in the manner set forth in the Natural Death Act,...
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26-1-2
Section 26-1-2 Durable power of attorney; appointment by court of guardian, etc., subsequent
to execution of durable power of attorney; effect of death of principal upon agency relationship;
affidavit by person exercising power of attorney as to lack of knowledge of revocation, etc.;
health care power of attorney. (a) A durable power of attorney is a power of attorney by which
a principal designates another his or her attorney in fact or agent in writing and the writing
contains the words "This power of attorney shall not be affected by disability, incompetency,
or incapacity of the principal" or "This power of attorney shall become effective
upon the disability, incompetency, or incapacity of the principal" or similar words showing
the intent of the principal that the authority conferred shall be exercisable notwithstanding
the principal's subsequent disability, incompetency, or incapacity. (b) All acts done by an
attorney in fact pursuant to a durable power of attorney during any...
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25-14-9
Section 25-14-9 Written contract; rights and duties of clients; employees, and professional
employer organizations. (a) All professional employer organization arrangements shall have
a written contract between the client and the professional employer organization recognizing
the rights, responsibilities, and duties of each party. The contract shall disclose to the
client the services to be rendered by the professional employer organization, including the
total administrative fees charged for professional employer organization services, the respective
rights and obligations of the parties, and shall provide the following: (1) The professional
employer organization reserves a right of direction and control over contract employees and
exercises that right in the context of the need to do so according to the terms and conditions
of the professional employment agreement. The client, however, as an employer, may retain
sufficient direction and control over covered employees necessary to...
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