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27-57-5
Section 27-57-5 Coverage by participating providers; selection criteria and utilization protocols;
maximum benefits, exclusions, etc. (a) This chapter does not require and shall not be construed
to require the coverage of services of providers who are not designated as covered providers,
or who are not selected as a participating provider, by a group health benefit plan or insurer
having a participating network of service providers. Nothing in this chapter is intended to
expand the list or designation of participating providers as specified in any health benefit
plan. (b) Insurers or other issuers of any health benefit plan covered by this chapter shall
continue to be able to establish and apply selection criteria and utilization protocols for
health care providers including the designation of types of providers for which coverage is
provided as well as credentialing criteria used in the selection of providers. (c) A group
health benefit plan, policy, or contract that provides coverage...
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27-56-7
Section 27-56-7 Applicability to certain providers. (a) This chapter does not require and shall
not be construed to require any insurance policy, plan, or contract to provide health care
coverage for eye care. The provisions of this chapter are applicable only to those insurance
policies, plans, or contracts which provide coverage for eye care. (b) Insurers or other issuers
of any insurance policy, plan, or contract which provides coverage for eye care shall continue
to be able to establish and apply selection criteria and utilization protocols for health
care providers as well as credentialing criteria used in the selection of providers. (c) This
chapter does not require and shall not be construed to require the coverage of eye care services
by providers who are not designated as covered providers, or who are not selected as participating
providers, by an insurance policy, plan, or contract, or the issuer thereof having a participating
network of service providers. Provided, however,...
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27-54-4
Section 27-54-4 Illnesses covered; requirements of benefit plans, etc. (a) All group health
benefit plans shall offer to provide, at a minimum, additional benefits according to this
chapter for a person receiving medical treatment for any of the following mental illnesses
diagnosed by an appropriately licensed provider. (1) Schizophrenia, schizophrenia form disorder,
schizo affective disorder. (2) Bipolar disorder. (3) Panic disorder. (4) Obsessive-compulsive
disorder. (5) Major depressive disorder. (6) Anxiety disorders. (7) Mood disorders. (8) Any
condition or disorder involving mental illness, excluding alcohol and substance abuse, that
falls under any of the diagnostic categories listed in the mental disorders section of the
International Classification of Disease, as periodically revised. (b) All group health benefit
plans, policies, contracts, and certificates executed, delivered, issued for delivery, continue,
or renewed in this state on or after January 1, 2001, shall offer, at...
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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...
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27-49-4
Section 27-49-4 Obstetricians and gynecologists as primary care physicians; direct access to
obstetrician and gynecologist not used as primary care physicians. (a) Each health benefit
plan which is issued, delivered, issued for delivery, or renewed in this state on or after
October 1, 1996, shall allow obstetricians and gynecologists as primary care physicians. This
subsection shall not be construed to require an individual obstetrician or gynecologist to
accept primary care physician status if the obstetrician or gynecologist does not wish to
be designated as a primary care physician, nor to interfere with the credentialing and other
selection criteria usually applied by a health benefit plan with respect to other physicians
within its network. (b) For women not using an obstetrician or gynecologist as their primary
care physician, no health benefit plan which is issued, delivered, issued for delivery, or
renewed in this state on or after October 1, 1996, shall require as a condition...
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22-11D-8
Section 22-11D-8 Rules and regulations. (a) In accordance with the Alabama Administrative Procedure
Act, the board, with the advice and after approval of the council, shall promulgate rules
to implement and administer this chapter. Rules promulgated by the board may include, but
are not limited to, the following: (1) Criteria to ensure that severely injured or ill people
are promptly transported and treated at designated trauma centers appropriate to the severity
of the injury. Minimum criteria shall address emergency medical service trauma triage and
transportation guidelines as approved under the board's emergency medical services rules,
designation of health care facilities as trauma centers, interhospital transfers, and a trauma
system governance structure. (2) Standards for verification of trauma and health care center
status which assign level designations based on resources available within the facility. Standards
shall be based upon national guidelines, including, but not...
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16-6F-7
Section 16-6F-7 Applicant proposals; conversion to public charter school; terms of charters;
contracts. (a) Request for proposals. (1) To solicit, encourage, and guide the development
of quality public charter school applications, every local school board, in its role as public
charter school authorizer, shall issue and broadly publicize a request for proposals for public
charter school applications by July 17, 2015, and by November 1 in each subsequent year. The
content and dissemination of the request for proposals shall be consistent with the purposes
and requirements of this act. (2) Public charter school applicants may submit a proposal for
a particular public charter school to no more than one local school board at a time. (3) The
department shall annually establish and disseminate a statewide timeline for charter approval
or denial decisions, which shall apply to all authorizers in the state. (4) Each local school
board's request for proposals shall present the board's strategic...
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41-16-72
Section 41-16-72 Procurement of professional services. Any other provision of law notwithstanding,
the procurement of professional services by any agency, department, board, bureau, commission,
authority, public corporation, or instrumentality of the State of Alabama shall be conducted
through the following selection process: (1)a. Except as otherwise provided herein, attorneys
retained to represent the state in litigation shall be appointed by the Attorney General in
consultation with the Governor from a listing of attorneys maintained by the Attorney General.
All attorneys interested in representing the State of Alabama may apply and shall be included
on the listing. The selection of the attorney or law firm shall be based upon the level of
skill, experience, and expertise required in the litigation and the fees charged by the attorney
or law firm shall be taken into consideration so that the State of Alabama receives the best
representation for the funds paid. Fees shall be...
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25-5-77
Section 25-5-77 Expenses of medical and surgical treatment, vocational rehabilitation, medicine,
etc.; medical examinations; review by ombudsman of medical services. (a) In addition to the
compensation provided in this article and Article 4 of this chapter, the employer, where applicable,
shall pay the actual cost of the repair, refitting, or replacement of artificial members damaged
as the result of an accident arising out of and in the course of employment, and the employer,
except as otherwise provided in this amendatory act, shall pay an amount not to exceed the
prevailing rate or maximum schedule of fees as established herein of reasonably necessary
medical and surgical treatment and attention, physical rehabilitation, medicine, medical and
surgical supplies, crutches, artificial members, and other apparatus as the result of an accident
arising out of and in the course of the employment, as may be obtained by the injured employee
or, in case of death, obtained during the period...
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27-56-8
Section 27-56-8 Implementation of coverage. (a) Any insurance policy, plan, or contract that
provides coverage for eye care services may contain provisions for maximum benefits and coinsurance
limitations, deductibles, exclusions, and utilization review protocols to the extent that
these provisions are not inconsistent with the requirements of this chapter. (b) If eye care
coverage is provided, the eye care benefits for services provided by optometrists within the
scope of their licenses shall be subject to the same annual deductible or coinsurance established
for all other eye care providers for which coverage is provided. (Act 2001-477, p. 640, ยง8.)...
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