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27-52-3
Section 27-52-3 Additional powers; guidelines. (a) The commissioner shall, by regulation, establish
additional powers and duties of the plan and may adopt such rules as are necessary and proper
to implement this article. For the purpose of this section, the term "insurer" means
any entity covered by the Health Insurance Portability Act, including, but not limited to,
as the terms are defined in the Health Insurance Portability Act, a health insurance issuer,
a health maintenance organization and, notwithstanding Section 10-4-115, any health benefit
plan. In the case of a self-funded health benefit plan operating through a third party administrator,
the third party administrator shall be the insurer for the purpose of this section. The commissioner
may, by regulation, define health insurance premiums consistent with the purpose of this section.
(b) The regulations shall set forth coverage eligibility criteria consistent with the requirements
of Health Insurance Portability and...
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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, ยง4.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-58-4.htm - 1K - Match Info - Similar pages
22-52-12.1
Section 22-52-12.1 Designated mental health facilities; standards of care. (a) The department
shall designate certain mental health facilities that shall have the authority to receive
respondents for evaluation, admission, detention, treatment and discharge pursuant to the
provisions of this chapter. (b) The department shall establish standards of care and services
to be rendered by each designated mental health facility and shall certify those facilities
designated to provide evaluation, admission, detention, treatment and discharge. (c) The probate
judges of the State of Alabama may commit respondents, who meet the criteria for involuntary
commitment, to a designated mental health facility. Provided, however, that such designated
mental health facility shall not be required to accept a committed respondent if they are
unable to provide proper services and treatment. (d) The designated mental health facilities
shall have the authority to contract with public or private mental health...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-52-12.1.htm - 1K - Match Info - Similar pages
27-26-2
Section 27-26-2 Purpose of chapter. It is hereby declared by the Legislature of the State of
Alabama that the availability of medical liability insurance at reasonable rates for the medical
profession, medical institutions, and other health care providers is essential to provide
adequate health services to the people of Alabama, and without such insurance, medical services
by the medical profession may be curtailed, and that while the need for such insurance is
increasing, availability is limited and likely to become increasingly so, unless remedial
legislation is enacted. The Legislature further finds and declares that by reason of complicated
and highly technical medical concepts, and the existence of sophisticated medical techniques,
decisions with respect to optional procedures of diagnosis and treatment have become increasingly
complex and are necessarily made on the basis of professional judgment, on which opinions
may and often will reasonably vary. It is the purpose of this...
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26-23C-2
Section 26-23C-2 Legislative findings. (a) The Legislature of the State of Alabama finds all
of the following: (1) Under the Patient Protection and Affordable Care Act, P.L. 111-148,
federal tax dollars, via affordability credits, subsidies provided to individuals between
150-400 percent of the federal poverty level, are routed to exchange participating health
insurance plans, including plans that provide coverage for abortions. (2) Federal funding
of insurance plans that provide abortions is an unprecedented change in federal abortion funding
policy. The Hyde Amendment, as passed each year in the Labor Health and Human Services Appropriations
bill, and the Federal Employee Health Benefits Program, FEHBP, prohibit federal funds from
subsidizing health insurance plans that provide abortions. Under this new law, however, exchange
participating health insurance plans that provide abortions can receive federal funds. (3)
The provision of federal funding for health insurance plans that...
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27-1-17.1
Section 27-1-17.1 Payment of providers through electronic funds transfer methods. (a) As used
in this section, the following words shall have the following meanings: (1) ACH ELECTRONIC
FUNDS TRANSFER. An electronic funds transfer through the Health Insurance Portability and
Accountability Act (HIPPA) standard Automated Clearing House network. (2) COVERED HEALTH CARE
PROVIDER. A physician as defined in Section 34-24-50.1; a dentist as defined in Section 34-9-1;
a chiropractor as defined in Section 34-24-120; an individual engaged in the practice of optometry
as defined in Section 34-22-1; other licensed health care professionals as defined in Title
34; a hospital as defined in Section 22-21-20; and a health care facility, or other provider
who or that is accredited, licensed, or certified and who or that is performing within the
scope of that accreditation, license, or certification. (3) HEALTH INSURANCE PLAN. Any hospital
and medical expense incurred policy, health maintenance...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-17.1.htm - 3K - Match Info - Similar pages
11-91A-3
Section 11-91A-3 Employee, retiree, and dependent coverage; premiums; summary documents. (a)
All full-time employees, elected officials, and retirees of employer participants who are
eligible for health care benefits for themselves or their dependents under the provisions
of the program shall be entitled to coverage and benefits as designated by the board. (b)
Each employee and retiree shall be entitled to have his or her spouse and dependent children,
as those persons are defined by the board, included in the coverage under rules and regulations
promulgated by the board upon agreeing to pay the employee's contribution of the health care
premium for the dependents. The board shall adopt rules and regulations governing the discontinuance
and resumption of coverage for dependents by the employees and retirees. The board shall adopt
rules governing the discontinuance and resumption of coverage for dependents by the employees
and retirees. (c) The board shall establish premiums required...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/11-91A-3.htm - 2K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-19.htm - 2K - Match Info - Similar pages
36-1-6.1
Section 36-1-6.1 Professional liability coverage for state employees or agents; duties of Finance
Director; self-insurance; costs of insurance. (a) The various state agencies, departments,
boards, or commissions shall determine and report their needs for liability coverage to the
Finance Director, the Insurance Commissioner, and the Attorney General. The Finance Director,
with the advice of the Insurance Commissioner and Attorney General, shall then determine the
type of blanket policy needed to provide basic coverage for deaths, injuries, or damages arising
out of the negligent or wrongful acts or omissions committed by state employees or agents
of the state, including retired licensed physicians and dentists while they are voluntarily
serving at free health care clinics and individuals serving as foster parents licensed or
approved by the Department of Human Resources to maintain homes for a child or children under
the supervision of the department or serving as adult foster care...
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36-29-1
Section 36-29-1 Definitions. When used in this chapter, the following terms shall have the
following meanings, respectively, unless the context clearly indicates otherwise: (1) BOARD.
The State Employees' Insurance Board. (2) CLASS. An employee or retiree shall be included
in one of the following classes: (i) active employee single, (ii) active employee family,
(iii) non-Medicare retiree single, (iv) non-Medicare retiree family, (v) Medicare retiree
single, (vi) Medicare retiree family, (vii) non-Medicare retiree with Medicare eligible dependent(s),
or (viii) Medicare retiree with non-Medicare dependent(s). (3) EMPLOYEE. A person who works
full time for the State of Alabama or for a county health department and who receives his
or her full compensation on a monthly basis through means of a state warrant drawn upon the
State Treasury or by check drawn by the Treasurer of the Alabama State Port Authority or by
check drawn by the treasurer of the Alabama state agency for surplus property...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-29-1.htm - 11K - Match Info - Similar pages
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