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27-1-10.1
Section 27-1-10.1 Insurance coverage for drugs to treat life-threatening illnesses. (a) The
Legislature finds and declares the following: (1) The citizens of this state rely upon health
insurance to cover the cost of obtaining health care and it is essential that the citizens'
expectation that their health care costs will be paid by their insurance policies is not disappointed
and that they obtain the coverage necessary and appropriate for their care within the terms
of their insurance policies. (2) Some insurers deny payment for drugs that have been approved
by the Federal Food and Drug Administration, hereafter referred to as FDA, when the drugs
are used for indications other than those stated in the labelling approved by the FDA, off-label
use, while other insurers with similar coverage terms do pay for off-label use. (3) Denial
of payment for off-label use can interrupt or effectively deny access to necessary and appropriate
treatment for a person being treated for a...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-1-10.1.htm - 6K - Match Info - Similar pages
27-42-12
Section 27-42-12 Exhaustion of rights; nonduplication of recovery. (a) Any person having a
claim under an insurance policy, whether or not it is a policy issued by a member insurer,
where the claim under the other policy arises from the same facts, injury, or loss that gave
rise to the covered claim against the association, shall be required first to exhaust all
coverage provided by any such policy. Any amount payable on a covered claim under this chapter
shall be reduced by the full applicable limits stated in the other insurance policy and the
association shall receive a full credit for the stated limits, or, where there are no applicable
stated limits, the claim shall be reduced by the total recovery. Notwithstanding the foregoing,
no person shall be required to exhaust any right under the policy of an insolvent insurer.
(1) A claim under a policy providing liability coverage to a person who may be jointly and
severally liable with, or a joint tortfeasor with, the person covered...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-42-12.htm - 2K - Match Info - Similar pages
27-12A-1
Section 27-12A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) COMMISSIONER. The Alabama Commissioner of Insurance or his or her designee.
(2) DEPARTMENT. The Alabama Department of Insurance. (3) INSURANCE. As defined in Section
27-1-2, and specifically including any contract, arrangement, or agreement, in which one undertakes
to do any one of the following: a. Pay or indemnify another as to loss from certain contingencies
called risks. b. Pay or grant a specified amount or determinable benefit to another in connection
with ascertainable risk contingencies. c. Pay an annuity to another. d. Act as surety. For
the purposes of this chapter, insurance also includes any health benefit plan as defined in
Section 27-53-1. (4) INSURANCE PRODUCER or PRODUCER. As defined in Section 27-7-1. (5) INSURER.
A person entering into agreements, contracts of insurance, arrangements, or reinsurance, or
a health benefit plan, or a group health plan as...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-12A-1.htm - 3K - Match Info - Similar pages
27-21A-3
Section 27-21A-3 Issuance of certificate of authority. (a)(1) Upon receipt of an application
for issuance of a certificate of authority, the commissioner shall forthwith transmit copies
of such application and accompanying documents to the State Health Officer. (2) The State
Health Officer shall determine whether the applicant for a certificate of authority, with
respect to health care services to be furnished: a. Has demonstrated the willingness and potential
ability to assure that such health care services will be provided in a manner to assure both
availability and accessibility of adequate personnel and facilities and in a manner enhancing
availability, accessibility, and continuity of service; b. Has arrangements, established in
accordance with the regulations promulgated by the State Health Officer, for an on-going quality
assurance program concerning health care processes and outcomes; and c. Has a procedure, established
in accordance with regulations of the State Health...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-3.htm - 7K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/25-5-77.htm - 13K - Match Info - Similar pages
22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance
procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for
Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid
region for at least one fully certified regional care organization to provide, pursuant to
a risk contract under which the Medicaid Agency makes a capitated payment, medical care to
Medicaid beneficiaries. However, the Medicaid Agency may enter into a contract pursuant to
this section only if, in the judgment of the Medicaid Agency, care of Medicaid beneficiaries
would be better, more efficient, and less costly than under the then existing care delivery
system. The Medicaid Agency may contract with more than one regional care organization in
a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments
for the regional care organization. (b) The Medicaid Agency shall...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-153.htm - 10K - Match Info - Similar pages
36-25-1
Section 36-25-1 Definitions. Whenever used in this chapter, the following words and terms shall
have the following meanings: (1) BUSINESS. Any corporation, partnership, proprietorship, firm,
enterprise, franchise, association, organization, self-employed individual, or any other legal
entity. (2) BUSINESS WITH WHICH THE PERSON IS ASSOCIATED. Any business of which the person
or a member of his or her family is an officer, owner, partner, board of director member,
employee, or holder of more than five percent of the fair market value of the business. (3)
CANDIDATE. This term as used in this chapter shall have the same meaning ascribed to it in
Section 17-5-2. (4) COMMISSION. The State Ethics Commission. (5) COMPLAINT. Written allegation
or allegations that a violation of this chapter has occurred. (6) COMPLAINANT. A person who
alleges a violation or violations of this chapter by filing a complaint against a respondent.
(7) CONFIDENTIAL INFORMATION. A complaint filed pursuant to this...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/36-25-1.htm - 21K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/16-6F-7.htm - 16K - Match Info - Similar pages
45-37-123.01
Section 45-37-123.01 Definitions. For the purposes of this part, the following terms shall
have the following meanings: (1) ACT. The act adding this part, to be called the General Retirement
System for Employees of Jefferson County Act. (2) ACTIVE MEMBER. An individual who currently
is employed by the county or other entities set forth in subdivision (20) and is making employee
contributions to the system. (3) ACTUARIAL EQUIVALENT. Effective July 30, 1984, or such other
dates as set forth in Exhibit A, which is maintained in the office of the pension board, a
form of benefit differing in time, period, or manner of payment from a specific benefit provided
under the plan but having the same value when computed using the mortality tables, the interest
rate, and any other assumptions last adopted by the pension board, which assumptions shall
clearly preclude any discretion in the determination of the amount of a member's benefit.
(4) ACTUARIAL GAIN. As defined in Section...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/45-37-123.01.htm - 27K - Match Info - Similar pages
27-44-3
Section 27-44-3 Scope of chapter. (a) This chapter shall provide coverage for the policies
and contracts specified in subsection (b) as follows: (1) To persons who, regardless of where
they reside (except for non-resident certificate holders under group policies or contracts),
are the beneficiaries, assignees, or payees of the persons covered under subdivision (2).
(2) To persons who are owners of or certificate holders under the policies or contracts, other
than structured settlement annuities, and in each case who are either of the following: a.
Residents b. Not residents, but only under all of the following conditions: 1. The insurer
that issued the policies or contracts is domiciled in this state. 2. The states in which the
persons reside have associations similar to the association created by this chapter. 3. The
persons are not eligible for coverage by an association in any other state due to the fact
the insurer was not licensed in the state at the time specified in the state's...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-44-3.htm - 12K - Match Info - Similar pages
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