22-4-13
Section 22-4-13 Preparation, review, and revision of State Medical Facilities Plan. Upon the
adoption of federal regulations pursuant to Title XVI of the Public Health Service Act, the
State Board of Health is hereby authorized and required to prepare, review and revise, at
least annually, with such interim revisions as may become necessary, a Medical Facilities
Plan, which shall include all health care facilities defined in Section 22-4-2, shall divide
the State of Alabama into health service areas and, based on population and health facility
utilization statistics and such other criteria as the State Board of Health may direct, set
forth the need for health care facilities in such numbers and locations that all citizens
of the state shall have access to an integrated and interrelated system of health care. The
State Medical Facilities Plan shall consider the medical facilities plans of the health systems
agencies and shall be submitted to the Statewide Health Coordinating Council for...
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27-45-20
Section 27-45-20 No agreement for services until written verification of registration obtained.
No insurance company, health maintenance organization (HMO), employer or organization offering
a pharmaceutical prescription program to their employees or members in Alabama, shall enter
into an agreement for services until they have obtained written verification that the provider
pharmacies are registered with the Alabama State Board of Pharmacy. Such verification must
be filed with the Alabama Department of Insurance within 10 days of initiating such agreement.
Said department shall provide a copy of the verification to the Alabama State Board of Pharmacy.
Failure to comply with such verification requirement shall result in a fine to the sponsor
of such prescription program, of $100.00 per day, from the date that such agreement was signed
until such verification requirement is satisfied. (Acts 1991, No. 91-595, p. 1098, §1.)...

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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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27-21A-7
Section 27-21A-7 Evidence of coverage and charges for health care services. (a)(1) Every enrollee
residing in this state is entitled to an evidence of coverage. If the enrollee obtains such
coverage through an insurance policy or a contract issued by a health care service plan, the
insurer or the health care service plan shall issue the evidence of coverage. Otherwise, the
health maintenance organization shall issue the evidence of coverage. (2) No evidence of coverage,
or amendment thereto, shall be issued or delivered to any person in this state until a copy
of the basic form of the evidence of coverage, or amendment thereto, has been filed with the
commissioner and the State Health Officer, and approved by the commissioner. (3) An evidence
of coverage shall contain: a. No provisions or statements which encourage misrepresentation,
or which are untrue, misleading, or deceptive as defined in subsection (a) of Section 27-21A-13;
and b. A clear and concise statement, if a contract, or a...
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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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27-54-6
Section 27-54-6 Cost report. Every issuer of a group health benefit plan subject to this chapter
shall provide a cost report for each calendar year to the Commissioner of Insurance no later
than April 30th of the following year. The report shall be in a form prescribed by the commissioner
and shall include certification of parity in mental health benefits and total annual costs
of mental health services relative to total health costs. The commissioner shall compile this
data for all health benefit plans in an annual report solely for the purpose of demonstrating
the health cost impact of the requirements of this chapter. (Act 2000-386, p. 605, §7.)...

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36-29-3
Section 36-29-3 Factors to be considered by board in design of health insurance plan. The health
insurance plan provided for in this chapter shall be designed by the State Employees' Insurance
Board to provide a reasonable relationship between the hospital, surgical, and medical benefits
to be included and the expected hospital, surgical, and medical expenses to be incurred by
the affected employee and retiree and dependents and to include reasonable controls, which
may include, but are not limited to, deductible, copayment, coinsurance, and other cost containment
measures to prevent unnecessary utilization of the various hospital, surgical, and medical
services available and to provide reasonable assurance of stability in future years for the
plan. (Acts 1965, No. 833, p. 1564, §5; Act 2004-647, 1st Sp. Sess., p. 17, §1.)...
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6-5-549.1
Section 6-5-549.1 Limits of liability insurance coverage in legal action against health care
providers; testimony of health care providers as specialists. (a) This section and Sections
6-5-548 and 6-5-549 shall be known and may be cited as "The Alabama Medical Liability
Act of 1996." (b) The Legislature of the State of Alabama finds and declares that a crisis
continues to threaten the delivery and availability of medical services to the people of Alabama
and the health and safety of the citizens of this state are in jeopardy as a result of this
crisis. In accordance with the previous declarations of the Legislature of Alabama in Sections
6-5-480 to 6-5-488, inclusive, 27-26-1 to 27-26-4, inclusive, and 27-26-20 to 27-26-43, inclusive,
and Sections 6-5-540 to 6-5-552, inclusive, it is the declared intent of this Legislature
to ensure that quality medical services continue to be available at reasonable costs to the
citizens of the State of Alabama. The continuing and ever increasing...
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27-45-6
Section 27-45-6 Compliance with article. It shall be unlawful for any insurer or any person
to provide any health insurance policy or employee benefit plan providing for pharmaceutical
services, including without limitation, prescription drugs, that does not conform to the provisions
of this article. (Acts 1988, No. 88-379, p. 565, §6.)...
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27-45-7
Section 27-45-7 Nonconforming policies and plans not to be approved for sale. The Commissioner
of Insurance shall not approve for sale in this state any health insurance policy or employee
benefit plan providing for pharmaceutical services, including without limitation, prescription
drugs, which does not conform to the provisions of this article or to the provisions of Sections
27-14-8 and 27-14-9. (Acts 1988, No. 88-379, p. 565, §7.)...
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