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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, §4.)...
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31-9B-3
Section 31-9B-3 Providing of information; requirements for emergency and disaster planning
provisions; immunity. (a) All appropriate agencies and community-based service providers,
including, but not limited to, home health care providers, hospices, community mental health
centers, and related facilities, but not including health care facilities which provide inpatient
care to include general and specialized hospitals including ancillary services, skilled nursing
facilities, intermediate care facilities, or any assisted living facility, shall provide information
on the number of individuals with medical needs and shall assist the State Health Department
in the establishment of programs to increase the awareness of medical needs shelters, and
in educating clients and sponsors or caregivers about the procedures that may be necessary
for their safety during disasters. (b) State agencies that regulate or contract with providers
of services, or both, for persons with disabilities or...
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34-25A-4
Section 34-25A-4 Referral and consultation limits. (a) A licensed prosthetist, licensed orthotist,
or licensed prosthetist/orthotist may provide services utilizing new prostheses or orthoses
for which he or she is licensed and only under a written order from an authorized health care
practitioner. A consultation with and periodic review by an authorized health care practitioner
is not required for the evaluation, repair, adjusting, or servicing of a prosthesis by a licensed
prosthetist, or licensed prosthetist/orthotist and for the evaluation, repair, adjusting,
or servicing of an orthosis by a licensed orthotist, or licensed prosthetist/orthotist; nor
is an order from an authorized health care practitioner required for maintenance or replacement
of an orthosis or prosthesis to the level of its original prescription for an indefinite period
of time if the original order remains appropriate for the patient's medical needs. (b) Prosthetists
and orthotists must refer persons receiving...
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22-12A-3
Section 22-12A-3 Plan to reduce infant mortality and handicapping conditions; procedure, contents,
etc. The Bureau of Maternal and Child Health under the direction of the State Board of Health
shall, in coordination with the State Health Planning and Development Agency, the State Health
Coordinating Council, the Alabama Council on Maternal and Infant Health and the regional and
State Perinatal Advisory Committees, annually prepare a plan, consistent with the legislative
intent of Section 22-12A-2, to reduce infant mortality and handicapping conditions to be presented
to legislative health and finance committees prior to each regular session of the Legislature.
Such a plan shall include: primary care, hospital and prenatal; secondary and tertiary levels
of care both in hospital and on an out-patient basis; transportation of patients for medical
services and care and follow-up and evaluation of infants through the first year of life;
and optional educational programs, including pupils in...
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27-19A-2
Section 27-19A-2 Definitions. As used in this chapter, the following terms shall have the respective
meanings herein set forth, unless the context shall otherwise require: (1) ALABAMA INSURANCE
CODE. Title 27 of the Code of Alabama 1975. (2) INSURER. Such term shall have the meaning
ascribed in Section 27-1-2. (3) PERSON. Such term shall have the meaning ascribed in Section
27-1-2. (4) COMMISSIONER and DEPARTMENT. Such terms, respectively, shall have the meanings
ascribed in Section 27-1-2. (5) CONTRACTUAL OBLIGATION. Any obligation under covered policies
or employee benefit plans. (6) COVERED POLICY OR PLAN. Any policy, employee benefit plan,
or contract within the scope of this chapter. (7) HEALTH INSURANCE POLICY. Any individual,
group, blanket, or franchise insurance policy, insurance agreement, or group hospital service
contract providing benefits for dental care expenses incurred as a result of an accident or
sickness. (8) EMPLOYEE BENEFIT PLAN. Any plan, fund, or program...
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27-19A-7
Section 27-19A-7 Contracting directly with patient; distribution of information about policy
or plan; payment and reimbursement procedures. The provisions of this chapter do not prohibit
the following conduct and shall be construed to provide that: (1) A dentist may contract directly
with a patient for the furnishing of dental care services to said patient as may be otherwise
authorized by law; (2) Any person providing a health insurance policy or employee benefit
plan, or an employer, or an employee organization may: a. Make available to its insureds,
beneficiaries, participants, employees, or members information relating to dental care services
by the distribution of factually accurate information regarding dental care services, rates,
fees, location, and hours of service, provided such distribution is made upon the request
of any dentist licensed by this state; or b. Establish an administrative mechanism which facilitates
payment for dental care services by insureds, beneficiaries,...
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34-19-16
Section 34-19-16 Where care may be performed; required forms an duties of licensed midwife.
(a) A licensed midwife may provide midwifery care in the setting of the client's choice, except
a hospital. (b) A licensed midwife shall ensure that the client has signed a midwife disclosure
form provided by the board indicating receipt of a written statement that includes all of
the following information: (1) A description of the licensed midwife's education, training,
and experience in midwifery. (2) Antepartum, intrapartum, and postpartum conditions requiring
medical referral, transfer of care, and transport to a hospital. (3) A plan for medical referral,
transfer of care, and transport of the client or newborn or both when indicated by specific
antepartum, intrapartum, or postpartum conditions. (4) Instructions for filing a complaint
against a licensed midwife. (5) A statement that the licensed midwife must comply with the
federal Health Insurance Portability and Accountability Act. (6) The...
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20-2-213
Section 20-2-213 Reporting requirements. (a) Each of the entities designated in subsection
(b) shall report to the department, or to an entity designated by the department, controlled
substances prescription information as designated by regulation pertaining to all Class II,
Class III, Class IV, and Class V controlled substances in such manner as may be prescribed
by the department by regulation. (b) The following entities or practitioners are subject to
the reporting requirements of subsection (a): (1) Licensed pharmacies, not including pharmacies
of general and specialized hospitals, nursing homes, and any other health care facilities
which provide inpatient care, so long as the controlled substance is administered and used
by a patient on the premises of the facility. (2) Mail order pharmacies or pharmacy benefit
programs filling prescriptions for or dispensing controlled substances to residents of this
state. (3) Licensed physicians, dentists, podiatrists, or optometrists who...
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27-3A-2
Section 27-3A-2 Purposes. The purposes of this chapter are to: (1) Promote the delivery of
quality health care in a cost-effective manner. (2) Assure that utilization review agents
adhere to reasonable standards for conducting utilization review. (3) Foster greater coordination
and cooperation between health care providers and utilization review agents. (4) Improve communications
and knowledge of benefit plan requirements among all parties concerned before expenses are
incurred. (5) Ensure that utilization review agents maintain the confidentiality of medical
records in accordance with applicable laws. (Acts 1994, 1st Ex. Sess., No. 94-786, p. 80,
§2.)...
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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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