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-4
Section 27-19A-4 Required provisions. Any health insurance policy or employee benefit plan which is delivered, renewed, issued for delivery, or otherwise contracted for in this state shall, to the extent that it provides benefits for dental care expenses: (1) Disclose, if applicable, that the benefit offered is limited to the least costly treatment; (2) Define and explain the standard upon which the payment of benefits or reimbursement for the cost of dental care services is based, such as "usual and customary," "reasonable and customary," "usual, customary, and reasonable," fees or words of similar import or specify in dollars and cents the amount of the payment or reimbursement for dental care services to be provided. Said payment or reimbursement for a noncontracting provider dentist shall be the same as the payment or reimbursement for a contracting provider dentist; provided, however, that the health insurance policy or the employee benefit plan shall not be required to make...
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27-51-1
Section 27-51-1 Payment for services of licensed physician assistant. (a) An insurance policy or contract providing for third-party payment or prepayment of health or medical expenses shall include a provision for the payment to a supervising physician for necessary medical or surgical services that are provided by a licensed physician assistant practicing under the supervision of the physician, and pursuant to the rules, regulations, and parameters for physician assistants, if the policy or contract pays for the same care and treatment provided by a licensed physician or doctor of osteopathy. (b) An insurance policy or contract subject to this section shall not impose a practice or supervision restriction which is inconsistent with or more restrictive than provided by law. (c) This section shall apply to services provided under a policy or contract delivered, continued, or renewed in this state on or after August 1, 1997, and to any existing policy or contract, on the policy's or...
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27-55-2
Section 27-55-2 Definitions. As used in this chapter, these terms shall have the following meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting to cause or intentionally, knowingly, or recklessly causing another person, including a minor child, bodily injury, severe emotional injury, or psychological trauma or conduct which constitutes the crime of rape. b. Intentionally following another person, including a minor child, without proper authority, under circumstances that place the person in reasonable fear of bodily injury or physical harm. c. Subjecting another person, including a minor child, to false imprisonment or kidnapping. d. Attempting to cause or intentionally, knowingly, or recklessly causing damage to property to intimidate or attempt to control the behavior of another person, including a minor child. e. Assault, child abuse, criminal...
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22-21-33
Section 22-21-33 Penalties for operation of or referring persons to unlicensed hospital. (a)(1) Any individual, association, corporation, partnership, limited liability company, or other business entity who operates or causes to be operated a hospital of any kind as defined in this article or any rules promulgated hereunder, without having been granted a license by the State Board of Health shall be guilty of a Class B misdemeanor upon conviction, except that any individual, association, corporation, partnership, limited liability company, or other business entity who operates or causes to be operated a hospital of any kind as defined in this article or any rules promulgated hereunder without having been granted a license by the State Board of Health shall be guilty of a Class A misdemeanor upon conviction of a second or any subsequent offense. (2) The State Board of Health, upon determination that a facility or business is operating as a hospital, within the meaning of this article or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-21-33.htm - 7K - Match Info - Similar pages
22-6-151
Section 22-6-151 Regional care organizations; governing board of directors; citizen's advisory committee; solvency and financial requirements; reporting; provider standards committee. (a) A regional care organization shall serve only Medicaid beneficiaries in providing medical care and services. (b) Notwithstanding any other provision of law, a regional care organization shall not be deemed an insurance company under state law. (c)(1) A regional care organization and an organization with probationary regional care organization certification shall have a governing board of directors composed of the following members: a. Twelve members shall be persons representing risk-bearing participants in the regional care organization or organization with probationary certification. A participant bears risk by contributing cash, capital, or other assets to the regional care organization. A participant also bears risk by contracting with the regional care organization to treat Medicaid beneficiaries...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-151.htm - 9K - Match Info - Similar pages
27-19-105
Section 27-19-105 Regulations for long-term care policies; outline of coverage, policy summary, and monthly report. (a) The commissioner may adopt regulations that include standards for full and fair disclosure setting forth the manner, content, and required disclosures for the sale of long-term care insurance policies, terms of renewability, initial and subsequent conditions of eligibility, nonduplication of coverage provisions, coverage of dependents, preexisting conditions, termination of insurance, continuation or conversion, probationary periods, limitations, exceptions, reductions, elimination periods, requirements for replacement, recurrent conditions, and definitions of terms. Regulations under this subsection should recognize the developing and unique nature of long-term care insurance and the distinction between group and individual long-term insurance policies. (b) No long-term care insurance policy may do any of the following: (1) Be cancelled, nonrenewed, or otherwise...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19-105.htm - 11K - Match Info - Similar pages
27-21A-32
Section 27-21A-32 HMO enrollment requirements. (a) The state government, or any agency, board, commission, institution, or political subdivision thereof, and any city or county, or board of education, which offers its employees a health benefits plan may make available to and inform its employees or members of the option to enroll in at least one health maintenance organization holding a valid certificate of authority which provides health care services in the geographic areas in which such employees or members reside. (b) The first time a health maintenance organization is offered by an employer, either public or private, each covered employee must make an affirmative written selection among the different alternatives included in the health benefits plan. Thereafter, those who wish to change from one plan to another will be allowed to do so annually, provided, that nothing in this section shall prevent any health maintenance organization or insurer from requiring evidence of...
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22-21-318
Section 22-21-318 Powers of authority. (a) In addition to all other powers granted elsewhere in this article, and subject to the express provisions of its certificate of incorporation, an authority shall have the following powers, together with all powers incidental thereto or necessary to the discharge thereof in corporate form: (1) To have succession by its corporate name for the duration of time, which may be in perpetuity, specified in its certificate of incorporation or until dissolved as provided in Section 22-21-339; (2) To sue and be sued in its own name in civil suits and actions, and to defend suits and actions against it, including suits and actions ex delicto and ex contractu, subject, however, to the provisions of Chapter 93 of Title 11, which chapter is hereby made applicable to the authority; (3) To adopt and make use of a corporate seal and to alter the same at pleasure; (4) To adopt, alter, amend and repeal bylaws, regulations and rules, not inconsistent with the...
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22-6-11
Section 22-6-11 Breast and cervical cancer prevention and treatment. (a) This section shall be known and may be cited as the "2009 Breast and Cervical Cancer Prevention and Treatment Act." (b)(1) Medicaid eligibility and coverage shall be extended to a woman who has been determined to be eligible to participate in and has been screened for breast or cervical cancer by any health care provider or entity, or both, that satisfies any of the following: a. Receives direct payment for screening services by National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Title XV funds. b. Is funded at least in part by NBCCEDP grantee Title XV funds for screening services. c. Is not funded at all by NBCCEDP grantee Title XV funds but has been identified by the Department of Public Health as part of the Alabama Breast and Cervical Cancer Early Detection Program and operates consistently within its guidelines. (2) Coverage under this section shall be limited to any woman screened and...
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