Code of Alabama

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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-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...
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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...
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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...
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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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