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34-40-2
Section 34-40-2 Definitions. As used in this chapter, the following words and phrases shall
have the following meanings, respectively, unless the context clearly indicates otherwise:
(1) APPRENTICE ATHLETIC TRAINER. A person who assists in the duties usually performed by an
athletic trainer and who works under the direct supervision of a licensed athletic trainer.
(2) ATHLETE. A person who participates in an athletic activity being conducted by an educational
institution, professional athletic organization, or a board sanctioned amateur athletic organization.
(3) ATHLETIC INJURY. An injury received by an athlete as a result of the preparation or participation
of the athlete in an athletic activity. (4) ATHLETIC TRAINER. A person licensed by the Alabama
Board of Athletic Trainers as an athletic trainer and who practices athletic training on an
athlete under the direction or referral, or both, of a licensed physician after meeting the
requirements of this chapter and rules and...
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27-19A-3
Section 27-19A-3 Prohibited provisions. No health insurance policy or employee benefit plan
which is delivered, renewed, issued for delivery, or otherwise contracted for in this state
shall: (1) Prevent any person who is a party to or beneficiary of any such health insurance
policy or employee benefit plan from selecting the dentist of his choice to furnish the dental
care services offered by said policy or plan or interfere with said selection provided the
dentist is licensed to furnish such dental care services in this state; (2) Deny any dentist
the right to participate as a contracting provider for such policy or plan provided the dentist
is licensed to furnish the dental care services offered by said policy or plan; (3) Authorize
any person to regulate, interfere, or intervene in any manner in the diagnosis or treatment
rendered by a dentist to his patient for the purpose of preventing, alleviating, curing, or
healing dental illness or injury provided said dentist practices within...
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27-21A-23
Section 27-21A-23 Statutory construction and relationship to other laws. (a) Except as otherwise
provided in this chapter, provisions of the insurance law and provisions of health care service
plan laws shall not be applicable to any health maintenance organization granted a certificate
of authority under this chapter. This provision shall not apply to an insurer or health care
service plan licensed and regulated pursuant to the insurance law or the health care service
plan laws of this state except with respect to its health maintenance organization activities
authorized and regulated pursuant to this chapter. (b) Solicitation of enrollees by a health
maintenance organization granted a certificate of authority shall not be construed to violate
any provision of law relating to solicitation or advertising by health professionals. (c)
Any health maintenance organization authorized under this chapter shall not be deemed to be
practicing medicine and shall be exempt from the provisions of...
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27-47-1
Section 27-47-1 Qualified long-term care services. For purposes of this chapter, "qualified
long-term care services" includes care for necessary diagnostic, preventive, therapeutic,
and rehabilitative services and maintenance, assisted living, or personal care services which
are required by a chronically ill individual in a qualified facility or services which are
provided pursuant to a plan of care prescribed by a licensed health care practitioner. (Acts
1995, No. 95-738, p. 772, §1; Acts 1996, No. 96-796, p. 1501, §1.)...
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27-49-3
Section 27-49-3 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, policy, or contract for health
care services issued, delivered, issued for delivery, renewed in this state by a health care
insurer, health maintenance organization, accident and sickness insurer, fraternal benefit
society, nonprofit hospital service corporation, nonprofit medical service corporation, health
care service plan, or any other person, firm, corporation, joint venture, or other similar
business entity that pays for, purchases, or furnishes health care services to patients, insureds,
or beneficiaries in this state. The term includes, but is not limited to, entities created
pursuant to Article 6 of Chapter 4 of Title 10. For the purposes of this chapter, a health
benefit plan located or domiciled outside of the State of Alabama is deemed to be subject
to the provisions of this chapter if it receives, processes,...
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34-23-181
Section 34-23-181 Definitions. The following words shall have the following meanings as used
in this article: (1) HEALTH BENEFIT PLAN. Any individual or group plan, employee welfare benefit
plan, policy, or contract for health care services issued, delivered, issued for delivery,
or renewed in this state by a health care insurer, health maintenance organization, accident
and sickness insurer, fraternal benefit society, nonprofit hospital service corporation, nonprofit
medical service corporation, health care service plan, or any other person, firm, corporation,
joint venture, or other similar business entity that pays for insureds or beneficiaries in
this state. The term includes, but is not limited to, entities created pursuant to Article
6 of Chapter 20 of Title 10A. A health benefit plan located or domiciled outside of the State
of Alabama is deemed to be subject to this article if it receives, processes, adjudicates,
pays, or denies claims for health care services submitted by or...
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27-21A-15
Section 27-21A-15 Powers of insurers and health care service plans. (a) An insurance company
licensed in this state, or a health care service plan authorized to do business in this state,
may either directly or through a subsidiary or affiliate organize and operate a health maintenance
organization under the provisions of this chapter. Notwithstanding any other law which may
be inconsistent herewith, any two or more such insurance companies, health care service plans,
or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance
organization. The business of insurance is deemed to include the providing of health care
by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.
(b) Notwithstanding any provision of insurance and health care service plan laws, Title 10,
Chapter 4, Article 6 and Title 27, an insurer or a health care service plan may contract with
a health maintenance organization to provide insurance or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-15.htm - 1K - Match Info - Similar pages
27-48-3
Section 27-48-3 Prohibition against plan termination of services, reduction of capitation payment,
or other penalty for health care provider in compliance with chapter; prohibition against
financial encouragement of early discharge from postpartum care. No health benefit plan subject
to the provisions of this chapter shall terminate the services, reduce capitation payment,
or otherwise penalize an attending physician, certified nurse midwife, or other health care
provider who orders medical care consistent with this chapter. No health benefit plan shall
provide, directly or indirectly, any financial incentive or disincentive or grant or deny
any special favor or advantage of any kind or nature to any person to encourage or cause early
discharge of a hospital patient from postpartum care, excluding capitation or global fee arrangements.
Provided nothing contained in this chapter is intended to expand the list or designation of
covered providers as specified in any health benefit plan or...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-48-3.htm - 1K - Match Info - Similar pages
22-21-293
Section 22-21-293 Financial responsibility for out-of-county indigent patients treated at a
regional referral hospital. Ultimate financial responsibility for treatment received at a
regional referral hospital by a certified indigent patient, who is a resident of the State
of Alabama but is not a resident of the county in which the regional referral hospital is
located, shall be the obligation of the county of which the certified indigent patient is
a resident. A county's annual financial responsibility for each of its resident certified
indigent patients receiving treatment at a regional referral hospital shall be limited to
payment for 30 days or the number of days of services allowed per annum for the care of Medicaid
patients through the State Medicaid Program at the time of the patient's hospitalization,
whichever shall be less, at the per diem reimbursement rate currently in effect for the regional
referral hospital under the medical assistance program for the needy under Title...
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27-21A-1
Section 27-21A-1 Definitions. As used in this chapter, the following terms shall have the following
meanings, respectively: (1) AGENT. A person who is appointed or employed by a health maintenance
organization and who engages in solicitation of membership in such organization. This definition
does not include a person enrolling members on behalf of an employer, union, or other organization.
(2) BASIC HEALTH CARE SERVICES. Emergency care, inpatient hospital and physician care, and
outpatient medical services. (3) COMMISSIONER. The Commissioner of Insurance. (4) ENROLLEE.
An individual who is enrolled in a health maintenance organization. (5) EVIDENCE OF COVERAGE.
Any certificate, agreement, or contract issued to an enrollee setting out the coverage to
which he is entitled. (6) HEALTH CARE SERVICES. Any services included in the furnishing to
any individual of medical or dental care, or hospitalization or incident to the furnishing
of such care or hospitalization, as well as the...
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