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27-54-2
Section 27-54-2 Definitions. For purposes of this chapter, the following terms have the following
meanings: (1) DAY TREATMENT SERVICES. Includes, but is not limited to: Physiological, psychological,
and psychosocial concepts, techniques, and processes necessary to maintain or develop functional
skills of clients, provided to individuals and groups for periods of more than two hours but
less than 24 hours a day. (2) HEALTH BENEFIT PLAN. A health care service plan governed by
the provisions of Article 6, Chapter 4, Title 10, and a group health insurance policy, including
an employee welfare health benefit plan, that covers hospital, medical, or surgical expenses,
issued by insurers, health maintenance organizations, preferred provider organizations, medical
service organizations, physician-hospital organizations, 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...
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27-1-22
Section 27-1-22 Uniform prescription drug information card or technology. (a) Every health
benefit plan that provides coverage for prescription drugs or devices, or administers a plan,
including, but not limited to, third party administrators for self-insured plans and state
administered plans, excluding the Alabama Medicaid Program, shall issue to its insureds a
card or other technology containing prescription drug information. The uniform prescription
drug information card or technology shall be in the format approved by the National Council
for Prescription Drug Programs (NCPDP) and shall include all of the required fields and conform
to the most recent pharmacy ID card or technology implementation guide produced by NCPDP or
conform to a national format acceptable to the Commissioner of Insurance. If a health care
plan includes a conditional or situational field, it shall conform to the most recent pharmacy
information card or technology implementation guide by the NCPDP or conform...
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22-21-271
Section 22-21-271 Certificates of need - Application fees; appropriation of funds; disposition
of fees. (a) Each application for a certificate of need shall be accompanied by a fee of one
percent of the estimated cost of the proposed cost of the new Institutional Health Service,
or a maximum of twelve thousand dollars ($12,000) (indexed) per application. Provided, that
the application fee shall be three-fourths of one percent of the estimated cost of the proposed
new Institutional Health Service, or a maximum of eight thousand dollars ($8,000) if the applicant
has had an average daily census comprised of 50 percent or more Medicaid patients within the
last year prior to the filing of the application and a maximum of six thousand dollars ($6,000)
if a rural hospital applicant has had an average daily census comprised of 30 percent or more
Medicaid/Medicare patients within the last year prior to the filing of the application. The
minimum fee shall be set by the SHPDA. Fees shall be used...
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13A-9-150
Section 13A-9-150 Public assistance fraud; penalties. (a) For the purposes of this section,
public assistance means money or property provided directly or indirectly to eligible persons
through programs of the federal government, the state, or any political subdivision thereof,
including any program administered by a public housing authority. (b) It shall be unlawful
for an individual or business entity to knowingly do any of the following: (1) Fail, by false
statement, misrepresentation, impersonation, or other fraudulent means, to disclose a material
fact used in making a determination as to the qualification of the person to receive public
assistance. (2) Fail to disclose a change in circumstances in order to obtain or continue
to receive any public assistance to which he or she is not entitled or in an amount larger
than that to which he or she is entitled. (3) Aid and abet another person in the commission
of the prohibitions enumerated in subdivisions (1) and (2). (4) Use,...
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22-21-265
Section 22-21-265 Certificates of need - Required for new institutional health service. (a)
On or after July 30, 1979, no person to which this article applies shall acquire, construct,
or operate a new institutional health service, as defined in this article, or furnish or offer,
or purport to furnish a new institutional health service, as defined in this article, or make
an arrangement or commitment for financing the offering of a new institutional health service,
unless the person shall first obtain from the SHPDA a certificate of need therefor. Notwithstanding
any provisions of this article to the contrary, those facilities and distinct units operated
by the Department of Mental Health, and those facilities and distinct units operating under
contract or subcontract with the Department of Mental Health where the contract constitutes
the primary source of income to the facility, shall not be required to obtain a certificate
of need under this article. (b) Notwithstanding all other...
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15-23-3
Section 15-23-3 Definitions. As used in this article the following words shall include, but
are not limited to the following meanings unless the context clearly requires a different
meaning: (1) COMMISSION. The Alabama Crime Victims Compensation Commission as created by Section
15-23-4. (2) CRIMINALLY INJURIOUS CONDUCT. Criminally injurious conduct includes any of the
following acts: a. An act occurring or attempted within the geographical boundaries of this
state which results in serious personal injury or death to a victim for which punishment by
fine, imprisonment, or death may be imposed. b. An act occurring or attempted outside the
geographical boundaries of this state in another state of the United States of America which
is punishable by fine, imprisonment, or death and which results in personal injury or death
to a citizen of this state, and shall include an act of terrorism, as defined in Section 2331
of Title 18, United States Code, committed outside of the United States,...
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22-21-260
Section 22-21-260 Definitions. As used in this article, the following words and terms, and
the plurals thereof, shall have the meanings ascribed to them in this section, unless otherwise
required by their respective context: (1) ACQUISITION. Obtaining the legal equitable title
to a freehold or leasehold estate or otherwise obtaining the substantial benefit of such titles
or estates, whether by purchase, lease, loan or suffrage, gift, devise, legacy, settlement
of a trust or means whatever, and shall include any act of acquisition. The term "acquisition"
shall not mean or include any conveyance, or creation of any lien or security interest by
mortgage, deed of trust, security agreement, or similar financing instrument, nor shall it
mean or include any transfer of title or rights as a result of the foreclosure, or conveyance
or transfer in lieu of the foreclosure, of any such mortgage, deed of trust, security agreement,
or similar financing instrument, nor shall it mean or include any...
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25-5-1
Section 25-5-1 Definitions. Throughout this chapter, the following words and phrases as used
therein shall be considered to have the following meanings, respectively, unless the context
shall clearly indicate a different meaning in the connection used: (1) COMPENSATION. The money
benefits to be paid on account of injury or death, as provided in Articles 3 and 4. The recovery
which an employee may receive by action at law under Article 2 of this chapter is termed "recovery
of civil damages," as provided for in Sections 25-5-31 and 25-5-34. "Compensation"
does not include medical and surgical treatment and attention, medicine, medical and surgical
supplies, and crutches and apparatus furnished an employee on account of an injury. (2) CHILD
or CHILDREN. The terms include posthumous children and all other children entitled by law
to inherit as children of the deceased; stepchildren who were members of the family of the
deceased, at the time of the accident, and were dependent upon him or...
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22-6-224
Section 22-6-224 Medicaid Agency to contract for medical care; enrollment; delivery of services;
reimbursement. (a) Subject to approval of the federal Centers for Medicare and Medicaid Services,
the Medicaid Agency shall enter into contracts with one or more integrated care networks to
provide, pursuant to a risk contract under which the Medicaid Agency makes a capitated payment,
medical care to Medicaid beneficiaries assigned to the integrated care network. The Medicaid
Agency may enter into a contract pursuant to this section only if, in the judgment of the
Medicaid Agency, care of Medicaid beneficiaries would be better, more efficient, and less
costly than under the then existing care delivery system. Pursuant to the contract, the Medicaid
Agency shall set capitation payments for the integrated care network. (b) The Medicaid Agency
shall enroll beneficiaries it designates into an integrated care network consistent with guidance
from the Center for Medicare and Medicaid Services. (c)...
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40-26B-60
Section 40-26B-60 Definitions. (a) For the purposes of this article the following words have
the following meanings unless the context clearly indicates otherwise: (1) DISPROPORTIONATE
SHARE HOSPITAL. A hospital meeting the requirements of Section 1923 of the Social Security
Act and other criteria adopted by the Alabama Medicaid Agency in its state plan for medical
assistance under Title XIX of the Social Security Act. (2) FISCAL YEAR. An accounting period
of 12 months beginning on the first day of the first month of the state fiscal year. (3) HOSPITAL.
A facility, which is licensed as a hospital under the laws of the State of Alabama, provides
24-hour nursing services, and is primarily engaged in providing, by or under the supervision
of doctors of medicine or osteopathy, inpatient services for the diagnosis, treatment, and
care or rehabilitation of persons who are sick, injured, or disabled. (4) PUBLICLY-OWNED HOSPITAL.
A hospital created and operating under the authority of a...
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