|
22-6-196
Section 22-6-196 Privilege assessment - Failure to pay. Any PACE provider that fails to pay
the assessment levied by this article within the time required by this article shall pay,
in addition to the assessment, a penalty of 10 percent of the amount of assessment due, together
with interest thereon at the rate prescribed by Section 40-1-44, the penalty and interest
to be assessed and collected as part of the taxes. Provided, however, the department, if a
good and sufficient reason is shown, may waive or remit the penalty of 10 percent or a portion
thereof. If payment is not received by the last day of the month, the department shall notify
the Medicaid Agency which shall determine whether the PACE provider is a Medicaid provider,
and if so, shall withhold the payment, interest, and penalty due from any reimbursement due
the provider under the Medicaid program. The assessment levied by this article shall constitute
a debt due the State of Alabama and may be collected by civil action in...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-196.htm - 1K - Match Info - Similar pages
27-56-2
Section 27-56-2 Definitions. As used in this chapter, the following terms shall have the following
meanings: (1) COVERED PERSON. Any individual, family, or family member on whose behalf third-party
payment or prepayment of health or medical expenses is provided under an insurance policy,
plan, or contract providing for third-party payment or prepayment of health care or medical
expenses. (2) EYE CARE PROVIDER. A licensed optometrist or a licensed ophthalmologist. (3)
INSURANCE POLICY, PLAN, OR CONTRACT PROVIDING FOR THIRD-PARTY PAYMENT OR PREPAYMENT OF HEALTH
OR MEDICAL EXPENSES. Includes an individual or group policy for accident or health insurance,
an individual or group hospital or health care service contract, an individual or group health
maintenance organization contract, an organized delivery system contract, or a preferred provider
organization contract, and any other similar policy, plan, or contract. This term shall not
include any employee welfare benefit plan, as defined...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-56-2.htm - 1K - Match Info - Similar pages
40-26B-22
Section 40-26B-22 Payment and collection of privilege assessment; appropriation of funds and
use by Alabama Medicaid Agency. (a) The privilege assessments imposed by this article shall
be due and payable in monthly installments to the department on or before the twentieth day
of the month next succeeding the month in which the assessment accrues, and shall, when collected,
be paid by the department into the State Treasury. Payment by United States mail will be timely
if mailed in accordance with Section 40-1-45. When so paid into the State Treasury, all such
privilege assessments shall be deposited to the credit of the Alabama Health Care Trust Fund
or any successor fund administered by or on behalf of the Alabama Medicaid Agency. (b) The
receipts from the privilege assessments levied in this article shall be solely available for
appropriation by the Alabama Legislature to the Alabama Medicaid Agency for use by the agency
in accomplishing the purposes of this article. Provided,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/40-26B-22.htm - 2K - Match Info - Similar pages
20-2-212
Section 20-2-212 Controlled substances prescription database program; powers and duties of
department; trust fund; advisory committee; review committee. (a) The department may establish,
create, and maintain a controlled substances prescription database program. In order to carry
out its responsibilities under this article, the department is granted the following powers
and authority: (1) To adopt regulations, in accordance with the Alabama Administrative Procedure
Act, governing the establishment and operation of a controlled substances prescription database
program. (2) To receive and to expend for the purposes stated in this article funds in the
form of grants, donations, federal matching funds, interagency transfers, and appropriated
funds designated for the development, implementation, operation, and maintenance of the controlled
substances prescription database. The funds received pursuant to this subdivision shall be
deposited in a new fund that is established as a separate...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/20-2-212.htm - 6K - Match Info - Similar pages
22-6-154
Section 22-6-154 Quality assurance committee; collection and publication of information. (a)
The Medicaid Agency shall create a quality assurance committee appointed by the Medicaid Commissioner.
The members of the committee shall serve two-year terms. At least 60 percent of the members
shall be physicians who provide care to Medicaid beneficiaries served by a regional care organization.
In making appointments to the committee, the Medicaid Commissioner shall seek input from the
appropriate professional associations. (b) The committee shall identify objective outcome
and quality measures, including measures of outcome and quality for ambulatory care, inpatient
care, chemical dependency and mental health treatment, oral health care, and all other health
services provided by coordinated care organizations. Quality measures adopted by the committee
shall be consistent with existing state and national quality measures. The Medicaid Commissioner
shall incorporate these measures into...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-154.htm - 2K - Match Info - Similar pages
22-5B-3
Section 22-5B-3 Definitions. When used in this chapter, the following words shall have the
following meanings: (1) ADULT WITH SPECIAL NEED. A person 19 years of age or older who requires
care or supervision to meet the person's basic needs or prevent physical self-injury or injury
to others, or avoid placement in an institutional facility. (2) AGING AND DISABILITY RESOURCE
CENTER. An entity that provides a coordinated system for providing information on long-term
care programs and options, personal counseling, and consumer access to publicly support long-term
care programs. (3) CHILD WITH SPECIAL NEED. A person under age 19 who requires care or supervision
beyond that required for children generally to meet the child's basic needs or prevent physical
injury to self or others. (4) ELIGIBLE STATE AGENCY. A state agency that administers the Older
Americans Act or the state's Medicaid program or one designated by the Governor, and is an
aging and disability resource center working in...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-5B-3.htm - 2K - Match Info - Similar pages
22-6-122
Section 22-6-122 Medicaid Pharmacy and Therapeutics Committee - Classification and recommendation
of drugs; assurance of quality patient care; review of pharmaceutical products. (a) The Medicaid
Pharmacy and Therapeutics Committee shall review and recommend classes of drugs to the Medicaid
Commissioner for inclusion in the Medicaid Preferred Drug Plan. Class means a therapeutic
group of pharmaceutical agents approved by the FDA as defined by the American Hospital Formulary
Service. The classes of anti-retroviral and anti-psychotic drugs shall not be included in
the Medicaid Preferred Drug Plan. (b) The Medicaid Pharmacy and Therapeutics Committee shall
develop its preferred drug list recommendations by considering the clinical efficacy, safety,
and cost effectiveness of a product. Within each covered class, the committee shall review
and recommend drugs to the Medicaid Commissioner for inclusion on a preferred drug list. Generics
and over the counter drugs covered by Medicaid may be...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-122.htm - 4K - Match Info - Similar pages
27-19A-12
Section 27-19A-12 Dental services - Coverages; fees; exceptions. (a) As used in this section,
the following terms shall have the following meanings: (1) COVERED PERSON. Any individual,
family, or family member on whose behalf third-party payment or prepayment of health or medical
expenses is provided under an insurance policy, plan, or contract providing for third-party
payment or prepayment of health care or medical expenses. (2) COVERED SERVICES. Dental care
services for which a reimbursement is available under an enrollee's plan contract, or for
which a reimbursement would be available but for the application of contractual limitations
such as deductibles, copayments, coinsurance, waiting periods, annual or lifetime maximums,
frequency limitations, alternative benefit payments, or any other limitation. (3) DENTAL CARE
PROVIDER. A licensed dentist. (4) DENTAL PLAN. Includes any policy of insurance which is issued
by a health care service contractor which provides for coverage of...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-19A-12.htm - 2K - Match Info - Similar pages
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...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-51-1.htm - 2K - Match Info - Similar pages
6-5-548
Section 6-5-548 Burden of proof; reasonable care as similarly situated health care provider;
no evidence admitted of medical liability insurance. (a) In any action for injury or damages
or wrongful death, whether in contract or in tort, against a health care provider for breach
of the standard of care, the plaintiff shall have the burden of proving by substantial evidence
that the health care provider failed to exercise such reasonable care, skill, and diligence
as other similarly situated health care providers in the same general line of practice ordinarily
have and exercise in a like case. (b) Notwithstanding any provision of the Alabama Rules of
Evidence to the contrary, if the health care provider whose breach of the standard of care
is claimed to have created the cause of action is not certified by an appropriate American
board as being a specialist, is not trained and experienced in a medical specialty, or does
not hold himself or herself out as a specialist, a "similarly...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/6-5-548.htm - 4K - Match Info - Similar pages
|