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27-21A-10
to provide reasonable procedures for the resolution of written complaints initiated by enrollees.
(2) Each health maintenance organization shall submit to the commissioner and the State Health
Officer an annual report in a form prescribed by the commissioner, after consultation with
the State Health Officer, which shall include: a. A description of the procedures of such
complaint system; b. The total number of complaints handled through such complaint system
and a compilation of causes underlying the complaints filed; and c. The number, amount, and
disposition of malpractice claims and other claims relating to the service or care
rendered by the health maintenance organization made by enrollees of the organization that
were settled during the year by the health maintenance organization. All such information
shall be held in confidence by the commissioner. (b) The commissioner or the State Health
Officer may examine such complaint system. (Acts 1986, No. 86-471, p. 854, ยง10.)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-10.htm - 1K - Match Info - Similar pages
27-21A-17
Section 27-21A-17 Suspension or revocation of certificate of authority. (a) The commissioner
in consultation with and with the approval of the State Health Officer, where necessary, may
suspend or revoke any certificate of authority issued to a health maintenance organization
under this chapter if he finds that any of the following conditions exist: (1) The health
maintenance organization is operating significantly in contravention of its basic organizational
document or in a manner contrary to that described in any other information submitted under
Section 27-21A-2, unless amendments to such submissions have been filed with the commissioner
and the State Health Officer and approved by the commissioner; (2) The health maintenance
organization issues evidence of coverage or uses a schedule of charges for health care services
which do not comply with requirements of Section 27-21A-7; (3) The health maintenance organization
does not provide or arrange for basic health care services; (4)...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-21A-17.htm - 3K - Match Info - Similar pages
27-21A-2
Section 27-21A-2 Establishment of health maintenance organizations. (a) Notwithstanding any
law of this state to the contrary, any person may apply to the commissioner for and obtain
a certificate of authority to establish and operate a health maintenance organization in compliance
with this chapter. No person shall establish or operate a health maintenance organization
in this state without obtaining a certificate of authority under this chapter. A foreign corporation
may qualify under this chapter, subject to its registration to do business in this state as
a foreign corporation under the provisions of Sections 10-2A-220, et seq. (b) Health maintenance
organizations licensed as of May 29, 1986, shall be issued a certificate of authority in accordance
with Section 27-21A-29. (c) Each application for a certificate of authority shall be verified
by an officer or authorized representative of the applicant, shall be in a form prescribed
by the commissioner, and shall set forth or be...
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41-15B-2.2
Section 41-15B-2.2 Allocation of trust fund revenues. (a) For each fiscal year, beginning October
1, 1999, contingent upon the Children First Trust Fund receiving tobacco revenues and upon
appropriation by the Legislature, an amount of up to and including two hundred twenty-five
thousand dollars ($225,000), or equivalent percentage of the total fund, shall be designated
for the administration of the fund by the council and the Commissioner of Children's Affairs.
(b) For the each fiscal year, beginning October 1, 1999, contingent upon the Children First
Trust Fund receiving tobacco revenues, the remainder of the Children First Trust Fund, in
the amounts provided for in Section 41-15B-2.1, shall be allocated as follows: (1) Ten percent
of the fund shall be allocated to the Department of Public Health for distribution to one
or more of the following: a. The Children's Health Insurance Program. b. Programs for tobacco
control among children with the purpose being to reduce the consumption...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/41-15B-2.2.htm - 22K - Match Info - Similar pages
27-21A-20
Section 27-21A-20 Administrative procedures. (a) When the commissioner has cause to believe
that grounds for the denial of an application for a certificate of authority exist, or that
grounds for the suspension or revocation of a certificate of authority exist, he shall notify
the health maintenance organization and the State Health Officer in writing specifically stating
the grounds for denial, suspension, or revocation. If so requested in writing by the health
maintenance organization, the commissioner shall set a hearing on the matter within 30 days
of the receipt of such request. (b) The State Health Officer, or his designated representative,
shall be in attendance at the hearing and shall participate in the proceedings. The recommendation
and findings of the State Health Officer with respect to matters relating to the quality of
health care services provided in connection with any decision regarding denial, suspension,
or revocation of a certificate of authority, shall be...
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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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22-4-5
Section 22-4-5 Adoption, revision, etc., of rules, regulations, standards, etc., by State Board
of Health; appeals therefrom; State Board of Health not to discriminate among branches of
healing arts in administration of funds. (a) The State Board of Health, with the advice and
consultation of the Statewide Health Coordinating Council, is hereby authorized and empowered
to adopt, revise, abolish, promulgate and publish rules, regulations, standards and procedures
for: (1) The preparation of the preliminary State Health Plan and the State Medical Facilities
Plan; (2) The administration of the State Health Plan and of the State Medical Facilities
Plan after approval by the Statewide Health Coordinating Council; (3) The construction and
operation of health care facilities established under the State Medical Facilities Plan; and
(4) Such other matters as may be necessary to carry out the intent and purpose of this article.
(b) The State Board of Health is also authorized and empowered to...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-4-5.htm - 4K - Match Info - Similar pages
22-50-11
Section 22-50-11 Department - Additional and cumulative powers. The Department of Mental Health
is given hereby the following additional and cumulative powers through its commissioner: (1)
It is authorized and directed to set up state plans for the purpose of controlling and treating
any and all forms of mental and emotional illness and any and all forms of mental retardation
and shall divide the state into regions, districts, areas or zones, which need not be geographic
areas, but shall be areas for the purpose of establishing priorities and programs and for
organizational and administrative purposes in accordance with these state plans. (2) It is
designated and authorized to supervise, coordinate, and establish standards for all operations
and activities of the state related to mental health and the providing of mental health services;
and it is authorized to receive and administer any funds available from any source for the
purpose of acquiring building sites for, constructing,...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-50-11.htm - 10K - Match Info - Similar pages
22-6-153
Section 22-6-153 Contract to provide medical care to Medicaid beneficiaries; enrollment; grievance
procedures; duties of Medicaid Agency. (a) Subject to approval of the federal Centers for
Medicare and Medicaid Services, the Medicaid Agency shall enter into a contract in each Medicaid
region for at least one fully certified regional care organization to provide, pursuant to
a risk contract under which the Medicaid Agency makes a capitated payment, medical care to
Medicaid beneficiaries. However, 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. The Medicaid Agency may contract with more than one regional care organization in
a Medicaid region. Pursuant to the contract, the Medicaid Agency shall set capitation payments
for the regional care organization. (b) The Medicaid Agency shall...
alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/22-6-153.htm - 10K - Match Info - Similar pages
34-21-2
Section 34-21-2 Board of Nursing generally. (a) There is created the Board of Nursing, which
shall be composed of 13 members to be appointed and have the duties and powers enumerated
in this section. The membership of the board shall be inclusive and reflect the racial, gender,
geographic, urban/rural, and economic diversity of the state. In order to insure continuity
of administration, the nine board members provided for by Section 3 of Act 427, Regular Session
1975, shall continue to serve to the completion of the term for which they are serving. The
Governor, within 60 days of January 1, 1984, shall appoint a tenth member who shall be a licensed
practical nurse for a term of four years from a list of nominees furnished him or her by the
Alabama Federation of Licensed Practical Nurses, Incorporated, or its successor organization.
As the terms of all board members expire, their successors shall be appointed for terms of
four years each. Vacancies in unexpired terms shall be filled in...
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