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27-21A-4
Section 27-21A-4 Powers of health maintenance organizations. (a) The powers of a health maintenance
organization include, but are not limited to the following: (1) The purchase, lease, construction,
renovation, operation, or maintenance of hospitals, medical facilities, or both, and their
ancillary equipment; (2) The making of loans other than in the ordinary course of business,
to providers under contract with it in furtherance of its program or the making of loans to
a corporation or corporations in which it owns a majority interest for the purpose of acquiring
or constructing medical facilities and hospitals or in furtherance of a program providing
health care services to enrollees. (3) The furnishing of health care services through providers
which are under contract with or employed by the health maintenance organization. (4) The
contracting with any person for the performance on its behalf of certain functions such as
marketing, enrollment, and administration. (5) The purchase,...
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22-21-263
Section 22-21-263 New institutional health services subject to review. (a) All new institutional
health services which are subject to this article and which are proposed to be offered or
developed within the state shall be subject to review under this article. No institutional
health services which are subject to this article shall be permitted which are inconsistent
with the State Health Plan. For the purposes of this article, new institutional health services
shall include any of the following: (1) The construction, development, acquisition through
lease or purchase, or other establishment of a new health care facility or health maintenance
organization. A transaction involving the sale, lease, or other transfer or change of control
of an existing health care facility, existing health maintenance organization, or existing
institutional health service is not subject to certificate of need review or approval under
this article unless the transaction also involves implementing one or...
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27-21A-23
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 Section
34-24-310, et seq., relating to the practice of medicine. (d) No person participating in the
arrangements of a health maintenance organization other than the actual provider of health
care services or supplies directly to enrollees and their families shall be liable for negligence,
misfeasance, nonfeasance, or malpractice in connection with the furnishing of such
services and supplies. (e) Nothing in this chapter shall be construed in any way to repeal
or conflict with any provision of the certificate of need law. (f) Notwithstanding the provisions
of subsection (a), a health maintenance organization shall be subject to all of the following:
(1) Section 27-1-17. (2) Chapter 56. (3) Chapter 54. (4) Chapter 57. (5) Chapter 58. (6) Chapter
59. (7) Rules promulgated by the Commissioner of Insurance pursuant to...
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22-11D-3
Section 22-11D-3 Establishment and operation of statewide trauma system. (a) The board, in
consultation with, and having solicited the advice of the council, shall establish and maintain
a statewide trauma system that shall include centralized dispatch for participating trauma
centers and emergency medical services. (b) The statewide trauma system shall become operational
within 12 months after the State Health Officer certifies to the Governor in writing that
the department has sufficient funds to finance its development, implementation, and operation.
(c) The board, in consultation with and having solicited the advice of the council, may establish
and maintain other coordinated statewide systems of emergency medical and hospital care for
other illnesses, such as stroke. Other statewide coordinated health care systems may be implemented
by the board as funds become available to the board. (Act 2007-299, p. 541, §3; Act 2012-526,
p. 1556, §1.)...
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27-21A-11
Section 27-21A-11 Investments. With the exception of investments made in accordance with subdivisions
(a)(1), (a)(2), (a)(5), and subsection (b) of Section 27-21A-4, the funds of a health maintenance
organization shall be invested only in securities or other investments permitted by the laws
of this state for the investment of assets constituting the legal reserves of life insurance
companies or such other securities or investments as the commissioner may permit. (Acts 1986,
No. 86-471, p. 854, §11.)...
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27-3A-3
Section 27-3A-3 Definitions. As used in this chapter, the following words and phrases shall
have the following meanings: (1) DEPARTMENT. The Alabama Department of Public Health. (2)
ENROLLEE. An individual who has contracted for or who participates in coverage under an insurance
policy, a health maintenance organization contract, a health service corporation contract,
an employee welfare benefit plan, a hospital or medical services plan, or any other benefit
program providing payment, reimbursement, or indemnification for health care costs for the
individual or the eligible dependents of the individual. (3) PROVIDER. A health care provider
duly licensed or certified by the State of Alabama. (4) UTILIZATION REVIEW. A system for prospective
and concurrent review of the necessity and appropriateness in the allocation of health care
resources and services given or proposed to be given to an individual within this state. The
term does not include elective requests for clarification of...
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27-21A-14
Section 27-21A-14 Regulation of producers. (a) Unless exempted pursuant to subsection (c),
health maintenance organizations in this state shall only solicit enrollees or otherwise market
their services through producers duly licensed in accordance with Chapters 7 and 8A of this
title. (b) The commissioner shall, after notice and hearing, promulgate such reasonable rules
and regulations as are necessary to provide for the licensing of producers. (c) The commissioner
may, by rule, exempt certain classes of persons from the requirement of obtaining a license
for either of the following reasons: (1) If the functions they perform do not require special
competence, trustworthiness, or the regulatory surveillance made possible by licensing. (2)
If other existing safeguards make regulation unnecessary. (d) Nothing in this section shall
be deemed to prohibit a health maintenance organization from advertising. (Acts 1986, No.
86-471, p. 854, §14; Act 2001-702, p. 1509, §15.)...
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2-27-30
Section 2-27-30 Establishment and operation; policy committee and executive committee therefor.
The commissioner and state Department of Agriculture and Industries shall have authority to
provide for the establishment and operation of a laboratory to obtain reliable analysis of
raw and processed agricultural products, the materials used in production of agricultural
products for harmful pesticide residues for the protection of public health and interest,
to aid in developing and expanding markets for agricultural products, the protection and production
of fish and wildlife, and the use of recreational areas as related to pesticide residues.
In connection therewith, there shall be established a policy committee to be composed of the
following: (1) The Director, Alabama Cooperative Extension Service, who shall be chairman
of the committee; (2) The Commissioner of the Department of Agriculture and Industries; (3)
The Director, Alabama Experiment Station System; (4) The State Health...
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22-5C-2
Section 22-5C-2 State Advisory Council on Palliative Care and Quality of Life. (a) Not later
than November 23, 2015, the State Health Department shall establish a State Advisory Council
on Palliative Care and Quality of Life within the department. (b) The council membership shall
be appointed by the State Health Officer and shall include interdisciplinary palliative care
medical, nursing, social work, pharmacy, and spiritual professional expertise; patient and
family caregiver advocate representation, and any other relevant appointees the State Health
Officer determines appropriate. The State Health Officer shall consider the racial, gender,
geographic, urban/rural, and economic diversity of the state when appointing members. Membership
shall specifically include health professionals having palliative care work experience or
expertise in palliative care delivery models in a variety of inpatient, outpatient, and community
settings such as acute care, long-term care, and hospice and with...
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27-20A-2
Section 27-20A-2 Chapter applicable to group, etc., policies. No group, blanket, franchise,
or association health insurance policy providing coverage on an expense incurred basis, nor
group, blanket, franchise, or association service or indemnity type contract issued by a nonprofit
corporation, nor group-type self insurance plan providing protection, insurance, or indemnity
against hospital, medical, or surgical expenses, nor health maintenance organization plan
shall be issued, delivered, executed, or renewed in this state, or approved for issuance or
renewal in this state by the Commissioner of Insurance after 90 days beyond the effective
date of this chapter, unless such policy, contract, or plan, at the option of the policyholder
or sponsor, provides benefits to any insured, subscriber, or other person covered under the
policy, contract, or plan for expenses incurred in connection with the treatment of alcoholism
when such treatment is prescribed by a duly licensed doctor of...
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