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25-5-311
Section 25-5-311 Workers' Compensation Medical Services Board; creation, members, functions.
There is established a Workers' Compensation Medical Services Board composed of five physicians
licensed to practice medicine in the State of Alabama who shall be appointed by the Secretary
of the Department of Labor. The initial board shall be selected from a list of 15 physicians
who are members of the Medical Association of the State of Alabama, submitted by the association.
Members of the board shall serve terms of five years. In order that the appointments be staggered,
one member shall serve an initial term of six years, one member shall serve an initial term
of two years, one member shall serve an initial term of three years, one member shall serve
an initial term of four years, and the remaining member shall serve an initial term of five
years. Thereafter, successors shall be appointed by the secretary from among a list of three
nominees submitted by the Medical Association of the State...
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27-1-10.1
Section 27-1-10.1 Insurance coverage for drugs to treat life-threatening illnesses. (a) The
Legislature finds and declares the following: (1) The citizens of this state rely upon health
insurance to cover the cost of obtaining health care and it is essential that the citizens'
expectation that their health care costs will be paid by their insurance policies is not disappointed
and that they obtain the coverage necessary and appropriate for their care within the terms
of their insurance policies. (2) Some insurers deny payment for drugs that have been approved
by the Federal Food and Drug Administration, hereafter referred to as FDA, when the drugs
are used for indications other than those stated in the labelling approved by the FDA, off-label
use, while other insurers with similar coverage terms do pay for off-label use. (3) Denial
of payment for off-label use can interrupt or effectively deny access to necessary and appropriate
treatment for a person being treated for a...
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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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34-14C-2
Section 34-14C-2 Board of Home Medical Equipment. (a) The Governor shall appoint a minimum
of nine persons to serve on the Board of Home Medical Equipment, such persons to include a
majority who are employed in the home medical equipment industry, and at least one person
from each of the following categories: A consumer of home medical equipment services, a physician,
a representative from the acute-care hospital community, and a representative from the home
health agency community. Those persons employed in the home medical equipment industry shall
be selected from a list submitted by the Alabama Durable Medical Equipment Association, or
its successor. The consumer member shall be selected from a list of names submitted by the
Governor's Office on Disability, or its successor. The physician member shall be selected
from a list of names submitted by the Medical Association of Alabama, or its successor. The
acute-care hospital community member shall be selected from a list submitted by...
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36-21-7
Section 36-21-7 Reimbursement by new employer for training expenses. In those instances in
which a law enforcement officer, certified corrections officer, fire protection personnel,
or firefighter of any municipality, county, sheriff's department, fire district, or the state
is employed by the State of Alabama, any county, sheriff's department, fire district, or another
municipality, within 24 months after completing the training requirements mandated by Article
3 (commencing with Section 36-21-40) of this chapter, or by Chapter 32 (commencing with Section
36-32-1), the total expense of the training, including, but not limited to, salary paid during
training, transportation costs paid to the trainee for travel to and from the training facility,
room, board, tuition, overtime paid to other employees who fill in for the trainee during
his or her absence, and any other related training expenses, shall be reimbursed to the municipality,
county, fire district, or the state which paid for...
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7-4A-208
Section 7-4A-208 Misdescription of intermediary bank or beneficiary's bank. (a) This subsection
applies to a payment order identifying an intermediary bank or the beneficiary's bank only
by an identifying number. (1) The receiving bank may rely on the number as the proper identification
of the intermediary or beneficiary's bank and need not determine whether the number identifies
a bank. (2) The sender is obliged to compensate the receiving bank for any loss and expenses
incurred by the receiving bank as a result of its reliance on the number in executing or attempting
to execute the order. (b) This subsection applies to a payment order identifying an intermediary
bank or the beneficiary's bank both by name and an identifying number if the name and number
identify different persons. (1) If the sender is a bank, the receiving bank may rely on the
number as the proper identification of the intermediary or beneficiary's bank if the receiving
bank, when it executes the sender's order, does...
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25-5-292
Section 25-5-292 Resolution of disputes, settlement agreements; written reports; interlocutory
orders; final determinations of liability. (a) A dispute may be resolved either in whole or
in part at the benefit review conference. If the conference results in the resolution of some
of the disputed issues by mutual agreement or in a settlement, the ombudsman shall reduce
the agreement or the settlement to writing. The ombudsman and each party or the designated
representative of the party shall sign the agreement or settlement. A settlement reached hereunder
shall, unless otherwise provided herein, be effective on the date the settlement is signed
unless one of the parties submits the settlement to the court for approval as provided in
this article. (b) An agreement signed pursuant to this section shall be binding on all parties
through the final conclusion of all matters relating to the claim, unless within 60 days after
the agreement is signed or approved the court on a finding of fraud,...
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27-7-5.1
be exempt from the 40-hour prelicensing course and written examination requirements of Section
27-7-5, and the continuing education requirements of Chapter 8A of this title. (d) A rental
company licensed pursuant to this section may offer or sell insurance only in connection with
and incidental to the rental of vehicles, whether at the rental office or by preselection
of coverage in a master, corporate, individual, or group rental agreement, in any of the following
general categories: (1) Personal accident insurance covering the risks of travel, including,
but not limited to, accident and health insurance that provides coverage, as applicable, to
renters and other rental vehicle occupants for accidental death or dismemberment and reimbursement
for medical expenses resulting from an accident that occurs during the rental period. (2)
Liability insurance, including uninsured and underinsured motorist coverage whether offered
separately or in combination with other liability insurance,...
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34-24-360
Section 34-24-360 Restrictions, etc., on license; grounds. The Medical Licensure Commission
shall have the power and duty to suspend, revoke, or restrict any license to practice medicine
or osteopathy in the State of Alabama or place on probation or fine any licensee whenever
the licensee shall be found guilty on the basis of substantial evidence of any of the following
acts or offenses: (1) Fraud in applying for or procuring a certificate of qualification to
practice medicine or osteopathy or a license to practice medicine or osteopathy in the State
of Alabama. (2) Unprofessional conduct as defined herein or in the rules and regulations promulgated
by the commission. (3) Practicing medicine or osteopathy in such a manner as to endanger the
health of the patients of the practitioner. (4) Conviction of a felony; a copy of the record
of conviction, certified to by the clerk of the court entering the conviction, shall be conclusive
evidence. (5) Conviction of any crime or offense which...
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40-26B-26
Section 40-26B-26 Reduction of revenues; reimbursement computations; quality incentive program.
THIS SECTION WAS AMENDED BY ACT 2020-147 IN THE 2020 REGULAR SESSION, EFFECTIVE MAY 18, 2020.
THIS IS NOT IN THE CURRENT CODE SUPPLEMENT. (a) No revenues resulting from the privilege assessment
established by this article and applied to increases in covered services or reimbursement
levels or other enhancements of the Medicaid program shall be subject to reduction or elimination
while the privilege assessment is in effect. (b) Every nursing facility participating in the
Medicaid program in the State of Alabama shall be reimbursed according to the reimbursement
methodology contained in Chapter 560-X-22 of the Alabama Medicaid Agency Administrative Code
(Supp. 12/31/95) on January 31, 1998, which methodology is incorporated by reference herein,
except that the following shall apply: (1) The ceiling for the operating cost center described
in Title 560-X-22-.06 (2)(a) of the Alabama Medicaid...
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