Title 27

This chapter shall be known and may be cited as the “Women’s Access to Health Care Act.” (Acts 1996, No. 96-671, p. 1135, §1.)

The Legislature finds that the specialty of obstetrics and gynecology is devoted to primary and preventive health care of women throughout their lifetime. Significant numbers of women view their obstetrician and gynecologist as their primary or only physician. For many women, an …

As used in this chapter, the following terms shall have the following meanings: (1) HEALTH BENEFIT PLAN. Any individual or group plan, policy, or contract for health care services issued, delivered, issued for delivery, renewed in this state by a health care insurer, health maint…

(a) Each health benefit plan which is issued, delivered, issued for delivery, or renewed in this state on or after October 1, 1996, shall allow obstetricians and gynecologists as primary care physicians. This subsection shall not be construed to require an individual obstetrician…

Any violation of this chapter shall constitute grounds for suspension or revocation of a license by the Department of Insurance issued to an insurance company or health maintenance organization. (Acts 1996, No. 96-671, p. 1135, §5.)

This chapter shall be known as “The Breast Cancer Screening Act.” (Acts 1997, No. 97-414, p. 685, §1.)

It is the intent of the Legislature to assist women with the early detection of breast cancer and thereby prevent the following: (1) Avoidable early death from breast cancer. (2) Avoidable suffering and impaired quality of life from late detection of breast cancer. (3) Avoidable …

As used in this chapter, the term “health benefit plan” has the following meaning: A health insurance policy, including a self-insured health plan, that covers hospital, medical, or surgical expenses, health maintenance organizations, preferred provider organizations, medical ser…

Every health benefit plan which provides coverage for surgical services for a mastectomy shall provide coverage for screening mammography as follows: (1) For women ages 40 to 49, inclusive, a mammogram at least every two years or more frequently based on the recommendation of a w…

(a) No health benefit plan subject to the provisions of this chapter shall terminate the services, reduce capitation payment, or otherwise penalize an attending physician or other health care provider who orders medical care consistent with this chapter. (b) Nothing in this chapt…

A license issued by the Department of Insurance to an insurance company or a health maintenance organization shall be subject to suspension, revocation, or imposition or other administrative penalty authorized by law, within the discretion of the Commissioner of Insurance, for an…

This chapter shall apply to all programs administered by the Alabama Medicaid Agency. (Acts 1997, No. 97-414, p. 685, §7.)

(a) For purposes of this section, the following terms have the following meanings: (1) COST-SHARING REQUIREMENT. A deductible, copayment, coinsurance, or similar expense borne by the insured for a covered benefit under a health benefit plan. (2) DIAGNOSTIC BREAST EXAMINATION. A m…

(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 pr…

(a) There is hereby created the Alabama Health Insurance Plan which shall, as a high risk pool in the State of Alabama, provide health insurance coverage to eligible individuals as an alternative to requiring insurers to offer guaranteed-issue policies, as provided in the Health …

The plan shall have the general powers and authority granted under the laws of this state to health insurers and in addition thereto, the specific authority to do all of the following: (1) Enter into contracts as are necessary or proper to carry out the provisions and purposes of…

(a) The commissioner shall, by regulation, establish additional powers and duties of the plan and may adopt such rules as are necessary and proper to implement this article. For the purpose of this section, the term “insurer” means any entity covered by the Health Insurance Porta…

The plan shall offer health care coverage consistent with major medical expense coverage to every eligible person who is not eligible for Medicare. The coverage to be issued by the plan, its schedule of benefits, exclusions, and other limitations shall be established by the plan,…

Neither the establishment of rates, forms, or procedures nor any other joint or collective action required by this article shall be the basis of any legal action, criminal or civil liability, or penalty against the plan. (Acts 1997, No. 97-713, p. 1476, §5.)

The plan established pursuant to this article shall be exempt from payment of all fees and all taxes levied by this state or any of its subdivisions. If the Commissioner of Insurance enters into a contract with one or more third parties to provide any or all of the services in th…

There is hereby created the Alabama Small Employer Allocation Program which shall promote the availability of health insurance coverage to small employers regardless of their health status or claims experience, to prevent abusive rating practices, to prevent segmentation of the h…

(a) The Commissioner of Insurance shall, by regulation, establish the conditions, restrictions, requirements, and plan of operation of the Alabama Small Employer Allocation Program consistent with the requirements of the Health Insurance Portability and Accountability Act of 1996…

The commissioner shall consult with the State Board of Health on all aspects related to the provision of medical services under the Alabama Health Insurance Plan and the Alabama Small Employer Allocation Program established under this chapter. All regulations, bylaws, policies, g…

As used in this chapter, the following terms shall have the following meanings: (1) GENETIC CHARACTERISTICS. A scientifically or medically identifiable gene or chromosome, or alteration thereof, that is known to be a cause of a disease or disorder, or determined to be associated …

(a) A health benefit plan may not require as a condition of insurability that a person take a genetic test to determine if the person has a predisposition for cancer. (b) A health benefit plan may not use the results of a genetic test which may show the predisposition of a person…

A license issued by the Department of Insurance to an insurance company or a health maintenance organization shall be subject to suspension, revocation, or imposition or other administrative penalty authorized by law, within the discretion of the Commissioner of Insurance, for an…

This chapter shall apply to all programs administered by the Alabama Medicaid Agency. (Acts 1997, No. 97-721, p. 1492, §4.)

(a) The Legislature finds the following: (1) Mental illness affects many citizens of this state each year, resulting in anguish, grief, desperation, fear, isolation, and a sense of hopelessness of significant levels among victims and families. (2) Consequences of mental illness i…

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 cli…

Each group health benefit plan shall offer to provide, at a minimum, the following additional benefits for a person suffering from a mental or nervous condition: (1) Inpatient services. (2) Day treatment services. (3) Outpatient services. (Act 2000-386, p. 605, §4.)

(a) All group health benefit plans shall offer to provide, at a minimum, additional benefits according to this chapter for a person receiving medical treatment for any of the following mental illnesses diagnosed by an appropriately licensed provider. (1) Schizophrenia, schizophre…

(a) A group health benefit plan, policy, or contract that provides coverage for the services to be offered pursuant to this chapter may contain provisions for maximum benefits and coinsurance and limitations, deductibles, exclusions, and utilization review protocols to the extent…

Every issuer of a group health benefit plan subject to this chapter shall provide a cost report for each calendar year to the Commissioner of Insurance no later than April 30th of the following year. The report shall be in a form prescribed by the commissioner and shall include c…

This chapter shall supersede subsection (c), Section 27-1-18, and any other conflicting laws to the extent there is a conflict with this chapter. (Act 2000-386, p. 605, §8.)

This chapter may be known and cited as the Riley Ward Act. (Act 2012-298, p. 647, §1.)

(a) As used in this section, the following words have the following meanings: (1) APPLIED BEHAVIOR ANALYSIS. The design, implementation, and evaluation of environmental modifications, using behavioral stimuli and consequences, to produce socially significant improvement in human …

This chapter shall be known as and may be cited as the Domestic Abuse Insurance Protection Act. (Act 2000-595, p. 1185, §1.)

As used in this chapter, these terms shall have the following meanings: (1) ABUSE. The occurrence of one or more of the following acts by a family or household member, as defined by subdivision (3) of subsection (b) of Section 15-10-3: a. Attempting to cause or intentionally, kno…

(a) No insurer may: (1) Deny, refuse to issue, renew, or reissue, cancel, or otherwise terminate, restrict, or exclude coverage on an insurance policy or health benefit plan on the basis of an applicant’s or insured’s abuse status, or on the basis of any association, relationship…

An insurer that takes an action which adversely affects a subject of abuse, or a related individual or entity, based on an abuse-related medical condition, abuse-related claim, abuse status, or association or relationship with a subject of abuse, pursuant to an individual or grou…

This chapter shall not be applied or construed to prohibit or limit the application or scope of coverage, limitations, exclusions, and other terms and provisions of insurance contracts so long as such terms and provisions do not apply solely to persons who are in abuse status. (A…

(a) A person claiming to be adversely affected by an act or practice prohibited by this chapter may file a complaint with the commissioner for individual relief seeking remedies and penalties authorized by this chapter. (b) The commissioner shall conduct a reasonable investigatio…

The commissioner shall enforce this chapter in the manner authorized for the enforcement of this title. In lieu of any other penalty provided in this title, a violation of this chapter shall be punishable as provided by Section 27-55-6. (Act 2000-595, p. 1185, §7.)

This chapter does not and shall not be construed as creating a private cause of action and does not and shall not require insurers, including any health benefit plan, to extend coverage to any providers or type of providers for which coverage is not specifically provided within t…

Nothing in this chapter shall require an insurer to conduct a comprehensive search of its contract files existing on August 1, 2000, to determine which applicants or insureds are subjects of abuse. (Act 2000-595, p. 1185, §10.)

This chapter shall be known and may be cited as the “Access to Eye Care Act.” (Act 2001-477, p. 640, §1.)