§ 27-21A-1 Definitions
§ 27-21A-2 Establishment of health maintenance organizations
§ 27-21A-3 Issuance of certificate of authority
§ 27-21A-4 Powers of health maintenance organizations
§ 27-21A-5 Governing body
§ 27-21A-6 Fiduciary responsibilities of directors, officers, employees, and partners
§ 27-21A-7 Evidence of coverage and charges for health care services
§ 27-21A-8 Reporting requirements
§ 27-21A-9 Information to enrollees
§ 27-21A-10 Complaint system
§ 27-21A-11 Investments
§ 27-21A-12 Protection against insolvency
§ 27-21A-13 Prohibited practices
§ 27-21A-14 Regulation of producers
§ 27-21A-15 Powers of insurers and health care service plans
§ 27-21A-16 Examination
§ 27-21A-17 Suspension or revocation of certificate of authority
§ 27-21A-18 Rehabilitation, liquidation, or conservation of a health maintenance organization
§ 27-21A-19 Regulations
§ 27-21A-20 Administrative procedures
§ 27-21A-21 Fees
§ 27-21A-22 Penalties and enforcement
§ 27-21A-23 Statutory construction and relationship to other laws
§ 27-21A-24 Filings and reports as public documents
§ 27-21A-25 Confidentiality of medical information
§ 27-21A-26 State Health Officer’s and commissioner’s authority to contract
§ 27-21A-27 Acquisition of control of or merger of a health maintenance organization
§ 27-21A-28 Taxes
§ 27-21A-29 Existing health maintenance organizations
§ 27-21A-30 Coordination of benefits
§ 27-21A-31 Health maintenance organization advisory council
§ 27-21A-32 HMO enrollment requirements

Terms Used In Alabama Code > Title 27 > Chapter 21A

  • agent: A person who is appointed or employed by a health maintenance organization and who engages in solicitation of membership in such organization. See Alabama Code 27-21A-1
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Appropriation: The provision of funds, through an annual appropriations act or a permanent law, for federal agencies to make payments out of the Treasury for specified purposes. The formal federal spending process consists of two sequential steps: authorization
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • BASIC HEALTH CARE SERVICES: Emergency care, inpatient hospital and physician care, and outpatient medical services. See Alabama Code 27-21A-1
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Codicil: An addition, change, or supplement to a will executed with the same formalities required for the will itself.
  • commissioner: The Commissioner of Insurance. See Alabama Code 27-21A-1
  • company: means any franchised or other duly licensed company which is operated or intended to be operated to perform the service of receiving and amplifying the signals broadcast by one or more television stations and redistributing such signals by wire, cable or other device or means for accomplishing such redistribution, to members of the public who subscribe to such service, or distributing through such company's antennae, poles, wires, cables, conduits or other property used in providing service to its subscribers and customers any television signals whether broadcast or not. See Alabama Code 13A-8-120
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • COMPLETE WRITTEN INSTRUMENT: One which purports to be a genuine written instrument fully drawn with respect to every essential feature thereof. See Alabama Code 13A-9-1
  • Credit report: A detailed report of an individual's credit history prepared by a credit bureau and used by a lender in determining a loan applicant's creditworthiness. Source: OCC
  • Deed: The legal instrument used to transfer title in real property from one person to another.
  • Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Docket: A log containing brief entries of court proceedings.
  • enrollee: An individual who is enrolled in a health maintenance organization. See Alabama Code 27-21A-1
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • EVIDENCE OF COVERAGE: Any certificate, agreement, or contract issued to an enrollee setting out the coverage to which he is entitled. See Alabama Code 27-21A-1
  • Fair Credit Reporting Act: A federal law, established in 1971 and revised in 1997, that gives consumers the right to see their credit records and correct any mistakes. Source: OCC
  • FALSELY ALTER: To "falsely alter" a written instrument means to change, without lawful authority, a written instrument, whether complete or incomplete, by means of erasure, obliteration, deletion, addition or transportation of matter, or in any other manner, so that the instrument so changed falsely appears or purports to be in all respects an authentic creation of its ostensible maker or authorized by him. See Alabama Code 13A-9-1
  • FALSELY COMPLETE: To "falsely complete" a written instrument means to transform, by adding, inserting or changing matter, an incomplete written instrument into a complete one, without lawful authority, so that the completed written instrument falsely appears or purports to be in all respects an authentic creation of its ostensible maker or authorized by him. See Alabama Code 13A-9-1
  • FALSELY MAKE: To "falsely make" a written instrument means to make or draw a complete written instrument in its entirety, or an incomplete written instrument, which purports to be authentic creation of its ostensible maker, but which is not either because the ostensible maker is fictitious or because, if real, he did not authorize the making or drawing thereof. See Alabama Code 13A-9-1
  • Fiduciary: A trustee, executor, or administrator.
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • FORGED INSTRUMENT: A written instrument which has been falsely made, completed or altered. See Alabama Code 13A-9-1
  • Forgery: The fraudulent signing or alteration of another's name to an instrument such as a deed, mortgage, or check. The intent of the forgery is to deceive or defraud. Source: OCC
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • government: Such term is defined as in Section 13A-8-1(5). See Alabama Code 13A-9-1
  • 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 furnishing to any person of any and all other services for the purpose of preventing, alleviating, curing, or healing human illness, injury, or physical disability. See Alabama Code 27-21A-1
  • HEALTH MAINTENANCE ORGANIZATION: Any person that undertakes to provide or arrange for basic health care services through an organized system which combines the delivery and financing of health care to enrollees. See Alabama Code 27-21A-1
  • INCOMPLETE WRITTEN INSTRUMENT: One which contains some matter by way of content or authentication, but which requires additional matter in order to render it a complete written instrument. See Alabama Code 13A-9-1
  • insurer: Every insurer authorized in this state to issue contracts of accident and sickness insurance. See Alabama Code 27-21A-1
  • INTENT TO DEFRAUD: A purpose to use deception, as defined in Section 13A-8-1(1), or to injure another person's interest which has value, as defined in Section 13A-8-1(14). See Alabama Code 13A-9-1
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • month: means a calendar month. See Alabama Code 1-1-1
  • person: Any natural or artificial person including, but not limited to, individuals, partnerships, associations, trusts, or corporations. See Alabama Code 27-21A-1
  • personal property: includes money, goods, chattels, things in action and evidence of debt, deeds and conveyances. See Alabama Code 1-1-1
  • Personal property: All property that is not real property.
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • preceding: means next before. See Alabama Code 1-1-1
  • Probate: Proving a will
  • property: Such term is defined as in Section 13A-8-1(10). See Alabama Code 13A-9-1
  • provider: Any physician, hospital, or other person which is licensed or otherwise authorized in this state to furnish health care services. See Alabama Code 27-21A-1
  • Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
  • Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
  • SCHEDULE OF CHARGES: A statement of the method used by a health maintenance organization to establish rates. See Alabama Code 27-21A-1
  • services: Such term is defined as in Section 13A-8-10(b). See Alabama Code 13A-9-1
  • STATE HEALTH OFFICER: The executive officer of the State Department of Public Health. See Alabama Code 27-21A-1
  • Statute: A law passed by a legislature.
  • Statute of limitations: A law that sets the time within which parties must take action to enforce their rights.
  • Summons: Another word for subpoena used by the criminal justice system.
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • UNCOVERED EXPENDITURES: The costs of health care services that are covered by a health maintenance organization, for which an enrollee would also be liable in the event of the organization's insolvency. See Alabama Code 27-21A-1
  • utter: means to directly or indirectly offer, assert, declare or put forth a forged instrument as genuine. See Alabama Code 13A-9-1
  • writing: includes typewriting and printing on paper. See Alabama Code 1-1-1
  • WRITTEN INSTRUMENT: Such term means:

    a. See Alabama Code 13A-9-1