§ 27-3A-1 Short title
§ 27-3A-2 Purposes
§ 27-3A-3 Definitions
§ 27-3A-4 Duties of utilization review agents
§ 27-3A-5 Standards for utilization review agents
§ 27-3A-6 Violations of chapter by utilization review agent

Terms Used In Alabama Code > Title 27 > Chapter 3A - Health Care Service Utilization Review Act

  • 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.
  • authority: The Lamar County Water Coordinating and Fire Prevention Authority, a public corporation organized pursuant to this part. See Alabama Code 45-38-141
  • board: The Board of Directors of the Lamar County Water Coordinating and Fire Prevention Authority. See Alabama Code 45-38-141
  • bonds: Bonds, notes, and certificates representing an obligation to pay money. See Alabama Code 45-38-141
  • Capital offense: A crime punishable by death.
  • CAPITAL OFFENSE: An offense for which a defendant shall be punished by a sentence of death or life imprisonment without parole, or in the case of a defendant who establishes that he or she was under the age of 18 years at the time of the capital offense, life imprisonment, or life imprisonment without parole, according to the provisions of this article. See Alabama Code 13A-5-39
  • county: Lamar County. See Alabama Code 45-38-141
  • department: The Alabama Department of Public Health. See Alabama Code 27-3A-3
  • during: The term as used in Section 13A-5-40(a) means in the course of or in connection with the commission of, or in immediate flight from the commission of the underlying felony or attempt thereof. See Alabama Code 13A-5-39
  • 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. See Alabama Code 27-3A-3
  • Indemnification: In general, a collateral contract or assurance under which one person agrees to secure another person against either anticipated financial losses or potential adverse legal consequences. Source: FDIC
  • Intangible property: Property that has no intrinsic value, but is merely the evidence of value such as stock certificates, bonds, and promissory notes.
  • Mistrial: An invalid trial, caused by fundamental error. When a mistrial is declared, the trial must start again from the selection of the jury.
  • municipality: An incorporated city or town of Lamar County. See Alabama Code 45-38-141
  • Plea: In a criminal case, the defendant's statement pleading "guilty" or "not guilty" in answer to the charges, a declaration made in open court.
  • property: Real and personal property and interests therein. See Alabama Code 45-38-141
  • provider: A health care provider duly licensed or certified by the State of Alabama. See Alabama Code 27-3A-3
  • SERVICE AREA: The geographic area or areas in which the authority is authorized by its certificate of incorporation or any amendment thereto to render water and fire protection service, or any thereof, which area may include not only territory located outside the boundaries of any municipality but also territory located within the boundaries of one or more municipalities. See Alabama Code 45-38-141
  • state: The State of Alabama. See Alabama Code 45-38-141
  • Trial jury: A group of citizens who hear the evidence presented by both sides at trial and determine the facts in dispute. Federal criminal juries consist of 12 persons. Federal civil juries consist of six persons.
  • UNDER SENTENCE OF IMPRISONMENT: As used in Section 13A-5-49(1), the term means while serving a term of imprisonment, while under a suspended sentence, while on probation or parole, or while on work release, furlough, escape, or any other type of release or freedom while or after serving a term of imprisonment, other than unconditional release and freedom after expiration of the term of sentence. See Alabama Code 13A-5-39
  • United States: includes the territories thereof and the District of Columbia. See Alabama Code 1-1-1
  • Usury: Charging an illegally high interest rate on a loan. Source: OCC
  • 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. See Alabama Code 27-3A-3
  • UTILIZATION REVIEW AGENT: Any person or entity, including the State of Alabama, performing a utilization review, except the following:

    a. See Alabama Code 27-3A-3

  • Verdict: The decision of a petit jury or a judge.
  • WATER SERVICE: The providing, furnishing, supplying, or distributing of water and the performing of all of the functions and activities reasonably incident to the operation of a water system. See Alabama Code 45-38-141
  • WATER SYSTEM: Land, plants, systems, facilities, buildings, and other property, or any combination of any thereof, which are used or useful or capable of future use in providing, furnishing, supplying, or distributing water, including, but not limited to, water supply systems, water distribution systems, reservoirs, wells, intakes, mains, laterals, aqueducts, pumping stations, standpipes, filtration plants, purification plants, meters, valves, fire hydrants, and all necessary appurtenances and equipment, and all properties, rights, easements, and franchises deemed necessary or desirable by the authority for use in rendering water service. See Alabama Code 45-38-141