reglab/housing_qa huggingface dataset:
AL Code § 27-21A-21 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-21 - Fees.

Section 27-21A-21Fees. (a) Every health maintenance organization subject to this chapter shall pay to the commissioner the following fees: (1) For filing an application for certificate of authority or amendment thereto, $50.00; (2) For filing an amendment to the organization documents that requires approval, $10.00; (3) For filing each annual report, $20.00; (4) For renewal of annual certificates of authority, $200.00. (b) Fees charged under this section shall be deposited to the credit of the General Fund. (Acts 1986, No. 86-471, p. 854, §21.)
AL Code § 27-21A-22 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-22 - Penalties and Enforcement.

Section 27-21A-22Penalties and enforcement. (a) The commissioner may, in lieu of suspension or revocation of a certificate of authority under Section 27-21A-17, levy an administrative penalty in an amount not less than $500.00 nor more than $5,000.00, if reasonable notice in writing is given of the intent to levy the penalty and the health maintenance organization has a reasonable time within which to remedy the defect in its operations which gave rise to the penalty citation. The commissioner may augment this penalty by an amount equal to the sum that he calculates to be the damages suffered by enrollees or other members of the public. All moneys collected under this section shall be deposited to the credit of the General Fund. (b)(1) If the commissioner or the State Health Officer shall for any reason have cause to believe that any violation of this chapter has occurred or is threatened, the commissioner or State Health Officer may give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in such suspected violation, to arrange a conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to such suspected violation, and, in the event it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing such violation. (2) Proceedings under this subsection shall not be governed by any formal procedural requirements, and may be conducted in such manner as the commissioner or the State Health Officer may deem appropriate under the circumstances. However, unless consented to by the health maintenance organization, no rule or order may result from a conference until the requirements of this section or Section 27-21A-20 of this chapter are satisfied. (c)(1) The commissioner, after notice to the State Health Officer, may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provisions of this chapter. (2) Within 30 days after service of the cease and desist order, the respondent may request a hearing on the question of whether acts or practices in violation of this chapter have occurred. Such hearings shall be conducted and judicial review had in accord with the provisions of this title. (d) In the case of any violation of the provisions of this chapter, if the commissioner elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order issued pursuant to subsection (c), the commissioner may institute a proceeding to obtain injunctive or other appropriate relief in the Circuit Court of Montgomery County. (Acts 1986, No. 86-471, p. 854, §22.)
AL Code § 27-21A-23 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-23 - Statutory Construction and Relationship to Other Laws.

Section 27-21A-23Statutory construction and relationship to other laws. (a) Except as otherwise provided in this chapter, provisions of the insurance law and provisions of health care service plan laws shall not be applicable to any health maintenance organization granted a certificate of authority under this chapter. This provision shall not apply to an insurer or health care service plan licensed and regulated pursuant to the insurance law or the health care service plan laws of this state except with respect to its health maintenance organization activities authorized and regulated pursuant to this chapter.  (b) Solicitation of enrollees by a health maintenance organization granted a certificate of authority shall not be construed to violate any provision of law relating to solicitation or advertising by health 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 adopted by the Commissioner of Insurance pursuant to Sections 27-7-43 and 27-7-44.  (8) Chapter 12A. (9) Chapter 54A. (10) Chapter 2B. (11) Chapter 29. (12) Chapter 62. (13) Chapter 63. (14) Chapter 45A. (Acts 1986, No. 86-471, p. 854, §23; Act 2001-445, p. 573, §1; Act 2001-477, p. 640, §10; Act 2002-511, p. 1315, §1; Act 2004-502, p. 969, §8; Act 2007-389, p. 778, §5; Act 2008-502, p. 1106, §4; Act 2012-298, p. 647, §3; Act 2012-429, p. 1170, §6; Act 2014-324, p. 1151, §1; Act 2014-377, p. 1407, §7; Act 2017-337, §1; Act 2019-98, §13; Act 2021-341, §3; Act 2021-236, §2.)
AL Code § 27-21A-24 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-24 - Filings and Reports as Public Documents.

Section 27-21A-24Filings and reports as public documents. All applications, filings, and reports required under this chapter, except those which are trade secrets or privileged or confidential commercial or financial information, other than any annual financial statement that may be required under Section 27-21A-8, shall be treated as public documents. All testimony, documents, and other evidence required to be submitted to the commissioner or State Health Officer in connection with enforcement of this chapter shall be absolutely confidential and shall not be admissible in evidence in any other proceeding. The commissioner or the State Health Officer may withhold from public inspection any examination or investigation report for so long as they deem necessary to protect the person examined from unwarranted injury or to be in the public interest. (Acts 1986, No. 86-471, p. 854, §24.)
AL Code § 27-21A-25 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-25 - Confidentiality of Medical Information.

Section 27-21A-25Confidentiality of medical information. Any data or information pertaining to the diagnosis, treatment, or health of any enrollee or applicant obtained from such person or from any provider by any health maintenance organization shall be held in confidence and shall not be disclosed to any person except to the extent that it may be necessary to carry out the purposes of this chapter; or upon the express consent of the enrollee or applicant; or pursuant to statute or court order for the production of evidence or the discovery thereof; or in the event of claim or litigation between such person and the health maintenance organization wherein such data or information is pertinent. A health maintenance organization shall be entitled to claim any statutory privileges against such disclosure which the provider who furnished such information to the health maintenance organization is entitled to claim. (Acts 1986, No. 86-471, p. 854, §25.)
AL Code § 27-21A-26 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-26 - State Health Officer's and Commissioner's Authority to Contract.

Section 27-21A-26State Health Officer's and commissioner's authority to contract. The State Health Officer and the commissioner, in carrying out their obligations under this chapter, may contract with qualified persons to make recommendations concerning the determinations required to be made by them. Such recommendations may be accepted in full or in part by the State Health Officer or commissioner. (Acts 1986, No. 86-471, p. 854, §26.)
AL Code § 27-21A-27 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-27 - Acquisition of Control of or Merger of a Health Maintenance Organization.

Section 27-21A-27Acquisition of control of or merger of a health maintenance organization. No person may make a tender for or a request or invitation for tenders of, or enter into an agreement to exchange securities for or acquire in the open market or otherwise, any voting security of a health maintenance organization or enter into any other agreement if, after the consummation thereof, that person would, directly or indirectly, (or by conversion or by exercise of any right to acquire) be in control of the health maintenance organization, and no person may enter into an agreement to merge or consolidate with or otherwise to acquire control of a health maintenance organization, unless at the time any offer, request, or invitation is made or any agreement is entered into, or prior to the acquisition of the securities if no offer or agreement is involved, the person has filed with the commissioner and has sent to the health maintenance organization, information required by Section 27-29-3, and the offer, request, invitation, agreement, or acquisition has been approved by the commissioner. Approval by the commissioner shall be governed by the provisions of said Section 27-29-3. Control under this section shall be defined in the same manner as it is defined for the purposes of Section 27-29-3, as amended from time to time. (Acts 1986, No. 86-471, p. 854, §27.)
AL Code § 27-21A-28 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-28 - Taxes.

Section 27-21A-28Taxes. Health maintenance organizations doing business in this state shall be subject to and pay the annual premium tax to be paid by health insurers on health insurance premiums. The same taxes and filing requirements applicable to health insurers under this title, shall apply to and shall be imposed upon each health insurance organization licensed under the provisions of this chapter; and the organization shall also be entitled to the same tax deductions, reductions, abatements, and credits that health insurers are entitled to receive. (Acts 1986, No. 86-471, p. 854, §28; Acts 1993, No. 93-679, p. 1291, §9; Acts 1997, No. 97-227, p. 372, §1.)
AL Code § 27-21A-29 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-29 - Existing Health Maintenance Organizations.

Section 27-21A-29Existing health maintenance organizations. (a) Notwithstanding any other provision of this chapter, any health maintenance organization licensed by the State Board of Health and in operation on May 29, 1986, shall be granted a certificate of authority upon payment of the application fee prescribed in Section 27-21A-21 and compliance with Section 27-21A-12. Nothing in this section shall prohibit any such health maintenance organization from continuing to conduct business in this state until such certificate of authority is issued. (b) Any health maintenance organization which was licensed in this state prior to January 1, 1986, may continue to operate under existing noncontractual provider arrangements (which have been approved by the State Health Officer) for three years. (c) After issuance of a certificate of authority in accordance with subsection (a) of this section, the commissioner may require submission by the health maintenance organization of any additional information required in Section 27-21A-2 which has not previously been submitted to the State Health Officer. (Acts 1986, No. 86-471, p. 854, §29.)
AL Code § 27-21A-30 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-30 - Coordination of Benefits.

Section 27-21A-30Coordination of benefits. (a) A health maintenance organization is entitled to coordinate benefits on the same basis as an insurer. No such coordination shall be allowed against policies covering individuals on other than a group basis. (b) A health maintenance organization providing medical benefits or payments to an enrollee who suffers injury, disease, or illness by virtue of the negligent act or omission of a third party is entitled to reimbursement from such third party for the reasonable value of the benefits or payments provided. (Acts 1986, No. 86-471, p. 854, §30.)
AL Code § 27-21A-31 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-31 - Health Maintenance Organization Advisory Council.

Section 27-21A-31Health maintenance organization advisory council. There shall be established a three member HMO advisory council to advise and consult with the commissioner and the State Health Officer in carrying out their duties under this chapter. The members of such advisory body shall be appointed annually by the Alabama Association of Health Maintenance Organizations. (Acts 1986, No. 86-471, p. 854, §31.)
AL Code § 27-21A-32 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21A - Health Maintenance Organizations.|Section 27-21A-32 - Hmo Enrollment Requirements.

Section 27-21A-32HMO enrollment requirements. (a) The state government, or any agency, board, commission, institution, or political subdivision thereof, and any city or county, or board of education, which offers its employees a health benefits plan may make available to and inform its employees or members of the option to enroll in at least one health maintenance organization holding a valid certificate of authority which provides health care services in the geographic areas in which such employees or members reside. (b) The first time a health maintenance organization is offered by an employer, either public or private, each covered employee must make an affirmative written selection among the different alternatives included in the health benefits plan. Thereafter, those who wish to change from one plan to another will be allowed to do so annually, provided, that nothing in this section shall prevent any health maintenance organization or insurer from requiring evidence of insurability or imposing underwriting restrictions on the acceptance of any such employee. In addition to the annual group enrollment period, the employer shall make available the opportunity to select among different existing alternatives within a health benefits plan to eligible employees, who are new employees or have changed their place of residence resulting in eligibility for the plan. (c) This section shall impose no responsibilities or duties upon any employer, either public or private, to offer health maintenance organization coverage as part of its health benefits plan. (d) No employer shall in any way be required to pay more for health benefits as a result of the application of this section than would otherwise be required by a prevailing collective bargaining agreement or other legally enforceable contract or obligation for the provision of health benefits to its employees, or in any plan provided voluntarily by an employer. (Acts 1986, No. 86-471, p. 854, §32.)
AL Code § 27-21B-1 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21B - Medical Support Health Care Access Act.|Section 27-21B-1 - Short Title.

Section 27-21B-1Short title. This chapter shall be known as the "Medical Support Health Care Access Act." (Acts 1994, No. 94-710, p. 1377, §1.)
AL Code § 27-21B-2 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21B - Medical Support Health Care Access Act.|Section 27-21B-2 - Definitions.

Section 27-21B-2Definitions. As used in this chapter, the following terms shall have the following meanings: (1) AGENCY. Any state agency responsible for administering programs under Title IV-D or Title XIX of the Social Security Act. (2) INSURER. A health insurer, including a group health plan as defined in Section 607(1) of the Employee Retirement Income Security Act of 1974, a health maintenance organization, or an entity offering a service benefit plan. (Acts 1994, No. 94-710, p. 1377, §2.)
AL Code § 27-21B-3 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21B - Medical Support Health Care Access Act.|Section 27-21B-3 - Power to Conduct Investigations.

Section 27-21B-3Power to conduct investigations. The Alabama Medicaid Agency is authorized and empowered to conduct investigations to determine whether a medical support order exists or eligibility for enrollment of a recipient in a parent's family health coverage exists. The parents of any child who is a recipient shall cooperate in this investigation. State agencies may share information regarding parentage and support orders. (Acts 1994, No. 94-710, p. 1377, §3.)
AL Code § 27-21B-4 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21B - Medical Support Health Care Access Act.|Section 27-21B-4 - Enrollment of Child.

Section 27-21B-4Enrollment of child. An insurer shall not deny enrollment of a child under the health coverage of the child's parent on any of the following grounds: (1) That the child was born out of wedlock. (2) That the child is not claimed as a dependent on the parent's federal income tax return. (3) That the child does not reside with the parent or in the insurer's service area. (Acts 1994, No. 94-710, p. 1377, §4.)
AL Code § 27-21B-5 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21B - Medical Support Health Care Access Act.|Section 27-21B-5 - Health Coverage Through Insurer.

Section 27-21B-5Health coverage through insurer. When a parent is required by a court or administrative order to provide health coverage and the parent is eligible for family health coverage through an insurer, all of the following shall apply: (1) The parent shall be able to enroll a child in family coverage without regard to open enrollment season restrictions. (2) If the parent fails to enroll a child as required by court or administrative order, the child's other parent or the agency may make an enrollment. (3) A child enrolled in health coverage pursuant to this section shall not be disenrolled unless the insurer is provided satisfactory written evidence of either of the following: a. The court or administrative order is no longer in effect. b. The child is or will be enrolled in comparable health coverage through another insurer which will take effect not later than the effective date of the disenrollment. (Acts 1994, No. 94-710, p. 1377, §5.)
AL Code § 27-21B-6 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21B - Medical Support Health Care Access Act.|Section 27-21B-6 - Health Coverage Through Employer.

Section 27-21B-6Health coverage through employer. When a parent is required by a court or administrative order to provide health coverage and the parent is eligible for family health coverage through an employer doing business in the state, all of the following shall apply: (1) The parent shall be able to enroll any child in family coverage without regard to open enrollment season restrictions. (2) If the parent fails to enroll a child, the child's other parent or the agency can make the enrollment. (3) The child shall not be disenrolled unless the employer is provided satisfactory written evidence of any of the following: a. The court or administrative order is no longer in effect. b. The child is or will be enrolled in comparable health coverage through another employer which will take effect not later than the effective date of the disenrollment. c. The employer has eliminated family coverage for all of its employees. (4) The employer shall withhold from the employee's compensation the employee's share, if any, of premiums for health coverage, so long as the amount does not exceed the maximum amount allowed by law. The employer shall then pay the employee's share of premiums to the insurer. (Acts 1994, No. 94-710, p. 1377, §6.)
AL Code § 27-21B-7 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21B - Medical Support Health Care Access Act.|Section 27-21B-7 - Imposition of Additional Requirements.

Section 27-21B-7Imposition of additional requirements. An insurer shall not impose any additional requirements on any state agency which has been assigned the rights of an individual eligible for medical assistance under this chapter and covered for health benefits from the insurer that are different from requirements applicable to an agent or assignee of a covered individual. (Acts 1994, No. 94-710, p. 1377, §7.)
AL Code § 27-21B-8 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21B - Medical Support Health Care Access Act.|Section 27-21B-8 - Coverage Through Insurer of Non-Custodial Parent.

Section 27-21B-8Coverage through insurer of non-custodial parent. When a child has health coverage through the insurer of a noncustodial parent, the insurer shall do all of the following: (1) Provide necessary information to the custodial parent in order for the child to obtain benefits through the coverage. (2) Allow the custodial parent or the health provider, with the custodial parent's approval, to submit claims for covered services without approval from the noncustodial parent. (3) Make payment on the submitted claims directly to the custodial parent, provider, or the agency. (Acts 1994, No. 94-710, p. 1377, §8.)
AL Code § 27-21B-9 (2021)
2021 Code of Alabama|Title 27 - Insurance.|Chapter 21B - Medical Support Health Care Access Act.|Section 27-21B-9 - Garnishment of Wages.

Section 27-21B-9Garnishment of wages. (a) The Alabama Medicaid Agency may garnish the wages, salary, or other employment income of any person who is required by a court or administrative order to provide coverage of the costs of health services to a child who is eligible for medical assistance and has received payment from a third party for the cost of services for the child but has not used the payments to reimburse the other parent or guardian of the child, the provider of services, or the Alabama Medicaid Agency for its payments made. Current or past due child support shall have priority over claims for the costs of the services. (b) In addition to the powers granted in subsection (a), the Alabama Medicaid Agency may notify the State Department of Revenue of any amounts due under this section. Upon proper and timely notice, the department shall withhold any amount from any state tax refund due to the above-described person. (Acts 1994, No. 94-710, p. 1377, §9.)