(a) An insurance company licensed in this state, or a health care service plan authorized to do business in this state, may either directly or through a subsidiary or affiliate organize and operate a health maintenance organization under the provisions of this chapter. Notwithstanding any other law which may be inconsistent herewith, any two or more such insurance companies, health care service plans, or subsidiaries or affiliates thereof, may jointly organize and operate a health maintenance organization. The business of insurance is deemed to include the providing of health care by a health maintenance organization owned or operated by an insurer or a subsidiary thereof.
(b) Notwithstanding any provision of insurance and health care service plan laws, Title 10, Chapter 4, Article 6 and Title 27, an insurer or a health care service plan may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of the failure of the health maintenance organization to meet its obligations. For such purposes, the enrollees of a health maintenance organization constitute a permissible group under such laws. Among other things, under such contracts, the insurer or health care service plan may make benefit payments to health maintenance organizations for health care services rendered by providers.
Structure Code of Alabama
Chapter 21A - Health Maintenance Organizations.
Section 27-21A-1 - Definitions.
Section 27-21A-2 - Establishment of Health Maintenance Organizations.
Section 27-21A-3 - Issuance of Certificate of Authority.
Section 27-21A-4 - Powers of Health Maintenance Organizations.
Section 27-21A-5 - Governing Body.
Section 27-21A-6 - Fiduciary Responsibilities of Directors, Officers, Employees, and Partners.
Section 27-21A-7 - Evidence of Coverage and Charges for Health Care Services.
Section 27-21A-8 - Reporting Requirements.
Section 27-21A-9 - Information to Enrollees.
Section 27-21A-10 - Complaint System.
Section 27-21A-11 - Investments.
Section 27-21A-12 - Protection Against Insolvency.
Section 27-21A-13 - Prohibited Practices.
Section 27-21A-14 - Regulation of Producers.
Section 27-21A-15 - Powers of Insurers and Health Care Service Plans.
Section 27-21A-16 - Examination.
Section 27-21A-17 - Suspension or Revocation of Certificate of Authority.
Section 27-21A-19 - Regulations.
Section 27-21A-20 - Administrative Procedures.
Section 27-21A-22 - Penalties and Enforcement.
Section 27-21A-23 - Statutory Construction and Relationship to Other Laws.
Section 27-21A-24 - Filings and Reports as Public Documents.
Section 27-21A-25 - Confidentiality of Medical Information.
Section 27-21A-26 - State Health Officer's and Commissioner's Authority to Contract.
Section 27-21A-27 - Acquisition of Control of or Merger of a Health Maintenance Organization.
Section 27-21A-29 - Existing Health Maintenance Organizations.
Section 27-21A-30 - Coordination of Benefits.
Section 27-21A-31 - Health Maintenance Organization Advisory Council.