(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 practicing under the supervision of the physician, and pursuant to the rules, regulations, and parameters for physician assistants, if the policy or contract pays for the same care and treatment provided by a licensed physician or doctor of osteopathy.
(b) An insurance policy or contract subject to this section shall not impose a practice or supervision restriction which is inconsistent with or more restrictive than provided by law.
(c) This section shall apply to services provided under a policy or contract delivered, continued, or renewed in this state on or after August 1, 1997, and to any existing policy or contract, on the policy’s or contract’s anniversary or renewal date, or upon the expiration of the applicable collective bargaining contract, if any, whichever is later.
(d) This section does not apply to policyholders or subscribers eligible for coverage under Title XVIII of the federal Social Security Act or any similar coverage under a state or federal government plan.
(e) For purposes of this section, third-party payment or prepayment includes an individual or group policy or accident or health insurance or individual or group hospital or health care service contract, an individual or group health maintenance organization contract, an organized delivery system contract, a medical service organization created pursuant to Article 6, Chapter 4, Title 10, or a preferred provider organization contract.
(f) This section shall not be interpreted to require an individual or group health maintenance organization, an organized delivery system, a medical service organization created pursuant to Article 6, Chapter 4, Title 10, or a preferred provider organization or arrangement to provide payment or prepayment to a physician for services provided by a physician assistant, unless the supervising physician of the physician assistant has entered into a contract or other agreement to provide services with the individual or group health maintenance organization, the organized delivery system, the medical service organization, or the preferred provider organization or arrangement.
(Acts 1997, No. 97-635, p. 1157, §1.)
Notes of Decisions
Blue Cross v. Hodurski, 899 So. 2d 949 (Ala. 2004).
· cites it 28× “The issue presented is whether a statute included in the Insurance Code, the Physician Assistant Act, codified at § 27-51-1, Ala.Code 1975, is applicable to BCBS, a nonprofit health-care service organization that exists pursuant to Title 10 of the Alabama Code of 1975.”
Hobbs v. Blue Cross & Blue Shield of Alabama, 100 F. Supp. 2d 1299 (M.D. Ala. 2000).
· cites it 9× “"Plaintiffs bring this action on behalf of themselves and a class composed of Physicians Assistants, and physicians who employ and or have employed Physicians Assistants after the effective date of Ala.Code § 27-51-1 (i.e. May 27, 1997), and who are or have been entitled to…”
Hobbs v. Blue Cross Blue Shield, 276 F.3d 1236 (11th Cir. 2001).
· cites it 3× “On August 26,1999, they filed an action in the Circuit Court of Alabama seeking compensatory and punitive damages as well as injunctive relief against Blue Cross for its failure to comply with Alabama Code § 27-51-1. They filed the complaint individually and as representatives…”
Norman Hobbs v. Blue Cross Blue Shield, 270 F.3d 1324 (11th Cir. 2001).
· cites it 5× “On August 26, 1999, they filed an action in the Circuit Court of Alabama seeking compensatory and punitive damages as well as injunctive relief against Blue Cross for its failure to comply with Alabama Code § 27-51-1. They filed the complaint individually and as representatives…”
Norman Hobbs v. Blue Cross Blue Shield, 270 F.3d 1324 (11th Cir. 2001).
· cites it 5× “On August 26, 1999, they filed an action in the Circuit Court of Alabama seeking compensatory and punitive damages as well as injunctive relief against Blue Cross for its failure to comply with Alabama Code § 27-51-1. They filed the complaint individually and as representatives…”
Ala. Code § 27-51-1(a): 2 cases
Blue Cross v. Hodurski, 899 So. 2d 949 (Ala. 2004).
“The issue presented is whether a statute included in the Insurance Code, the Physician Assistant Act, codified at § 27-51-1, Ala.Code 1975, is applicable to BCBS, a nonprofit health-care service organization that exists pursuant to Title 10 of the Alabama Code of 1975.”
Hobbs v. Blue Cross & Blue Shield of Alabama, 100 F. Supp. 2d 1299 (M.D. Ala. 2000).
“"Plaintiffs bring this action on behalf of themselves and a class composed of Physicians Assistants, and physicians who employ and or have employed Physicians Assistants after the effective date of Ala.Code § 27-51-1 (i.e. May 27, 1997), and who are or have been entitled to…”
Ala. Code § 27-51-1(e): 2 cases
Blue Cross v. Hodurski, 899 So. 2d 949 (Ala. 2004).
“The issue presented is whether a statute included in the Insurance Code, the Physician Assistant Act, codified at § 27-51-1, Ala.Code 1975, is applicable to BCBS, a nonprofit health-care service organization that exists pursuant to Title 10 of the Alabama Code of 1975.”
Hobbs v. Blue Cross & Blue Shield of Alabama, 100 F. Supp. 2d 1299 (M.D. Ala. 2000).
“"Plaintiffs bring this action on behalf of themselves and a class composed of Physicians Assistants, and physicians who employ and or have employed Physicians Assistants after the effective date of Ala.Code § 27-51-1 (i.e. May 27, 1997), and who are or have been entitled to…”
Ala. Code § 27-51-1(f): 1 case
Blue Cross v. Hodurski, 899 So. 2d 949 (Ala. 2004).
“The issue presented is whether a statute included in the Insurance Code, the Physician Assistant Act, codified at § 27-51-1, Ala.Code 1975, is applicable to BCBS, a nonprofit health-care service organization that exists pursuant to Title 10 of the Alabama Code of 1975.”
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