ALABAMA

Overview

Alabama is one of the few states that prohibits most non-compete provisions in employment contracts for professionals, which include physicians. Specifically, the courts held that statutory exemptions allowing non-competes in employment contracts do not apply to professionals and that physicians and other medical providers are professionals under state law.

While the state does not have statutory authority for review or approval of provider mergers, Alabama is the site of a major private antitrust enforcement action against health insurer Blue Shield/Blue Cross. Healthcare providers and individual and small-employer customers separately sued BCBS of Alabama in 2013, alleging horizontal market allocation and conspiracy to divvy up insurance markets all over the country in violation of Section 1 of the Sherman Antitrust Act. The lawsuits were consolidated as MDL in the Northern District of Alabama, which held that the alleged practice of creating exclusive territories is a “per se” violation of the Sherman Antitrust Act and would be subject to the highest legal standard. After the 11th Circuit upheld the decision, BCBS agreed to a settlement agreement with employer subscribers that would pay $2.7 billion to the class plaintiffs, in addition to modification of alleged anticompetitive practices.

See below for an overview of existing Alabama state mandates. Click on citation tab for detailed information of specific statutes (click link to download statute text).

State Action


Latest Legislative Session: 3/7/2023 - 6/6/2023 (2023 term). *Current session bill updates are ongoing. Check back weekly for updates.

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© 2018- The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

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© 2018- The SLIHCQ DatabaseInitial funding for this project was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
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Additional Resources

STATE BUDGET

Alabama’s fiscal year runs from October 1 and ends on September 30 of the following year. To view Alabama’s most recent Budget proposal, click here.

REGULATION & ENFORCEMENT

  • FTC Review of Community Health Systems / Health Management Associates Merger: In April 2014, the Federal Trade Commission issued its final order in connection with Community Health Systems, Inc.’s proposed $7.6 billion acquisition of rival health system Health Management Associates, Inc.  The FTC required Community Health Systems, one of the nation’s largest hospital operators, to divest hospitals and related assets, including outpatient facilities, in Alabama and South Carolina as a condition of the acquisition. Prior to issuing the order, in March 2015, the FTC approved CHS’s sale of a Gadsen hospital in accordance with its order. Find the FTC case summary and related documents here.

KEY RESOURCES