HB 2138--
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HOUSE BILL No. 2138
By Committee on Insurance
1-30
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AN ACT concerning insurance, relating to mental illness coverage; amending K.S.A. 1996 Supp. 40-2,105 and repealing the existing section. Be it enacted by the Legislature of the State of Kansas: Section 1. K.S.A. 1996 Supp. 40-2,105 is hereby amended to read as follows: 40-2,105. (a) On or after the effective date of this act, every insurer which issues any individual or group policy of accident and sick- ness insurance providing medical, surgical or hospital expense coverage for other than specific diseases or accidents only and which provides for reimbursement or indemnity for services rendered to a person covered by such policy in a medical care facility, must provide for reimbursement or indemnity under such individual policy or under such group policy, except as provided in subsection (d) (e), which shall be limited to not less than 30 days per year when such person is confined for treatment of alcoholism, drug abuse or nervous or mental conditions in a medical care facility licensed under the provisions of K.S.A. 65-429 and amendments thereto, a treatment facility for alcoholics licensed under the provisions of K.S.A. 65-4014 and amendments thereto, a treatment facility for drug abusers licensed under the provisions of K.S.A. 65-4605 and amendments thereto, a community mental health center or clinic licensed under the provisions of K.S.A. 75-3307b and amendments thereto or a psychiatric hospital licensed under the provisions of K.S.A. 75-3307b and amend- ments thereto. Such individual policy or such group policy shall also pro- vide for reimbursement or indemnity, except as provided in subsection (d), of the costs of treatment of such person for alcoholism, drug abuse and nervous or mental conditions, limited to not less than 100% of the first $100, 80% of the next $100 and 50% of the next $1,640 in any year and limited to not less than $7,500 in such person's lifetime, in the facil- ities enumerated when confinement is not necessary for the treatment or by a physician licensed or psychologist licensed to practice under the laws of the state of Kansas. Notwithstanding the foregoing, every insurer, which issues any individual or group policy of accident and sickness in- surance providing medical, surgical or hospital expense coverage for other than specific diseases or accidents only and which provides for reimburse- ment or indemnity for services rendered to a person covered by such policy, shall provide coverage for diagnosis and treatment of mental ill- nesses under terms and conditions no less extensive than coverage for any other type of health care. (b) For the purposes of this section ``nervous or mental conditions'' means disorders specified in the diagnostic and statistical manual of men- tal disorders, fourth edition, (DSM-IV, 1994) of the American psychiatric association but shall not include conditions not attributable to a mental disorder that are a focus of attention or treatment (DSM-IV, 1994). (c) For the purpose of this section, ``mental illnesses'' means the fol- lowing: (1) Schizophrenia, schizoaffective disorder, schizophreniform disor- der, brief reactive psychosis, paranoid or delusional disorder, atypical psychosis; (2) major affective disorders (bipolar and major depression), cyclo- thymic and dysthymic disorders; (3) obsessive compulsive disorder; (4) panic disorder; (5) pervasive developmental disorder, including autism; (6) other childhood mental illnesses, including attention deficit dis- order and attention deficit hyperactivity disorder; or (7) borderline personality disorder. (c)(d) The provisions of this section shall be applicable to health maintenance organizations organized under article 32 of chapter 40 of the Kansas Statutes Annotated. (d)(e) There shall be no coverage under the provisions of this section for any assessment against any person required by a diversion agreement or by order of a court to attend an alcohol and drug safety action program certified pursuant to K.S.A. 8-1008 and amendments thereto. (e)(f) The provisions of this section shall not apply to any medicare supplement policy of insurance, as defined by the commissioner of in- surance by rule and regulation. (f)(g) The provisions of this section shall be applicable to the Kansas state employees health care benefits program developed and provided by the Kansas state employees health care commission. Sec. 2. K.S.A. 1996 Supp. 40-2,105 is hereby repealed. Sec. 3. This act shall take effect and be in force from and after its publication in the statute book.