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.