As Amended by Senate Committee
         
Session of 2000
         
SENATE BILL No. 619
         
By Committee on Financial Institutions and Insurance
         
2-10
         

10             AN  ACT concerning insurance; relating to health maintenance organi-
11             zations; amending K.S.A. 1999 Supp. 40-3202, 40-3209, 40-3220, 40-
12             3227, 40-3606 and 45-221 and repealing the existing sections.
13      
14       Be it enacted by the Legislature of the State of Kansas:
15             New Section  1. As used in this act:
16             (a) ``Adjusted RBC report'' means an RBC report which has been
17       adjusted by the commissioner in accordance with section (2) 4 and
18       amendments thereto.
19             (b) ``Corrective order'' means an order issued by the commissioner
20       specifying corrective actions which the commissioner has determined are
21       required.
22             (c) ``Domestic health organization'' means any health organization
23       which is licensed and organized in this state.
24             (d) ``Foreign health organization'' means any health organization not
25       domiciled in this state which is licensed to do business in this state
26       pursuant to article 41 articles 19a, 19c or 32 of chapter 40 of the Kansas
27       Statutes Annotated or K.S.A. 40-209, and amendments thereto.
28             (e) ``NAIC'' means the national association of insurance
29       commissioners.
30             (f) ``Health organization'' means a health maintenance organization,
31       limited health service organization, dental or vision plan, hospital, medical
32       and dental indemnity or service corporation or other managed care or-
33       ganization licensed under articles 19a, 19c or 32 of chapter 40 of the
34       Kansas Statutes Annotated, and amendments thereto. This definition
35       shall not include an organization that is licensed as either a life and health
36       insurer or a property and casualty insurer under articles 4, 5, 9, 10, 11,
37       12, 12a, 15 or 16 of chapter 40 of the Kansas Statutes Annotated, and
38       amendments thereto, and that is otherwise subject to either the life or
39       property and casualty RBC requirements in K.S.A. 1999 Supp. 40-2c01
40       et seq., and amendments thereto.
41             (g) ``RBC'' means risk-based capital.
42             (h) ``RBC instructions'' means the risk-based capital instructions for
43       managed care organizations promulgated by the NAIC which may be


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  1       amended by NAIC from time to time in accordance with the procedures
  2       adopted by the NAIC are in effect on December 31, 1999, or any
  3       later version as adopted by the commissioner in rules and
  4       regulations.
  5             (i) ``RBC level'' means a health organization's company action level
  6       RBC, regulatory action level RBC, authorized control level RBC, or man-
  7       datory control level RBC where:
  8             (1) ``Company action level RBC'' means, with respect to any health
  9       organization, the product of 2.0 and its authorized control level RBC;
10             (2) ``regulatory action level RBC'' means the product of 1.5 and its
11       authorized control level RBC;
12             (3) ``authorized control level RBC'' means the number determined
13       under the risk-based capital formula in accordance with the RBC instruc-
14       tions; and
15             (4) ``mandatory control level RBC'' means the product of .70 and the
16       authorized control level RBC.
17             (j) ``RBC plan'' means a comprehensive financial plan containing the
18       elements specified in section 6, and amendments thereto. If the com-
19       missioner rejects the RBC plan, and it is revised by the health organiza-
20       tion, with or without the commissioner's recommendation, the plan shall
21       be called the ``revised RBC plan.''
22             (k) ``RBC report'' means the report required by section 2 sections 2,
23       3 and 4, and amendments thereto.
24             (l) ``Total adjusted capital'' means the sum of:
25             (1) A health organization's capital and surplus or surplus only if a
26       mutual insurer as determined in accordance with the annual finan-
27       cial statements required to be filed under articles 19a, 19c or 32 of
28       chapter 40 of the Kansas Statutes Annotated and amendments
29       thereto; and
30             (2) such other items, if any, as the RBC instructions may provide.
31             (m) ``Commissioner'' means the commissioner of insurance.
32             New Sec.  2. Every (a) Except as provided in paragraph (b),
33       every domestic health organization shall prepare and submit to the com-
34       missioner, on or before March 1, a report of its RBC levels as of the end
35       of the calendar year just ended in a form and containing such information
36       as is required by the RBC instructions. In addition, every domestic health
37       organization shall file its RBC report:
38             (a) (1) With the NAIC in accordance with the RBC instructions; and
39             (b) (2) with the insurance commissioner in any state in which the
40       health organization is authorized to do business, if such insurance com-
41       missioner has notified the health organization of its request in writing, in
42       which case, the health organization shall file its RBC report not later than
43       the later of:


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  1             (1) (A) 15 days from the receipt of notice to file its RBC report with
  2       that state; or
  3             (2) (B) the filing date otherwise specified in this subsection.
  4        (b) The risk-based capital requirements of this section shall not
  5       apply to any health organization contracting with the Kansas de-
  6       partment of social and rehabilitation services to provide services
  7       provided under title XIX and title XXI of the social security act or
  8       any other public benefits, provided the public benefit contracts rep-
  9       resent at least 90% of the premium volume of the health
10       organization.
11             New Sec.  3. (a) A health organization's RBC shall be determined in
12       accordance with the formula set forth in the RBC instructions. The for-
13       mula shall take into account and may adjust for the covariance between:
14             (1) Asset risk;
15             (2) credit risk;
16             (3) underwriting risk; and
17             (4) all other business risks and such other relevant risks as are set
18       forth in the RBC instructions; determined in each case by applying the
19       factors in the manner set forth in the RBC instructions.
20             (b) An excess of capital over the amount produced by the risk-based
21       capital requirements contained in this act and the formulas, schedules
22       and instructions referenced in this act is desirable in the business of in-
23       surance. Accordingly, each health organization should seek to maintain
24       capital above the RBC levels required by this act. Additional capital is
25       used and useful in the insurance business and helps to secure an insurer
26       health organization against various risks inherent in, or affecting, the
27       business of insurance and not accounted for or only partially measured
28       by the risk-based capital requirements contained in this act.
29             New Sec.  4. If a domestic health organization files an RBC report
30       which in the judgment of the commissioner is inaccurate, the commis-
31       sioner shall adjust the RBC report to correct the inaccuracy and shall
32       notify such health organization of the adjustment. The notice shall contain
33       a statement of the reason for the adjustment. A RBC report as so adjusted
34       is referred to as an adjusted RBC report.
35             New Sec.  5. ``Company action level event'' means any of the follow-
36       ing events:
37             (a) The filing of an RBC report by a health organization which indi-
38       cates that a health organization's total adjusted capital is greater than or
39       equal to its regulatory action level RBC but less than its company action
40       level RBC.
41             (b) The notification by the commissioner to the health organization
42       of an adjusted RBC report that indicates the event described in subsec-
43       tion (a), unless the health organization challenges the adjusted RBC re-


4

  1       port pursuant to section 19, and amendments thereto, and such challenge
  2       has not been rejected by the commissioner notification by the com-
  3       missioner to the health organization of an adjusted RBC report that
  4       indicates the event described in subsection (a) if:
  5             (1) The health organization does not challenge the adjusted
  6       RBC report pursuant to section 19, and amendments thereto; or
  7             (2) the commissioner has rejected such challenge after a
  8       hearing.
  9             New Sec.  6. In the event of a company action level event, the health
10       organization shall prepare and submit to the commissioner an RBC plan
11       which shall:
12             (a) Identify the conditions in the health organization's operation
13       which contribute to the company action level event;
14             (b) contain proposals of corrective actions which the health organi-
15       zation intends to take that would be expected to result in the elimination
16       of the company action level event;
17             (c) provide projections of the health organization's financial results in
18       the current year and at least the two succeeding years, both in the absence
19       of the proposed corrective actions and giving effect to the proposed cor-
20       rective actions, including projections of statutory balance sheets, oper-
21       ating income, net income, capital and surplus, and RBC levels. The pro-
22       jections for both new and renewal business may include separate
23       projections for each major line of business and separately identify each
24       significant income, expense and benefit component;
25             (d) identify the key assumptions impacting the health organization's
26       projections and the sensitivity of the projections to the assumptions; and
27             (e) identify the quality of, and problems associated with, the health
28       organization's business, including, but not limited to, its assets, antici-
29       pated business growth and associated surplus strain, extraordinary expo-
30       sure to risk, mix of business and use of reinsurance in each case, if any.
31             New Sec.  7. The RBC plan shall be submitted:
32             (a) Within 45 days of the company action level event; or
33             (b) within 45 days after notification to the health organization that
34       the commissioner has rejected the health organization's challenge to an
35       adjusted RBC report pursuant to section 19 and amendments thereto.
36             New Sec.  8. Within 60 days after the submission by a health organ-
37       ization of an RBC plan to the commissioner, the commissioner shall notify
38       the health organization whether the RBC plan shall be implemented or
39       is, in the judgment of the commissioner, unsatisfactory. If the commis-
40       sioner determines the RBC plan is unsatisfactory, the notification to the
41       health organization shall state the reasons for the determination, and may
42       state proposed revisions which, in the judgments of the commissioner,
43       will render the RBC plan satisfactory. Upon notification from the com-


5

  1       missioner, the health organization shall prepare a revised RBC plan and
  2       shall submit the revised RBC plan to the commissioner:
  3             (a) Within 45 days after the notification from the commissioner; or
  4             (b) within 45 days after a notification to the health organization that
  5       the commissioner has, pursuant to section 19, and amendments thereto,
  6       rejected the health organization's challenge to the commissioner's original
  7       findings as authorized by this section.
  8             New Sec.  9. In the event of a notification by the commissioner to a
  9       health organization that the health organization's RBC plan or revised
10       RBC plan is unsatisfactory, the commissioner, subject to the health or-
11       ganization's right to a hearing under section 19, and amendments thereto,
12       may specify in the notification that the notification constitutes a regulatory
13       action level event.
14             New Sec.  10. Every domestic health organization that files an RBC
15       plan or revised RBC plan with the commissioner shall file a copy of the
16       RBC plan or revised RBC plan with the insurance commissioner in any
17       state in which the health organization is authorized to do business if:
18             (a) Such state has an RBC provision substantially similar to section
19       20, and amendments thereto; and
20             (b) the insurance commissioner of that state has notified the health
21       organization of such insurance commissioner's request for the filing in
22       writing, in which case the health organization shall file a copy of the RBC
23       plan or revised RBC plan in that state no later than the later of:
24             (1) 15 days after the receipt of notice to file a copy of its RBC plan
25       or revised RBC plan with the state; or
26             (2) the date on which the final RBC plan or revised RBC plan is filed
27       under section 3 or 4 7 or 8, and amendments thereto.
28             New Sec.  11. ``Regulatory action level event'' means, with respect to
29       any health organization, any of the following events:
30             (a) The filing of an RBC report by the health organization which
31       indicates that the health organization's total adjusted capital is greater
32       than or equal to its authorized control level RBC but less than its regu-
33       latory action level RBC;
34             (b) the notification by the commissioner to a health organization of
35       an adjusted RBC report that indicates the result described in subsection
36       (a) if the health organization does not challenge the adjusted RBC report
37       pursuant to section 19, and amendments thereto;
38             (c) the filing of an adjusted RBC report that indicates the result de-
39       scribed in subsection (a) if the commissioner has rejected the health or-
40       ganization's challenge after a hearing held pursuant to K.S.A. 1999 Supp.
41       40-2c19, and amendments thereto the notification by the commis-
42       sioner to the health organization of an adjusted RBC report that
43       indicates the event described in subsection (a) if:


6

  1             (1) The health organization does not challenge the adjusted
  2       RBC report pursuant to section 19, and amendments thereto; or
  3             (2) the commissioner has rejected such challenge after a hear-
  4       ing; and;
  5             (d) (c) the failure of the health organization to file an RBC report by
  6       the filing date, unless the health organization has provided an explanation
  7       for such failure which is satisfactory to the commissioner and has cured
  8       the failure within 10 days after the filing date;
  9             (e) (d) the failure of the health organization to submit an RBC plan
10       to the commissioner within the time period set forth in section 7, and
11       amendments thereto;
12             (f) (e) notification by the commissioner to the health organization
13       that:
14             (1) The RBC plan or revised RBC plan submitted by the health or-
15       ganization is, in the judgment of the commissioner, unsatisfactory; and
16             (2) (A) the health organization has not challenged the determination
17       pursuant to section 19, and amendments thereto; or
18             (B) the commissioner has rejected such challenge.
19             (g) (f) Notification by the commissioner to the health organization
20       that the health organization has failed to adhere to its RBC plan or revised
21       RBC plan, but only if such failure has a substantial adverse effect on the
22       ability of the health organization to eliminate the company action level
23       event in accordance with its RBC plan or revised RBC plan and the
24       commissioner has so stated in the notification, if:
25             (1) The health organization has not challenged such determination
26       pursuant to section 19, and amendments thereto; or
27             (2) the commissioner has rejected such challenge after a hearing.
28             New Sec.  12. In the event of a regulatory action level event, the
29       commissioner shall:
30             (a) Require the health organization to prepare and submit an RBC
31       plan or, if applicable, a revised RBC plan;
32             (b) perform such examination or analysis as the commissioner deems
33       necessary of the assets, liabilities and operations of the health organization
34       including a review of its RBC plan or revised RBC plan; and
35             (c) subsequent to the examination or analysis, issue a corrective order
36       specifying such actions as the commissioner determines are required.
37             New Sec.  13. In determining corrective actions, the commissioner
38       may take into account such factors as are deemed relevant with respect
39       to the health organization based upon the commissioner's examination or
40       analysis of the assets, liabilities and operations of the health organization,
41       including, but not limited to, the results of any sensitivity tests undertaken
42       pursuant to the RBC instructions. The RBC plan or revised RBC plan
43       shall be submitted:


7

  1             (a) Within 45 days after the occurrence of the regulatory action level
  2       event;
  3             (b) within 45 days after the notification to the health organization
  4       that the commissioner has rejected the health organization's challenge to
  5       an adjusted RBC report pursuant to section 19, and amendments thereto;
  6       or
  7             (c) within 45 days after notification to the health organization that
  8       the commissioner has rejected the health organization's challenge to a
  9       revised RBC plan pursuant to section 19, and amendments thereto.
10             New Sec.  14. The commissioner may retain actuaries and investment
11       experts and other consultants as may be necessary in the judgment of the
12       commissioner to review the health organization's RBC plan or revised
13       RBC plan, examine or analyze the assets, liabilities and operations of the
14       health organization and formulate the corrective order with respect to
15       the health organization. The reasonable fees, costs and expenses relating
16       to consultants shall be borne by the affected health organization or other
17       party as directed by the commissioner.
18             New Sec.  15. ``Authorized control level event'' means any of the fol-
19       lowing events:
20             (a) The filing of an RBC report by the health organization which
21       indicates that the health organization's total adjusted capital is greater
22       than or equal to its mandatory control level RBC but less than its au-
23       thorized control level RBC;
24             (b) the notification by the commissioner to the health organization of
25       an adjusted RBC report that indicates the event described in subsection
26       (a) if:
27             (1) The health organization does not challenge the adjusted RBC re-
28       port pursuant to section 19, and amendments thereto; or
29             (2) the commissioner has rejected such challenge after a hearing;
30             (c) the failure of the health organization to respond, in a manner
31       satisfactory to the commissioner, to a corrective order if the health or-
32       ganization has not challenged the corrective order under section 19, and
33       amendments thereto; or
34             (d) if the commissioner has rejected the challenge to the corrective
35       order or modified the corrective order pursuant to section 19, and amend-
36       ments thereto, the failure of the health organization to respond, in a
37       manner satisfactory to the commissioner, to the corrective order subse-
38       quent to rejection or modification by the commissioner.
39             New Sec.  16. In the event of an authorized control level event with
40       respect to a health organization, the commissioner:
41             (a) Shall take such actions as are required under sections 11 through
42       14, and amendments thereto, regarding a health organization with respect
43       to which a regulatory action level event has occurred; or


8

  1             (b) if the commissioner deems it to be in the best interests of the
  2       policyholders and creditors of the health organization and of the public,
  3       shall take such actions as are necessary to cause the health organization
  4       to be placed under regulatory control pursuant to K.S.A. 40-3605 et seq.,
  5       and amendments thereto. In the event the commissioner takes such ac-
  6       tions, the authorized control level event shall be deemed sufficient
  7       grounds for the commissioner to take action under K.S.A. 40-3605 et seq.,
  8       and amendments thereto, and the commissioner shall have the rights,
  9       powers and duties with respect to the health organization as are set forth
10       in K.S.A. 40-3605 et seq., and amendments thereto. In the event the
11       commissioner takes actions under this subsection pursuant to an adjusted
12       RBC report, the health organization shall be entitled to such protections
13       as are afforded to health organizations under the provisions of K.S.A. 77-
14       501 et seq., and amendments thereto, pertaining to summar proceedings.
15             New Sec.  17. ``Mandatory control event'' means any of the following
16       events:
17             (a) The filing of an RBC report by the health organization which
18       indicates that the health organization's total adjusted capital is less than
19       its mandatory control level RBC;
20             (b) the notification by the commissioner to the health organization
21       of an adjusted RBC report that indicates the event described in subsec-
22       tion (a) if:
23             (1) The health organization does not challenge the adjusted RBC re-
24       port pursuant to section 19 and amendments thereto; or
25             (2) the commissioner has rejected such challenge.
26             New Sec.  18. In the event of a mandatory control level event the
27       commissioner shall take actions as are necessary to cause the health or-
28       ganization to be placed under regulatory control under K.S.A. 40-3605 et
29       seq., and amendments thereto. In that event, the mandatory control level
30       event shall be deemed sufficient grounds for the commissioner to take
31       action under K.S.A. 40-3605 et seq., and amendments thereto, and the
32       commissioner shall have the rights, powers and duties with respect to the
33       health organization as are set forth in K.S.A. 40-3605 et seq., and amend-
34       ments thereto. In the event the commissioner takes actions pursuant to
35       an adjusted RBC report, the health organization shall be entitled to such
36       protections as are afforded to health organizations under the provisions
37       of K.S.A. 77-501 et seq. and amendments thereto, pertaining to summary
38       proceedings. Notwithstanding any of the foregoing, the commissioner
39       may forego action for up to 90 days after the mandatory control level
40       event if there is a reasonable expectation that the mandatory control level
41       event may be eliminated within the 90-day period.
42             New Sec.  19. (a) Upon notification to a health organization by the
43       commissioner of an adjusted RBC report; or


9

  1             (b) upon notification to an health organization by the commissioner
  2       that:
  3             (1) The health organization's RBC plan or revised RBC plan is un-
  4       satisfactory; and
  5             (2) such notification constitutes a regulatory action level event with
  6       respect to such health organization; or
  7             (c) upon notification to any health organization by the commissioner
  8       that the health organization has failed to adhere to its RBC plan or revised
  9       RBC plan and that such failure has a substantial adverse effect on the
10       ability of the health organization to eliminate the company action level
11       event with respect to the health organization in accordance with its RBC
12       plan or revised RBC plan; or
13             (d) upon notification to an health organization by the commissioner
14       of a corrective order with respect to the health organization, the health
15       organization shall have the right to a hearing under the Kansas adminis-
16       trative procedure act, at which the health organization may challenge any
17       determination or action by the commissioner. The health organization
18       shall notify the commissioner of its request for a hearing within five days
19       after the notification by the commissioner under subsections (a), (b), (c)
20       or (d). Upon receipt of the health organization's request for a hearing,
21       the commissioner shall set a date for the hearing, which date shall be no
22       less than 10 nor more than 30 days after receipt of the health organiza-
23       tion's request. Such hearing shall be governed by K.S.A. 77-513 through
24       77-532 and amendments thereto.
25             New Sec.  20. (a) All RBC reports, RBC plans and any corrective
26       orders, including the working papers and the results of any analysis of a
27       health organization performed under this act shall be kept confidential
28       by the commissioner. This information shall not be made public or subject
29       to subpoena, other than by the commissioner and then only for the pur-
30       pose of enforcement actions taken by the commissioner pursuant to this
31       act or any other provision of the insurance laws of this state.
32             (b) RBC instructions, RBC reports, adjusted RBC reports, RBC
33       plans and revised RBC plans are intended solely for use by the commis-
34       sioner in monitoring the solvency of health organizations and the need
35       for possible corrective action with respect to health organizations and shall
36       not be used by the commissioner for ratemaking nor considered or intro-
37       duced as evidence in any rate proceeding nor used by the commissioner
38       to calculate or derive any elements of an appropriate premium level or
39       rate of return for any line of insurance which an health organization or
40       any affiliate is authorized to write.
41        (c)  (1) The commissioner may share or exchange any docu-
42       ments, materials or other information, including confidential and
43       privileged documents referred to in subsection (a), received in the


10

  1       performance of the commissioner's duties under this act, with:
  2             (A) The NAIC;
  3             (B) other state, federal or international regulatory agencies;
  4       and
  5             (C) other state, federal or international law enforcement
  6       authorities.
  7             (2)  (A) The sharing or exchanging of documents, materials or
  8       other information under this subsection shall be conditioned upon
  9       the recipient's authority and agreement to maintain the confidential
10       and privileged status, if any, of the documents, materials or other
11       information being shared or exchanged.
12             (B) No waiver of an existing privilege or claim of confidentiality
13       in the documents, materials or information shall occur as a result
14       of disclosure to the commissioner under this section or as a result
15       of sharing as authorized by paragraph (1) of subsection (c).
16             (3) The commissioner of insurance is hereby authorized to
17       adopt such rules and regulations establishing protocols governing
18       the exchange of information as may be necessary to implement and
19       carry out the provisions of this act.
20             New Sec.  21. The comparison of a health organization's total ad-
21       justed capital to any of its RBC levels is a regulatory tool, and shall not
22       be used to rank health organizations generally. Therefore, except as oth-
23       erwise required under the provisions of this act, the making, publishing,
24       disseminating, circulating or placing before the public, or causing, directly
25       or indirectly to be made, published, disseminated, circulated or placed
26       before the public, in a newspaper, magazine or other publication, or in
27       the form of a notice, circular, pamphlet, letter or poster, or over any radio
28       or television station, or in any other way, an advertisement, announce-
29       ment or statement containing an assertion, representation or statement
30       with regard to the RBC levels of any health organization, or of any com-
31       ponent derived in the calculation, by any health organization, agent, bro-
32       ker or other person engaged in any manner in the insurance business is
33       prohibited. Notwithstanding the foregoing, if any materially false state-
34       ment with respect to the comparison regarding a health organization's
35       total adjusted capital to any of its RBC levels or an inappropriate com-
36       parison of any other amount to the health organization's RBC levels is
37       published in any written publication and the health organization is able
38       to demonstrate to the commissioner with substantial proof the falsity or
39       misrepresentative nature of such statement, the health organization may
40       publish a rebuttal if the sole purpose of such publication is to rebut the
41       materially false or improper statement.
42             New Sec.  22. The provisions of this act are supplemental to any other
43       provisions of the laws of this state, and shall not preclude nor limit any


11

  1       other powers or duties of the commissioner under such laws, including
  2       but not limited to K.S.A. 40-3605 et seq. and amendments thereto.
  3             New Sec.  23. Any foreign health organization, upon the written re-
  4       quest of the commissioner, shall submit to the commissioner an RBC
  5       report as of the end of the calendar year just ended the later of:
  6             (a) The date an RBC report would be required to be filed by a do-
  7       mestic health organization under this act; or
  8             (b) 15 days after the request is received by the foreign health
  9       organization.
10             Any foreign health organization, at the written request of the commis-
11       sioner, shall submit promptly to the commissioner a copy of any RBC
12       plan that is filed with the insurance commissioner of any other state.
13             New Sec.  24. In the event of a company action level event, regulatory
14       action level event or authorized control level event with respect to any
15       foreign health organization as determined under the RBC statute appli-
16       cable in the state of domicile of the health organization or, if no RBC
17       provision is in force in that state, under the provisions of this act, if the
18       insurance commissioner of the state of domicile of the foreign health
19       organization fails to require the foreign health organization to file an RBC
20       plan in the manner specified under the RBC statute or, if there are no
21       RBC provisions in force in the state, under section 5, 6, 7, 8, 9 and 10,
22       and amendments thereto, the commissioner may require the foreign
23       health organization to file an RBC plan with the commissioner. In such
24       event, the failure of the foreign health organization to file an RBC plan
25       with the commissioner shall be grounds to order the health organization
26       to cease and desist from writing new insurance business in this state.
27             New Sec.  25. In the event of a mandatory control level event with
28       respect to any foreign health organization, if no domiciliary receiver has
29       been appointed with respect to the foreign health organization under the
30       rehabilitation and liquidation statute applicable in the state of domicile
31       of the foreign health organization, the commissioner may make applica-
32       tion to the district court as permitted under K.S.A. 40-3605 et seq. and
33       amendments thereto with respect to the liquidation of property of foreign
34       health organizations found in this state, and the occurrence of the man-
35       datory control level event shall be considered adequate grounds for the
36       application.
37             New Sec.  26. All notices by the commissioner to a health organiza-
38       tion which may result in regulatory action under this act shall be effective
39       upon dispatch if transmitted by registered or certified mail, or in the case
40       of any other transmission shall be effective upon the health organization's
41       receipt of such notice.
42             New Sec.  27. If any provision of this act, or the application of the act
43       to any person or circumstance, is held invalid, such determination shall


12

  1       not affect the provisions or applications of this act which can be given
  2       effect without the invalid provision or application, and to that end the
  3       provisions of this act are severable.
  4             New Sec.  28. Under this act, the RBC instructions, RBC reports,
  5       adjusted RBC reports, RBC plans and revised RBC plans are intended
  6       solely for use by the commissioner in monitoring the solvency of health
  7       organizations and the need for possible corrective action with respect to
  8       health organizations and shall not be:
  9             (a) Used by the commissioner for ratemaking;
10             (b) considered or introduced as evidence in any rate proceeding; or
11             (c) used by the commissioner to calculate or derive any elements of
12       an appropriate premium level or rate of return for any line of insurance
13       that a health organization or any affiliate is authorized to write.
14        New Sec.  28. (a) Any regulatory action based upon any RBC
15       report required to be filed by a health organization for such health
16       organization's operations during calendar years 2000 and 2001
17       shall be subject to the following:
18             (1) In the event of a company action level event with respect to
19       any health organization, the commissioner shall take no regulatory
20       action under this act with respect to such health organization.
21             (2) In the event of a regulatory action level event with respect
22       to any health organization under either subsection (a) or (b) of sec-
23       tion 11, and amendments thereto, the commissioner shall take such
24       action with respect to such health organization under sections 5
25       through 10, inclusive, and amendments thereto, as the commis-
26       sioner deems necessary.
27             (3) In the event of a regulatory action level event with respect
28       to any health organization under any of subsections (c), (d), (e) or
29       (f) of section 11, and amendments thereto, or an authorized control
30       level event, the commissioner shall take such action with respect to
31       such health organization under sections 11 through 14, inclusive,
32       and amendments thereto, as the commissioner deems necessary.
33             (4) In the event of a mandatory control level event with respect
34       to any health organization, the commissioner shall take action with
35       respect to such health organization as required under sections 15
36       and 16, and amendments thereto.
37             (b) The provisions of subsection (a) shall not limit the right of
38       the commissioner to proceed as authorized by any other provision
39       of chapter 40 of the Kansas Statutes Annotated, and amendments
40       thereto or any rule and regulation adopted thereunder.
41             New Sec.  29. The commissioner may adopt reasonable rules
42       and regulations necessary for the implementation of this act.
43             New Sec.  30. Sections 1 through 30, inclusive, and amendments


13

  1       thereto, shall constitute and may be cited as the health organization
  2       risk based capital act.
  3             New Sec.  29. 31. (a) If uncovered expenditures exceed eight percent
  4       10% of total health care expenditures for two consecutive months, a
  5       health maintenance organization shall place an uncovered expenditure
  6       insolvency deposit with the commissioner, with an organization or trustee
  7       acceptable to the commissioner through which a custodial or controlled
  8       account is maintained, cash or securities that are acceptable to the com-
  9       missioner. The deposit at all times shall have a fair market value in an
10       amount 120% of the health maintenance organization's outstanding lia-
11       bility for uncovered expenditures for enrollees in this state, including
12       incurred but not reported claims, and shall be calculated as of the first
13       day of the month and maintained for the remainder of the month. If a
14       health maintenance organization is not otherwise required to file a quar-
15       terly report, such health maintenance organization shall file a report
16       within 45 days of the end of the calendar quarter with information suf-
17       ficient to demonstrate compliance with this section.
18             (b) The deposit required under this section shall be in addition to the
19       deposit required under K.S.A. 40-3227, and amendments thereto, and
20       shall be deemed to be an admitted asset of the health maintenance or-
21       ganization in the determination of such health maintenance organization's
22       net worth. All income from deposits or trust accounts shall be deemed
23       to be assets of the health maintenance organization and may be withdrawn
24       from the deposit or account quarterly with the approval of the
25       commissioner.
26             (c) A health maintenance organization that has made a deposit may
27       withdraw that deposit or any part of the deposit if: (1) A substitute deposit
28       of cash or securities of equal amount and value is made; (2) the fair
29       market value of such substitute deposit exceeds the amount of the re-
30       quired deposit; or (3) the deposit required under subsection (a) is re-
31       duced or eliminated. Deposits, substitutions or withdrawals may be made
32       only with the prior written approval of the commissioner.
33             (d) The deposit required under this section shall be held in trust and
34       may be used only as provided under this section. The commissioner may
35       use all or any portion of the deposit of an insolvent health maintenance
36       organization for administrative costs associated with administering such
37       deposit and the payment of any claim of an enrollee of this state for
38       uncovered expenditures in this state. Each claim for uncovered expend-
39       itures shall be paid on a pro rata basis based on assets available to pay
40       the ultimate liability for incurred expenditures. A partial distribution may
41       be made pending final distribution. Any amount of such deposit remain-
42       ing shall be paid into the liquidation or receivership of the health main-
43       tenance organization.


14

  1             (e) The commissioner by regulation may prescribe the time, manner
  2       and form for filing claims under subsection (d).
  3             (f) The commissioner by regulation or order may require health
  4       maintenance organizations to file annual, quarterly or more frequent re-
  5       ports deemed necessary to demonstrate compliance with this section. The
  6       commissioner may require that the reports include liability for uncovered
  7       expenditures as well as an audit opinion.
  8             (g) The deposit required under this section may be satisfied through
  9       other arrangement acceptable to the commissioner including parental
10       guarantees and letters of credit.
11             (h) The commissioner may adopt rules and regulations to implement
12       this section.
13             New Sec.  30. 32. (a) In the event of an insolvency of a health main-
14       tenance organization, the commissioner may order that all other carriers
15       that participated in the enrollment process with the insolvent health main-
16       tenance organization at a group's last regular enrollment period shall offer
17       the group's enrollees of the insolvent health maintenance organization a
18       30-day enrollment period commencing upon the date of insolvency. Un-
19       der such order each carrier shall offer to each enrollee of the insolvent
20       health maintenance organization the same coverages that such insolvent
21       health maintenance organization had offered to each enrollee of the
22       group at such group's last regular enrollment period at rates determined
23       in accordance with the successor health maintenance organization's ex-
24       isting rating methodology.
25             (b) Any individual or enrollee who has health insurance coverage in-
26       voluntarily terminated because of the insolvency of such individual's or
27       enrollee's health maintenance organization shall be treated as the equiv-
28       alent of a federally defined eligible individual for the purposes of the
29       Kansas uninsurable health insurance plan act, K.S.A. 40-2117 et seq. and
30       amendments thereto.
31             New Sec.  31. 33. (a) A rehabilitation liquidation or conservation of
32       a health maintenance organization shall be deemed to be the rehabilita-
33       tion, liquidation or conservation of an insurance company and shall be
34       conducted under the supervision of the commissioner pursuant to the law
35       governing the rehabilitation, liquidation or conservation of insurance
36       companies. The commissioner may apply for an order directing the com-
37       missioner to rehabilitate, liquidate or conserve a health maintenance or-
38       ganization upon any one or more grounds set out in the insurers super-
39       vision, rehabilitation and liquidation act, K.S.A. 40-3605 et seq., and
40       amendments thereto, or when in the commissioner's discretion the con-
41       tinued operation of such health maintenance organization would be haz-
42       ardous either to the enrollees of such health maintenance organization or
43       to the people of this state. Each enrollee of such health maintenance


15

  1       organization shall have the same priority in the event of liquidation or
  2       rehabilitation as the law provides to policy holders of an health
  3       organization.
  4             (b) For purpose of determining the priority of distribution of general
  5       assets, any claim of any enrollee or enrollees' beneficiary shall have the
  6       same priority as established by K.S.A. 40-3641, and amendments thereto,
  7       for policyholders and beneficiaries of insureds of insurance companies. If
  8       an enrollee is liable to a nonparticipating provider for services provided
  9       pursuant to and covered by the health maintenance organization, such
10       liability shall have the status of such enrollee's claim for distribution of
11       general assets. A provider who is obligated by statute or agreement to
12       hold any enrollee harmless from liability for services provided pursuant
13       to and covered by a health maintenance organization shall have a priority
14       of distribution of the general assets immediately following that of enroll-
15       ees and enrollees' beneficiaries as described herein, and immediately pre-
16       ceding the priority of distribution described in subsection (d) of K.S.A.
17       40-3641 and amendments thereto.
18             New Sec.  32. 34. (a) Whenever the commissioner determines that
19       the financial condition of a health maintenance organization is such that
20       its continued operation might be hazardous to its enrollees, creditors or
21       the general public, or that such health maintenance organization has vi-
22       olated any provisions of this act, the commissioner, after notice and hear-
23       ing, may order such health maintenance organization to take action rea-
24       sonably necessary to rectify the condition or violation. Such action may
25       include, but not limited to one or more of the following:
26             (1) Reduce the total amount of present and potential liability for ben-
27       efits by reinsurance or other method acceptable to the commissioner;
28             (2) reduce the volume of any new business being accepted;
29             (3) reduce expenses by specified methods acceptable to the
30       commissioner;
31             (4) suspend or limit the writing of any new business for a period of
32       time;
33             (5) increase the health maintenance organization's capital and surplus
34       by contribution; or
35             (6) take such other steps the commissioner may deem appropriate
36       under the circumstances.
37             (b) The commissioner may adopt rules and regulations which set uni-
38       form standards and criteria for early warning that the continued operation
39       of any health maintenance organization might be hazardous to its enroll-
40       ees, creditors or the general public and set standards for evaluating the
41       financial condition of any health maintenance organization.
42             New Sec.  33. (a) When a health maintenance organization in this
43       state is declared insolvent by a court of competent jurisdiction, the com-


16

  1       missioner may levy an assessment on any or all other health maintenance
  2       organizations doing business in this state to pay claims for uncovered
  3       expenditures for subscribers or enrollees of such insolvent health main-
  4       tenance organization who are residents of this state and to provide con-
  5       tinuation of coverage for such subscribers or enrollees. The commissioner
  6       may not assess in any one calendar year more than two percent of the
  7       aggregate premium written by each health maintenance organization in
  8       this state for the prior calendar year.
  9             (b) The commissioner may use funds obtained under subsection (a)
10       to pay claims for uncovered expenditures for subscribers or enrollees for
11       an insolvent health maintenance organization who are residents of this
12       state, provide for continuation of coverage for subscribers or enrollees
13       who are residents of this state, and administrative costs. The commis-
14       sioner by regulation may prescribe the time, manner and form for filing
15       claims under this section or may require claims to be allowed by any
16       ancillary receiver or the domestic liquidator or receiver of such insolvent
17       health maintenance organization.
18             (c) (1) A receiver or liquidator of an insolvent health maintenance or-
19       ganization shall allow a claim in the proceeding in an amount equal to
20       the administrative costs and any uncovered expenditures paid under this
21       section.
22             (2) Any person receiving benefits under this section for uncovered
23       expenditures shall be deemed to have assigned to the commissioner such
24       person's rights under the covered health care plan certificates to the ex-
25       tent of the benefits received. The commissioner may require an assign-
26       ment to it of such rights by any payee, enrollee, or beneficiary as a con-
27       dition precedent to the receipt of any rights or benefits conferred by the
28       section upon that person. The commissioner shall be subrogated to these
29       rights against the assets of an insolvent health maintenance organization
30       held by a receiver or liquidator of another jurisdiction.
31             (3) The assignment of subrogation rights of the commissioner and
32       allowed claims under this subsection have the same priority against the
33       assets of the insolvent health maintenance organization as those possessed
34       by any person entitled to receive benefits under this section or for similar
35       expenses in the receivership or liquidation.
36             (d) When assessed funds are unused following the completion of the
37       liquidation of a health maintenance organization, the commissioner shall
38       distribute to the health maintenance organizations that have been as-
39       sessed under this section on a pro rata basis any amounts received under
40       subsection (a) which are not de minimis.
41             (e) The aggregate coverage of uncovered expenditures under this sec-
42       tion shall not exceed $300,000 with respect to one individual. Any con-
43       tinuation of coverage shall not continue for more than:


17

  1             (1) The lesser of one year after the health maintenance organization
  2       coverage is terminated by insolvency; or
  3             (2) the remaining term of the contract. The commissioner may pro-
  4       vide continuation of coverage of any reasonable basis, including, but not
  5       limited to, continuation of the health maintenance organization contract
  6       or substitution of indemnity coverage in a form determined by the
  7       commissioner.
  8             (f) The commissioner may waive an assessment of a health mainte-
  9       nance organization if such health maintenance organization would be or
10       is impaired or placed in financially hazardous condition. Any health main-
11       tenance organization which fails, within 30 days after notice, to pay any
12       assessment made under this section shall be subject to a civil forfeiture
13       of not more than $1,000 per day and suspension or revocation of its cer-
14       tificate of authority. Any health maintenance organization which is af-
15       fected by an action taken by the commissioner to enforce the provisions
16       of this section shall be given an opportunity for a hearing in accordance
17       with the provisions of the Kansas administrative procedures act.
18             (g) The commissioner may establish a health maintenance organiza-
19       tion assessment oversight board which shall be activated only when a
20       health maintenance organization has been declared insolvent and an as-
21       sessment will be levied against health maintenance organizations doing
22       business in this state. The commissioner shall:
23             (1) Request that members of the health maintenance organization
24       industry submit the names and qualifications of persons who are inter-
25       ested in serving on the health maintenance organization assessment over-
26       sight assessment board;
27             (2) select four members from among the names submitted in para-
28       graph (1);
29             (3) select one member from the general public, not identified with
30       the managed care or health insurance industry;
31             (4) designate two classes of assessment, one for the purpose of meet-
32       ing administrative and legal costs and one necessary to carry out the pow-
33       ers and duties of the health maintenance organization assessment board
34       with regard to the insolvent health maintenance organization.
35             (h) The health maintenance organization assessment board shall be
36       deactivated when the assessment is complete and the commissioner de-
37       termines that such board has fully discharged its responsibilities.
38             (i) The commissioner may adopt rules and regulations necessary to
39       carry out the provisions of this section.
40             New Sec.  34. The provisions of this act are supplemental to any other
41       provisions of the laws of this state and shall not preclude or limit any
42       other powers or duties of the commissioner under such laws including,
43       but not limited to, K.S.A. 40-3605 et seq., and amendments thereto.


18

  1             New Sec.  35. The commissioner may adopt reasonable rules and reg-
  2       ulations necessary for the implementation of this act.
  3             New Sec.  36. Sections 1 through 30, inclusive, and amendments
  4       thereto shall constitute and may be cited as the health organization sol-
  5       vency act Sections 31 through 34, and amendments thereto, shall be
  6       part of and supplemental to the health maintenance organization
  7       act cited at K.S.A. 40-3201 et seq., and amendments thereto.
  8             Sec.  37. 35 K.S.A. 1999 Supp. 40-3202 is hereby amended to read
  9       as follows: 40-3202. As used in this act:
10             (a) ``Commissioner'' means the commissioner of insurance of the
11       state of Kansas.
12             (b) ``Basic health care services'' means but is not limited to usual
13       physician, hospitalization, laboratory, x-ray, emergency and preventive
14       services and out-of-area coverage.
15             (c) ``Capitated basis'' means a fixed per member per month payment
16       or percentage of premium payment wherein the provider assumes risk
17       for the cost of contracted services without regard to the type, value or
18       frequency of services provided. For purposes of this definition, capitated
19       basis includes the cost associated with operating staff model facilities.
20        (d) ``Carrier'' means a health maintenance organization, an in-
21       surer, a nonprofit hospital and medical service corporation, or
22       other entity responsible for the payment of benefits or provision of
23       services under a group contract.
24             (d) (e) ``Certificate of coverage'' means a statement of the essential
25       features and services of the health maintenance organization coverage
26       which is given to the subscriber by the health maintenance organization,
27       medicare provider organization or by the group contract holder.
28             (e) (f) ``Copayment'' means an amount an enrollee must pay in order
29       to receive a specific service which is not fully prepaid.
30             (f) (g) ``Deductible'' means an amount an enrollee is responsible to
31       pay out-of-pocket before the health maintenance organization begins to
32       pay the costs associated with treatment.
33             (g) (h) ``Director'' means the secretary of health and environment.
34             (h) (i) ``Disability'' means an injury or illness that results in a sub-
35       stantial physical or mental limitation in one or more major life activities
36       such as working or independent activities of daily living that a person was
37       able to do prior to the injury or illness.
38             (i) (j) ``Enrollee'' means a person who has entered into a contractual
39       arrangement or on whose behalf a contractual arrangement has been
40       entered into with a health maintenance organization or the medicare pro-
41       vider organization for health care services.
42             (j) (k) ``Grievance'' means a written complaint submitted in accord-
43       ance with the formal grievance procedure by or on behalf of the enrollee


19

  1       regarding any aspect of the health maintenance organization or the med-
  2       icare provider organization relative to the enrollee.
  3             (k) (l) ``Group contract'' means a contract for health care services
  4       which by its terms limits eligibility to members of a specified group. The
  5       group contract may include coverage for dependents.
  6             (l) (m) ``Group contract holder'' means the person to which a group
  7       contract has been issued.
  8             (m) (n) ``Health care services'' means basic health care services and
  9       other services, medical equipment and supplies which may include, but
10       are not limited to, medical, surgical and dental care; psychological, ob-
11       stetrical, osteopathic, optometric, optic, podiatric, nursing, occupational
12       therapy services, physical therapy services, chiropractic services and phar-
13       maceutical services; health education, preventive medical, rehabilitative
14       and home health services; inpatient and outpatient hospital services, ex-
15       tended care, nursing home care, convalescent institutional care, labora-
16       tory and ambulance services, appliances, drugs, medicines and supplies;
17       and any other care, service or treatment for the prevention, control or
18       elimination of disease, the correction of defects or the maintenance of
19       the physical or mental well-being of human beings.
20             (n) ``Health Carrier'' means a person that undertakes to provide or
21       arrange for the delivery of basic health care services to enrollees on a
22       prepaid basis, except for enrollee responsibility for copayments or deduc-
23       tibles or both. Insurers subject ot K.S.A. 40-3001 et seq., and amendments
24       thereto, and dental service corporations as defined in K.S.A. 40-19a01 et
25       seq., and amendments thereto, shall not be considered health carriers for
26       the purposes of this act.
27             (o) ``Health maintenance organization'' means an organization which:
28             (1) Provides or otherwise makes available to enrollees health care
29       services, including at a minimum those basic health care services which
30       are determined by the commissioner to be generally available on an in-
31       sured or prepaid basis in the geographic area served;
32             (2) is compensated, except for reasonable copayments, for the pro-
33       vision of basic health care services to enrollees solely on a predetermined
34       periodic rate basis;
35             (3) provides physician services directly through physicians who are
36       either employees or partners of such organization or under arrangements
37       with a physician or any group of physicians or under arrangements as an
38       independent contractor with a physician or any group of physicians;
39             (4) is responsible for the availability, accessibility and quality of the
40       health care services provided or made available.
41             (o) (p) ``Individual contract'' means a contract for health care services
42       issued to and covering an individual. The individual contract may include
43       dependents of the subscriber.


20

  1             (p) (q) ``Individual practice association'' means a partnership, corpo-
  2       ration, association or other legal entity which delivers or arranges for the
  3       delivery of basic health care services and which has entered into a services
  4       arrangement with persons who are licensed to practice medicine and
  5       surgery, dentistry, chiropractic, pharmacy, podiatry, optometry or any
  6       other health profession and a majority of whom are licensed to practice
  7       medicine and surgery. Such an arrangement shall provide:
  8             (1) That such persons shall provide their professional services in ac-
  9       cordance with a compensation arrangement established by the entity; and
10             (2) to the extent feasible for the sharing by such persons of medical
11       and other records, equipment, and professional, technical and adminis-
12       trative staff.
13             (q) (r) ``Medical group'' or ``staff model'' means a partnership, asso-
14       ciation or other group:
15             (1) Which is composed of health professionals licensed to practice
16       medicine and surgery and of such other licensed health professionals,
17       including but not limited to dentists, chiropractors, pharmacists, optom-
18       etrists and podiatrists as are necessary for the provision of health services
19       for which the group is responsible;
20             (2) a majority of the members of which are licensed to practice med-
21       icine and surgery; and
22             (3) the members of which: (A) As their principal professional activity
23       over 50% individually and as a group responsibility are engaged in the
24       coordinated practice of their profession for a health maintenance organ-
25       ization; (B) pool their income and distribute it among themselves accord-
26       ing to a prearranged salary or drawing account or other plan, or are sal-
27       aried employees of the health maintenance organization; (C) share
28       medical and other records and substantial portions of major equipment
29       and of professional, technical and administrative staff; and (D) establish
30       an arrangement whereby the enrollee's enrollment status is not known to
31       the member of the group who provides health services to the enrollee.
32             (r) (s) ``Medicare provider organization'' means an organization
33       which:
34             (1) Is a provider-sponsored organization as defined by Section 4001
35       of the Balanced Budget Act of 1997 (PL 105-33); and
36             (2) provides or otherwise makes available to enrollees basic health
37       care services pursuant to Section 4001 of the Balanced Budget Act of
38       1997 (PL 105-33).
39             (s) (t) ``Net worth'' means the excess of assets over liabilities as de-
40       termined by the commissioner from the latest annual report filed pur-
41       suant to K.S.A. 40-3220 and amendments thereto.
42             (t) (u) ``Person'' means any natural or artificial person including but
43       not limited to individuals, partnerships, associations, trusts or


21

  1       corporations.
  2             (u) (v) ``Physician'' means a person licensed to practice medicine and
  3       surgery under the healing arts act.
  4             (v) (w) ``Provider'' means any physician, hospital or other person
  5       which is licensed or otherwise authorized in this state to furnish health
  6       care services.
  7             (w) (x) ``Uncovered expenditures'' means the costs of health care
  8       services that are covered by a health maintenance organization for which
  9       an enrollee would also be liable in the event of the organization's insol-
10       vency as determined by the commissioner from the latest annual state-
11       ment filed pursuant to K.S.A. 40-3220 and amendments thereto and
12       which are not guaranteed, insured or assumed by any person or organi-
13       zation other than the health carrier.
14             Sec.  38. 36. K.S.A. 1999 Supp. 40-3209 is hereby amended to read
15       as follows: 40-3209. (a) All forms of group and individual certificates of
16       coverage and contracts issued by the organization to enrollees or other
17       marketing documents purporting to describe the organization's health
18       care services shall contain as a minimum:
19             (1) A complete description of the health care services and other ben-
20       efits to which the enrollee is entitled;
21             (2) The locations of all facilities, the hours of operation and the serv-
22       ices which are provided in each facility in the case of individual practice
23       associations or medical staff and group practices, and, in all other cases,
24       a list of providers by specialty with a list of addresses and telephone
25       numbers;
26             (3) the financial responsibilities of the enrollee and the amount of
27       any deductible, copayment or coinsurance required;
28             (4) all exclusions and limitations on services or any other benefits to
29       be provided including any deductible or copayment feature and all re-
30       strictions relating to pre-existing conditions;
31             (5) all criteria by which an enrollee may be disenrolled or denied re-
32       enrollment;
33             (6) service priorities in case of epidemic, or other emergency condi-
34       tions affecting demand for medical services;
35             (7) in the case of a health maintenance organization, a provision that
36       an enrollee or a covered dependent of an enrollee whose coverage under
37       a health maintenance organization group contract has been terminated
38       for any reason but who remains in the service area and who has been
39       continuously covered by the health maintenance organization for at least
40       three months shall be entitled to obtain a converted contract or have such
41       coverage continued under the group contract for a period of six months
42       following which such enrollee or dependent shall be entitled to obtain a
43       converted contract in accordance with the provisions of this section. The


22

  1       converted contract shall provide coverage at least equal to the conversion
  2       coverage options generally available from insurers or mutual nonprofit
  3       hospital and medical service corporations in the service area at the ap-
  4       plicable premium cost. The group enrollee or enrollees shall be solely
  5       responsible for paying the premiums for the alternative coverage. The
  6       frequency of premium payment shall be the frequency customarily re-
  7       quired by the health maintenance organization, mutual nonprofit hospital
  8       and medical service corporation or insurer for the policy form and plan
  9       selected, except that the insurer, mutual nonprofit hospital and medical
10       service corporation or health maintenance organization shall require pre-
11       mium payments at least quarterly. The coverage shall be available to all
12       enrollees of any group without medical underwriting. The requirement
13       imposed by this subsection shall not apply to a contract which provides
14       benefits for specific diseases or for accidental injuries only, nor shall it
15       apply to any employee or member or such employee's or member's cov-
16       ered dependents when:
17             (A) Such person was terminated for cause as permitted by the group
18       contract approved by the commissioner;
19             (B) any discontinued group coverage was replaced by similar group
20       coverage within 31 days; or
21             (C) the employee or member is or could be covered by any other
22       insured or noninsured arrangement which provides expense incurred hos-
23       pital, surgical or medical coverage and benefits for individuals in a group
24       under which the person was not covered prior to such termination. Writ-
25       ten application for the converted contract shall be made and the first
26       premium paid not later than 31 days after termination of the group cov-
27       erage or receipt of notice of conversion rights from the health mainte-
28       nance organization, whichever is later, and shall become effective the day
29       following the termination of coverage under the group contract. The
30       health maintenance organization shall give the employee or member and
31       such employee's or member's covered dependents reasonable notice of
32       the right to convert at least once within 30 days of termination of coverage
33       under the group contract. The group contract and certificates may include
34       provisions necessary to identify or obtain identification of persons and
35       notification of events that would activate the notice requirements and
36       conversion rights created by this section but such requirements and rights
37       shall not be invalidated by failure of persons other than the employee or
38       member entitled to conversion to comply with any such provisions. In
39       addition, the converted contract shall be subject to the provisions con-
40       tained in paragraphs (2), (4), (5), (6), (7), (8), (9), (13), (14), (15), (16),
41       (17) and (19) of subsection (j) of K.S.A. 40-2209, and amendments
42       thereto;
43             (8)  (A) group contracts shall contain a provision extending payment


23

  1       of such benefits until discharged or for a period not less than 31 days
  2       following the expiration date of the contract, whichever is earlier, for
  3       covered enrollees and dependents confined in a hospital on the date of
  4       termination;
  5             (B) a provision that coverage under any subsequent replacement con-
  6       tract that is intended to afford continuous coverage will commence im-
  7       mediately following expiration of any prior contract with respect to cov-
  8       ered services not provided pursuant to subparagraph (8)(A); and
  9             (9) an individual contract shall provide for a 10-day period for the
10       enrollee to examine and return the contract and have the premium re-
11       funded, but if services were received by the enrollee during the 10-day
12       period, and the enrollee returns the contract to receive a refund of the
13       premium paid, the enrollee must pay for such services.
14             (b) No health maintenance organization or medicare provider organ-
15       ization authorized under this act shall contract with any provider under
16       provisions which require enrollees to guarantee payment, other than co-
17       payments and deductibles, to such provider in the event of nonpayment
18       by the health maintenance organization or medicare provider organiza-
19       tion for any services which have been performed under contracts between
20       such enrollees and the health maintenance organization or medicare pro-
21       vider organization. Further, any contract between a health maintenance
22       organization or medicare provider organization and a provider shall pro-
23       vide that if the health maintenance organization or medicare provider
24       organization fails to pay for covered health care services as set forth in
25       the contract between the health maintenance organization or medicare
26       provider organization and its enrollee, the enrollee or covered dependents
27       shall not be liable to any provider for any amounts owed by the health
28       maintenance organization or medicare provider organization. If there is
29       no written contract between the health maintenance organization or med-
30       icare provider organization and the provider or if the written contract fails
31       to include the above provision, the enrollee and dependents are not liable
32       to any provider for any amounts owed by the health maintenance organ-
33       ization or medicare provider organization. Any action by a provider to
34       collect or attempt to collect from a subscriber or enrollee any sum owed
35       by the health maintenance organization to a provider shall be deemed to
36       be an unconscionable act within the meaning of K.S.A. 50-627 and amend-
37       ments thereto.
38             (c) No group or individual certificate of coverage or contract form or
39       amendment to an approved certificate of coverage or contract form shall
40       be issued unless it is filed with the commissioner. Such contract form or
41       amendment shall become effective within 30 days of such filing unless
42       the commissioner finds that such contract form or amendment does not
43       comply with the requirements of this section.


24

  1             (d) Every contract shall include a clear and understandable descrip-
  2       tion of the health maintenance organization's or medicare provider or-
  3       ganization's method for resolving enrollee grievances.
  4             (e) The provisions of subsections (A), (B), (C), (D) and (E) of K.S.A.
  5       40-2209 and 40-2215 and amendments thereto shall apply to all contracts
  6       issued under this section, and the provisions of such sections shall apply
  7       to health maintenance organizations.
  8             (f)  In lieu of any of the requirements of subsection (a), the commis-
  9       sioner may accept certificates of coverage issued by a medicare provider
10       organization in conformity with requirements imposed by any appropriate
11       federal regulatory agency.
12             Sec.  39. 37. K.S.A. 1999 Supp. 40-3220 is hereby amended to read
13       as follows: 40-3220. Every health maintenance organization and medicare
14       provider organization authorized under this act shall annually on or before
15       the first day of March, file a verified report with the commissioner, show-
16       ing its condition on the last day of the preceding calendar year, on forms
17       prescribed by the commissioner. Such report shall include:
18             (a) A financial statement of the organization, including its balance
19       sheet and receipts and disbursements for the preceding year; and
20             (b) such other information relating to the performance of health
21       maintenance organizations as shall be required by the commissioner.
22       Every health maintenance organization and medicare provider organi-
23       zation authorized under this act shall be subject to the provisions of K.S.A.
24       40-225 and amendments thereto.
25             Sec.  40. 38. K.S.A. 1999 Supp. 40-3227 is hereby amended to read
26       as follows: 40-3227. (a) Before Except as provided in paragraph (e),
27       before issuing any certificate of authority, the commissioner shall require
28       that the health maintenance organization have an initial net worth of
29       $1,500,000 and shall thereafter maintain the minimum net worth required
30       under subsection (b).
31             (b) Except as provided in subsections (c) and (d) of this section, every
32       health maintenance organization shall maintain a minimum net worth
33       equal to the greater of:
34             (1) $1,000,000; or
35             (2) two percent of annual premium revenues as reported on the most
36       recent annual financial statement filed with the commissioner on the first
37       $150,000,000 of premium and 1% of annual premium on the premium in
38       excess of $150,000,000; or
39             (3) an amount equal to the sum of three months uncovered health
40       care expenditures as reported on the most recent financial statement filed
41       with the commissioner; or
42             (4) an amount equal to the sum of:
43             (A) Eight percent of annual health care expenditures except those paid


25

  1       on a capitated basis or managed hospital payment basis as reported on
  2       the most recent financial statement filed with the commissioner; and
  3             (B) four percent of annual hospital expenditures paid on a managed
  4       hospital payment basis as reported on the most recent financial statement
  5       filed with the commissioner.
  6             (c) A health maintenance organization licensed on or before the day
  7       preceding the effective date of this section must maintain a minimum net
  8       worth of:
  9             (1) Twenty-five percent of the amount required by subsection (b) by
10       December 31, 2000;
11             (2) 50% of the amount required by subsection (b) by December 31,
12       2001;
13             (3) 75% of the amount required by subsection (b) by December 31,
14       2002; and
15             (4) 100% of the amount required by subsection (b) by December 31,
16       2003.
17             (d) In determining net worth, no debt shall be considered fully sub-
18       ordinated unless the subordination clause is in a form acceptable to the
19       commissioner. An interest obligation relating to the repayment of any
20       subordinated debt shall be similarly subordinated. The interest expenses
21       relating to the repayment of a fully subordinated debt shall be considered
22       covered expenses. A debt incurred by a note meeting the requirements of
23       this section, and otherwise acceptable to the commissioner, shall not be
24       considered a liability and shall be recorded as equity.
25        (e) The net worth requirements of subsections (a) through (d)
26       shall not apply to any health organization contracting with the Kan-
27       sas department of social and rehabilitation services to provide serv-
28       ices provided under title XIX and title XXI of the social security act
29       or any other public benefits, provided the public benefit contracts
30       represent at least 90% of the premium volume of the health
31       organization.
32             (e) (f)  Unless otherwise provided below, each health maintenance
33       organization do ing business in this state shall deposit with any organi-
34       zation or trustee acceptable to the commissioner through which a cus-
35       todial or controlled account is utilized, cash, securities or any combination
36       of these or other measures, for the benefit of all of the enrollees of the
37       health maintenance organization, that are acceptable in the amount of
38       $150,000 for a medical group or staff model health maintenance organi-
39       zation or $300,000 for an individual practice association.
40             (b) (f) (g) The commissioner may waive any of the deposit require-
41       ments set forth in subsection (a) (f) whenever satisfied that: (1) The or-
42       ganization has sufficient net worth and an adequate history of generating
43       net income to assure its financial viability for the next year; or (2) the


26

  1       organization's performance and obligations are guaranteed by an organ-
  2       ization with sufficient net worth and an adequate history of generating
  3       net income; or (3) the assets of the organization or its contracts with
  4       insurers, hospital or medical service corporations, governments or other
  5       organizations are reasonably sufficient to assure the performance of its
  6       obligations.
  7             (c) When an organization has achieved a net worth not including land,
  8       buildings and equipment of at least $1,000,000 or has achieved a net
  9       worth including land, buildings and equipment of at least $5,000,000, the
10       annual deposit requirement shall not apply.
11             (d) If the organization has a guaranteeing organization which has
12       been in operation for at least five years and has a net worth not including
13       land, buildings and equipment of at least $1,000,000 or which has been
14       in operation for at least 10 years and has a net worth including land,
15       buildings and equipment of at least $5,000,000, the annual deposit re-
16       quirement shall not apply. If the guaranteeing organization is sponsoring
17       more than one organization, the net worth requirement shall be increased
18       by a multiple equal to the number of such organizations. This require-
19       ment to maintain a deposit in excess of the deposit required of an accident
20       and health insurer shall not apply during any time that the guaranteeing
21       organization maintains for each organization it sponsors a net worth at
22       least equal to the capital and surplus requirements set forth in article 11
23       of chapter 40 of the Kansas Statutes Annotated for an accident and health
24       insurer.
25             (e) (g) (h) The deposit requirements imposed by this act shall not
26       apply to health maintenance organizations not organized under the laws
27       of this state to the extent an amount equal to or exceeding that required
28       by this act has been deposited with the commissioner or an organization
29       or trustee acceptable to the department of insurance of its state of dom-
30       icile for the benefit of Kansas enrollees.
31             (f) (h) (i) All income from deposits shall belong to the depositing
32       organization and shall be paid to it as it becomes available. A health main-
33       tenance organization that has made a securities deposit may withdraw
34       that deposit or any part thereof after making a substitute deposit of cash,
35       securities or any combination of these or other measures of equal amount
36       and value. Any securities shall be approved by the commissioner before
37       being substituted.
38             (i) (j) Every health maintenance organization, when determining li-
39       ability, shall include an amount estimated in the aggregate to provide for
40       any unearned premium and for the payment of all claims for health care
41       expenditures that have been incurred, whether reported or unreported,
42       that are unpaid and for which the organization is or may be liable, and
43       to provide for the expense of adjustment or settlement of those claims.


27

  1             (g) (j) (k) The commissioner shall require that each health mainte-
  2       nance organization have a plan for handling insolvency which allows for
  3       continuation of benefits for the duration of the contract period for which
  4       premiums have been paid and continuation of benefits to members who
  5       are confined on the date of insolvency in an inpatient facility until their
  6       discharge or expiration of benefits. In considering such a plan, the com-
  7       missioner may require:
  8             (1) Insurance to cover the expenses to be paid for continued benefits
  9       after an insolvency;
10             (2) provisions in provider contracts that obligate the provider to pro-
11       vide services for the duration of the period after the health maintenance
12       organization's insolvency for which premium payment has been made and
13       until the enrollees' discharge from inpatient facilities;
14             (3) insolvency reserves;
15             (4) acceptable letters of credit; or
16             (5) any other arrangements to assure that benefits are continued as
17       specified in this subsection (g) (j).
18             Sec.  41. 39. K.S.A. 1999 Supp. 40-3606 is hereby amended to read
19       as follows: 40-3606. This act shall apply to all insurance companies, fra-
20       ternal benefit societies, health maintenance organization organizations,
21       reciprocal insurance exchanges, mutual nonprofit hospital and medical
22       service corporations, captive insurance companies, group funded pools
23       except municipal group funded pools governed by K.S.A. 12-2616
24       through 12-2629 and amendments thereto, prepaid service plans oper-
25       ating under article 19a of chapter 40 of the Kansas Statutes Annotated,
26       regardless of whether such entities are authorized to do business in this
27       state, and such entities which are in the process of organization.
28             Sec.  42. 40. K.S.A. 1999 Supp. 45-221 is hereby amended to read as
29       follows: 45-221. (a) Except to the extent disclosure is otherwise required
30       by law, a public agency shall not be required to disclose:
31             (1) Records the disclosure of which is specifically prohibited or re-
32       stricted by federal law, state statute or rule of the Kansas supreme court
33       or the disclosure of which is prohibited or restricted pursuant to specific
34       authorization of federal law, state statute or rule of the Kansas supreme
35       court to restrict or prohibit disclosure.
36             (2) Records which are privileged under the rules of evidence, unless
37       the holder of the privilege consents to the disclosure.
38             (3) Medical, psychiatric, psychological or alcoholism or drug depend-
39       ency treatment records which pertain to identifiable patients.
40             (4) Personnel records, performance ratings or individually identifia-
41       ble records pertaining to employees or applicants for employment, except
42       that this exemption shall not apply to the names, positions, salaries and
43       lengths of service of officers and employees of public agencies once they


28

  1       are employed as such.
  2             (5) Information which would reveal the identity of any undercover
  3       agent or any informant reporting a specific violation of law.
  4             (6) Letters of reference or recommendation pertaining to the char-
  5       acter or qualifications of an identifiable individual.
  6             (7) Library, archive and museum materials contributed by private
  7       persons, to the extent of any limitations imposed as conditions of the
  8       contribution.
  9             (8) Information which would reveal the identity of an individual who
10       lawfully makes a donation to a public agency, if anonymity of the donor
11       is a condition of the donation.
12             (9) Testing and examination materials, before the test or examination
13       is given or if it is to be given again, or records of individual test or ex-
14       amination scores, other than records which show only passage or failure
15       and not specific scores.
16             (10) Criminal investigation records, except that the district court, in
17       an action brought pursuant to K.S.A. 45-222, and amendments thereto,
18       may order disclosure of such records, subject to such conditions as the
19       court may impose, if the court finds that disclosure:
20             (A) Is in the public interest;
21             (B) would not interfere with any prospective law enforcement action;
22             (C) would not reveal the identity of any confidential source or un-
23       dercover agent;
24             (D) would not reveal confidential investigative techniques or proce-
25       dures not known to the general public;
26             (E) would not endanger the life or physical safety of any person; and
27             (F) would not reveal the name, address, phone number or any other
28       information which specifically and individually identifies the victim of any
29       sexual offense in article 35 of chapter 21 of the Kansas Statutes Anno-
30       tated, and amendments thereto.
31             (11) Records of agencies involved in administrative adjudication or
32       civil litigation, compiled in the process of detecting or investigating vio-
33       lations of civil law or administrative rules and regulations, if disclosure
34       would interfere with a prospective administrative adjudication or civil
35       litigation or reveal the identity of a confidential source or undercover
36       agent.
37             (12) Records of emergency or security information or procedures of
38       a public agency, or plans, drawings, specifications or related information
39       for any building or facility which is used for purposes requiring security
40       measures in or around the building or facility or which is used for the
41       generation or transmission of power, water, fuels or communications, if
42       disclosure would jeopardize security of the public agency, building or
43       facility.


29

  1             (13) The contents of appraisals or engineering or feasibility estimates
  2       or evaluations made by or for a public agency relative to the acquisition
  3       of property, prior to the award of formal contracts therefor.
  4             (14) Correspondence between a public agency and a private individ-
  5       ual, other than correspondence which is intended to give notice of an
  6       action, policy or determination relating to any regulatory, supervisory or
  7       enforcement responsibility of the public agency or which is widely dis-
  8       tributed to the public by a public agency and is not specifically in response
  9       to communications from such a private individual.
10             (15) Records pertaining to employer-employee negotiations, if dis-
11       closure would reveal information discussed in a lawful executive session
12       under K.S.A. 75-4319, and amendments thereto.
13             (16) Software programs for electronic data processing and documen-
14       tation thereof, but each public agency shall maintain a register, open to
15       the public, that describes:
16             (A) The information which the agency maintains on computer facil-
17       ities; and
18             (B) the form in which the information can be made available using
19       existing computer programs.
20             (17) Applications, financial statements and other information sub-
21       mitted in connection with applications for student financial assistance
22       where financial need is a consideration for the award.
23             (18) Plans, designs, drawings or specifications which are prepared by
24       a person other than an employee of a public agency or records which are
25       the property of a private person.
26             (19) Well samples, logs or surveys which the state corporation com-
27       mission requires to be filed by persons who have drilled or caused to be
28       drilled, or are drilling or causing to be drilled, holes for the purpose of
29       discovery or production of oil or gas, to the extent that disclosure is limited
30       by rules and regulations of the state corporation commission.
31             (20) Notes, preliminary drafts, research data in the process of anal-
32       ysis, unfunded grant proposals, memoranda, recommendations or other
33       records in which opinions are expressed or policies or actions are pro-
34       posed, except that this exemption shall not apply when such records are
35       publicly cited or identified in an open meeting or in an agenda of an open
36       meeting.
37             (21) Records of a public agency having legislative powers, which re-
38       cords pertain to proposed legislation or amendments to proposed legis-
39       lation, except that this exemption shall not apply when such records are:
40             (A) Publicly cited or identified in an open meeting or in an agenda
41       of an open meeting; or
42             (B) distributed to a majority of a quorum of any body which has au-
43       thority to take action or make recommendations to the public agency with


30

  1       regard to the matters to which such records pertain.
  2             (22) Records of a public agency having legislative powers, which re-
  3       cords pertain to research prepared for one or more members of such
  4       agency, except that this exemption shall not apply when such records are:
  5             (A) Publicly cited or identified in an open meeting or in an agenda
  6       of an open meeting; or
  7             (B) distributed to a majority of a quorum of any body which has au-
  8       thority to take action or make recommendations to the public agency with
  9       regard to the matters to which such records pertain.
10             (23) Library patron and circulation records which pertain to identi-
11       fiable individuals.
12             (24) Records which are compiled for census or research purposes and
13       which pertain to identifiable individuals.
14             (25) Records which represent and constitute the work product of an
15       attorney.
16             (26) Records of a utility or other public service pertaining to individ-
17       ually identifiable residential customers of the utility or service, except that
18       information concerning billings for specific individual customers named
19       by the requester shall be subject to disclosure as provided by this act.
20             (27) Specifications for competitive bidding, until the specifications
21       are officially approved by the public agency.
22             (28) Sealed bids and related documents, until a bid is accepted or all
23       bids rejected.
24             (29) Correctional records pertaining to an identifiable inmate or re-
25       lease, except that:
26             (A) The name; photograph and other identifying information; sen-
27       tence data; parole eligibility date; custody or supervision level; disciplinary
28       record; supervision violations; conditions of supervision, excluding
29       requirements pertaining to mental health or substance abuse counseling;
30       location of facility where incarcerated or location of parole office main-
31       taining supervision and address of a releasee whose crime was committed
32       after the effective date of this act shall be subject to disclosure to any
33       person other than another inmate or releasee, except that the disclosure
34       of the location of an inmate transferred to another state pursuant to the
35       interstate corrections compact shall be at the discretion of the secretary
36       of corrections;
37             (B) the ombudsman of corrections, the attorney general, law enforce-
38       ment agencies, counsel for the inmate to whom the record pertains and
39       any county or district attorney shall have access to correctional records to
40       the extent otherwise permitted by law;
41             (C) the information provided to the law enforcement agency pursu-
42       ant to the sex offender registration act, K.S.A. 22-4901, et seq., and
43       amendments thereto, shall be subject to disclosure to any person, except


31

  1       that the name, address, telephone number or any other information which
  2       specifically and individually identifies the victim of any offender required
  3       to register as provided by the Kansas offender registration act, K.S.A. 22-
  4       4901 et seq. and amendments thereto, shall not be disclosed; and
  5             (D) records of the department of corrections regarding the financial
  6       assets of an offender in the custody of the secretary of corrections shall
  7       be subject to disclosure to the victim, or such victim's family, of the crime
  8       for which the inmate is in custody as set forth in an order of restitution
  9       by the sentencing court.
10             (30) Public records containing information of a personal nature
11       where the public disclosure thereof would constitute a clearly unwar-
12       ranted invasion of personal privacy.
13             (31) Public records pertaining to prospective location of a business
14       or industry where no previous public disclosure has been made of the
15       business' or industry's interest in locating in, relocating within or expand-
16       ing within the state. This exception shall not include those records per-
17       taining to application of agencies for permits or licenses necessary to do
18       business or to expand business operations within this state, except as
19       otherwise provided by law.
20             (32) The bidder's list of contractors who have requested bid proposals
21       for construction projects from any public agency, until a bid is accepted
22       or all bids rejected.
23             (33) Engineering and architectural estimates made by or for any pub-
24       lic agency relative to public improvements.
25             (34) Financial information submitted by contractors in qualification
26       statements to any public agency.
27             (35) Records involved in the obtaining and processing of intellectual
28       property rights that are expected to be, wholly or partially vested in or
29       owned by a state educational institution, as defined in K.S.A. 76-711, and
30       amendments thereto, or an assignee of the institution organized and ex-
31       isting for the benefit of the institution.
32             (36) Any report or record which is made pursuant to K.S.A. 65-4922,
33       65-4923 or 65-4924, and amendments thereto, and which is privileged
34       pursuant to K.S.A. 65-4915 or 65-4925, and amendments thereto.
35             (37) Information which would reveal the precise location of an ar-
36       cheological site.
37             (38) Any financial data or traffic information from a railroad company,
38       to a public agency, concerning the sale, lease or rehabilitation of the
39       railroad's property in Kansas.
40             (39) Risk-based capital reports, risk-based capital plans and corrective
41       orders including the working papers and the results of any analysis filed
42       with the commissioner of insurance in accordance with K.S.A. 1999 Supp.
43       40-2c20 and section 20, and amendments thereto.


32

  1             (40) Memoranda and related materials required to be used to support
  2       the annual actuarial opinions submitted pursuant to subsection (b) of
  3       K.S.A. 40-409, and amendments thereto.
  4             (41) Disclosure reports filed with the commissioner of insurance un-
  5       der subsection (a) of K.S.A. 1999 Supp. 40-2,156, and amendments
  6       thereto.
  7             (42) All financial analysis ratios and examination synopses concerning
  8       insurance companies that are submitted to the commissioner by the na-
  9       tional association of insurance commissioners' insurance regulatory infor-
10       mation system.
11             (43) Any records the disclosure of which is restricted or prohibited
12       by a tribal-state gaming compact.
13             (44) Market research, market plans, business plans and the terms and
14       conditions of managed care or other third party contracts, developed or
15       entered into by the university of Kansas medical center in the operation
16       and management of the university hospital which the chancellor of the
17       university of Kansas or the chancellor's designee determines would give
18       an unfair advantage to competitors of the university of Kansas medical
19       center.
20             (b) Except to the extent disclosure is otherwise required by law or as
21       appropriate during the course of an administrative proceeding or on ap-
22       peal from agency action, a public agency or officer shall not disclose fi-
23       nancial information of a taxpayer which may be required or requested by
24       a county appraiser or the director of property valuation to assist in the
25       determination of the value of the taxpayer's property for ad valorem tax-
26       ation purposes; or any financial information of a personal nature required
27       or requested by a public agency or officer, including a name, job descrip-
28       tion or title revealing the salary or other compensation of officers, em-
29       ployees or applicants for employment with a firm, corporation or agency,
30       except a public agency. Nothing contained herein shall be construed to
31       prohibit the publication of statistics, so classified as to prevent identifi-
32       cation of particular reports or returns and the items thereof.
33             (c) As used in this section, the term ``cited or identified'' shall not
34       include a request to an employee of a public agency that a document be
35       prepared.
36             (d) If a public record contains material which is not subject to dis-
37       closure pursuant to this act, the public agency shall separate or delete
38       such material and make available to the requester that material in the
39       public record which is subject to disclosure pursuant to this act. If a public
40       record is not subject to disclosure because it pertains to an identifiable
41       individual, the public agency shall delete the identifying portions of the
42       record and make available to the requester any remaining portions which
43       are subject to disclosure pursuant to this act, unless the request is for a


33

  1       record pertaining to a specific individual or to such a limited group of
  2       individuals that the individuals' identities are reasonably ascertainable, the
  3       public agency shall not be required to disclose those portions of the record
  4       which pertain to such individual or individuals.
  5             (e) The provisions of this section shall not be construed to exempt
  6       from public disclosure statistical information not descriptive of any iden-
  7       tifiable person.
  8             (f) Notwithstanding the provisions of subsection (a), any public rec-
  9       ord which has been in existence more than 70 years shall be open for
10       inspection by any person unless disclosure of the record is specifically
11       prohibited or restricted by federal law, state statute or rule of the Kansas
12       supreme court or by a policy adopted pursuant to K.S.A. 72-6214, and
13       amendments thereto. 
14       Sec.  43. 41. K.S.A. 1999 Supp. 40-3202, 40-3209, 40-3220, 40-3227,
15       40-3606 and 45-221 are hereby repealed.
16        Sec.  44. 42. This act shall take effect and be in force from and after
17       its publication in the statute book.