CHAPTER 178
SENATE Substitute for HOUSE BILL No. 2033
An Act concerning insurance; providing coverage for certain
mental health conditions;
amending K.S.A. 40-2,103, 40-2,105 and 40-19c09 and
repealing the existing sections.
Be it enacted by the Legislature of the State of Kansas:
New Section 1. (a) (1) Any group
health insurance policy, medical
service plan, contract, hospital service corporation contract,
hospital and
medical service corporation contract, fraternal benefit society or
health
maintenance organization which provides coverage for mental health
ben-
efits and which is delivered, issued for delivery, amended or
renewed on
or after January 1, 2002, shall include coverage for diagnosis and
treat-
ment of mental illnesses. Except as provided in paragraph (2), such
cov-
erage shall be subject to the same deductibles, coinsurance and
other
limitations as apply to other covered services.
(2) The coverage required by paragraph
(1) shall include annual cov-
erage for both 45 days of in-patient care for mental illness and
for 45
visits for out-patient care for mental illness.
(b) Notwithstanding the provisions of
K.S.A. 40-2249a, and amend-
ments thereto, the state insurance department shall deliver to the
presi-
dent of the senate and to the speaker of the house of
representatives on
or before January 1, 2003, a report indicating the impact of
providing
mental illness benefits required by this act. Such report shall
include
information regarding access to and usage of such services and the
cost
of such services.
(c) For the purposes of this section,
``mental illness'' means the fol-
lowing: Schizophrenia, schizoaffective disorder, schizophreniform
disor-
der, brief reactive psychosis, paranoid or delusional disorder,
atypical psy-
chosis, major affective disorders (bipolar and major
depression),
cyclothymic and dysthymic disorders, obsessive compulsive
disorder,
panic disorder, pervasive developmental disorder, including autism,
at-
tention deficit disorder and attention deficit hyperactive disorder
as such
terms are defined in the diagnostic and statistical manual of
mental dis-
orders, fourth edition, (DSM-IV, 1994) of the American psychiatric
as-
sociation but shall not include conditions not attributable to a
mental
disorder that are a focus of attention or treatment.
(d) The provisions of this section shall
be applicable to health main-
tenance organizations organized under article 32 of chapter 40 of
the
Kansas Statutes Annotated.
(e) The provisions of this section shall
not apply to any medicare
supplement policy of insurance, as defined by the commissioner of
in-
surance by rule and regulation.
(f) The provisions of this section shall
be applicable to the Kansas
state employees health care benefits program and municipal
funded
pools.
(g) The provisions of this section shall
not apply to any policy or cer-
tificate which provides coverage for any specified disease,
specified ac-
cident or accident only coverage, credit, dental, disability
income, hospital
indemnity, long-term care insurance as defined by K.S.A. 40-2227
and
amendments thereto, vision care or any other limited supplemental
ben-
efit nor to any medicare supplement policy of insurance as defined
by
the commissioner of insurance by rule and regulation, any coverage
issued
as a supplement to liability insurance, workers compensation or
similar
insurance, automobile medical-payment insurance or any insurance
un-
der which benefits are payable with or without regard to fault,
whether
written on a group, blanket or individual basis.
(h) From and after January 1, 2002, the
provisions of K.S.A. 40-2,105,
and amendments thereto, shall not apply to mental illnesses as
defined
in this act.
(i) There shall be no coverage under this
section for evaluations and
diagnostic tests ordered or requested in connection with criminal
actions,
divorce, child custody or child visitation proceedings.
New Sec. 2. On and after January 1,
2002, any group health insur-
ance policy, nonprofit medical and hospital service corporation
contract,
fraternal benefit society, health maintenance organization,
municipal
group funded pool and state employee benefit program which
provides
coverage for prescription drugs, other than prescription drugs
adminis-
tered in a hospital or physician's office shall provide coverage
for psycho-
therapeutic drugs used for the treatment of mental illness under
terms
and conditions no less favorable than coverage provided for other
pre-
scription drugs.
New Sec. 3. The provisions of
K.S.A. 40-2249a, and amendments
thereto, shall not apply to this act.
Sec. 4. On and after January 1,
2002, K.S.A. 40-2,103 is hereby
amended to read as follows: 40-2,103. The requirements of K.S.A.
40-
2,100, 40-2,101, 40-2,102, 40-2,104, 40-2,105, 40-2,114 and
40-2250, and
amendments thereto and K.S.A. 40-2,160
and, 40-2,165 through 40-
2,170, inclusive, 40-2250, section 1 and section 2, and
amendments
thereto, shall apply to all insurance policies, subscriber
contracts or cer-
tificates of insurance delivered, renewed or issued for delivery
within or
outside of this state or used within this state by or for an
individual who
resides or is employed in this state.
Sec. 5. On and after January 1,
2002, K.S.A. 40-2,105 is hereby
amended to read as follows: 40-2,105. (a) On or after the effective
date
of this act, every insurer which issues any individual or group
policy of
accident and sickness insurance providing medical, surgical or
hospital
expense coverage for other than specific diseases or accidents only
and
which provides for reimbursement or indemnity for services rendered
to
a person covered by such policy in a medical care facility, must
provide
for reimbursement or indemnity under such individual policy or
under
such group policy, except as provided in subsection (d), which
shall be
limited to not less than 30 days per year when such person is
confined
for treatment of alcoholism, drug abuse or nervous or mental
conditions
in a medical care facility licensed under the provisions of K.S.A.
65-429
and amendments thereto, a treatment facility for alcoholics
licensed un-
der the provisions of K.S.A. 65-4014 and amendments thereto, a
treat-
ment facility for drug abusers licensed under the provisions of
K.S.A. 65-
4605 and amendments thereto, a community mental health center
or
clinic licensed under the provisions of K.S.A. 75-3307b and
amendments
thereto or a psychiatric hospital licensed under the provisions of
K.S.A.
75-3307b and amendments thereto. Such individual policy or such
group
policy shall also provide for reimbursement or indemnity, except as
pro-
vided in subsection (d), of the costs of treatment of such person
for al-
coholism, drug abuse and nervous or mental conditions, limited to
not
less than 100% of the first $100, 80% of the next $100 and 50% of
the
next $1,640 in any year and limited to not less than $7,500 in such
person's
lifetime, in the facilities enumerated when confinement is not
necessary
for the treatment or by a physician licensed or psychologist
licensed to
practice under the laws of the state of Kansas.
(b) For the purposes of this section
``nervous or mental conditions''
means disorders specified in the diagnostic and statistical manual
of men-
tal disorders, fourth edition, (DSM-IV, 1994) of the American
psychiatric
association but shall not include conditions
not:
(1) Not attributable to a mental
disorder that are a focus of attention
or treatment (DSM-IV, 1994); and
(2) defined as a mental illness in section
1 and amendments thereto.
(c) The provisions of this section shall
be applicable to health main-
tenance organizations organized under article 32 of chapter 40 of
the
Kansas Statutes Annotated.
(d) There shall be no coverage under the
provisions of this section
for any assessment against any person required by a diversion
agreement
or by order of a court to attend an alcohol and drug safety action
program
certified pursuant to K.S.A. 8-1008 and amendments thereto or
for eval-
uations and diagnostic tests ordered or requested in connection
with crim-
inal actions, divorce, child custody or child visitation
proceedings.
(e) The provisions of this section shall
not apply to any medicare
supplement policy of insurance, as defined by the commissioner of
in-
surance by rule and regulation.
(f) The provisions of this section shall
be applicable to the Kansas
state employees health care benefits program developed and provided
by
the Kansas state employees health care commission.
(g) The outpatient coverage provisions of
this section shall not apply
to a high deductible health plan as defined in Section 301 of P.L.
104-
191 and any amendments thereto if such plan is purchased in
connection
with a medical savings account pursuant to that act. After the
amount of
eligible deductible expenses have been paid by the insured, the
outpatient
costs of treatment of the insured for alcoholism, drug abuse and
nervous
or mental conditions shall be paid on the same level they are
provided
for a medical condition, subject to the yearly and lifetime
maximums
provided in subsection (a).
Sec. 6. On and after January 1,
2002, K.S.A. 40-19c09 is hereby
amended to read as follows: 40-19c09. (a) Corporations organized
under
the nonprofit medical and hospital service corporation act shall be
subject
to the provisions of the Kansas general corporation code, articles
60 to
74, inclusive, of chapter 17 of the Kansas Statutes Annotated,
applicable
to nonprofit corporations, to the provisions of K.S.A. 40-214,
40-215, 40-
216, 40-218, 40-219, 40-222, 40-223, 40-224, 40-225, 40-226,
40-229, 40-
230, 40-231, 40-235, 40-236, 40-237, 40-247, 40-248, 40-249,
40-250, 40-
251, 40-252, 40-254, 40-2,100, 40-2,101, 40-2,102, 40-2,103,
40-2,104,
40-2,105, 40-2,116, 40-2,117, 40-2,153, 40-2,154, 40-2,160,
40-2,161, 40-
2,163 through 40-2,170, inclusive, 40-2a01 et seq.,
40-2111 to 40-2116,
inclusive, 40-2215 to 40-2220, inclusive, 40-2221a, 40-2221b,
40-2229,
40-2230, 40-2250, 40-2251, 40-2253, 40-2254, 40-2401 to 40-2421,
inclu-
sive, and 40-3301 to 40-3313, inclusive, K.S.A. 40-2,153,
40-2,154, 40-
2,160, 40-2,161, 40-2,163, 40-2,164 and 40-2,165 through
40-2,170 sec-
tion 1 and section 2, and amendments thereto, except as the
context
otherwise requires, and shall not be subject to any other
provisions of the
insurance code except as expressly provided in this act.
(b) No policy, agreement, contract or
certificate issued by a corpo-
ration to which this section applies shall contain a provision
which ex-
cludes, limits or otherwise restricts coverage because medicaid
benefits
as permitted by title XIX of the social security act of 1965 are or
may be
available for the same accident or illness.
(c) Violation of subsection (b) shall be
subject to the penalties pre-
scribed by K.S.A. 40-2407 and 40-2411, and amendments thereto.
New Sec. 7. Sections 1, 2 and 3,
and amendments thereto, shall be
known as the Kansas mental health parity act.
Sec. 8. On January 1, 2002, K.S.A. 40-2,103,
40-2,105 and 40-19c09
are hereby repealed.
Sec. 9. This act shall take effect and be in force
from and after its
publication in the statute book.
Approved May 21, 2001.
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