Session of 2000
HOUSE BILL No. 2765
By Committee on Insurance
1-31
10 AN ACT
concerning insurance; eliminating discrimination in the cover-
11 age of specific mental
illnesses; amending K.S.A. 1998 Supp. 40-2,103
12 and 40-2,105 and
repealing the existing sections.
13
14 Be it enacted by the Legislature of the
State of Kansas:
15 Section
1. K.S.A. 1998 Supp. 40-2,103 is hereby amended to read as
16 follows: 40-2,103. The requirements of
K.S.A. 40-2,100, 40-2,101, 40-
17 2,102, 40-2,104, 40-2,105, 40-2,114 and
40-2250, and amendments
18 thereto and K.S.A. 1998 Supp. 40-2,160
and section 2, and amendments
19 thereto, shall apply to all
insurance policies, subscriber contracts or cer-
20 tificates of insurance delivered, renewed
or issued for delivery within or
21 outside of this state or used within this
state by or for an individual who
22 resides or is employed in this state.
23 Sec.
2. K.S.A. 1998 Supp. 40-2,105 is hereby amended to read as
24 follows: 40-2,105. (a) On or after the
effective date of this act, every
25 insurer which issues any individual or
group policy of accident and sick-
26 ness insurance providing medical, surgical
or hospital expense coverage
27 for other than specific diseases or
accidents only and which provides for
28 reimbursement or indemnity for services
rendered to a person covered
29 by such policy in a medical care facility,
must provide for reimbursement
30 or indemnity under such individual policy
or under such group policy,
31 except as provided in subsection
(d) (e), which shall be limited to not
less
32 than 30 days per year when such person is
confined for treatment of
33 alcoholism, drug abuse or nervous or mental
conditions in a medical care
34 facility licensed under the provisions of
K.S.A. 65-429 and amendments
35 thereto, a treatment facility for
alcoholics licensed under the provisions
36 of K.S.A. 65-4014 and amendments thereto, a
treatment facility for drug
37 abusers licensed under the provisions of
K.S.A. 65-4605 and amendments
38 thereto, a community mental health center
or clinic licensed under the
39 provisions of K.S.A. 75-3307b and
amendments thereto or a psychiatric
40 hospital licensed under the provisions of
K.S.A. 75-3307b and amend-
41 ments thereto. Such individual policy or
such group policy shall also pro-
42 vide for reimbursement or indemnity, except
as provided in subsection
43 (d) (e), of the
costs of treatment of such person for alcoholism, drug abuse
2
1 and nervous or mental conditions,
limited to not less than 100% of the
2 first $100, 80% of the next $100 and
50% of the next $1,640 in any year
3 and limited to not less than $7,500
in such person's lifetime, in the facil-
4 ities enumerated when confinement is
not necessary for the treatment or
5 by a physician licensed or
psychologist licensed to practice under the laws
6 of the state of Kansas.
Notwithstanding the foregoing, every insurer,
7 which issues any individual or
group policy of accident and sickness in-
8 surance providing medical,
surgical or hospital expense coverage for other
9 than specific diseases or
accidents only and which provides for reimburse-
10 ment or indemnity for services rendered
to a person covered by such
11 policy, shall provide coverage for
diagnosis and treatment of mental ill-
12 nesses under terms and conditions no
less extensive than coverage for any
13 other type of health care.
14 (b) For the
purposes of this section "nervous or mental conditions"
15 means disorders specified in the diagnostic
and statistical manual of men-
16 tal disorders, fourth edition, (DSM-IV,
1994) of the American psychiatric
17 association but shall not include
conditions not attributable to a mental
18 disorder that are a focus of attention or
treatment (DSM-IV, 1994).
19 (c) The
provisions of this section shall be applicable to health main-
20 tenance organizations organized under
article 32 of chapter 40 of the
21 Kansas Statutes Annotated.
22 (d) For the
purpose of this section, "mental illnesses" means the
23 following:
24
(1) Schizophrenia, schizoaffective disorder, schizophreniform
disor-
25 der, brief reactive psychosis, paranoid
or delusional disorder, atypical
26 psychosis;
27 (2) major
affective disorders (bipolar and major depression), cyclo-
28 thymic and dysthymic disorders;
29 (3) obsessive
compulsive disorder;
30 (4) panic
disorder; and
31 (5) pervasive
developmental disorder, including autism.
32 (d)
(e) There shall be no coverage under the provisions of
this section
33 for any assessment against any person
required by a diversion agreement
34 or by order of a court to attend an alcohol
and drug safety action program
35 certified pursuant to K.S.A. 8-1008 and
amendments thereto.
36 (e)
(f) The provisions of this section shall not apply to
any medicare
37 supplement policy of insurance, as defined
by the commissioner of in-
38 surance by rule and regulation.
39 (f)
(g) The provisions of this section shall be applicable
to the Kansas
40 state employees health care benefits
program developed and provided by
41 the Kansas state employees health care
commission.
42 (g)
(h) The outpatient coverage provisions of this section
shall not
43 apply to a high deductible health plan as
defined in Section 301 of P.L.
3
1 104-191 and any amendments thereto if
such plan is purchased in con-
2 nection with a medical savings
account pursuant to that act. After the
3 amount of eligible deductible
expenses have been paid by the insured,
4 the outpatient costs of treatment of
the insured for alcoholism, drug abuse
5 and nervous or mental conditions
shall be paid on the same level they are
6 provided for a medical condition,
subject to the yearly and lifetime max-
7 imums provided in subsection (a).
8 (i) The
provisions of this section shall not apply to any policy or
cer-
9 tificate which provides coverage for
any specified disease, specified ac-
10 cident or accident only coverage, credit,
dental, disability income, hospital
11 indemnity, long-term care insurance as
defined by K.S.A. 1998 Supp. 40-
12 2227 and amendments thereto, vision care or
any other limited supple-
13 mental benefit nor to any medicare
supplement policy of insurance as
14 defined by the commissioner of insurance by
rule and regulation, any
15 coverage issued as a supplement to
liability insurance, workers' compen-
16 sation or similar insurance, automobile
medical-payment insurance or any
17 insurance under which benefits are payable
with or without regard to
18 fault, whether written on a group, blanket
or individual basis.
19 Sec. 3. K.S.A. 1998 Supp.
40-2,103 and 40-2,105 are hereby
20 repealed.
21 Sec. 4. This act shall
take effect and be in force from and after its
22 publication in the statute book.