Session Law

Identifying Information:L. 2001 ch. 054
Other Identifying Information:2001 Senate Bill 29
Tax Type:Other
Brief Description:An Act relating to Kansas insurance coverage for children; concerning the six month waiting period; amending K.S.A. 38-2001 and repealing the existing section.
Keywords:


Body:

CHAPTER 54

SENATE BILL No. 29


An Act relating to Kansas insurance coverage for children; concerning the six month waiting

period; amending K.S.A. 38-2001 and repealing the existing section.

Be it enacted by the Legislature of the State of Kansas:

Section 1. K.S.A. 38-2001 is hereby amended to read as follows: 38-

2001. (a) The secretary of social and rehabilitation services shall develop

and submit a plan consistent with federal guidelines established under

section 4901 of public law 105-33 (42 U.S.C. 1397aa et seq.; title XXI).

(b) The plan developed under subsection (a) shall be a capitated man-

aged care plan covering Kansas children from zero to 19 years which:

(1) Contains benefit levels at least equal to those for the early and

periodic screening, diagnosis and treatment program;

(2) provides for presumptive eligibility for children where applicable;

(3) provides continuous eligibility for 12 months once a formal de-

termination is made that a child is eligible subject to subsection (e);

(4) has performance based contracting with measurable outcomes in-

dicating age appropriate utilization of plan services to include, but not

limited to, such measurable services as immunizations, vision, hearing and

dental exams, emergency room utilization, annual physical exams and

asthma;

(5) shall use the same prior authorization standards and requirements

as used for health care services under medicaid to further the goal of

seamlessness of coverage between the two programs; and

(6) will provide targeted low-income children, as defined under sec-

tion 4901 of public law 105-33 (42 U.S.C. 1397aa, et seq.), coverage sub-

ject to appropriations.

(c) The secretary is authorized to contract with entities authorized to

transact health insurance business in this state to implement the health

insurance coverage plan pursuant to subsection (a) providing for several

plan options to enrollees which are coordinated with federal and state

child health care programs, except that when contracting to provide man-

aged mental health care services the secretary shall assure that contracted

entities demonstrate the ability to provide a full array of mental health

services in accordance with the early and periodic screening, diagnosis

and treatment plan. The secretary shall not develop a request for proposal

process which excludes community mental health centers from the op-

portunity to bid for managed mental health care services.

(d) When developing and implementing the plan in subsection (a),

the secretary to the extent authorized by law:

(1) Shall include provisions that encourage contracting insurers to

utilize and coordinate with existing community health care institutions

and providers;

(2) may work with public health care providers and other community

resources to provide educational programs promoting healthy lifestyles

and appropriate use of the plan's health services;

(3) shall plan for outreach and maximum enrollment of eligible chil-

dren through cooperation with local health departments, schools, child

care facilities and other community institutions and providers;

(4) shall provide for a simplified enrollment plan;

(5) shall provide cost sharing as allowed by law;

(6) shall not count the caring program for children, the Kansas health

insurance association plan or any charity health care plan as insurance

under subsection (e)(1); and

(7) may provide for payment of health insurance premiums, including

contributions to a medical savings account if applicable, if it is determined

cost effective, taking into account the number of children to be served

and the benefits to be provided.

(e) A child shall not be eligible for coverage and shall lose coverage

under the plan developed under subsection (a) of K.S.A. 38-2001, and

amendments thereto, if:

(1) During the prior six months, the child was covered with a com-

prehensive health insurance policy by an insurance company, health

maintenance organization or nonprofit hospital and medical insurance

corporation authorized to do business in this state and such insurance is

still available to the child; or

(2) such child's family has not paid the enrollee's applicable share of

any premium due.

If the family pays all of the delinquent premiums owed during the year,

such child will again be eligible for coverage for the remaining months

of the continuous eligibility period.

(f) The plan developed under section 4901 of public law 105-33 (42

U.S.C. 1397aa et seq., and amendments thereto) is not an entitlement

program. The availability of the plan benefits shall be subject to funds

appropriated. The secretary shall not utilize waiting lists, but shall monitor

costs of the program and make necessary adjustments to stay within the

program's appropriations.

Sec. 2. K.S.A. 38-2001 is hereby repealed.

Sec. 3. This act shall take effect and be in force from and after its

publication in the Kansas register.

Approved March 30, 2000.

Published in the Kansas Register April 5, 2000.


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Date Composed: 09/25/2001 Date Modified: 09/25/2001