Session of 1998
By Representative Franklin
            9             AN ACT concerning health care services; accident and sickness insurance;
10             chronic diseases and illnesses.
12       Be it enacted by the Legislature of the State of Kansas:
13           Section 1. (a) As used in this section:
14           (1) ``Health plan'' means any insurer or corporation which issues in-
15       dividual and group health insurance policies providing coverage on an
16       expense-incurred basis, individual and group service or indemnity-type of
17       contracts issued by a profit or nonprofit corporation and all contracts
18       issued by health maintenance organizations organized or authorized to
19       transact business in this state;
20           (2) ``chronically ill person'' means a person who has a disease such as
21       asthma, diabetes, cancer, arthritis or other chronic illness requiring con-
22       tinual treatment by a specialist over an extended period of time;
23           (3) ``point of service'' means a health plan option under which the
24       insured person may obtain medically or psychologically necessary care
25       from a nonparticipating network provider without a referral from such
26       person's primary care physician.
27           (b) All health plans shall offer a point of service option to chronically
28       ill persons and allow such chronically ill persons to select a specialist as
29       such person's primary care physician.
30           (c) Under such health plan, the chronically ill person who chooses
31       the point of service option and receives health services from a nonparti-
32       cipating health care provider may pay the reasonable cost difference be-
33       tween what the health plan pays and what the person was billed for the
34       service.
35           Sec. 2. This act shall take effect and be in force from and after its
36       publication in the statute book.