Session of 1999


An  Act regarding insurance, relating to coverage for off-label use of prescription drugs;

amending K.S.A. 1998 Supp. 40-2,103 and 40-19c09 and repealing the existing sections.

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

      New Section  1. As used in section 1 through 4, and amendments
thereto, unless the context clearly indicates otherwise:

      (a) "Peer-reviewed medical literature" means a published scientific
study in a journal or other publication in which original manuscripts have
been published only after having been critically reviewed for scientific
accuracy, validity and reliability by unbiased independent experts, and
that has been determined by the international committee of medical jour-
nal editors to have met the uniform requirements for manuscripts sub-
mitted to biomedical journals. Peer-reviewed medical literature does not
include publications or supplements to publications that are sponsored to
a significant extent by a pharmaceutical manufacturing company or health

      (b) "Off-label use of drugs" means prescribing prescription drugs for
treatments other than those stated in the labeling approved by the federal
food and drug administration.

      (c) "Standard reference compendia" means the United States phar-
macopeia drug information, the American hospital formulary service drug
information or the American Medical Association drug evaluation.

      New Sec.  2. An insurance company, nonprofit health service cor-
poration, nonprofit medical and hospital service corporation or health
maintenance organization that provides coverage for prescription drugs
may not issue, deliver, execute or renew any health insurance policy or
health service contract on an individual, group, blanket, franchise or as-
sociation basis which excludes coverage of a prescription drug for cancer
treatment on the grounds the prescription drug has not been approved
by the federal food and drug administration for that covered indication if
the prescription drug is recognized for treatment of the indication in one
of the standard reference compendia or in substantially accepted peer-
reviewed medical literature. The prescribing physician shall submit to the
insurer documentation supporting the proposed off-label use or uses if
requested by the insurer.

      New Sec.  3. The commissioner of insurance may direct an insurer
or contractor regulated by this act to make payments as required by this

      New Sec.  4. This act shall not be construed to affect the prescribing
and coverage of off-label use of drugs for any indication not specified in
new section 2, nor does this act alter existing law regarding provisions
limiting the coverage of prescription drugs that have not been approved
by the federal food and drug administration; does not require coverage
for any prescription drug when the federal food and drug administration
has determined its use to be contraindicated; and does not require cov-
erage for experimental drugs not otherwise approved for any indication
by the federal food and drug administration.

      Sec.  5. K.S.A. 1998 Supp. 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. 1998 Supp. 40-2,160 and sections 1 through 4 of this
act, and amendments thereto, shall apply to all insurance policies, sub-
scriber contracts or certificates 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.  6. K.S.A. 1998 Supp. 40-19c09 is hereby amended to read as
follows: 40-19c09. (a) Corporations organized under the nonprofit med-
ical 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 cor-
porations, 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, 40-2a01 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, inclusive, and 40-3301
to 40-3313, inclusive, K.S.A. 1998 Supp. 40-2,153, 40-2,154, 40-2,160,
40-2,161, 40-2,163 and, 40-2,164 and sections 1 through 4 of this act, 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.

      Sec.  7. K.S.A. 1998 Supp. 40-2,103 and 40-19c09 are hereby re-

 Sec.  8. This act shall take effect and be in force from and after its
publication in the Kansas register.

I hereby certify that the above BILL originated in the
SENATE, and passed that body


SENATE adopted
  Conference Committee Report ______________________________

President of the Senate
Secretary of the Senate

Passed the HOUSE
     as amended ______________________________

HOUSE adopted
  Conference Committee Report ______________________________

Speaker of the House
Chief Clerk of the House

APPROVED ______________________________