Session of 1999
SENATE BILL No. 160
By Committee on Financial Institutions and Insurance
9 AN ACT concerning insurance; eliminating discrimination in the cover-
10 age of specific mental illnesses; amending K.S.A. 1998 Supp. 40-2,103
11 and 40-2,105 and repealing the existing sections.
13 Be it enacted by the Legislature of the State of Kansas:
14 Section 1. K.S.A. 1998 Supp. 40-2,103 is hereby amended to read as
15 follows: 40-2,103. The requirements of K.S.A. 40-2,100, 40-2,101, 40-
16 2,102, 40-2,104, 40-2,105, 40-2,114 and 40-2250, and amendments
17 thereto and K.S.A. 1998 Supp. 40-2,160 and section 2, and amendments
18 thereto, shall apply to all insurance policies, subscriber contracts or cer-
19 tificates of insurance delivered, renewed or issued for delivery within or
20 outside of this state or used within this state by or for an individual who
21 resides or is employed in this state.
22 Sec. 2. K.S.A. 1998 Supp. 40-2,105 is hereby amended to read as
23 follows: 40-2,105. (a) On or after the effective date of this act, every
24 insurer which issues any individual or group policy of accident and sick-
25 ness insurance providing medical, surgical or hospital expense coverage
26 for other than specific diseases or accidents only and which provides for
27 reimbursement or indemnity for services rendered to a person covered
28 by such policy in a medical care facility, must provide for reimbursement
29 or indemnity under such individual policy or under such group policy,
30 except as provided in subsection
(d) (e), which shall be limited to not less
31 than 30 days per year when such person is confined for treatment of
32 alcoholism, drug abuse or nervous or mental conditions in a medical care
33 facility licensed under the provisions of K.S.A. 65-429 and amendments
34 thereto, a treatment facility for alcoholics licensed under the provisions
35 of K.S.A. 65-4014 and amendments thereto, a treatment facility for drug
36 abusers licensed under the provisions of K.S.A. 65-4605 and amendments
37 thereto, a community mental health center or clinic licensed under the
38 provisions of K.S.A. 75-3307b and amendments thereto or a psychiatric
39 hospital licensed under the provisions of K.S.A. 75-3307b and amend-
40 ments thereto. Such individual policy or such group policy shall also pro-
41 vide for reimbursement or indemnity, except as provided in subsection
(d) (e), of the costs of treatment of such person for alcoholism, drug abuse
43 and nervous or mental conditions, limited to not less than 100% of the
SB 160 2
1 first $100, 80% of the next $100 and 50% of the next $1,640 in any year
2 and limited to not less than $7,500 in such person's lifetime, in the facil-
3 ities enumerated when confinement is not necessary for the treatment or
4 by a physician licensed or psychologist licensed to practice under the laws
5 of the state of Kansas. Notwithstanding the foregoing, every insurer,
6 which issues any individual or group policy of accident and sickness in-
7 surance providing medical, surgical or hospital expense coverage for other
8 than specific diseases or accidents only and which provides for reimburse-
9 ment or indemnity for services rendered to a person covered by such
10 policy, shall provide coverage for diagnosis and treatment of mental ill-
11 nesses under terms and conditions no less extensive than coverage for any
12 other type of health care.
13 (b) For the purposes of this section "nervous or mental conditions"
14 means disorders specified in the diagnostic and statistical manual of men-
15 tal disorders, fourth edition, (DSM-IV, 1994) of the American psychiatric
16 association but shall not include conditions not attributable to a mental
17 disorder that are a focus of attention or treatment (DSM-IV, 1994).
18 (c) The provisions of this section shall be applicable to health main-
19 tenance organizations organized under article 32 of chapter 40 of the
20 Kansas Statutes Annotated.
21 (d) For the purpose of this section, "mental illnesses" means the
23 (1) Schizophrenia, schizoaffective disorder, schizophreniform disor-
24 der, brief reactive psychosis, paranoid or delusional disorder, atypical
26 (2) major affective disorders (bipolar and major depression), cyclo-
27 thymic and dysthymic disorders;
28 (3) obsessive compulsive disorder;
29 (4) panic disorder; and
30 (5) pervasive developmental disorder, including autism.
(d) (e) There shall be no coverage under the provisions of this section
32 for any assessment against any person required by a diversion agreement
33 or by order of a court to attend an alcohol and drug safety action program
34 certified pursuant to K.S.A. 8-1008 and amendments thereto.
(e) (f) The provisions of this section shall not apply to any medicare
36 supplement policy of insurance, as defined by the commissioner of in-
37 surance by rule and regulation.
(f) (g) The provisions of this section shall be applicable to the Kansas
39 state employees health care benefits program developed and provided by
40 the Kansas state employees health care commission.
(g) (h) The outpatient coverage provisions of this section shall not
42 apply to a high deductible health plan as defined in Section 301 of P.L.
43 104-191 and any amendments thereto if such plan is purchased in con-
SB 160 3
1 nection with a medical savings account pursuant to that act. After the
2 amount of eligible deductible expenses have been paid by the insured,
3 the outpatient costs of treatment of the insured for alcoholism, drug abuse
4 and nervous or mental conditions shall be paid on the same level they are
5 provided for a medical condition, subject to the yearly and lifetime max-
6 imums provided in subsection (a).
7 New Sec. 3. The provisions of this section shall not apply to any pol-
8 icy or certificate which provides coverage for any specified disease, spec-
9 ified accident or accident only coverage, credit dental, disability income,
10 hospital indemnity, long-term care insurance as defined by K.S.A. 1998
11 Supp. 40-2227 and amendments thereto, vision care or any other limited
12 supplemental benefit nor to any medicare supplement policy of insurance
13 as defined by the commissioner of insurance by rule and regulation, any
14 coverage issued as a supplement to liability insurance, workers' compen-
15 sation or similar insurance, automobile medical-payment insurance or any
16 insurance under which benefits are payable with or without regard to
17 fault, whether written on a group, blanket or individual basis.
18 Sec. 4. K.S.A. 1998 Supp. 40-2,103 and 40-2,105 are hereby
20 Sec. 5. This act shall take effect and be in force from and after its
21 publication in the statute book.