SENATE BILL No. 108
(Amended by Chapter 162)
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
been published only after having been critically reviewed for
accuracy, validity and reliability by unbiased independent experts,
that has been determined by the international committee of medical
nal editors to have met the uniform requirements for manuscripts
mitted to biomedical journals. Peer-reviewed medical literature
include publications or supplements to publications that are
a significant extent by a pharmaceutical manufacturing company or
(b) ``Off-label use of drugs'' means
prescribing prescription drugs for
treatments other than those stated in the labeling approved by the
food and drug administration.
(c) ``Standard reference compendia''
means the United States phar-
macopeia drug information, the American hospital formulary service
information or the American Medical Association drug
New Sec. 2. An insurance company,
nonprofit health service cor-
poration, nonprofit medical and hospital service corporation or
maintenance organization that provides coverage for prescription
may not issue, deliver, execute or renew any health insurance
health service contract on an individual, group, blanket, franchise
sociation basis which excludes coverage of a prescription drug for
treatment on the grounds the prescription drug has not been
by the federal food and drug administration for that covered
the prescription drug is recognized for treatment of the indication
of the standard reference compendia or in substantially accepted
reviewed medical literature. The prescribing physician shall submit
insurer documentation supporting the proposed off-label use or uses
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
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
new section 2, nor does this act alter existing law regarding
limiting the coverage of prescription drugs that have not been
by the federal food and drug administration; does not require
for any prescription drug when the federal food and drug
has determined its use to be contraindicated; and does not require
erage for experimental drugs not otherwise approved for any
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,
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
act, and amendments thereto, shall apply to all insurance
scriber contracts or certificates of insurance delivered, renewed
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
ical and hospital service corporation act shall be subject to the
of the Kansas general corporation code, articles 60 to 74,
chapter 17 of the Kansas Statutes Annotated, applicable to
porations, to the provisions of K.S.A. 40-214, 40-215, 40-216,
219, 40-222, 40-223, 40-224, 40-225, 40-226, 40-229, 40-230,
235, 40-236, 40-237, 40-247, 40-248, 40-249, 40-250, 40-251,
40-254, 40-2,100, 40-2,101, 40-2,102, 40-2,103, 40-2,104, 40-2,105,
2,116, 40-2,117, 40-2a01 et seq., 40-2111 to 40-2116,
to 40-2220, inclusive, 40-2221a, 40-2221b, 40-2229, 40-2230,
40-2251, 40-2253, 40-2254, 40-2401 to 40-2421, inclusive, and
to 40-3313, inclusive, K.S.A. 1998 Supp. 40-2,153, 40-2,154,
and, 40-2,164 and
sections 1 through 4 of this act, and
amendments thereto, except as the context otherwise requires, and
not be subject to any other provisions of the insurance code except
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
cludes, limits or otherwise restricts coverage because medicaid
as permitted by title XIX of the social security act of 1965 are or
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.
Approved April 25, 1999.
Published in the Kansas Register May 6, 1999.