Terms Used In Kansas Statutes 40-2,105a

  • Automobile: means a passenger vehicle as defined by Kan. See Kansas Statutes 40-298
  • Commissioner: means the commissioner of insurance of this state;

    (b) "company" means any person engaging in or proposing or attempting to engage in any transaction or kind of insurance or surety business and any person or group of persons who may otherwise be subject to the administrative, regulatory or taxing authority of the commissioner;

    (c) "department" means the department of insurance of this state;

    (d) "examiner" means any individual or firm having been authorized by the commissioner to conduct an examination under this act;

    (e) "insurer" shall have the meaning ascribed to the term "insurance company" by Kan. See Kansas Statutes 40-222f

  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • person: means any individual, aggregation of individuals, trust, association, partnership or corporation, or any affiliate thereof. See Kansas Statutes 40-222f
  • Service corporation: means a nonprofit medical and hospital service corporation organized under the provisions of Kan. See Kansas Statutes 40-2,116
  • State: when applied to the different parts of the United States, includes the District of Columbia and the territories. See Kansas Statutes 77-201

(a) (1) Any group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society or health maintenance organization that provides medical, surgical or hospital expense coverage shall include coverage for diagnosis and treatment of mental illnesses and alcoholism, drug abuse or other substance use disorders. Reimbursement or indemnity shall be provided for treatment in a medical care facility licensed under the provisions of Kan. Stat. Ann. § 65-429, and amendments thereto, treatment facilities licensed under Kan. Stat. Ann. § 65-4605, and amendments thereto, a community mental health center or clinic licensed under the provisions of Kan. Stat. Ann. § 39-2001 et seq., and amendments thereto, a psychiatric hospital licensed under the provisions of Kan. Stat. Ann. § 39-2001 et seq., and amendments thereto, or by a physician or psychologist licensed to practice under the laws of the state of Kansas. Such coverage shall be subject to the same deductibles, copayments, coinsurance, out-of-pocket expenses, treatment limitations and other limitations as apply to other covered services.

(2) The coverage shall include treatment for in-patient care and out-patient care for mental illness, alcoholism, drug abuse or substance use disorders.

(b) For the purposes of this section, “mental illness, alcoholism, drug abuse or substance use” means any disorder as such terms are defined in the diagnostic and statistical manual of mental disorders, fourth edition, (DSM-IV, 1994) of the American psychiatric association.

(c) The provisions of this section shall be applicable to health maintenance organizations organized under article 32 of chapter 40 of the Kansas Statutes Annotated, and amendments thereto.

(d) The provisions of this section shall not apply to any small employer group policy, as defined under Kan. Stat. Ann. § 40-2209, and amendments thereto, providing medical, surgical or hospital expense coverage or to any medicare supplement policy of insurance, as defined by the commissioner of insurance by rule and regulation.

(e) The provisions of this section shall be applicable to the Kansas state employees health care benefits program and municipal funded pools.

(f) The provisions of this section shall not apply to any policy or certificate that provides coverage for any specified disease, specified accident or accident only coverage, credit, dental, disability income, hospital indemnity, long-term care insurance as defined by Kan. Stat. Ann. § 40-2227, and amendments thereto, vision care or any other limited supplemental benefit nor to any medicare supplement policy of insurance as defined by the commissioner of insurance by rule and regulation, any coverage issued as a supplement to liability insurance, workers compensation or similar insurance, automobile medical-payment insurance or any insurance under which benefits are payable with or without regard to fault, whether written on a group, blanket or individual basis.

(g) Treatment limitations include limits on the frequency of treatment, number of visits, days of coverage or other similar limits on the scope or duration of treatment.

(h) There shall be no coverage under the provisions of this section for any assessment against any person required by a diversion agreement or by order of a court to attend an alcohol and drug safety action program certified pursuant to Kan. Stat. Ann. § 8-1008, and amendments thereto, or for evaluations and diagnostic tests ordered or requested in connection with criminal actions, divorce, child custody or child visitation proceedings.

(i) Utilization review for mental illness shall be consistent with provisions in Kan. Stat. Ann. §§ 40-22a01 through 40-22a12, and amendments thereto.