Kansas Statutes 40-4604. Same; medically appropriate health care information; advocating on behalf of insured
Current as of: 2023 | Check for updates
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Terms Used In Kansas Statutes 40-4604
- Health insurer: means any insurance company, nonprofit medical and hospital service corporation, municipal group-funded pool, fraternal benefit society, health maintenance organization, or any other entity which offers a health benefit plan subject to the Kansas Statutes Annotated. See Kansas Statutes 40-4602
- Insured: means a person who is covered by a health benefit plan. See Kansas Statutes 40-4602
- Participating provider: means a provider who, under a contract with the health insurer or with its contractor or subcontractor, has agreed to provide one or more health care services to insureds with an expectation of receiving payment, other than coinsurance, copayments or deductibles, directly or indirectly from the health insurer. See Kansas Statutes 40-4602
- Provider: means a physician, hospital or other person which is licensed, accredited or certified to perform specified health care services. See Kansas Statutes 40-4602
No health insurer shall prohibit or restrict any participating provider from discussing with or disclosing to any insured or other individual any medically appropriate health care information that such provider deems appropriate regarding the nature of treatment options, the risks or alternatives thereto, the process used or the decision made by such insurer to approve or deny health care services, the availability of alternate therapies, consultations, or tests, or from advocating on behalf of the insured within the utilization review or grievance processes established by the health insurer.