reglab/housing_qa huggingface dataset:
KS Stat § 40-2261 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22 - Uniform Policy Provisions|40-2261 Employer providing certain health insurance coverage may offer cafeteria plan; employer not restricted in providing such benefits or coverage; definitions.

40-2261. Employer providing certain health insurance coverage may offer cafeteria plan; employer not restricted in providing such benefits or coverage; definitions. (a) An employer that provides health insurance coverage for which any portion of the premium is payable by an employee may also offer a premium only cafeteria plan as permitted under 26 U.S.C. section 125. The provisions of this subsection shall not apply to any employer who offers health insurance through any self-insured or self-funded group health benefit plan of any type or description.(b) No provision of this section shall prohibit or otherwise restrict an employer's ability to either provide a group health benefit plan or create a premium only cafeteria plan with defined contributions and in which the employee purchases the policy.(c) For the purposes of this section:(1) "Health benefit plan" means any hospital or medical expense policy, health, hospital or medical service corporation contract and a plan provided by a municipal group-funded pool or a health maintenance organization contract offered by an employer or any certificate issued under any such policies, contracts or plans. Health benefit plan also includes a cafeteria plan authorized by 26 U.S.C. section 125. The cafeteria plan may offer the option of paying all or any portion of the health insurance premium or the option of receiving health insurance coverage through a high deductible health plan and the establishment of a health savings account. In order for an eligible individual to obtain a high deductible health plan through the cafeteria plan, such individual shall present evidence to the employer that such individual has established a health savings account in compliance with 26 U.S.C. section 223 and any amendments and regulations. "Health benefit plan" does not include policies or certificates covering only accident, credit, dental, disability income, long-term care, hospital indemnity, medicare supplement, specified disease, vision care, coverage issued as a supplement to liability insurance, insurance arising out of a workers compensation or similar law, automobile medical-payment insurance or insurance under which benefits are payable with or without regard to fault and which is statutorily required to be contained in any liability insurance policy or equivalent self-insurance.(2) "Health savings account" shall have the same meaning ascribed to it as in subsection (d) of 26 U.S.C. section 223.(3) "High deductible health plan" shall mean a policy or contract of health insurance or health care plan that meets the criteria established in subsection (c) of 26 U.S.C. section 223 and any amendments and regulations.(d) The provisions of this section shall not take effect until July 1, 2008.History: L. 2008, ch. 164, § 2; May 29.
KS Stat § 40-22a01 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a01 Utilization review organization act.

40-22a01. Utilization review organization act. This act shall be known and may be cited as the utilization review organization act.History: L. 1994, ch. 238, § 1; July 1.
KS Stat § 40-22a02 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a02 Same; purpose.

40-22a02. Same; purpose. The legislature finds that in order to promote the delivery of quality health care services in a cost effective manner, it is necessary to encourage greater coordination between health care providers and those agencies performing utilization review of health care services. Effective standards for utilization review activities will protect patients while reducing administrative costs associated with the review and approval of health care services provided to patients.History: L. 1994, ch. 238, § 2; July 1.
KS Stat § 40-22a03 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a03 Same; definitions.

40-22a03. Same; definitions. For the purposes of this act:(a) "Commissioner" means the commissioner of insurance.(b) "Utilization review" means the evaluation of the necessity, appropriateness and efficiency of the use of health care services, procedures and facilities.(c) "Utilization review organization" means any entity which conducts utilization review and determines certification of an admission, extension of stay or other health care service.(d) "Health care provider" means a licensed medical care facility, a licensed health maintenance organization, or a person licensed or registered to engage in an occupation which renders health care services.History: L. 1994, ch. 238, § 3; July 1.
KS Stat § 40-22a04 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a04 Utilization review organization act; standards; rules and regulations; certificate; conditions; annual fee; suspension or revocation of certificate.

40-22a04. Utilization review organization act; standards; rules and regulations; certificate; conditions; annual fee; suspension or revocation of certificate. (a) The commissioner shall adopt rules and regulations establishing standards governing the conduct of utilization review activities performed in this state or affecting residents or healthcare providers of this state by utilization review organizations. Unless granted an exemption under K.S.A. 40-22a06, and amendments thereto, no utilization review organization may conduct utilization review services in this state or affecting residents of this state without first obtaining a certificate from the commissioner.(b) The commissioner shall not issue a certificate to a utilization review organization until the applicant:(1) Files a formal application for certification in such form and detail as required by the commissioner and such application has been executed under oath by the chief executive officer, president or other head official of the applicant;(2) files with the commissioner a certified copy of its charter or articles of incorporation and bylaws, if any;(3) states the location of the office or offices of the utilization review organization where utilization review affecting residents or health care providers of this state will be principally performed;(4) provides a summary of the qualifications and experience of persons performing utilization review affecting the persons and at the locations identified pursuant to paragraph (3);(5) makes payment of a certification fee of $100 to the commission; and(6) provides such other information or documentation as the commissioner requires.(c) Certificates issued by the commissioner pursuant to this act shall remain effective until suspended, surrendered or revoked subject to payment of an annual continuation fee of $50.(d) The commissioner may suspend or revoke the certificate or any exemption from certification requirements upon determination that the interests of Kansas insureds are not being properly served under such certificate or exemption. Any such action shall be taken only after a hearing conducted in accordance with the provisions of the Kansas administrative procedure act.History: L. 1994, ch. 238, § 4; L. 2021, ch. 108, § 7; July 1.
KS Stat § 40-22a05 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a05 Same; act not applicable to certain reviews and programs.

40-22a05. Same; act not applicable to certain reviews and programs. The utilization review organization act shall not apply to:(a) Utilization review of health care services provided to patients under the authority of the Kansas workers compensation act, K.S.A. 44-501 et seq., and amendments thereto;(b) reviews conducted by any insurance company, health maintenance organization, prepaid service plan, group-funded self-insured plan or similar entity solely for the purpose of determining compliance with the specific terms and conditions of an insurance policy, agreement or contract as a part of the normal claim settlement process; or(c) any medical programs operated by the secretary for aging and disability services or any entity to the extent it is acting under contract with the secretary.History: L. 1994, ch. 238, § 5; L. 2014, ch. 115, § 189; L. 2021, ch. 108, § 8; July 1.
KS Stat § 40-22a06 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a06 Same; certificate not required for certain review activities; certain provisions not applicable to certain organizations.

40-22a06. Same; certificate not required for certain review activities; certain provisions not applicable to certain organizations. (a) No certificate shall be required for utilization review activities conducted by or on behalf of:(1) An agency of the federal government;(2) a person, agency or utilization review organization acting on behalf of the federal government, but only to the extent such person, agency or organization is providing services under federal regulation;(3) a federally qualified health maintenance organization authorized to transact business in Kansas that is administering a quality assurance program and performing utilization review activities for its own members as required by 42 U.S.C. § 300e(c)(8) and 42 U.S.C. § 300e(c)(6) respectively;(4) a person employed or used by a utilization review organization authorized to perform utilization review in Kansas, including, but not limited to, individual nurses and other health care providers. This exemption shall not apply with respect to individual persons performing utilization review activities in conjunction with any insurance contract or health benefit plan pursuant to a direct contractual relationship with a health maintenance organization, group-funded self-insurance plan or insurance company;(5) a health benefit plan that is self-insured and qualified under the federal employee retirement income security act of 1974 as amended;(6) hospitals, home health agencies, clinics, private health care provider offices or any other authorized health care facility or entity conducting general, in-house utilization review unless such review is for the purpose of approving or denying payment for hospital or medical services in a particular case; or(7) utilization review organizations conducting utilization review only with respect to mental health, chemical dependency, chiropractic, optometric, podiatric, dental or any other health care service or services other than the practice of medicine and surgery, until utilization review standards governing such treatment or service are incorporated in rules and regulations adopted pursuant to K.S.A. 40-22a04, and amendments thereto.(b) The provisions of K.S.A. 40-22a04(b)(2), (3), (4), (5) and (6) and (c), and amendments thereto, shall not apply to:(1) Utilization review organizations accredited by and adhering to the national utilization review standards approved by URAC, an independent, nonprofit accreditation entity; or(2) such other utilization review organizations the commissioner approves.History: L. 1994, ch. 238, § 6; L. 1998, ch. 14, § 1; L. 2021, ch. 108, § 9; July 1.
KS Stat § 40-22a07 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a07 Same; unlawful acts; penalties; prior notification requirements, limitations on.

40-22a07. Same; unlawful acts; penalties; prior notification requirements, limitations on. (a) (1) It is unlawful for any person or utilization review organization to perform utilization review activities in this state except in accordance with this act.(2) No utilization review organization nor any individual performing utilization review activities may agree to be compensated or receive compensation which is contingent in any way upon frequency of certification denials, costs avoided by denial or reduction in payment of claims or other results which may be adverse to the needs of the patient as determined by the attending health care provider.(3) (A) A utilization review organization may establish prior notification requirements for inpatient and outpatient hospital admissions. A utilization review organization shall not require notification sooner than the next business day after any inpatient admission occurring on a weekend or holiday or any urgent or emergent inpatient or outpatient admission regardless of when the patient presents for services.(B) For the purposes of this paragraph, a patient that is unstable or uncommunicative shall not be deemed to have presented to a health care facility until the patient is able to provide insurance information and the health care facility is permitted under state and federal law to inquire about insurance coverage.(b) A utilization review organization may not reduce or deny payment to a provider for such provider's failure to comply with any utilization review organization's policy that conflicts with this act or any rules and regulations adopted pursuant to K.S.A. 40-22a11, and amendments thereto.(c) When the commissioner has reason to believe a utilization review organization subject to this act has been or is engaged in any conduct which violates this act or any rules and regulations adopted pursuant to K.S.A. 40-22a11, the commissioner, after a hearing conducted in accordance with the Kansas administrative procedure act, may:(1) Issue and cause to be served upon the utilization review organization an order requiring such organization to cease and desist from engaging in such violations;(2) suspend or revoke the utilization review organization's certificate to perform utilization review affecting residents of this state;(3) assess a monetary penalty of not less than $500 and not more than $1,000 for each violation; or(4) apply any combination of the above provisions as the commissioner, by written order, deems appropriate.History: L. 1994, ch. 238, § 7; L. 2008, ch. 134, § 7; July 1.
KS Stat § 40-22a08 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a08 Same; examination by commissioner; expenses.

40-22a08. Same; examination by commissioner; expenses. Whenever the insurance commissioner deems it to be prudent for the benefit of the insureds, health care providers or insurers, the commissioner or any person designated by the commissioner may visit and examine the affairs of any utilization review organization to determine if the organization is in compliance with this act or rules and regulations adopted under this act or orders issued by the commissioner pursuant to such act or rules and regulations.Any person or entity examined pursuant to the provisions of this section shall pay the reasonable and proper charges incurred for such examination, including the actual expenses of the insurance commissioner or the expenses and compensation of the commissioner's authorized representative and the expenses and compensation of assistants and examiners employed therein.History: L. 1994, ch. 238, § 8; July 1.
KS Stat § 40-22a09 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a09 Same; written procedures for utilization review; patient information confidential.

40-22a09. Same; written procedures for utilization review; patient information confidential. Each utilization review organization shall have written procedures for assuring that patient-specific information obtained during the process of utilization review will be:(a) Kept confidential in accordance with applicable federal and state laws; and(b) used solely for the purposes of utilization review, quality assurance, discharge planning and catastrophic case management.History: L. 1994, ch. 238, § 9; July 1.
KS Stat § 40-22a10 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a10 Same; patient information not subject to discovery or subpoena.

40-22a10. Same; patient information not subject to discovery or subpoena. Any records, charts or other information exchanged between a health care provider or patient and a utilization review organization shall not be subject to discovery, subpoena or other means of legal compulsion for their release to any person or entity and shall not be admissible in evidence in any judicial or administrative proceeding other than a disciplinary proceeding by the state board of healing arts or other agency of the state which regulates health care providers.History: L. 1994, ch. 238, § 10; July 1.
KS Stat § 40-22a11 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a11 Same; rules and regulations.

40-22a11. Same; rules and regulations. The commissioner shall adopt necessary rules and regulations, not inconsistent with this act, for implementing the provisions of this act.History: L. 1994, ch. 238, § 11; July 1.
KS Stat § 40-22a12 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a12 Same; severability.

40-22a12. Same; severability. If any provision or clause of this act or application thereof to any person or circumstance is held invalid, such invalidity shall not affect other provisions or applications of this act that can be given effect without the invalid provision or application. To this end, the provisions of this act are declared to be severable.History: L. 1994, ch. 238, § 12; July 1.
KS Stat § 40-22a16 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 22a - Utilization Review|40-22a16 Same; judicial review; limitation on duplicative reviews; contractual services; rules and regulations.

40-22a16. Same; judicial review; limitation on duplicative reviews; contractual services; rules and regulations. On and after July 1, 2011:(a) The decision of the external review organization may be reviewed directly by the district court at the request of either the insured, insurer or health insurance plan. The review by the district court shall be de novo. The decision of the external review organization shall not preclude the insured, insurer or health insurance plan from exercising other available remedies applicable under state or federal law. Seeking a review by the district court or any other available remedies exercised by the insured, insurer or health insurance plan after the decision of the external review organization will not stay the external review organization's decision as to the payment or provision of services to be rendered during the pendency of the review by the insurer or health insurance plan. All material used in an external review and the decision of the external review organization as a result of the external review shall be deemed admissible in any subsequent litigation.(b) In no event shall more than one external review be available for any request arising out of the same set of facts during a period of 12 consecutive months commencing on the date of the initial request for external review. An insured may not pursue, either concurrently or sequentially, an external review process under both a federal and state law.(c) The commissioner of insurance is hereby authorized to negotiate and enter into contracts necessary to perform the duties required by K.S.A. 40-22a13 through 40-22a16, and amendments thereto.(d) The commissioner of insurance shall adopt rules and regulations necessary to carry out the purposes of K.S.A. 40-22a13 through 40-22a16, and amendments thereto. The rules and regulations shall ensure that the commissioner is able to provide for an effective and efficient external review of health care services.(e) Except as provided in subsection (a), the decision of the external review organization shall be binding on the insured and the insurer or health insurance plan.History: L. 1999, ch. 162, § 9; L. 2011, ch. 111, § 5; July 1.
KS Stat § 40-2301 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 23 - Old-age And Survivors Insurance For Public Employees|40-2301 Declaration of policy.

40-2301. Declaration of policy. In order to extend to certain employees of the state and its political subdivisions and to the dependents and survivors of such employees, the basic protection accorded to others by the old-age and survivors insurance system embodied in the social security act, it is hereby declared to be the policy of the legislature, subject to the limitations of this act, that such steps be taken as to provide such protection to employees of the state and its political subdivisions on as broad a basis as is permitted under the social security act. It is also the policy of the legislature that the protection afforded employees in positions covered by a retirement system on the date an agreement under this act is made applicable to service performed in such positions, or receiving periodic benefits under such retirement system at such time, will not be impaired as a result of making the agreement so applicable or as result of legislative enactment in anticipation thereof.History: L. 1951, ch. 464, § 1; L. 1955, ch. 246, § 1; April 13.
KS Stat § 40-2304 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 23 - Old-age And Survivors Insurance For Public Employees|40-2304 Contributions by state employees.

40-2304. Contributions by state employees. (a) Every employee of the state whose services are covered by an agreement entered into under K.S.A. 40-2303, shall be required to pay for the period of such coverage, into the contribution fund established by K.S.A. 40-2307, contributions, with respect to wages, as defined in subsection (a) of K.S.A. 40-2302, equal to the amount of the employee tax which would be imposed by the federal insurance contributions act if such services constituted employment within the meaning of that act. Such liability shall arise in consideration of the employee's retention in the service of the state, or his entry upon such service, after the enactment of this act.(b) The contribution imposed by this section shall be collected by deducting the amount of the contribution from wages as and when paid, but failure to make such deduction shall not relieve the employee from liability for such contribution.(c) If more or less than the correct amount of the contribution imposed by this section is paid or deducted with respect to any remuneration, proper adjustments, or refund if adjustment is impracticable, shall be made, without interest, in such manner and at such times as the state agency shall prescribe.History: L. 1951, ch. 464, § 4; L. 1955, ch. 246, § 4; April 13.