reglab/housing_qa huggingface dataset:
KS Stat § 40-4602 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4602 Same; definitions.

40-4602. Same; definitions. As used in this act:(a) "Emergency medical condition" means the sudden and, at the time, unexpected onset of a health condition that requires immediate medical attention, where failure to provide medical attention would result in serious impairment to bodily functions or serious dysfunction of a bodily organ or part, or would place the person's health in serious jeopardy.(b) "Emergency services" means ambulance services and health care items and services furnished or required to evaluate and treat an emergency medical condition, as directed or ordered by a physician.(c) "Health benefit plan" means any hospital or medical expense policy, health, hospital or medical service corporation contract, a plan provided by a municipal group-funded pool, a policy or agreement entered into by a health insurer or a health maintenance organization contract offered by an employer or any certificate issued under any such policies, contracts or plans. "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.(d) "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.(e) "Insured" means a person who is covered by a health benefit plan.(f) "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.(g) "Provider" means a physician, hospital or other person which is licensed, accredited or certified to perform specified health care services.(h) "Provider network" means those participating providers who have entered into a contract or agreement with a health insurer to provide items or health care services to individuals covered by a health benefit plan offered by such health insurer.(i) "Physician" means a person licensed by the state board of healing arts to practice medicine and surgery.History: L. 1997, ch. 190, § 17; July 1.
KS Stat § 40-4603 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4603 Same; emergency services, prohibitions on health care plan; prior authorization after condition stabilized; post evaluation or post stabilization services.

40-4603. Same; emergency services, prohibitions on health care plan; prior authorization after condition stabilized; post evaluation or post stabilization services. (a) A health benefit plan shall not deny coverage for emergency services if the symptoms presented by an insured and recorded by the attending provider indicate that an emergency medical condition exists, or for emergency services necessary to provide an insured with a medical examination and stabilizing treatment, regardless of whether prior authorization was obtained to provide those services.(b) If a participating provider or other authorized representative of a health insurer authorizes emergency services, the health insurer shall not subsequently rescind or modify that authorization after the provider renders the authorized care in good faith and pursuant to the authorization except for:(1) Payments made as a result of misrepresentation, fraud, omission or clerical error; and(2) copayment, coinsurance or deductible amounts that are the responsibility of the insured.(c) Once an insured is stabilized pursuant to subsection (a), a health benefit plan may require as a condition of further coverage that a hospital emergency facility shall promptly contact the health insurer for prior authorization for continuing treatment, specialty consultations, transfer arrangements or other medically necessary and appropriate care for an insured.(d) Coverage of emergency services shall be subject to applicable copayments, coinsurance and deductibles.(e) For required post evaluation or post stabilization services immediately following treatment of an emergency medical condition, a health insurer shall provide access to an authorized representative 24 hours a day, seven days a week.History: L. 1997, ch. 190, § 18; July 1.
KS Stat § 40-4604 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4604 Same; medically appropriate health care information; advocating on behalf of insured.

40-4604. Same; medically appropriate health care information; advocating on behalf of insured. 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.History: L. 1997, ch. 190, § 19; July 1.
KS Stat § 40-4605 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4605 Same; arrangements which serve as inducement to reduce or limit delivery of medically necessary services prohibited; capitation payments or other risk sharing provisions not considered inducements.

40-4605. Same; arrangements which serve as inducement to reduce or limit delivery of medically necessary services prohibited; capitation payments or other risk sharing provisions not considered inducements. No health insurer shall offer or operate a compensation arrangement between such health insurer or its agents and a participating provider that may directly or indirectly serve as an inducement to reduce or limit the delivery of medically necessary services with respect to an insured in any health benefit plan offered by such health insurer. Compensation arrangements which involve capitation payments or other risk sharing provisions shall not be considered inducements.History: L. 1997, ch. 190, § 20; July 1.
KS Stat § 40-4606 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4606 Same; health insurer required to inform in writing current and prospective insureds of availability of certain information.

40-4606. Same; health insurer required to inform in writing current and prospective insureds of availability of certain information. Every health insurer shall inform in writing current and prospective insureds that the following information shall be available upon request:(a) A complete description of the health care services, items and other benefits to which the insured is entitled in the particular health benefit plan which is covering or being offered to such person;(b) a description of any limitations, exceptions or exclusions to coverage in the health benefit plan, including prior authorization policies, restricted drug formularies or other provisions which restrict access to covered services or items by the insured;(c) a listing of the health benefit plan's participating providers, their business addresses and telephone numbers, the availability of those providers, and any limitations on an insured's choice of provider;(d) notification in advance of any changes in the health benefit plan which either reduces the coverage or benefits, or increases the cost, to such person; and(e) a description of the grievance and appeal procedures available under the health benefit plan and an insured's rights regarding termination, disenrollment, nonrenewal or cancelation of coverage.History: L. 1997, ch. 190, § 21; July 1.
KS Stat § 40-4607 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4607 Same; provider network required to be sufficient to ensure covered services accessible without unreasonable delay; determination of sufficiency of provider network; plan to provide for referral of insured to specialists under certain conditions; exceptions to requirements.

40-4607. Same; provider network required to be sufficient to ensure covered services accessible without unreasonable delay; determination of sufficiency of provider network; plan to provide for referral of insured to specialists under certain conditions; exceptions to requirements. (a) A health insurer providing a health benefit plan shall maintain a provider network that is sufficient in numbers and types of providers to assure that all covered services to an insured will be accessible without unreasonable delay. Sufficiency of the provider network shall be determined in accordance with the requirements of this section, and may be established by reference to any reasonable criteria used by the health insurer, including but not limited to: provider-insured ratios by specialty; primary care provider-insured ratios; geographic accessibility; waiting times for appointments with participating providers; hours of operation; and the availability of technological and specialty services to serve the needs of insureds requiring technologically advanced or specialty care.(b) A health insurer shall have a plan by which an insured with a life-threatening, chronic, degenerative or disabling condition or disease, which requires specialized medical care over a prolonged period of time, may receive a referral to a specialist with expertise in treating such disease or condition who shall be responsible for and capable of providing and coordinating the insured's specialty care.(c) Nothing in this section shall require a health insurer to provide benefits not otherwise covered by the terms of the health benefits plan.(d) A provider network shall not be determined to be insufficient for failure to contract with any provider unwilling to contract under the same terms and conditions, including reimbursement levels, as such health insurer offers to other similarly situated health care providers.History: L. 1997, ch. 190, § 22; July 1.
KS Stat § 40-4608 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4608 Same; rules and regulations.

40-4608. Same; rules and regulations. The commissioner of insurance may adopt rules and regulations as necessary to implement the provisions of the patient protection act.History: L. 1997, ch. 190, § 23; July 1.
KS Stat § 40-4609 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4609 Same; gynecological care.

40-4609. Same; gynecological care. (a) Each health insurer and the state health care benefits program shall permit a woman insured by the health insurer or such program to visit an in-network obstetrician or gynecologist for routine gynecological care from an in-network obstetrician or gynecologist one time each calendar year without requiring such woman to first visit or receive a referral from a primary care provider, so long as the care is medically necessary, including, but not limited to, care that is routine.(b) This section shall be part of and supplemental to the patient protection act, cited at K.S.A. 40-4601 et seq., and amendments thereto.History: L. 2001, ch. 198, § 1; July 1.
KS Stat § 40-4621 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4621 Uniform prescription drug information card act; name of act.

40-4621. Uniform prescription drug information card act; name of act. This act shall be known and may be cited as the uniform prescription drug information card act.History: L. 2003, ch. 89, § 1; July 1.
KS Stat § 40-4622 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4622 Same; definitions.

40-4622. Same; definitions. As used in this act:(a) "Commissioner" means the Kansas commissioner of insurance;(b) "department" means the Kansas department of insurance; and(c) "health benefit plan" shall have the meaning ascribed to such term by subsection (1) of K.S.A. 40-2209d, and amendments thereto.History: L. 2003, ch. 89, § 2; July 1.
KS Stat § 40-4623 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4623 Same; required information on card; use of social security number as cardholder identification number prohibited; issuance of card.

40-4623. Same; required information on card; use of social security number as cardholder identification number prohibited; issuance of card. (a) A health benefit plan that provides coverage for prescription drugs or devices and issues a card for claims processing and an administrator of any such plan, including, but not limited to, a pharmacy benefits manager and a third-party administrator shall issue a card containing uniform prescription drug information to each person entitled to such card under the health benefit plan. If required for claims adjudication, the uniform prescription drug information card shall specifically identify and display the following information:(1) ANSI-BIN number;(2) processor control number or group number or both;(3) card issuer identifier;(4) prescription claims processor, if different from card issuer;(5) cardholder identification number;(6) cardholder or insured name;(7) claims submission names and addresses; and(8) help desk telephone numbers.(b) A uniform prescription drug information card shall be issued by a health benefit plan to each person entitled to such card under the health benefit plan upon enrollment and reissued upon any change in such person's coverage that affects one or more mandatory data elements contained on the card.(c) Notwithstanding the foregoing provision, any health benefit plan or administrator of such plan may utilize, in lieu of such card, electronic technology which contains all of the information required for claims adjudication, as long as such electronic technology is provided by the health benefit plan or administrator of such plan to the pharmacies which will adjudicate the prescription drug claims.(d) On and after July 1, 2006: (1) No cardholder's social security number shall be printed or encoded on or into any card issued under this section.(2) Any cardholder identification number or other distinguishing identifier assigned to the card issued to a cardholder shall be a combination of numbers or letters or both, which is unique to the cardholder.(3) A cardholder's identification number or other distinguishing identifier assigned to such insured's policy card shall not, in any way, be based on or depend on the cardholder's social security number.History: L. 2003, ch. 89, § 3; L. 2004, ch. 157, § 6; July 1.
KS Stat § 40-4624 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4624 Same; usage of prescription drug information card.

40-4624. Same; usage of prescription drug information card. The uniform prescription drug information card may be used for any and all coverage under a health benefit plan. Nothing in this act shall be construed as requiring any person issuing a card for processing of claims under a health benefit plan to issue a separate card for prescription drug coverage, as long as the card is able to accommodate the information necessary to process a prescription drug claim, as required by K.S.A. 40-4623, and amendments thereto.History: L. 2003, ch. 89, § 4; July 1.
KS Stat § 40-4625 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4625 Same; application of act; rules and regulations.

40-4625. Same; application of act; rules and regulations. (a) This act shall apply to any health benefit plan that is amended, delivered, issued or renewed on or after the effective date of this act.(b) The commissioner may adopt rules and regulations that are necessary to implement the provisions of this act.History: L. 2003, ch. 89, § 5; July 1.
KS Stat § 40-4626 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 46 - Managed Care|40-4626 Same; powers of commissioner.

40-4626. Same; powers of commissioner. This act shall be administered and enforced by the commissioner in the same manner as is provided for administering and enforcing the statutes regarding insurers' unfair methods of competition and unfair or deceptive acts or practices, as provided by K.S.A. 40-2405, 40-2406, 40-2407, 40-2408 and 40-2411, and amendments thereto, and the commissioner shall have and may exercise the powers granted by K.S.A. 40-2405, 40-2406, 40-2407, 40-2408 and 40-2411, and amendments thereto, in administering and enforcing the provisions of this act.History: L. 2003, ch. 89, § 6; July 1.
KS Stat § 40-4701 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 47 - Kansas Business Health Partnership|40-4701 Kansas business health partnership act; definitions.

40-4701. Kansas business health partnership act; definitions. As used in K.S.A. 40-4701 through 40-4707, and amendments thereto:(a) "Carrier" means any insurance company, nonprofit medical and hospital service corporation, nonprofit optometric, dental, or pharmacy service corporation, municipal group-funded pool, fraternal benefit society or health maintenance organization, as these terms are defined by chapter 40 of the Kansas Statutes Annotated, and amendments thereto, that offers health benefit plans covering eligible employees of one or more small employers in the state.(b) "Health committee" means the Kansas business health policy committee as specified in K.S.A. 40-4702, and amendments thereto.(c) "Dependent" means the spouse or any child of an eligible employee.(d) "Eligible employee" shall have the meaning ascribed to it in K.S.A. 40-2209d, and amendments thereto.(e) "Health benefit plan" means any hospital or medical expense policy, health, hospital or medical services corporation contract, and a plan provided by a municipal group-funded pool, or a health maintenance organization contract offered by any employer or any certificate issued under any such policy, contract or plan.(f) "Kansas business health partnership" or "health partnership" means a nonrisk bearing nonprofit corporation that has responded to a request for a proposal by the health committee and has been selected by the health committee to provide health insurance through multiple unaffiliated participating carriers to small employers and their eligible employees.(g) "Low wage or modest wage employee" means any eligible employee whose family income does not exceed 200% of the poverty level.(h) "Small employer" shall have the meaning ascribed to it in K.S.A. 40-2209d, and amendments thereto.History: L. 2000, ch. 147, § 47; L. 2002, ch. 112, § 2; July 1.
KS Stat § 40-4703 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 47 - Kansas Business Health Partnership|40-4703 Same; health partnership; organization.

40-4703. Same; health partnership; organization. (a) The health partnership selected by the health committee shall:(1) Be a domestic not-for-profit corporation; and(2) have a board of directors which includes among its members at least one director who is a small employer and at least one director who is an employee.(3) No director shall have any interest in any business which sells health insurance or which provides or delivers any health care services.(b) Operate the Kansas business health partnership.History: L. 2000, ch. 147, § 49; July 1.
KS Stat § 40-4705 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 47 - Kansas Business Health Partnership|40-4705 Same; health committee; subsidies for coverage.

40-4705. Same; health committee; subsidies for coverage. The health committee may provide a mechanism for direct subsidies to low and modest wage employees of employers acquiring coverage through a direct contract with a carrier rather than through the health partnership, and for provision to such employees of a supplemental benefit plan as described in subsection (a) of K.S.A. 40-4704.History: L. 2000, ch. 147, § 51; July 1.
KS Stat § 40-4706 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 47 - Kansas Business Health Partnership|40-4706 Same; division of health care finance of the department of health and environment; duties.

40-4706. Same; division of health care finance of the department of health and environment; duties. The division of health care finance of the department of health and environment shall investigate and pursue all possible policy options to bring into this partnership title XIX and the title XXI eligible families of any eligible employees employed by a small employer. The division of health care finance of the department of health and environment shall develop and seek federal approval of any appropriate variance or state plan amendment for the state children's health insurance program established by K.S.A. 38-2001 et seq., and amendments thereto, and the state medical assistance program required to accomplish the purposes of this act. The division of health care finance of the department of health and environment shall work with the health partnership to develop a single employee application that may be used by the health plan and the medicaid and state children's health insurance program to determine eligibility.History: L. 2000, ch. 147, § 52; L. 2002, ch. 112, § 5; L. 2004, ch. 159, § 17; L. 2005, ch. 187, § 39; L. 2012, ch. 102, § 21; July 1.
KS Stat § 40-4707 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 47 - Kansas Business Health Partnership|40-4707 Same; citation of act.

40-4707. Same; citation of act. K.S.A. 40-4701 through 40-4707, and amendments thereto, shall be known as the Kansas business health partnership act.History: L. 2000, ch. 147, § 53; L. 2002, ch. 112, § 1; July 1.
KS Stat § 40-4801 (2021)
2021 Kansas Statutes|Chapter 40 - Insurance|Article 48 - Amusement Rides|40-4801 Amusement ride insurance act; definitions.

40-4801. Amusement ride insurance act; definitions. As used in K.S.A. 40-4802 and 40-4803, and amendments thereto, the terms "amusement ride," "antique amusement ride," "limited-use amusement ride," "operator," "owner" and "registered agritourism activity" shall have the same meanings as those terms are defined in K.S.A. 44-1601, and amendments thereto.History: L. 2000, ch. 147, § 54; L. 2017, ch. 103, § 4; L. 2018, ch. 84, § 2; May 17.