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Kansas - Imposes Minimum on DME Coverage

By Committee on Financial Institutions and Insurance
AN ACT relating to accident and health insurance; providing
coverage for durable medical equipment; amending K.S.A. 1997
Supp. 40©19c09 and repealing the existing section; also
repealing K.S.A. 1997 Supp. 40©1909.
Be it enacted by the Legislature of the State of Kansas:
New Section 1. (a) Any individual or 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 which provides coverage for
accident and health services and which is delivered, issued
for delivery, amended or renewed on or after July 1, 1998,
also, shall provide coverage for durable medical equipment
in the amount of at least $10,000 per individual per year.
Power equipment, including powered wheelchairs and scooters,
shall be covered when prescribed by a physician.
(b) The benefits provided in this act shall be subject to
the same annual deductible or co©insurance established for
all other covered benefits within a given policy.
(c) As used this section, "durable medical equipment"
(1) Any item, piece of equipment or product system,
whether bought off the shelf, modified or customized, that:
(A) Is capable of withstanding repeated use;
(B) is used to correct or accommodate a physiological
condition or physical disability; and
(C) allows the user to regain, maintain, increase or
improve cognitive or physical functions which are prevented
or restricted due to disability (such functions include, but
are not limited to, ambulating from place to place
independently, reading, comprehending spoken language or
environmental sounds, expressive communications, counting,
memorizing or gathering thoughts. Examples of such
equipment shall include, but not limited to, manual
wheelchairs, motorized wheelchairs, motorized scooters and
other aides that enhance the mobility of an individual, low
vision devices, CCTVs, hearing aides and augmentative
communication devices; or
(2) any services which directly assist in the selection,
acquisition or use of durable medical equipment.
Sec. 2. K.S.A. 1997 Supp. 40©19c09 is hereby amended to
read as follows: 40©19c09. (a) Corporations organized
under the nonprofit medical and hospital service corporation
act shall be subject to the provisions of the Kansas general
corporation code, articles 60 to 74, inclusive, of chapter
17 of the Kansas Statutes Annotated, applicable to nonprofit
corporations, to the provisions of K.S.A. 40©214, 40©215,
40©216, 40©218, 40©219, 40©222, 40©223, 40©224, 40©225,
40©226, 40©229, 40©230, 40©231, 40©235, 40©236, 40©237,
40©247, 40©248, 40©249, 40©250, 40©251, 40©252, 40©254,
40©2,100, 40©2,101, 40©2,102, 40©2,103, 40©2,104, 40©2,105,
40©2,116, 40©2,117, 40©2a01 et seq., 40©2111 to 40©2116,
inclusive, 40©2215 to 40©2220, inclusive, 40©2221a,
40©2221b, 40©2229, 40©2230, 40©2250, 40©2251, 40©2253,
40©2254, 40©2401 to 40©2421, inclusive, and 40©3301 to
40©3313, inclusive, K.S.A. 1997 Supp. 40©2,153, 40©2,154,
40©2,160 and 40©2,161, and amendments thereto, and section
1, except as the context otherwise requires, and shall not
be subject to any other provisions of the insurance code
except as expressly provided in this act.
(b) No policy, agreement, contract or certificate issued
by a corporation to which this section applies shall contain
a provision which excludes, limits or otherwise restricts
coverage because medicaid benefits as permitted by title XIX
of the social security act of 1965 are or may be available
for the same accident or illness.
(c) Violation of subsection (b) shall be subject to the
penalties prescribed by K.S.A. 40©2407 and 40©2411, and
amendments thereto.
Sec. 3. K.S.A. 1997 Supp. 40©1909 and 40©19c09 are hereby
Sec. 4. This act shall take effect and be in force from
and after its publication in the statute book.

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