Legislative Issues

State Legislation

Health insurance among top priorities at Kansas Statehouse - March 2009

Mickle By Sunee Mickle, director of government relations,
Blue Cross and Blue Shield of Kansas

Unpredictable is a good word to use to describe the 2009 Kansas legislative session which opened Jan. 12 in Topeka. We entered the session thinking that many issues would take a back-seat to budget concerns and energy legislation. However, health insurance and health care reform are right there among the top priorities for legislators and many bills are still active after the turnaround period.

This year the legislative turnaround occurred Feb. 21, a week earlier than previous sessions. After the turnaround period, bills that remain in their house of origin are considered dead, unless they are introduced in an exempt committee such as the Senate Ways and Means or House Appropriations committees. Typically at this point in the session, we have a solid understanding of which bills and health insurance issues are likely to be passed by the Kansas legislature.

The remainder of the session will prove a busy time for us as several health insurance bills have survived the turnaround deadline and others have recently been introduced in exempt committees.

I would like to provide you with a brief summary of the 2009 health and life insurance Kansas legislative bills as of March 12. This is not a complete list of the bills that we are following, and the summaries do not include all of the provisions in each bill. However, I hope this general overview provides you an opportunity to understand the different types of health legislation that is active this year.

2009 Legislative Mid-Term Summary

SB 12 – Autism Mandate
SB 12 mandates guarantee issued individual and group coverage of autism and autism spectrum disorders up to a maximum of $75,000 per year through age 21. Coverage includes applied behavioral analysis (ABA) services. Small groups (less than 50 employees) and individuals with underwritten health plans have the option to exclude coverage.

SB 25 – Clean Indoor Air Act
The Clean Indoor Air Act, which also is known as the statewide smoking ban, prohibits smoking in most public places including restaurants and drinking establishments. The amended version of the bill excludes casinos and tobacco shops from the ban. The bill was passed by the Senate (26-13) with few amendments, but it is expected to have more opposition from House members.

SB 49 – Mental Health Parity
The Kansas Insurance Department (KID) introduced SB 49 to update current state mental health laws to match the new federal mental health parity requirements. The federal mental health parity law requires large groups (fully insured and ASO) with mental health insurance coverage to provide full parity. The Senate passed SB 49 without amendments (40-0). The House will hear the bill March 17.

SB 50 – Risk-Based Capital
Each year, legislation is introduced to update the Risk-Based Capital statute. This legislation is directed towards the insurance industry. This legislation generally is non-controversial and legislators generally know to keep it free of troublesome amendments given the relative importance placed on its passage. The Senate passed SB 50 and it is now on the House consent calendar. The bill should pass and go into effect July 1, 2009.

SB 83 – Autism Task Force
The bill re-establishes the legislature's autism task force to study and conduct hearings on autism service related issues. SB 83 was passed by the Senate (40-0) and is expected to pass in the House.

SB 90 – Electronic Filings
SB 90 grants the insurance commissioner the authority to adopt rules and regulations to require the electronic filing of rates and forms. This bill was introduced in Senate Ways and Means (an exempt committee) and referred to the Senate Financial Institutions and Insurance Committee. A hearing has not been scheduled at this time.

SB 136 – Patient Protection Act
This bill updates the current Patient Protection Act to include specific guidelines on the language that health insurers use in their provider and hospital contracts. The bill is in the Senate Financial Institutions and Insurance Committee.

SB 174 – Removing Mandatory Group Life Participation Requirements
SB 174 amends the current group life insurance law to allow both employers and insureds to pay towards life insurance premiums. The bill also removes the 75 percent eligible employee participation requirement. The Senate passed SB 174 (40-0), and the House will hear the bill March 17.

SB 181 – Mental Health Parity (II)
The mental health community introduced its own mental health bill to expand upon the provisions in SB 49. This bill began in the Senate Health and Welfare Committee and was referred to the Senate Financial Institutions and Insurance Committee. No further action has been taken at this time.

SB 195 – Orally Administered Anticancer Medications
SB 195 requires insurers to cover oral cancer prescription drugs the same as intravenous prescription drugs and chemotherapy under a major medical policy whether or not the insured has an outpatient pharmacy benefit. SB 195 is now in the Senate Financial Institutions and Insurance Committee.

HB 2044 – Amendment to State Continuation Coverage Law (Premium Collection)
HB 2044 reverses language in last session’s House Substitute for SB 81 which required small employers to collect insurance premiums for former employees who opt to continue insurance coverage. Small employers feel the bill places an unnecessary administrative burden on employers whereas insurance carriers were better equipped to manage the collection of state continuation insurance premiums. This bill has not been heard by the House Insurance Committee, but it is the goal of many legislators to see this bill passed before the end of the session.

HB 2075 – Colorectal Cancer Screening Mandate
HB 2075 was introduced to guarantee that all insurers cover colorectal cancer screening for insureds over age 50. The bill also requires insurers to cover screenings for members who are less than age 50, but have a high risk of colon cancer. Standard deductibles and coinsurance will apply.

HB 2262 – Amendment to State Continuation Coverage Law (Notice)
HB 2262 reverses language in last session’s House Substitute for SB 81 which required small employers to provide notice when a former insured employee is eligible for state continuation coverage. HB 2262 will be heard March 17.

HB 2286 – Rate Filing and Minimum Loss Ratio
This bill allows insurers to use premium rates upon filing with KID if the insurer provides a minimum loss ration guarantee. HB 2286 is now in the House Insurance Committee, but it is not likely to be heard this session.

HB 2291 – Health Care Price Transparency Act
HB 2291 requires health care providers to disclose their charges for medical services and the amount that they accept as reimbursement from an insurance carrier. The bill also requires insurers to disclose their negotiated rates for certain medical procedures.

HB 2344 – Dietary Formulas Mandate
HB 2344 is identical to last year's dietary formula mandate HB 2769. This bill mandates coverage for special dietary formulas for the treatment of various metabolic, malabsorption and gastric diseases including phenylketonuria (PKU).

Currently, the Kansas Department of Health and Environment (KDHE) provides financial support for children up to age 22 who suffer from PKU and other genetic malabsorption diseases. The state cannot fund the current program and individuals who need assistance are looking to private insurers for coverage.

HB 2367 – Autism Coverage Mandate
HB 2367 was introduced in the House Committee on Federal and State Affairs March 5. HB 2367 is similar to SB 12 (which was introduced at the beginning of the session) but the bill contains provisions that could wipe out the proposed $75,000 maximum coverage for an insured per year. The House Insurance Committee will hear the bill March 19.

What to Expect Next

The 2009 legislative regular session is expected to begin wrapping up the week of March 23. For the majority of legislation, this will be the last time that the representatives and senators can consider bills that moved out of their House of origin. The veto session is likely to begin by April 4 and Sine Die will be announced within approximately two-and-one-half weeks after the last day of the regular session.

Blue Cross and Blue Shield of Kansas will continue to monitor these bills and any bills or amendments that might arise. Our focus is to be available as a resource to legislators on health insurance issues and to express our concern to them on any proposed legislation which likely would raise the cost of health insurance for our members.

If you have specific questions on these or any other health insurance pieces of legislation, send your questions to grassrootsnet@bcbsks.com. To know more about how Blue Cross and Blue Shield of Kansas can keep you informed on legislation, see the Grassroots Network section of this site.