By Sunee Mickle,
Director of Government Relations,
& Lindsey Scott, Intern, Government Relations,
Blue Cross and Blue Shield of Kansas
April 7, 2010
Kansas Legislature Edition
The Kansas legislature adjourned the morning of March 31 with plans to reconvene on April 28. Typically the legislature has wrapped up budget issues before the first adjournment; this is not the case this year. April 28 will begin the veto session with the budget and many other issues still at hand.
HB 2160: Autism Test Track & Oral Chemotherapy Parity
In the early hours of March 31, shortly before adjourning for recess, HB 2160 was passed. The House concurred with the Senate's amendments 88-31. HB 2160 has been sent to Governor Parkinson to be signed into law. This bill includes two important pieces of legislation: An autism coverage mandate for the State Employees Health Plan and a mandate for oral chemotherapy parity.
The legislature has reviewed several different autism bills the past few years. An amended version of what was formerly known as SB 554 was incorporated into the recently passed HB 2160. The legislation requires:
- The State Employee Health Plan (SEHP) to cover the diagnosis and treatment of autism from birth up to 19 years of age
- Autism treatment and diagnostic services may be subject to annual deductibles, coinsurance, and any utilization or benefit limitations.
Annual benefit caps are:
- Not to exceed $36,000/yr - individuals from birth up to 7 years of age
- Not to exceed $27,000/yr - individuals 7 years of age up to 19 years of age
Following a full year of autism coverage, the Kansas Health Policy Authority (KHPA) must report the impact and utilization of coverage for this mandate. In addition, KHPA must recommend whether this mandate should continue as part of the SEHP or whether additional cost and utilization data is needed. The legislature will review the KHPA's report and recommendation before mandating the same autism spectrum disorder coverage requirements for individual and group health policies. If the legislature mandates autism coverage for all individual and group health policies, coverage would begin for policies delivered, amended or renewed on or after July 1, 2013. Blue Cross and Blue Shield of Kansas will keep you updated on this issue as it proceeds.
The second item in HB 2160 focuses on an oral chemotherapy parity mandate. This legislation was previously included in the 2009 session's SB 195. This provision requires all group and individual health insurance plans that include a prescription drug benefit to cover orally administered anticancer medications on a basis no less favorable than intravenously administered or injected cancer medications that are covered under medical benefits. Insurers can apply the same deductible, coinsurance, and other limitations as they do for other covered services. This mandate will become effective July 1, 2011. Blue Cross and Blue Shield of Kansas prescription drug benefits currently include coverage for oral chemotherapy medications.
SB 389: Non-Covered Dental Services Contract Provision
On March 29, SB 389 passed 40-0 in the House, the bill is now pending enrollment and presentation to Governor Parkinson. SB 389 prohibits dental insurers from setting fees for services or monitoring rates provided by dentists that are not covered by a contract. This legislation effects any contract issued or renewed after July 1, 2010 between a health insurer and a dentist who is a participating provider. Blue Cross and Blue Shield of Kansas has not engaged in this business practice with its dental providers, therefore SB 389 will not impact our contracting agreements with our network dental providers.
Colorectal Cancer Screening Resolution
Earlier in March, Kansas Insurance Commissioner Sandy Praeger, state health organizations, and members of the health insurance community urged Kansans to get colon cancer screenings. March was National Colon Cancer Awareness Month and Kansans were asked to stay educated and seek early detection of the disease. Blue Cross and Blue Shield of Kansas supports this resolution and encourages members to stay up to date on all preventive screenings.
Legislation to Monitor During the Veto Session
The following health-insurance related bills are pending for the House and Senate when each reconvenes:
SB 388: Includes amendments that focus on a health insurance rider for voluntary abortions and studies on clinical marriage and family therapy, clinical professional counselors, and clinical psychotherapists, in addition to other health services.
Under the legislation, individual and group health insurance plans issued for delivery, amended, or renewed on and after July 1, 2010, shall exclude coverage for abortions unless:
- The procedure is necessary to preserve the life of the mother, or
- In the case of rape reported to a law enforcement agency, or
- In the case of incest involving a minor and reporting to a law enforcement agency.
Furthermore, all individual policies and group health plans must offer a rider to cover abortions that are excluded under the policy. An additional premium must be paid for the rider.
The legislation also requires:
- KHPA to research insurance company reimbursement and long-term expenditures for clinical marriage and family therapists, clinical professional counselors, and clinical psychotherapists for the SEHP.
- KHPA to determine the cost of the CVS Caremark pharmacy benefits manager contract with the SEHP.
- The studies must be completed no later than December 31, 2010, and be made available for legislators.
Research more Kansas legislative items at: http://www.kslegislature.org/legsrv-legisportal/index.do.
If you have specific questions on these or any other health insurance legislation, send your questions to firstname.lastname@example.org or visit, the Grassroots Network Web page at http://www.bcbsks.com/news/LegislativeIssues/state.htm.