Kansas 2023-2024 Regular Session

Kansas Senate Bill SB26 Compare Versions

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Version 2 (New)

Old	New		Differences
	1	+	Session of 2023
1	2		SENATE BILL No. 26
2		-	AN ACT concerning gender identity medical care; creating a civil cause of action against a
3		-	physician who performs childhood gender reassignment service; requiring revocation
4		-	of a physician's license if such physician performs childhood gender reassignment
5		-	service; amending K.S.A. 2022 Supp. 65-2836 and repealing the existing section.
	3	+	By Committee on Financial Institutions and Insurance
	4	+	1-11
	5	+	AN ACT concerning insurance; relating to health maintenance
	6	+	organizations and medicare provider organizations; applications for
	7	+	certificates of authority; specifying certain requirements necessary to
	8	+	demonstrate fiscal soundness; amending K.S.A. 40-3203 and repealing
	9	+	the existing section.
6	10		Be it enacted by the Legislature of the State of Kansas:
7		-	New Section 1. (a) An individual who had a childhood gender
8		-	reassignment service performed on such individual as a child may bring
9		-	a civil cause of action against the physician who performed the
10		-	childhood gender reassignment service.
11		-	(1) An action against a physician pursuant to this section may be
12		-	commenced not more than three years after the date the individual
13		-	attains 18 years of age.
14		-	(b) As used in this section:
15		-	(1) "Childhood gender reassignment service" means performing,
16		-	or causing to be performed, acts including, but not limited to, any of the
17		-	following performed upon a child under 18 years of age for the purpose
18		-	of attempting to affirm the child's perception of the child's sex or
19		-	gender, if that perception is inconsistent with the child's sex:
20		-	(A) A surgery that sterilizes or is intended to result in sterilization,
21		-	including, but not limited to, castration, vasectomy, hysterectomy,
22		-	oophorectomy, orchiectomy and penectomy;
23		-	(B) a surgery that artificially constructs tissue with the appearance
24		-	of genitalia, including, but not limited to, metoidioplasty, phalloplasty
25		-	and vaginoplasty;
26		-	(C) a mastectomy;
27		-	(D) prescribing, dispensing, administering or otherwise supplying
28		-	the following medications:
29		-	(i) Puberty-blocking medication to delay, hinder, stop or reverse
30		-	normal puberty;
31		-	(ii) supraphysiologic doses of testosterone to females; or
32		-	(iii) supraphysiologic doses of estrogen to males; or
33		-	(E) removing any body part or tissue.
34		-	(2) "Physician" means a person licensed by the board of healing
35		-	arts to practice medicine and surgery.
36		-	(3) "Sex" means the biological state of being female or male based
37		-	on the individual's sex organs, chromosomes and endogenous hormone
38		-	profiles.
39		-	(4) "Supraphysiologic doses" means a pharmacologic dosage
40		-	regimen that produces blood concentrations greater than the accepted
41		-	range for a child's age and sex.
42		-	(c) The provisions of this section shall not apply if the child was
43		-	born with a medically verifiable disorder of sex development,
44		-	including, but not limited to:
45		-	(1) A child with external biological sex characteristics that are
46		-	irresolvably ambiguous, such as a child born having 46,XX
47		-	chromosomes with virilization, 46,XY chromosomes with
48		-	undervirilization or both ovarian and testicular tissue; or
49		-	(2) when a physician has otherwise diagnosed a disorder of sexual
50		-	development, in which the physician has determined through genetic or
51		-	biochemical testing that the child does not have the normal sex
52		-	chromosome structure, sex steroid hormone production or sex steroid
53		-	hormone action for a male or female of the child's age.
54		-	(d) (1) An individual who brings an action under this section may
55		-	seek actual damages, exemplary or punitive damages, injunctive relief
56		-	and other appropriate relief.
57		-	(2) In an action brought under this section, the court shall award a
58		-	prevailing plaintiff the cost of the suit including reasonable attorney
59		-	fees. SENATE BILL No. 26—page 2
60		-	(e) This section shall be applicable to:
61		-	(1) Any action commenced on or after July 1, 2023, including any
62		-	action that would be barred by the period of limitation applicable prior to
63		-	July 1, 2023; and
64		-	(2) any action commenced prior to July 1, 2023, and pending on July
65		-	1, 2023.
66		-	(f) This section shall be known and may be cited as the Kansas child
67		-	mutilation prevention act.
68		-	Sec. 2. K.S.A. 2022 Supp. 65-2836 is hereby amended to read as
69		-	follows: 65-2836. (a) A licensee's license may be revoked, suspended or
70		-	limited, or the licensee may be publicly censured or placed under
71		-	probationary conditions, or an application for a license or for
72		-	reinstatement of a license may be denied upon a finding of the existence
73		-	of any of the following grounds:
74		-	(a)(1) The licensee has committed fraud or misrepresentation in
75		-	applying for or securing an original, renewal or reinstated license.
76		-	(b)(2) The licensee has committed an act of unprofessional or
77		-	dishonorable conduct or professional incompetency, except that the board
78		-	may take appropriate disciplinary action or enter into a non-disciplinary
79		-	resolution when a licensee has engaged in any conduct or professional
80		-	practice on a single occasion that, if continued, would reasonably be
81		-	expected to constitute an inability to practice the healing arts with
82		-	reasonable skill and safety to patients or unprofessional conduct as
83		-	defined in K.S.A. 65-2837, and amendments thereto.
84		-	(c)(3) The licensee has been convicted of a felony or class A
85		-	misdemeanor, or substantially similar offense in another jurisdiction,
86		-	whether or not related to the practice of the healing arts, or the licensee
87		-	has been convicted in a special or general court-martial, whether or not
88		-	related to the practice of the healing arts. The board shall revoke a
89		-	licensee's license following conviction of a felony or substantially similar
90		-	offense in another jurisdiction, or following conviction in a general court-
91		-	martial occurring after July 1, 2000, unless a
	11	+	Section 1. K.S.A. 40-3203 is hereby amended to read as follows: 40-
	12	+	3203. (a) Except as otherwise provided by this act, it shall be unlawful for
	13	+	any person to provide health care services in the manner prescribed in
	14	+	subsection (n) or subsection (r) of K.S.A. 40-3202(n) or (r), and
	15	+	amendments thereto, without first obtaining a certificate of authority from
	16	+	the commissioner.
	17	+	(b) Applications for a certificate of authority shall be made in the
	18	+	form required by the commissioner and shall be verified by an officer or
	19	+	authorized representative of the applicant and shall set forth or be
	20	+	accompanied by:
	21	+	(1) A copy of the basic organizational documents of the applicant
	22	+	such as articles of incorporation, partnership agreements, trust agreements
	23	+	or other applicable documents;
	24	+	(2) a copy of the bylaws, regulations or similar document, if any,
	25	+	regulating the conduct of the internal affairs of the applicant;
	26	+	(3) a list of the names, addresses, official capacity with the
	27	+	organization and biographical information for all of the persons who are to
	28	+	be responsible for the conduct of its affairs, including all members of the
	29	+	governing body, the officers and directors in the case of a corporation and
	30	+	the partners or members in the case of a partnership or corporation;
	31	+	(4) a sample or representative copy of any contract or agreement
	32	+	made or to be made between the health maintenance organization or
	33	+	medicare provider organization and any class of providers and a copy of
	34	+	any contract made or agreement made or to be made, excluding individual
	35	+	employment contracts or agreements, between third party administrators,
	36	+	marketing consultants or persons listed in subsection (3) and the health
	37	+	maintenance organization or medicare provider organization;
	38	+	(5) a statement generally describing the organization, its enrollment
	39	+	process, its operation, its quality assurance mechanism, its internal
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93		-	/3 majority of the board
94		-	members present and voting determine by clear and convincing evidence
95		-	that such licensee will not pose a threat to the public in such person's
96		-	capacity as a licensee and that such person has been sufficiently
97		-	rehabilitated to warrant the public trust. In the case of a person who has
98		-	been convicted of a felony or convicted in a general court-martial and
99		-	who applies for an original license or to reinstate a canceled license, the
100		-	application for a license shall be denied unless a
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	76	+	grievance procedures, in the case of a health maintenance organization the
	77	+	methods it proposes to use to offer its enrollees an opportunity to
	78	+	participate in matters of policy and operation, the geographic area or areas
	79	+	to be served, the location and hours of operation of the facilities at which
	80	+	health care healthcare services will be regularly available to enrollees in
	81	+	the case of staff and group practices, the type and specialty of health care
	82	+	healthcare personnel and the number of personnel in each specialty
	83	+	category engaged to provide health care healthcare services in the case of
	84	+	staff and group practices, and a records system providing documentation
	85	+	of utilization rates for enrollees. In cases other than staff and group
	86	+	practices, the organization shall provide a list of names, addresses and
	87	+	telephone numbers of providers by specialty;
	88	+	(6) copies of all contract forms the organization proposes to offer
	89	+	enrollees together with a table of rates to be charged;
	90	+	(7) the following statements of the fiscal soundness of the
	91	+	organization:
	92	+	(A) Descriptions of financing arrangements for operational deficits
	93	+	and for developmental costs if operational one year or less;
	94	+	(B) a copy of the most recent unaudited financial statements of the
	95	+	health maintenance organization or medicare provider organization;
	96	+	(C) financial projections in conformity with statutory accounting
	97	+	practices prescribed or otherwise permitted by the department of insurance
	98	+	of the state of domicile for a minimum of three years from the anticipated
	99	+	date of certification and on a monthly basis from the date of certification
	100	+	through one year from the date of application. If the health maintenance
	101	+	organization or medicare provider organization is expected to incur a
	102	+	deficit, projections shall be made for each deficit year and for one year
	103	+	thereafter, up to a maximum of five years. All financial projections shall
	104	+	include:
	105	+	(i) Monthly statements of revenue and expense for the first year on a
	106	+	gross dollar as well as per-member-per-month basis, with quarters
	107	+	consistent with standard calendar year quarters;
	108	+	(ii) quarterly Statements of revenue and expense for each subsequent
	109	+	year;
	110	+	(iii)(ii) a quarterly balance sheet for each year; and
	111	+	(iv)(iii) a statement and justification of assumptions;
	112	+	(8) a description of the procedure to be utilized by a health
	113	+	maintenance organization or medicare provider organization to provide
	114	+	for:
	115	+	(A) Offering enrollees an opportunity to participate in matters of
	116	+	policy and operation of a health maintenance organization;
	117	+	(B) monitoring of the quality of care provided by such organization
	118	+	including, as a minimum, peer review; and
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102		-	/3 majority of the board
103		-	members present and voting on such application determine by clear and
104		-	convincing evidence that such person will not pose a threat to the public
105		-	in such person's capacity as a licensee and that such person has been
106		-	sufficiently rehabilitated to warrant the public trust.
107		-	(d)(4) The licensee has used fraudulent or false advertisements.
108		-	(e)(5) The licensee is addicted to or has distributed intoxicating
109		-	liquors or drugs for any other than lawful purposes.
110		-	(f)(6) The licensee has willfully or repeatedly violated this act, the
111		-	pharmacy act of the state of Kansas or the uniform controlled substances
112		-	act, or any rules and regulations adopted pursuant thereto, or any rules
113		-	and regulations of the secretary of health and environment that are
114		-	relevant to the practice of the healing arts.
115		-	(g)(7) The licensee has unlawfully invaded the field of practice of
116		-	any branch of the healing arts in which the licensee is not licensed to
117		-	practice.
118		-	(h)(8) The licensee has engaged in the practice of the healing arts
119		-	under a false or assumed name, or the impersonation of another
120		-	practitioner. The provisions of this subsection relating to an assumed
121		-	name shall not apply to licensees practicing under a professional
122		-	corporation, under a business entity that holds a certificate of SENATE BILL No. 26—page 3
123		-	authorization pursuant to K.S.A. 2022 Supp. 65-28,134, and amendments
124		-	thereto, or under any other legal entity duly authorized to provide such
125		-	professional services in the state of Kansas.
126		-	(i)(9) The licensee's ability to practice the healing arts with
127		-	reasonable skill and safety to patients is impaired by reason of physical or
128		-	mental illness, or condition or use of alcohol, drugs or controlled
129		-	substances. All information, reports, findings and other records relating to
130		-	impairment shall be confidential and not subject to discovery by or release
131		-	to any person or entity outside of a board proceeding.
132		-	(j)(10) The licensee has had a license to practice the healing arts
133		-	revoked, suspended or limited, has been censured or has had other
134		-	disciplinary action taken, or an application for a license denied, by the
135		-	proper licensing authority of another state, territory, District of Columbia,
136		-	or other country.
137		-	(k)(11) The licensee has violated any lawful rule and regulation
138		-	promulgated by the board or violated any lawful order or directive of the
139		-	board previously entered by the board.
140		-	(l)(12) The licensee has failed to report or reveal the knowledge
141		-	required to be reported or revealed under K.S.A. 65-28,122, and
142		-	amendments thereto.
143		-	(m)(13) The licensee, if licensed to practice medicine and surgery,
144		-	has failed to inform in writing a patient suffering from any form of
145		-	abnormality of the breast tissue for which surgery is a recommended form
146		-	of treatment, of alternative methods of treatment recognized by licensees
147		-	of the same profession in the same or similar communities as being
148		-	acceptable under like conditions and circumstances.
149		-	(n)(14) The licensee has cheated on or attempted to subvert the
150		-	validity of the examination for a license.
151		-	(o)(15) The licensee has been found to be mentally ill, disabled, not
152		-	guilty by reason of insanity, not guilty because the licensee suffers from a
153		-	mental disease or defect or incompetent to stand trial by a court of
154		-	competent jurisdiction.
155		-	(p)(16) The licensee has prescribed, sold, administered, distributed
156		-	or given a controlled substance to any person for other than medically
157		-	accepted or lawful purposes.
158		-	(q)(17) The licensee has violated a federal law or regulation relating
159		-	to controlled substances.
160		-	(r)(18) The licensee has failed to furnish the board, or its
161		-	investigators or representatives, any information legally requested by the
162		-	board.
163		-	(s)(19) Sanctions or disciplinary actions have been taken against the
164		-	licensee by a peer review committee, healthcare facility, a governmental
165		-	agency or department or a professional association or society for acts or
166		-	conduct similar to acts or conduct that would constitute grounds for
167		-	disciplinary action under this section.
168		-	(t)(20) The licensee has failed to report to the board any adverse
169		-	action taken against the licensee by another state or licensing jurisdiction,
170		-	a peer review body, a healthcare facility, a professional association or
171		-	society, a governmental agency, by a law enforcement agency or a court
172		-	for acts or conduct similar to acts or conduct that would constitute
173		-	grounds for disciplinary action under this section.
174		-	(u)(21) The licensee has surrendered a license or authorization to
175		-	practice the healing arts in another state or jurisdiction, has surrendered
176		-	the authority to utilize controlled substances issued by any state or federal
177		-	agency, has agreed to a limitation to or restriction of privileges at any
178		-	medical care facility or has surrendered the licensee's membership on any
179		-	professional staff or in any professional association or society while under
180		-	investigation for acts or conduct similar to acts or conduct that would
181		-	constitute grounds for disciplinary action under this section. SENATE BILL No. 26—page 4
182		-	(v)(22) The licensee has failed to report to the board surrender of the
183		-	licensee's license or authorization to practice the healing arts in another
184		-	state or jurisdiction or surrender of the licensee's membership on any
185		-	professional staff or in any professional association or society while under
186		-	investigation for acts or conduct similar to acts or conduct that would
187		-	constitute grounds for disciplinary action under this section.
188		-	(w)(23) The licensee has an adverse judgment, award or settlement
189		-	against the licensee resulting from a medical liability claim related to acts
190		-	or conduct similar to acts or conduct that would constitute grounds for
191		-	disciplinary action under this section.
192		-	(x)(24) The licensee has failed to report to the board any adverse
193		-	judgment, settlement or award against the licensee resulting from a
194		-	medical malpractice liability claim related to acts or conduct similar to
195		-	acts or conduct that would constitute grounds for disciplinary action under
196		-	this section.
197		-	(y)(25) The licensee has failed to maintain a policy of professional
198		-	liability insurance as required by K.S.A. 40-3402 or 40-3403a, and
199		-	amendments thereto.
200		-	(z)(26) The licensee has failed to pay the premium surcharges as
201		-	required by K.S.A. 40-3404, and amendments thereto.
202		-	(aa)(27) The licensee has knowingly submitted any misleading,
203		-	deceptive, untrue or fraudulent representation on a claim form, bill or
204		-	statement.
205		-	(bb)(28) The licensee as the supervising physician for a physician
206		-	assistant has failed to adequately direct and supervise the physician
207		-	assistant in accordance with the physician assistant licensure act or rules
208		-	and regulations adopted under such act.
209		-	(cc)(29) The licensee has assisted suicide in violation of K.S.A. 21-
210		-	3406, prior to its repeal, or K.S.A. 2022 Supp. 21-5407, and amendments
211		-	thereto, as established by any of the following:
212		-	(1)(A) A copy of the record of criminal conviction or plea of guilty
213		-	for a felony in violation of K.S.A. 21-3406, prior to its repeal, or K.S.A.
214		-	2022 Supp. 21-5407, and amendments thereto.
215		-	(2)(B) A copy of the record of a judgment of contempt of court for
216		-	violating an injunction issued under K.S.A. 60-4404, and amendments
217		-	thereto.
218		-	(3)(C) A copy of the record of a judgment assessing damages under
219		-	K.S.A. 60-4405, and amendments thereto.
220		-	(dd)(30) The licensee has given a worthless check or stopped
221		-	payment on a debit or credit card for fees or moneys legally due to the
222		-	board.
223		-	(ee)(31) The licensee has knowingly or negligently abandoned
224		-	medical records.
225		-	(b) A physician's license shall be revoked upon a finding that the
226		-	physician has performed a childhood gender reassignment service, as
227		-	defined in section 1, and amendments thereto.
228		-	Sec. 3. K.S.A. 2022 Supp. 65-2836 is hereby repealed. SENATE BILL No. 26—page 5
229		-	Sec. 4. This act shall take effect and be in force from and after its
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	162	+	(C) resolving complaints and grievances initiated by enrollees;
	163	+	(9) a written irrevocable consent duly executed by such applicant, if
	164	+	the applicant is a nonresident, appointing the commissioner as the person
	165	+	upon whom lawful process in any legal action against such organization on
	166	+	any cause of action arising in this state may be served and that such
	167	+	service of process shall be valid and binding in the same extent as if
	168	+	personal service had been had and obtained upon said nonresident in this
	169	+	state;
	170	+	(10) a plan, in the case of group or staff practices, that will provide
	171	+	for maintaining a medical records system which that is adequate to provide
	172	+	an accurate documentation of utilization by every enrollee, such system to
	173	+	identify clearly, at a minimum, each patient by name, age and sex and to
	174	+	indicate clearly the services provided, when, where, and by whom, the
	175	+	diagnosis, treatment and drug therapy, and in all other cases, evidence that
	176	+	contracts with providers require that similar medical records systems be in
	177	+	place;
	178	+	(11) evidence of adequate insurance coverage or an adequate plan for
	179	+	self-insurance to respond to claims for injuries arising out of the furnishing
	180	+	of health care healthcare;
	181	+	(12) such other information as may be required by the commissioner
	182	+	to make the determinations required by K.S.A. 40-3204, and amendments
	183	+	thereto; and
	184	+	(13) in lieu of any of the application requirements imposed by this
	185	+	section on a medicare provider organization, the commissioner may accept
	186	+	any report or application filed by the medicare provider organization with
	187	+	the appropriate examining agency or official of another state or agency of
	188	+	the federal government.
	189	+	(c) The commissioner may promulgate rules and regulations the
	190	+	commissioner deems necessary to the proper administration of this act to
	191	+	require a health maintenance organization or medicare provider
	192	+	organization, subsequent to receiving its certificate of authority to submit
	193	+	the information, modifications or amendments to the items described in
	194	+	subsection (b) to the commissioner prior to the effectuation of the
	195	+	modification or amendment or to require the health maintenance
	196	+	organization to indicate the modifications to the commissioner. Any
	197	+	modification or amendment for which the approval of the commissioner is
	198	+	required shall be deemed approved unless disapproved within 30 days,
	199	+	except the commissioner may postpone the action for such further time,
	200	+	not exceeding an additional 30 days, as necessary for proper consideration.
	201	+	Sec. 2. K.S.A. 40-3203 is hereby repealed.
	202	+	Sec. 3. This act shall take effect and be in force from and after its
230	203		publication in the statute book.
231		-	I hereby certify that the above BILL originated in the
232		-	SENATE, and passed that body
233		-	__________________________
234		-	SENATE adopted
235		-	Conference Committee Report ________________
236		-	_________________________
237		-	President of the Senate.
238		-	_________________________
239		-	Secretary of the Senate.
240		-
241		-	Passed the HOUSE
242		-	as amended _________________________
243		-	HOUSE adopted
244		-	Conference Committee Report ________________
245		-	_________________________
246		-	Speaker of the House.
247		-	_________________________
248		-	Chief Clerk of the House.
249		-	APPROVED _____________________________
250		-	_________________________
251		-	Governor.
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