1 | 1 | | Session of 2025 |
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2 | 2 | | HOUSE BILL No. 2375 |
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3 | 3 | | By Committee on Appropriations |
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4 | 4 | | Requested by Representative Ballard on behalf of the Office of the Governor |
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5 | 5 | | 2-11 |
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6 | 6 | | AN ACT concerning health and healthcare; relating to health insurance |
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7 | 7 | | coverage; expanding medical assistance eligibility; enacting the |
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8 | 8 | | healthcare access for working Kansans (HAWK) act; directing the |
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9 | 9 | | department of health and environment to study certain medicaid |
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10 | 10 | | expansion topics; adding meeting days to the Robert G. (Bob) Bethell |
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11 | 11 | | joint committee on home and community based services and KanCare |
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12 | 12 | | oversight to monitor implementation of expanded medical assistance |
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13 | 13 | | eligibility; amending K.S.A. 39-7,160 and 40-3213 and repealing the |
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14 | 14 | | existing sections. |
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15 | 15 | | Be it enacted by the Legislature of the State of Kansas: |
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16 | 16 | | New Section 1. (a) Sections 1 through 11, and amendments thereto, |
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17 | 17 | | shall be known and may be cited as the healthcare access for working |
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18 | 18 | | Kansans (HAWK) act. |
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19 | 19 | | (b) The legislature expressly consents to expand eligibility for receipt |
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20 | 20 | | of benefits under the Kansas program of medical assistance, as required by |
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21 | 21 | | K.S.A. 39-709(e)(2), and amendments thereto, by the passage and |
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22 | 22 | | enactment of the act, subject to all requirements and limitations established |
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23 | 23 | | in the act. |
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24 | 24 | | (c) The secretary of health and environment shall adopt rules and |
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25 | 25 | | regulations as necessary to implement and administer the act. |
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26 | 26 | | (d) As used in sections 1 through 11, and amendments thereto, unless |
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27 | 27 | | otherwise specified: |
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28 | 28 | | (1) "138% of the federal poverty level," or words of like effect, |
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29 | 29 | | includes a 5% income disregard permitted under the federal patient |
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30 | 30 | | protection and affordable care act. |
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31 | 31 | | (2) "Act" means the healthcare access for working Kansans (HAWK) |
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32 | 32 | | act. |
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33 | 33 | | New Sec. 2. (a) The secretary of health and environment shall submit |
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34 | 34 | | to the United States centers for medicare and medicaid services any state |
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35 | 35 | | plan amendment, waiver request or other approval request necessary to |
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36 | 36 | | implement the act. At least 10 calendar days prior to submission of any |
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37 | 37 | | such approval request to the United States centers for medicare and |
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38 | 38 | | medicaid services, the secretary of health and environment shall submit |
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39 | 39 | | such approval request application to the state finance council. |
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74 | 74 | | 35 HB 2375 2 |
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75 | 75 | | (b) For purposes of eligibility determinations under the Kansas |
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76 | 76 | | program of medical assistance on and after January 1, 2026, medical |
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77 | 77 | | assistance shall be granted to any adult under 65 years of age who is not |
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78 | 78 | | pregnant and whose income meets the limitation established in subsection |
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79 | 79 | | (c), as permitted under the provisions of 42 U.S.C. § 1396a, as it exists on |
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80 | 80 | | the effective date of the act, and subject to a 90% federal medical |
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81 | 81 | | assistance percentage and all requirements and limitations established in |
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82 | 82 | | the act. |
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83 | 83 | | (c) The secretary of health and environment shall submit to the |
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84 | 84 | | United States centers for medicare and medicaid services any approval |
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85 | 85 | | request necessary to provide medical assistance eligibility to individuals |
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86 | 86 | | described in subsection (b) whose modified adjusted gross income does |
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87 | 87 | | not exceed 138% of the federal poverty level. |
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88 | 88 | | New Sec. 3. (a) The secretary of health and environment shall require |
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89 | 89 | | each applicant for coverage under the act to provide employment |
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90 | 90 | | verification at the time of initial application or renewal application. Such |
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91 | 91 | | verification shall be a prerequisite for coverage under the act. |
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92 | 92 | | (b) "Employment verification" means documentation demonstrating |
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93 | 93 | | employment during the preceding 12 months that meets the eligibility |
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94 | 94 | | requirements of the act. "Employment verification" includes, but is not |
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95 | 95 | | limited to: |
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96 | 96 | | (1) Federal form W-2 wage and tax statement; |
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97 | 97 | | (2) a pay stub demonstrating gross income; |
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98 | 98 | | (3) employment records; |
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99 | 99 | | (4) federal form 1099 demonstrating payments for contract labor; |
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100 | 100 | | (5) compliance with the requirements of K.S.A. 39-709(b), and |
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101 | 101 | | amendments thereto; and |
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102 | 102 | | (6) any other documentation as determined by the secretary of health |
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103 | 103 | | and environment. |
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104 | 104 | | (c) The following individuals shall be exempt from the requirements |
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105 | 105 | | of this subsection: |
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106 | 106 | | (1) A full-time student enrolled in a postsecondary educational |
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107 | 107 | | institution or technical college, as defined by K.S.A. 74-3201b, and |
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108 | 108 | | amendments thereto, for each year the student is enrolled in such |
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109 | 109 | | educational setting; |
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110 | 110 | | (2) a parent or guardian of a dependent child under 18 years of age or |
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111 | 111 | | a parent or guardian of an incapacitated adult; |
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112 | 112 | | (3) an individual who is mentally or physically unfit for employment, |
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113 | 113 | | as defined by the secretary of health and environment, or has a pending |
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114 | 114 | | application for supplemental security income or social security disability |
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115 | 115 | | insurance; |
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116 | 116 | | (4) an individual who has a permanent partial disability, as such term |
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117 | 117 | | is used in K.S.A. 44-510e, and amendments thereto; |
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160 | 160 | | 43 HB 2375 3 |
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161 | 161 | | (5) an individual who is engaged in volunteer work for at least 20 |
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162 | 162 | | hours per week at a nonprofit organization, as such term is defined in |
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163 | 163 | | K.S.A. 17-1779, and amendments thereto; |
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164 | 164 | | (6) an individual experiencing homelessness, as such term is defined |
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165 | 165 | | in 42 U.S.C. § 11302, as in effect on the effective date of this act; |
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166 | 166 | | (7) an individual who served in the active military, naval, air or space |
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167 | 167 | | service and was discharged or released from such military service under |
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168 | 168 | | conditions other than dishonorable; |
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169 | 169 | | (8) an individual who is not more than 22 years of age and in the |
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170 | 170 | | custody of the secretary of children and families on the date that the |
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171 | 171 | | individual reached 18 years of age; and |
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172 | 172 | | (9) any individual who the secretary determines is experiencing |
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173 | 173 | | hardship. |
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174 | 174 | | New Sec. 4. (a) Except to the extent prohibited by 42 U.S.C. § |
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175 | 175 | | 1396u-2(a)(2), as it exists on the effective date of this act, the secretary of |
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176 | 176 | | health and environment shall administer medical assistance benefits using |
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177 | 177 | | a managed care delivery system using organizations subject to assessment |
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178 | 178 | | of the privilege fee under K.S.A. 40-3213, and amendments thereto. If the |
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179 | 179 | | United States centers for medicare and medicaid services determines that |
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180 | 180 | | the assessment of a privilege fee provided in K.S.A. 40-3213, and |
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181 | 181 | | amendments thereto, is unlawful or otherwise invalid, then the secretary of |
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182 | 182 | | health and environment shall administer state medicaid services using a |
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183 | 183 | | managed care delivery system. |
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184 | 184 | | (b) In awarding a contract for an entity to administer state medicaid |
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185 | 185 | | services using a managed care delivery system, the secretary of health and |
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186 | 186 | | environment shall: |
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187 | 187 | | (1) Not provide favorable or unfavorable treatment in awarding a |
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188 | 188 | | contract based on an entity's for-profit or not-for-profit tax status; |
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189 | 189 | | (2) give preference in awarding a contract to an entity that provides |
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190 | 190 | | health insurance coverage plans on the health benefit exchange in Kansas |
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191 | 191 | | established under the federal patient protection and affordable care act; and |
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192 | 192 | | (3) require that any entity administering state medicaid services |
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193 | 193 | | provide tiered benefit plans with enhanced benefits for covered individuals |
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194 | 194 | | who demonstrate healthy behaviors, as determined by the secretary of |
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195 | 195 | | health and environment, to be implemented on or before July 1, 2027. |
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196 | 196 | | New Sec. 5. If the federal medical assistance percentage for coverage |
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197 | 197 | | of medical assistance participants described in section 1902(a)(10)(A)(i) |
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198 | 198 | | (VIII) of the federal social security act, 42 U.S.C. § 1396a, as it exists on |
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199 | 199 | | the effective date of this act, becomes lower than 90%, then the secretary |
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200 | 200 | | of health and environment shall terminate coverage under the act over a |
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201 | 201 | | 12-month period, beginning on the first day that the federal medical |
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202 | 202 | | assistance percentage becomes lower than 90%. No individual shall be |
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203 | 203 | | newly enrolled for coverage under the act after such date. |
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246 | 246 | | 43 HB 2375 4 |
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247 | 247 | | New Sec. 6. (a) Section 5, and amendments thereto, shall be |
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248 | 248 | | nonseverable from the remainder of the act. If the provisions of section 5, |
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249 | 249 | | and amendments thereto, are not approved by the United States centers for |
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250 | 250 | | medicare and medicaid services, then the act shall be null and void and |
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251 | 251 | | shall have no force and effect. |
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252 | 252 | | (b) A denial of federal approval or federal financial participation that |
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253 | 253 | | applies to any provision of the act not enumerated in subsection (a) shall |
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254 | 254 | | not prohibit the secretary of health and environment from implementing |
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255 | 255 | | any other provision of the act. |
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256 | 256 | | New Sec. 7. (a) On or before January 10, 2027, and on or before the |
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257 | 257 | | first day of the regular session of the legislature each year thereafter, the |
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258 | 258 | | secretary of health and environment shall prepare and deliver a report to |
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259 | 259 | | the legislature that summarizes the cost savings achieved by the state from |
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260 | 260 | | the movement of covered individuals from the KanCare program to |
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261 | 261 | | coverage under the act, including, but not limited to, the MediKan |
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262 | 262 | | program, the medically needy spend-down program and the breast and |
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263 | 263 | | cervical cancer program. |
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264 | 264 | | (b) State cost savings shall be determined by calculating the cost of |
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265 | 265 | | providing services to covered individuals in the KanCare program less the |
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266 | 266 | | cost of services provided to covered individuals under the act. |
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267 | 267 | | (c) If the secretary of health and environment implements other |
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268 | 268 | | initiatives using cost savings achieved through the implementation of the |
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269 | 269 | | act, the secretary shall include such initiatives as part of the report required |
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270 | 270 | | in subsection (a). |
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271 | 271 | | New Sec. 8. (a) The secretary of corrections and the secretary of |
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272 | 272 | | health and environment shall coordinate with a county sheriff or such |
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273 | 273 | | sheriff's deputy who requests assistance in facilitating medicaid coverage |
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274 | 274 | | for any individual committed to a county jail or correctional facility during |
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275 | 275 | | any time period that such individual is eligible for coverage under state or |
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276 | 276 | | federal law. |
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277 | 277 | | (b) If an individual is enrolled in medicaid when such individual is |
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278 | 278 | | committed to a county jail or correctional facility, such medicaid status |
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279 | 279 | | shall not be suspended or terminated based on such individual's |
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280 | 280 | | incarceration for a minimum of 30 days. After 30 days, medicaid coverage |
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281 | 281 | | may be suspended, but not terminated, up to the maximum amount of time |
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282 | 282 | | permitted by state and federal law. |
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283 | 283 | | (c) The secretary of health and environment shall coordinate with a |
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284 | 284 | | county sheriff or such sheriff's deputy and the department of corrections to |
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285 | 285 | | assist any individual who is committed to a county jail or correctional |
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286 | 286 | | facility in applying for medicaid coverage prior to such individual's release |
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287 | 287 | | from custody if such individual is likely to meet the requirements for |
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288 | 288 | | medicaid coverage to allow adequate time for medicaid coverage to begin |
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289 | 289 | | promptly upon release. |
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332 | 332 | | 43 HB 2375 5 |
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333 | 333 | | (d) The secretary of health and environment shall adopt any rules and |
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334 | 334 | | regulations and supporting policies and procedures as necessary to |
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335 | 335 | | implement and administer this section prior to January 1, 2026. |
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336 | 336 | | New Sec. 9. On or before February 15, 2027, and on or before |
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337 | 337 | | February 15 of each year thereafter, the secretary of health and |
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338 | 338 | | environment shall present a report to the house of representatives standing |
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339 | 339 | | committee on appropriations and the senate standing committee on ways |
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340 | 340 | | and means that summarizes the costs of the act and the cost savings and |
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341 | 341 | | additional revenues generated during the preceding fiscal year. |
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342 | 342 | | New Sec. 10. (a) There is hereby established the rural health advisory |
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343 | 343 | | committee. |
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344 | 344 | | (b) The rural health advisory committee shall consist of 15 members |
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345 | 345 | | appointed by the governor. The membership shall be comprised of |
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346 | 346 | | individuals with a variety of backgrounds including medicine, education, |
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347 | 347 | | farming, finance, business and individuals representing community |
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348 | 348 | | interests in rural Kansas. |
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349 | 349 | | (c) The governor shall designate one of the appointed members to be |
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350 | 350 | | chairperson of the committee. The members of the advisory committee |
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351 | 351 | | shall select a vice chairperson from the membership of the advisory |
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352 | 352 | | committee. |
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353 | 353 | | (d) Upon first appointment, five of the members shall serve for a term |
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354 | 354 | | of one year, five of the members shall be appointed for a term of two years |
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355 | 355 | | and five of the members shall be appointed for term of three years, as |
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356 | 356 | | designated by the governor. The member designated as chairperson shall |
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357 | 357 | | serve for a term of three years. Subsequent appointees shall serve terms of |
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358 | 358 | | three years. |
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359 | 359 | | (e) (1) The advisory committee may meet at any time and at any |
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360 | 360 | | place within the state on the call of the chairperson. The advisory |
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361 | 361 | | committee shall meet regularly, but shall meet at least once every calendar |
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362 | 362 | | quarter. |
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363 | 363 | | (2) A quorum of the advisory committee shall be eight voting |
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364 | 364 | | members. All actions of the advisory committee shall be adopted by a |
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365 | 365 | | majority of those voting members present when there is a quorum. |
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366 | 366 | | (f) The advisory committee shall: |
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367 | 367 | | (1) Advise the governor and other state agencies on rural health |
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368 | 368 | | issues; |
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369 | 369 | | (2) recommend and evaluate mechanisms to encourage greater |
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370 | 370 | | cooperation between rural communities and rural health providers; |
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371 | 371 | | (3) recommend and evaluate approaches to rural health issues that are |
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372 | 372 | | sensitive to the needs of local communities; |
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373 | 373 | | (4) develop methods to identify individuals who are underserved by |
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374 | 374 | | the Kansas rural healthcare system; and |
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375 | 375 | | (5) beginning in 2026, provide an annual report to the governor |
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418 | 418 | | 43 HB 2375 6 |
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419 | 419 | | containing the advice, recommendations and conclusions of the advisory |
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420 | 420 | | committee. |
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421 | 421 | | (g) The secretary of health and environment shall facilitate the work |
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422 | 422 | | of the committee by providing access to meeting space and other necessary |
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423 | 423 | | staff and office support. The secretary of health and environment may |
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424 | 424 | | adopt any rules and regulations and supporting policies and procedures |
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425 | 425 | | that are necessary to support the work of the advisory committee. |
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426 | 426 | | New Sec. 11. The healthcare access for working Kansans (HAWK) |
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427 | 427 | | act shall not provide coverage for abortion services, except in cases where |
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428 | 428 | | coverage is mandated by federal law and federal financial participation is |
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429 | 429 | | available. |
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430 | 430 | | Sec. 12. K.S.A. 39-7,160 is hereby amended to read as follows: 39- |
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431 | 431 | | 7,160. (a) There is hereby established the Robert G. (Bob) Bethell joint |
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432 | 432 | | committee on home and community based services and KanCare |
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433 | 433 | | oversight. The joint committee shall review the number of individuals who |
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434 | 434 | | are transferred from state or private institutions and long-term care |
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435 | 435 | | facilities to the home and community based services and the associated |
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436 | 436 | | cost savings and other outcomes of the money-follows-the-person |
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437 | 437 | | program. The joint committee shall review the funding targets |
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438 | 438 | | recommended by the interim report submitted for the 2007 legislature by |
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439 | 439 | | the joint committee on legislative budget and use them as guidelines for |
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440 | 440 | | future funding planning and policy making. The joint committee shall have |
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441 | 441 | | oversight of savings resulting from the transfer of individuals from state or |
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442 | 442 | | private institutions to home and community based services. As used in |
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443 | 443 | | K.S.A. 39-7,159 through 39-7,162, and amendments thereto, "savings" |
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444 | 444 | | means the difference between the average cost of providing services for |
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445 | 445 | | individuals in an institutional setting and the cost of providing services in a |
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446 | 446 | | home and community based setting. The joint committee shall study and |
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447 | 447 | | determine the effectiveness of the program and cost-analysis of the state |
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448 | 448 | | institutions or long-term care facilities based on the success of the transfer |
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449 | 449 | | of individuals to home and community based services. The joint |
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450 | 450 | | committee shall consider the issues of whether sufficient funding is |
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451 | 451 | | provided for enhancement of wages and benefits of direct individual care |
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452 | 452 | | workers and their staff training and whether adequate progress is being |
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453 | 453 | | made to transfer individuals from the institutions and to move them from |
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454 | 454 | | the waiver waiting lists to receive home and community based services. |
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455 | 455 | | The joint committee shall review and ensure that any proceeds resulting |
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456 | 456 | | from the successful transfer be applied to the system of provision of |
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457 | 457 | | services for long-term care and home and community based services. The |
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458 | 458 | | joint committee shall monitor and study the implementation and operations |
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459 | 459 | | of the home and community based service programs, the children's health |
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460 | 460 | | insurance program, the program for the all-inclusive care of the elderly |
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461 | 461 | | and the state medicaid programs including, but not limited to, access to |
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504 | 504 | | 43 HB 2375 7 |
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505 | 505 | | and quality of services provided and any financial information and |
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506 | 506 | | budgetary issues. Any state agency shall provide data and information on |
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507 | 507 | | KanCare programs, including, but not limited to, pay for performance |
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508 | 508 | | measures, quality measures and enrollment and disenrollment in specific |
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509 | 509 | | plans, KanCare provider network data and appeals and grievances made to |
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510 | 510 | | the KanCare ombudsman, to the joint committee, as requested. |
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511 | 511 | | (b) The joint committee shall consist of 11 members of the legislature |
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512 | 512 | | appointed as follows: (1) Two members of the house committee on health |
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513 | 513 | | and human services appointed by the speaker of the house of |
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514 | 514 | | representatives; (2) one member of the house committee on health and |
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515 | 515 | | human services appointed by the minority leader of the house of |
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516 | 516 | | representatives; (3) two members of the senate committee on public health |
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517 | 517 | | and welfare appointed by the president of the senate; (4) one member of |
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518 | 518 | | the senate committee on public health and welfare appointed by the |
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519 | 519 | | minority leader of the senate; (5) two members of the house of |
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520 | 520 | | representatives appointed by the speaker of the house of representatives, |
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521 | 521 | | one of whom shall be a member of the house committee on appropriations; |
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522 | 522 | | (6) one member of the house of representatives appointed by the minority |
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523 | 523 | | leader of the house of representatives; and (7) two members of the senate |
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524 | 524 | | appointed by the president of the senate, one of whom shall be a member |
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525 | 525 | | of the senate committee on ways and means. |
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526 | 526 | | (c) Members shall be appointed for terms coinciding with the |
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527 | 527 | | legislative terms for which such members are elected or appointed. All |
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528 | 528 | | members appointed to fill vacancies in the membership of the joint |
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529 | 529 | | committee and all members appointed to succeed members appointed to |
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530 | 530 | | membership on the joint committee shall be appointed in the manner |
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531 | 531 | | provided for the original appointment of the member succeeded. |
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532 | 532 | | (d) (1) The members originally appointed as members of the joint |
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533 | 533 | | committee shall meet upon the call of the member appointed by the |
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534 | 534 | | speaker of the house of representatives, who shall be the first chairperson, |
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535 | 535 | | within 30 days of the effective date of this act. The vice-chairperson of the |
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536 | 536 | | joint committee shall be appointed by the president of the senate. |
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537 | 537 | | Chairperson and vice-chairperson shall alternate annually between the |
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538 | 538 | | members appointed by the speaker of the house of representatives and the |
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539 | 539 | | president of the senate. The ranking minority member shall be from the |
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540 | 540 | | same chamber as the chairperson. On and after the effective date of this act |
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541 | 541 | | Except as provided in paragraph (2), the joint committee shall meet at |
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542 | 542 | | least once in January and once in April when the legislature is in regular |
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543 | 543 | | session and at least once for two consecutive days during each of the third |
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544 | 544 | | and fourth calendar quarters, on the call of the chairperson, but not to |
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545 | 545 | | exceed six meetings in a calendar year, except additional meetings may be |
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546 | 546 | | held on call of the chairperson when urgent circumstances exist which |
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547 | 547 | | require such meetings. Six members of the joint committee shall constitute |
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590 | 590 | | 43 HB 2375 8 |
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591 | 591 | | a quorum. |
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592 | 592 | | (2) During calendar year 2026 and calendar year 2027, the joint |
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593 | 593 | | committee shall meet for one additional day per meeting pursuant to |
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594 | 594 | | paragraph (1) in order to monitor the implementation of the healthcare |
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595 | 595 | | access for working Kansans act and to review the following topics relating |
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596 | 596 | | to such implementation: |
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597 | 597 | | (A) Payment integrity and eligibility audits; |
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598 | 598 | | (B) outcomes related to section 3, and amendments thereto; |
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599 | 599 | | (C) health outcomes for individuals covered under the act; |
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600 | 600 | | (D) budget projections and actual expenditures related to |
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601 | 601 | | implementation of the act; and |
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602 | 602 | | (E) expenses incurred by hospitals arising from charity care and |
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603 | 603 | | services provided to patients who are unwilling or unable to pay for such |
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604 | 604 | | services. |
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605 | 605 | | (e) (1) At the beginning of each regular session of the legislature, the |
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606 | 606 | | committee shall submit to the president of the senate, the speaker of the |
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607 | 607 | | house of representatives, the house committee on health and human |
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608 | 608 | | services and the senate committee on public health and welfare a written |
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609 | 609 | | report on numbers of individuals transferred from the state or private |
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610 | 610 | | institutions to the home and community based services including the |
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611 | 611 | | average daily census in the state institutions and long-term care facilities, |
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612 | 612 | | savings resulting from the transfer certified by the secretary for aging and |
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613 | 613 | | disability services in a quarterly report filed in accordance with K.S.A. 39- |
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614 | 614 | | 7,162, and amendments thereto, and the current balance in the home and |
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615 | 615 | | community based services savings fund of the Kansas department for |
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616 | 616 | | aging and disability services. |
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617 | 617 | | (2) Such report submitted under this subsection shall also include, but |
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618 | 618 | | not be limited to, the following information on the KanCare program: |
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619 | 619 | | (A) Quality of care and health outcomes of individuals receiving state |
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620 | 620 | | medicaid services under the KanCare program, as compared to the |
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621 | 621 | | provision of state medicaid services prior to January 1, 2013; |
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622 | 622 | | (B) integration and coordination of health care healthcare procedures |
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623 | 623 | | for individuals receiving state medicaid services under the KanCare |
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624 | 624 | | program; |
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625 | 625 | | (C) availability of information to the public about the provision of |
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626 | 626 | | state medicaid services under the KanCare program, including, but not |
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627 | 627 | | limited to, accessibility to health services, expenditures for health services, |
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628 | 628 | | extent of consumer satisfaction with health services provided and |
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629 | 629 | | grievance procedures, including quantitative case data and summaries of |
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630 | 630 | | case resolution by the KanCare ombudsman; |
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631 | 631 | | (D) provisions for community outreach and efforts to promote the |
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632 | 632 | | public understanding of the KanCare program; |
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633 | 633 | | (E) comparison of the actual medicaid costs expended in providing |
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676 | 676 | | 43 HB 2375 9 |
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677 | 677 | | state medicaid services under the KanCare program after January 1, 2013, |
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678 | 678 | | to the actual costs expended under the provision of state medicaid services |
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679 | 679 | | prior to January 1, 2013, including the manner in which such cost |
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680 | 680 | | expenditures are calculated; |
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681 | 681 | | (F) comparison of the estimated costs expended in a managed care |
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682 | 682 | | system of providing state medicaid services under the KanCare program |
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683 | 683 | | after January 1, 2013, to the actual costs expended under the KanCare |
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684 | 684 | | program of providing state medicaid services after January 1, 2013; |
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685 | 685 | | (G) comparison of caseload information for individuals receiving |
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686 | 686 | | state medicaid services prior to January 1, 2013, to the caseload |
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687 | 687 | | information for individuals receiving state medicaid services under the |
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688 | 688 | | KanCare program after January 1, 2013; and |
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689 | 689 | | (H) all written testimony provided to the joint committee regarding |
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690 | 690 | | the impact of the provision of state medicaid services under the KanCare |
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691 | 691 | | program upon residents of adult care homes. |
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692 | 692 | | (3) The joint committee shall consider the external quality review |
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693 | 693 | | reports and quality assessment and performance improvement program |
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694 | 694 | | plans of each managed care organization providing state medicaid services |
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695 | 695 | | under the KanCare program in the development of the report submitted |
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696 | 696 | | under this subsection. |
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697 | 697 | | (4) The report submitted under this subsection shall be published on |
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698 | 698 | | the official website of the legislative research department. |
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699 | 699 | | (f) Members of the committee shall have access to any medical |
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700 | 700 | | assistance report and caseload data generated by the Kansas department of |
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701 | 701 | | health and environment division of health care finance. Members of the |
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702 | 702 | | committee shall have access to any report submitted by the Kansas |
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703 | 703 | | department of health and environment division of health care finance to |
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704 | 704 | | the centers for medicare and medicaid services of the United States |
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705 | 705 | | department of health and human services. |
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706 | 706 | | (g) Members of the committee shall be paid compensation, travel |
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707 | 707 | | expenses and subsistence expenses or allowance as provided in K.S.A. 75- |
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708 | 708 | | 3212, and amendments thereto, for attendance at any meeting of the joint |
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709 | 709 | | committee or any subcommittee meeting authorized by the committee. |
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710 | 710 | | (h) In accordance with K.S.A. 46-1204, and amendments thereto, the |
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711 | 711 | | legislative coordinating council may provide for such professional services |
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712 | 712 | | as may be requested by the joint committee. |
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713 | 713 | | (i) The joint committee may make recommendations and introduce |
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714 | 714 | | legislation as it deems necessary in performing its functions. |
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715 | 715 | | Sec. 13. K.S.A. 40-3213 is hereby amended to read as follows: 40- |
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716 | 716 | | 3213. (a) Every health maintenance organization and medicare provider |
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717 | 717 | | organization subject to this act shall pay to the commissioner the following |
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718 | 718 | | fees: |
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719 | 719 | | (1) For filing an application for a certificate of authority, $150; |
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763 | 763 | | (2) for filing each annual report, $50; and |
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764 | 764 | | (3) for filing an amendment to the certificate of authority, $10. |
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765 | 765 | | (b) Every health maintenance organization subject to this act shall |
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766 | 766 | | pay annually to the commissioner at the time such organization files its |
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767 | 767 | | annual report, a privilege fee in an amount equal to the following |
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768 | 768 | | percentages 5.77% of the total of all premiums, subscription charges or |
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769 | 769 | | any other term that may be used to describe the charges made by such |
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770 | 770 | | organization to enrollees: 3.31% during the reporting period beginning |
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771 | 771 | | January 1, 2015, and ending December 31, 2017; and 5.77% on and after |
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772 | 772 | | January 1, 2018. In such computations all such organizations shall be |
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773 | 773 | | entitled to deduct therefrom any premiums or subscription charges |
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774 | 774 | | returned on account of cancellations and dividends returned to enrollees. If |
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775 | 775 | | the commissioner shall determine at any time that the application of the |
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776 | 776 | | privilege fee, or a change in the rate of the privilege fee, would cause a |
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777 | 777 | | denial of, reduction in or elimination of federal financial assistance to the |
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778 | 778 | | state or to any health maintenance organization subject to this act, the |
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779 | 779 | | commissioner is hereby authorized to terminate the operation of such |
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780 | 780 | | privilege fee or the change in such privilege fee. |
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781 | 781 | | (c) For the purpose of insuring the collection of the privilege fee |
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782 | 782 | | provided for by subsection (b), every health maintenance organization |
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783 | 783 | | subject to this act and required by subsection (b) to pay such privilege fee |
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784 | 784 | | shall at the time it files its annual report, as required by K.S.A. 40-3220, |
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785 | 785 | | and amendments thereto, make a return, generated by or at the direction of |
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786 | 786 | | its chief officer or principal managing director, under penalty of K.S.A. |
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787 | 787 | | 21-5824, and amendments thereto, to the commissioner, stating the amount |
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788 | 788 | | of all premiums, assessments and charges received by the health |
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789 | 789 | | maintenance organization, whether in cash or notes, during the year ending |
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790 | 790 | | on the last day of the preceding calendar year. Upon the receipt of such |
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791 | 791 | | returns the commissioner of insurance shall verify such returns and |
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792 | 792 | | reconcile the fees pursuant to subsection (f) upon such organization on the |
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793 | 793 | | basis and at the rate provided in this section. |
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794 | 794 | | (d) Premiums or other charges received by an insurance company |
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795 | 795 | | from the operation of a health maintenance organization subject to this act |
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796 | 796 | | shall not be subject to any fee or tax imposed under the provisions of |
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797 | 797 | | K.S.A. 40-252, and amendments thereto. |
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798 | 798 | | (e) Fees charged under this section shall be remitted to the state |
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799 | 799 | | treasurer in accordance with the provisions of K.S.A. 75-4215, and |
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800 | 800 | | amendments thereto. Upon receipt of each such remittance, the state |
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801 | 801 | | treasurer shall deposit the entire amount in the state treasury to the credit |
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802 | 802 | | of the medical assistance fee fund created by K.S.A. 40-3236, and |
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803 | 803 | | amendments thereto. |
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804 | 804 | | (f) (1) On and after January 1, 2018, In addition to any other filing or |
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805 | 805 | | return required by this section, each health maintenance organization shall |
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848 | 848 | | 43 HB 2375 11 |
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849 | 849 | | submit a report to the commissioner on or before March 31 and September |
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850 | 850 | | 30 of each year containing an estimate of the total amount of all premiums, |
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851 | 851 | | subscription charges or any other term that may be used to describe the |
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852 | 852 | | charges made by such organization to enrollees that the organization |
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853 | 853 | | expects to collect during the current calendar year. Upon filing each March |
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854 | 854 | | 31 report, the organization shall submit payment equal to ½ of the |
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855 | 855 | | privilege fee that would be assessed by the commissioner for the current |
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856 | 856 | | calendar year based upon the organization's reported estimate. Upon filing |
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857 | 857 | | each September 30 report, the organization shall submit payment equal to |
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858 | 858 | | the balance of the privilege fee that would be assessed by the |
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859 | 859 | | commissioner for the current calendar year based upon the organization's |
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860 | 860 | | reported estimates. |
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861 | 861 | | (2) Any amount of privilege fees actually owed by a health |
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862 | 862 | | maintenance organization during any calendar year in excess of estimated |
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863 | 863 | | privilege fees paid shall be assessed by the commissioner and shall be due |
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864 | 864 | | and payable upon issuance of such assessment. |
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865 | 865 | | (3) Any amount of estimated privilege fees paid by a health |
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866 | 866 | | maintenance organization during any calendar year in excess of privilege |
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867 | 867 | | fees actually owed shall be reconciled when the commissioner assesses |
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868 | 868 | | privilege fees in the ensuing calendar year. The commissioner shall credit |
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869 | 869 | | such excess amount against future privilege fee assessments. Any such |
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870 | 870 | | excess amount paid by a health maintenance organization that is no longer |
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871 | 871 | | doing business in Kansas and that no longer has a duty to pay the privilege |
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872 | 872 | | fee shall be refunded by the commissioner from funds appropriated by the |
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873 | 873 | | legislature for such purpose. |
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874 | 874 | | Sec. 14. K.S.A. 39-7,160 and 40-3213 are hereby repealed. |
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875 | 875 | | Sec. 15. This act shall take effect and be in force from and after its |
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876 | 876 | | publication in the Kansas register. |
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902 | 902 | | 26 |
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903 | 903 | | 27 |
---|
904 | 904 | | 28 |
---|