House Substitute for SENATE BILL No. 126
AN ACT concerning health and healthcare; relating to the Kansas department of health and
environment; establishing an advance universal newborn screening program;
providing for the reimbursement of certain treatment services; authorizing the
secretary of health and environment to specify conditions included in newborn
screenings; extending the transfer of moneys to the Kansas newborn screening fund;
increasing state financial assistance to local health departments under certain
circumstances; increasing the annual assessment on services rate on inpatient and
outpatient revenue and expanding exemptions for such assessment; amending K.S.A.
65-181, 65-183, 65-242 and 65-6210 and K.S.A. 2024 Supp. 65-180, 65-6208 and
65-6209 and repealing the existing sections.
Be it enacted by the Legislature of the State of Kansas:
Section 1. K.S.A. 2024 Supp. 65-180 is hereby amended to read as
follows: 65-180. There is hereby established an advance universal
newborn screening program to be administered by the secretary of
health and environment. The secretary of health and environment shall:
(a) Institute and carry on an intensive educational program among
physicians, mid-level practitioners, as defined in K.S.A. 65-1626, and
amendments thereto, hospitals, public health nurses and the public
concerning congenital hypothyroidism, galactosemia, phenylketonuria
and other genetic diseases detectable with the same specimen
conditions identified by the secretary in accordance with subsection (i).
This educational program shall include information about the nature of
such conditions and examinations for the detection thereof in early
infancy in order that measures may be taken to prevent intellectual
disability, physical disability or morbidity resulting from such
conditions.
(b) Provide recognized screening tests for phenylketonuria,
galactosemia, hypothyroidism and such other diseases as may be
appropriately detected with the same specimen conditions identified by
the secretary in accordance with subsection (i). The initial laboratory
screening tests for these diseases shall be performed by the department
of health and environment or its designee for all infants born in the
state. Such services shall be performed without charge.
(c) Provide a follow-up program by providing test results and
other information to identified physicians or mid-level practitioners as
defined in K.S.A. 65-1626, and amendments thereto; locate infants with
abnormal newborn screening test results; with parental consent,
monitor infants to assure appropriate testing to either confirm or not
confirm the disease suggested by the screening test results; with
parental consent, monitor therapy and treatment for infants with
confirmed diagnosis of congenital hypothyroidism, galactosemia,
phenylketonuria or other genetic diseases being screened under this
statute; conditions identified by the secretary in accordance with
subsection (i) and establish ongoing education and support activities for
individuals with confirmed diagnosis of congenital hypothyroidism,
galactosemia, phenylketonuria and other genetic diseases being
screened under this statute and for the families of such individuals such
conditions.
(d) Maintain a registry of cases including information of
importance for the purpose of follow-up services to prevent intellectual
support early diagnosis, treatment and services for healthy
development and the prevention of disability or morbidity.
(e) Provide, within the limits of appropriations available therefor,
the necessary treatment product for diagnosed cases conditions
identified by the secretary in accordance with subsection (i) for as long
as medically indicated, when and the product is not available through
other state agencies. In addition to diagnosed cases under this section,
diagnosed cases of maple syrup urine disease shall be included as a
diagnosed case under this subsection. Where If the applicable income
of the person or persons who have legal responsibility for the
diagnosed individual meets medicaid eligibility, such individuals' House Substitute for SENATE BILL No. 126—page 2
individual's needs shall be covered under the medicaid state plan.
Where If the applicable income of the person or persons who have legal
responsibility for the diagnosed individual is not medicaid eligible, but
is below 300% of the federal poverty level established under the most
recent poverty guidelines issued by the United States department of
health and human services, the department of health and environment
shall provide reimbursement of between 50% to 100% of the product
cost in accordance with rules and regulations adopted by the secretary
of health and environment. Where If the applicable income of the
person or persons who have legal responsibility for the diagnosed
individual exceeds 300% of the federal poverty level established under
the most recent poverty guidelines issued by the United States
department of health and human services, the department of health and
environment shall provide reimbursement of an amount not to exceed
50% of the product cost in accordance with rules and regulations
adopted by the secretary of health and environment.
(f) Provide state assistance to an applicant pursuant to subsection
(e) only after it has been shown that the applicant has exhausted all
benefits from private third-party payers, medicare, medicaid and other
government assistance programs and after consideration of the
applicant's income and assets. The secretary of health and environment
shall adopt rules and regulations establishing standards for determining
eligibility for state assistance under this section.
(g) (1) Except for treatment products provided under subsection
(e), if the secretary of health and environment shall adopt rules and
regulations as needed to determine eligibility for reimbursement to
individuals for the purchase of medically necessary food treatment
product for diagnosed cases must be purchased, the purchaser shall be
reimbursed by the department of health and environment for costs
incurred up to $1,500 per year per diagnosed child age 18 or younger at
100% of the product cost upon submission of a receipt of purchase
identifying the company from which the product was purchased. For a
purchaser to be eligible for reimbursement under this subsection, the
applicable income of the person or persons who have legal
responsibility for the diagnosed child shall not exceed 300% of the
poverty level established under the most recent poverty guidelines
issued by the federal department of health and human services
conditions identified by the secretary in accordance with subsection (i).
(2) As an option to reimbursement authorized under subsection (g)
(1) paragraph (1), the department of health and environment may
purchase medically necessary food treatment products for distribution
to diagnosed children in an amount not to exceed $1,500 per year per
diagnosed child age 18 or younger. For a diagnosed child to be eligible
for the distribution of food treatment products under this subsection,
the applicable income of the person or persons who have legal
responsibility for the diagnosed child shall not exceed 300% of the
poverty level established under the most recent poverty guidelines
issued by the federal department of health and human services
individuals diagnosed with conditions identified by the secretary in
accordance with subsection (i).
(3) In addition to diagnosed cases under this section, diagnosed
cases of maple syrup urine disease shall be included as a diagnosed
case under this subsection.
(h) The department of health and environment shall continue to
receive orders for both medically necessary treatment products and
medically necessary food treatment products, purchase such products,
and shall deliver the such products to an address prescribed by the
diagnosed individual. The department of health and environment shall
bill the person or persons who have legal responsibility for the House Substitute for SENATE BILL No. 126—page 3
diagnosed patient individual for a pro-rata share of the total costs, in
accordance with the rules and regulations adopted pursuant to this
section.
(i) The secretary of health and environment shall adopt rules and
regulations as needed to require, to the extent of available funding,
newborn screening tests to screen for treatable disorders conditions.
The secretary shall determine and identify the conditions to be included
in the newborn screening tests, which may include, but not be limited
to, conditions listed in the core recommended uniform screening panel
of newborn screening conditions recommended in the 2005 report by
the American college of medical genetics entitled "Newborn Screening:
Toward a Uniform Screening Panel and System" issued by the United
States secretary of health and human services or another report
determined by the department of health and environment to provide
more appropriate newborn screening guidelines to protect the health
and welfare of newborns for treatable disorders conditions.
(j) In performing the duties under subsection (i), the secretary of
health and environment shall appoint an advisory council to advise the
department of health and environment on implementation of subsection
(i).
(k) The department of health and environment shall periodically
review the newborn screening program to determine the efficacy and
cost effectiveness of the program and determine whether adjustments to
the program are necessary to protect the health and welfare of
newborns and to maximize the number of newborn screenings that may
be conducted with the funding available for the screening program.
(l) There is hereby established in the state treasury the Kansas
newborn screening fund that, which shall be administered by the
secretary of health and environment. All expenditures from the fund
shall be for the newborn screening program. All expenditures from the
fund shall be made in accordance with appropriation acts upon warrants
of the director of accounts and reports issued pursuant to vouchers
approved by the secretary of health and environment or the secretary's
designee. On July 1 of each year, the director of accounts and reports
shall determine the amount credited to the medical assistance fee fund
pursuant to K.S.A. 40-3213, and amendments thereto, and shall transfer
the estimated portion of such amount that is necessary to fund the
newborn screening program for the ensuing fiscal year as certified by
the secretary of health and environment or the secretary's designee to
the Kansas newborn screening fund. Such amount shall not exceed
$5,000,000 in fiscal years 2024, 2025 and 2026.
Sec. 2. K.S.A. 65-181 is hereby amended to read as follows: 65-
181. (a) The administrative officer or other person in charge of each
institution or the attending physician or mid-level practitioner, caring
for infants 28 days of age or younger shall have administered to every
such infant or child in its or such institution's, mid-level practitioner's
or physician's care, tests for congenital hypothyroidism, galactosemia,
phenylketonuria and other genetic diseases which may be detected with
the same specimen conditions identified by the secretary of health and
environment under K.S.A. 65-180(i), and amendments thereto, in
accordance with rules and regulations adopted by the secretary of
health and environment.
(b) As used in this section, "mid-level practitioner" means the
same as defined in K.S.A. 65-1626, and amendments thereto.
Sec. 3. K.S.A. 65-183 is hereby amended to read as follows: 65-
183. (a) Every physician or mid-level practitioner having knowledge of
a case of congenital hypothyroidism, galactosemia or phenylketonuria
and other genetic diseases as may be detected with tests given pursuant
to this act a condition identified by the secretary of health and House Substitute for SENATE BILL No. 126—page 4
environment under K.S.A. 65-180(i), and amendments thereto, in one of
such physician's or mid-level practitioner's own patients shall report
the case to the secretary of health and environment on forms provided
by the secretary.
(b) As used in this section, "mid-level practitioner" means the
same as defined in K.S.A. 65-1626, and amendments thereto.
Sec. 4. K.S.A. 65-242 is hereby amended to read as follows: 65-
242. For the purpose of insuring ensuring that adequate public health
services are available to all inhabitants of the state of Kansas, the state
shall assist in the financing of the operation of local health departments.
Subject to appropriations therefor, state financial assistance shall be
distributed to local health departments as follows:
(a) First, each local health department shall, upon application
therefor, receive $7,000 $12,000. If sufficient funds are not available to
make this distribution, then the funds which that are available shall be
divided equally among those local health departments making
application therefor.
(b) Second, if any funds are available after the distribution
required in subsection (a), the secretary shall distribute such funds as
follows:
(1) A figure equal to the total amount of state financial assistance
available for distribution, before deduction for the distribution in
subsection (a), shall be determined.
(2) The figure determined in paragraph (1) of this subsection shall
be allocated to local health departments making application for
assistance based on the proportion that the population of the county or
counties comprising the local health department applying for such
assistance bears to the total population of all counties comprising local
health departments which that have applied for such financial
assistance.
(3) If any local health department making application for
assistance would receive receives an amount equal to or less than
$7,000 $12,000 using the formula in paragraph (2) of this subsection,
then such department shall be paid in accordance with subsection (a)
only. If any local health department making application for assistance
would receive receives more than $7,000 $12,000 using the formula in
paragraph (2) of this subsection, then such department shall be paid
based on the proportion that the population served by the county or
counties comprising such local health department bears to the total
population of all counties comprising local health departments which
that have made application for assistance, except for departments
receiving funds under subsection (a), except that in no case shall the
assistance distributed under this subsection (b) to a local health
department exceed the amount that the local health department receives
from local tax revenues for the county fiscal year in which the state
financial assistance is paid.
(c) If local tax revenues allotted to a local health department for a
fiscal year fall below the level of local tax revenues allotted to the local
health department for the preceding fiscal year, the amount of state
financial assistance under this act for which such local health
department is eligible for the fiscal year shall be reduced by a
percentage equal to the percentage of reduction in local tax revenue for
that fiscal year.
Sec. 5. K.S.A. 2024 Supp. 65-6208 is hereby amended to read as
follows: 65-6208. (a) Subject to the provisions of K.S.A. 65-6209, and
amendments thereto, an annual assessment on services is imposed on
each hospital provider in an amount not less than 1.83% of each
hospital's net inpatient operating revenue and not greater than 3% 6%
of each hospital's net inpatient and outpatient operating revenue, as House Substitute for SENATE BILL No. 126—page 5
determined by the healthcare access improvement panel in consultation
with the department of health and environment, for the hospital's fiscal
year three years prior to the assessment year. In the event that a hospital
does not have a complete 12-month fiscal year in such third prior fiscal
year, the assessment under this section shall be $200,000 until such
date that such hospital has completed the hospital's first 12-month fiscal
year. Upon completing such first 12-month fiscal year, such hospital's
assessment under this section shall be the amount not less than 1.83%
of each hospital's net inpatient operating revenue and not greater than
3% 6% of such hospital's net inpatient and outpatient operating
revenue, as determined by the healthcare access improvement panel in
consultation with the department of health and environment, for such
first completed 12-month fiscal year.
(b) Nothing in this act shall be construed to authorize any home
rule unit or other unit of local government to license for revenue or
impose a tax or assessment upon hospital providers or a tax or
assessment measured by the income or earnings of a hospital provider.
(c) (1) The department of health and environment shall submit to
the United States centers for medicare and medicaid services any
approval request necessary to implement the amendments made to
subsection (a) by section 1 of chapter 7 of the 2020 Session Laws of
Kansas and this act. If the department has submitted such a request
pursuant to section 80(l) of chapter 68 of the 2019 Session Laws of
Kansas or section 1 of chapter 7 of the 2020 Session Laws of Kansas,
then the department may continue such request, or modify such request
to conform to the amendments made to subsection (a) by section 1 of
chapter 7 of the 2020 Session Laws of Kansas and this act, to fulfill the
requirements of this paragraph.
(2) The secretary of health and environment shall certify to the
secretary of state the receipt of such approval and cause notice of such
approval to be published in the Kansas register.
(3) The amendments made to subsection (a) by section 1 of
chapter 7 of the 2020 Session Laws of Kansas and this act shall take
effect on and after January 1 or July 1 immediately following such
publication of such approval.
Sec. 6. K.S.A. 2024 Supp. 65-6209 is hereby amended to read as
follows: 65-6209. (a) A hospital provider that is a state agency, the
authority, as defined in K.S.A. 76-3304, and amendments thereto, a
state educational institution, as defined in K.S.A. 76-711, and
amendments thereto, a critical access hospital, as defined in K.S.A. 65-
468, and amendments thereto, with revenues below the threshold
determined by the healthcare access improvement panel, or a rural
emergency hospital licensed under the rural emergency hospital act,
K.S.A. 2024 Supp. 65-481 et seq., and amendments thereto, with
revenues below the threshold determined by the healthcare access
improvement panel, is exempt from the assessment imposed by K.S.A.
65-6208, and amendments thereto.
(b) A hospital operated by the department in the course of
performing its mental health or developmental disabilities functions is
exempt from the assessment imposed by K.S.A. 65-6208, and
amendments thereto.
Sec. 7. K.S.A. 65-6210 is hereby amended to read as follows: 65-
6210. (a) The assessment imposed by K.S.A. 65-6208, and
amendments thereto, for any state fiscal year to which this statute
applies shall be due and payable in equal installments on or before June
May 30 and December 31 November 30, commencing with whichever
date first occurs after the hospital has received payments for 150 days
after the effective date of the payment methodology approved by the
centers for medicare and medicaid services. No installment payment of House Substitute for SENATE BILL No. 126—page 6
an assessment under this act shall be due and payable, however, until
after:
(1) The hospital provider receives written notice from the
department that the payment methodologies to hospitals required under
this act have been approved by the centers for medicare and medicaid
services of the United States department of health and human services
under 42 C.F.R. § 433.68 for the assessment imposed by K.S.A. 65-
6208, and amendments thereto, has been granted by the centers for
medicare and medicaid services of the United States department of
health and human services; and
(2) in the case of a hospital provider, the hospital has received
payments for 150 days after the effective date of the payment
methodology approved by the centers for medicare and medicaid
services.
(b) The department is authorized to establish delayed payment
schedules for hospital providers that are unable to make installment
payments when due under this section due to financial difficulties, as
determined by the department.
(c) If a hospital provider fails to pay the full amount of an
installment when due, including any extensions granted under this
section, there shall be added to the assessment imposed by K.S.A. 65-
6208, and amendments thereto, unless waived by the department for
reasonable cause, a penalty assessment equal to the lesser of:
(1) An amount equal to 5% of the installment amount not paid on
or before the due date plus 5% of the portion thereof remaining unpaid
on the last day of each month thereafter; or
(2) an amount equal to 100% of the installment amount not paid
on or before the due date.
For purposes of this subsection (c), payments will shall be credited
first to unpaid installment amounts, rather than to penalty or interest
amounts, beginning with the most delinquent installment.
(d) The department is authorized to take legal action against any
hospital that fails to pay the amount due, including penalties, upon
recommendation of the healthcare access improvement program panel,
unless such hospital has established and is compliant with a payment
schedule approved by the department.
(e) The effective date for the payment methodology applicable to
hospital providers approved by the centers for medicare and medicaid
services shall be the date of July 1 or January 1, whichever date is
designated in the state plan submitted by the department of health and
environment for approval by the centers for medicare and medicaid
services.
Sec. 8. K.S.A. 65-181, 65-183, 65-242 and 65-6210 and K.S.A.
2024 Supp. 65-180, 65-6208 and 65-6209 are hereby repealed. House Substitute for SENATE BILL No. 126—page 7
Sec. 9. This act shall take effect and be in force from and after its
publication in the statute book.
I hereby certify that the above BILL originated in the
SENATE, and passed that body
__________________________
SENATE adopted
Conference Committee Report ________________
_________________________
President of the Senate.
_________________________
Secretary of the Senate.
Passed the HOUSE
as amended _________________________
HOUSE adopted
Conference Committee Report ________________
_________________________
Speaker of the House.
_________________________
Chief Clerk of the House.
APPROVED _____________________________
_________________________
Governor.