Kansas Statutes
Article 32 - Health Maintenance Organizations And Medicare Provider Organizations
40-3204 Notice that application incomplete, insufficient or unsatisfactory; issuance of certificate, when.

40-3204. Notice that application incomplete, insufficient or unsatisfactory; issuance of certificate, when. (a) The commissioner shall notify any person filing an application for a certificate of authority within 60 days of such filing if such application is not complete or sufficient and the reasons therefor, or that payment of the fees required by K.S.A. 40-3213 and amendments thereto has not been made or that the commissioner is not satisfied with the sufficiency of the information supplied pursuant to the provisions of K.S.A. 40-3203 and amendments thereto or that the organization has failed to demonstrate its ability to assure that health care services will be provided.
(b) The commissioner shall, within 60 days after the receipt of a completed application and any prescribed fees, issue a certificate of authority to any person filing such application if the commissioner finds that:
(1) The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy and possess good reputations;
(2) any deficiencies identified by the commissioner in the application have been corrected;
(3) the health maintenance organization or medicare provider organization will effectively provide or arrange for the provision of basic health care services on a prepaid basis, through insurance or otherwise except to the extent of reasonable requirements for copayments and/or deductibles; and
(4) in the case of a health maintenance organization, that the health maintenance organization is in compliance with K.S.A. 40-3227 and amendments thereto and in the case of a medicare provider organization, that the medicare provider organization is in compliance with such deposit or solvency requirements as the commissioner may establish by rules and regulations.
History: L. 1974, ch. 181, § 4; L. 1996, ch. 169, § 8; L. 1998, ch. 174, § 15; July 1.

Structure Kansas Statutes

Kansas Statutes

Chapter 40 - Insurance

Article 32 - Health Maintenance Organizations And Medicare Provider Organizations

40-3201 Title.

40-3202 Definitions.

40-3203 Certificate of authority required; application; contents; rules and regulations governing modifications and amendments; approval of commissioner.

40-3204 Notice that application incomplete, insufficient or unsatisfactory; issuance of certificate, when.

40-3207 Denial, suspension or revocation of certificate; administrative penalty; notice; hearing.

40-3208 Powers.

40-3209 Certificates of coverage, contracts and other marketing documents, contents, form, filing; continuation and conversion requirements; enrollee not liable to provider for amount owed; application of 40-2209 and 40-2215.

40-3210 Prepaid per capita or aggregate fixed sum contracts authorized.

40-3211 Examination of organizations and providers.

40-3212 Filings and reports as public documents.

40-3213 Fees; disposition of moneys; reporting requirements; payment of estimated fees owed; reconciliation of actual fees owed.

40-3214 Construction and relationship to other laws.

40-3215 Rules and regulations.

40-3216 Penalty.

40-3217 Operational health maintenance organizations; issuance of certificate.

40-3218 Contractual designation of persons to make recommended findings to commissioner.

40-3219 Effect of act on federal assistance.

40-3220 Annual report.

40-3221 Liability of officers.

40-3222 Use of certain words and initials prohibited.

40-3223 Open enrollment.

40-3224 Investments.

40-3225 Fiduciary responsibilities; fidelity bond or insurance.

40-3226 Confidentiality of medical information.

40-3227 Deposit requirements; waiver of deposit; plan for continuation of benefits following insolvency.

40-3228 Grievance procedures; minimum requirements.

40-3229 Prior authorization requirements for emergency medical treatment; duties and responsibilities of organization, enrollees and participating providers; resolution of disputes.

40-3230 Continuity of treatment upon termination of provider from plan.

40-3231 Uncovered expenditure deposit; amount; withdrawal, when; commissioner's duties; rules and regulations.

40-3232 Insolvent health maintenance organization; allocation of insureds to other health maintenance organizations, when; eligibility for Kansas uninsurable health insurance plan act, when.

40-3233 Rehabilitation, liquidation or conservation of health maintenance organization; commissioner's powers; priority of enrollee; distribution of assets.

40-3234 Health maintenance organization; financial condition; hearing; commissioner's powers.

40-3235 Health maintenance organization act; provisions supplemental to.

40-3236 Medical assistance fee fund; use and disposition of moneys credited to fund; reporting requirements.