Kansas Statutes
Article 32 - Health Maintenance Organizations And Medicare Provider Organizations
40-3208 Powers.

40-3208. Powers. (a) The powers of a health maintenance organization or medicare provider organization shall include but not be limited to the following:
(1) The purchase, lease, construction, renovation, operation, or maintenance of hospitals, medical facilities, or both, and their ancillary equipment, and such property as may reasonably be required for its principal office or for such other purposes as are necessary in the transaction of the business of the organization;
(2) the furnishing of health care services through providers which are under contract with or employed by the health maintenance organization;
(3) the contracting with any person for the performance on its behalf of certain functions such as marketing, enrollment and administration;
(4) the contracting with an insurance company licensed in this state, or with a hospital or medical service corporation or dental service corporation authorized to do business in this state, for the provision of insurance, indemnity or reimbursement against the cost of health care services provided by the health maintenance organization;
(5) the offering, in addition to health care services, of indemnity benefits covering out-of-area or emergency services; and
(6) receiving and accepting from governmental or private agencies payments covering all or part of the cost of the services provided or arranged for by the organization.
(b) Health maintenance organizations shall provide in their arrangements with all contracting parties and providers that if there be valid medicaid coverage, providing benefits for the same loss or condition, the medicaid coverage shall be the source of last resort of any provider payment.
History: L. 1974, ch. 181, § 8; L. 1993, ch. 132, § 8; L. 1998, ch. 174, § 17; 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.