Health Insurance Mandates in Kansas

This article examines required insurance benefits in Kansas law, the “test track” requirements for the Legislature’s consideration of proposed mandates, and any anticipated reporting from the State Employee Health Plan (SEHP).

What is a mandate? Statutes added in Kansas insurance law require certain health care providers be paid for services rendered (provider mandates) or be paid for certain types of prescribed coverage or benefits (benefit mandates). For example, Kansas has a benefit mandate for osteoporosis:

a) Any individual or group health insurance policy. . . which [is] delivered, issued for delivery, amended or renewed on or after July 1, 2001, shall include coverage for services related to diagnosis, treatment and management of osteoporosis when such services are provided by a person licensed to practice medicine and surgery in this state, for individuals with a condition or medical history for which bone mass measurement is medically necessary for such individual. Such policy, provision, contract, plan or agreement may apply to such services the same deductibles, coinsurance, and other limitations as apply to other covered services (KSA 40-2,166a).

Which health insurance plans are affected when a new mandate becomes law? Generally, the new law would apply to individual health insurance policies and group health insurance policies issued. The legislation would likely also specify policies issued by Health Maintenance Organizations (HMOs), municipal group-funded pools, and the SEHP.

Which health plans and policies would not be required to incorporate new mandate requirements in their policies?

• Self-insured health plans, including Association Health Plans (Employee Retirement Income Security Act of 1974 [ERISA] plans). Self-insured plans are governed by federal laws and are enforced by the U.S. Department of Labor. (States cannot regulate these self-insured plans.);
• Supplemental benefit policies (e.g., dental care and vision plans); and
• Short-term, limited-duration plans.

How do proposed new mandates become law? The following chart illustrates the statutory process and associated timing for the Legislature’s consideration of a proposal during the 2024 Session.

Are any proposed mandates currently subject to the “test track”? The 2022 Legislature passed HB 2110 (treatment of PANS/PANDAS – autoimmune conditions that affect children; proposed coverage only in the SEHP). Coverage for PANS/ PANDAS commenced in Plan Year 2023; the report to the Legislature’s Presiding Officers must be provided on or before March 1, 2024.

During the 2023 Session, legislation was introduced that would require coverage of the following benefits or specified conditions: breast cancer examinations (SB 161 and HB 2287) and prescription insulin drugs (HB 2347).

Kansas Health Insurance Mandates
Prescribed Path – Kansas Law*

Step	Process	Date
1) Requirements on proponents (KSA 40-2248, KSA 40-2249)	Prior to legislative consideration, proponents must complete a social and financial impact report.	2024 (if law is passed)
2) Study in the SEHP** (KSA 40-2249a)	Before being implemented statewide, the coverage mandate must be studied for at least one year in the SEHP.	Study completed in Plan Year 2025.
3) Report to the Legislature (KSA 40-2249a)	The SEHP study report is submitted to the Legislature.	By March 1, 2026
	The Legislature could allow the coverage mandate to apply statewide by not taking action.	Effective after March 1, 2026
	Or, the Legislature could pass a new law to continue the SEHP study only or make the mandate effective statewide beginning at a later date.	As early as July 1, 2026