BULLETIN 2000-6 TO: All companies authorized to transact Accident and Health Insurance in the State of Kansas FROM: Kathleen Sebelius Commissioner of Insurance SUBJECT: Kansas Health Care Prompt Payment Act; Definition of  “Violation” DATE:    December 21, 2000 The 2000 Kansas Legislature passed the Kansas Health Care Prompt Payment Act (“the Act”), L. 2000, ch. 147, §§ 43 – 45, to establish a framework for payment of health insurance claims.  Although the Act contemplates that the private parties involved in these transactions will perform the majority of the correspondence, collection, and enforcement governed by the Act, section 45(f) of the Act allows this department to penalize insurers under the Unfair Trade Practices Act, K.S.A. 40-2401 et seq., for committing “any violation” of the Act.  I have issued this bulletin to establish what I will consider a “violation” of the Act for purposes of my enforcement under section 45(f) of the Act and K.S.A. 40-2401 et seq. An insurer commits a “violation” of the Act for purposes of section 45(f) of the act if it engages in, either with flagrant and conscious disregard of the provisions of the act or with such frequency as to constitute a general business practice, any of the following behaviors: 1.   Within 30 days of receipt of any claim, regardless of whether a good faith dispute about the legitimacy of the claim exists, failing to either   a.   pay a clean claim; or   b.   send written or electronic notice that acknowledges receipt of such claim and states that the insurer refuses to   i.   reimburse all or part of the claim and   ii.   specifies each reason for denial or that additional information is necessary to determine if all or any part of the claim will be reimbursed and what specific additional information is necessary.