KANSAS INSURANCE DEPARTMENT

Notice of Hearing on Proposed

Administrative Regulations

A public hearing will be conducted at 9:30 a.m., February 23, 2006, in the third floor conference room, Kansas Insurance Department, 420 S.W. 9th, Topeka, Kansas, to consider the adoption of proposed changes in existing rules and regulations.

The 60-day notice of the public hearing shall constitute a public comment period for purpose of receiving written public comments on the proposed rules and regulations. All interested parties may submit written comments prior to the hearing to Deletria Nash, Kansas Insurance Department, 420 S.W. 9th, Topeka, Kansas, 66612-1678, via facsimile at 785-291-3673, or via email at dnash@ksinsurance.org. All interested parties will be given a reasonable opportunity to present their views orally on the adoption of the proposed regulation during the hearing.

A summary of the regulations and their economic impact follows.

K.A.R. 40-4-41. Utililization review organizations; application; definitions. The purpose of the proposed amendments is to reflect changes made by the American Accreditation Health Commission a/k/a as URAC. This is one of the major entities that accredits utilization review organizations nationally. These amendments were also made after consulting with the Utilization Review Advisory Committee. The amendments to this particular regulation define the terms that are included in other utilization review regulations and are used in the utilization review process.

Some of the definitions require individuals and entities who perform certain utilization review functions to possess certain credentials and be trained in utilization review procedures.

Definitions have been added and deleted to accurately reflect those services that are subject to regulations regarding utilization review organizations. Language within existing definitions have been changed to update current terminology. Other changes include the addition and deletion of statutory citations and technical changes.

The entities most impacted are utilization review organizations and health insurance carriers who perform utilization review activities and consumers of health insurance. The economic impact on those entities who perform utilization review functions is justified in the protection of Kansas consumers in that these definitions could require the entities who perform utilization functions to hire new personnel who meet these qualifications or provide additional training to existing personnel. This could result in additional costs. However, with the increase of managed care as mechanism to deliver health care to consumers, many of these requirements are needed to safeguard consumer and insure that they obtain the care that they need. There will be little or no economic impact on consumers, the Kansas Insurance Department, and other governmental agencies.

K.A.R. 40-4-25. Accident and sickness insurance standards for benefits; purpose. This proposed regulation provides exemptions regarding individual accident and sickness insurance policies and subscriber contracts of hospital and medical and dental service corporations delivered in the state of Kansas as required in K.A.R. 40-4-26 through 40-4-33. The primary changes to K.A.R. 40-4-25 are the addition and deletion of statutes and technical changes.

There is no economic impact on insurers, consumers, the Kansas Insurance Department, and other governmental agencies, if any.

Any individual with a disability may request accommodation in order to participate in the public hearing and may request the proposed regulations and economic impact statements in an accessible format. Requests for accommodation to participate in the hearing should be made at least 5 working days in advance by contacting Deletria Nash at (785) 296-4140 or via email at dnash@ksinsurance.org. Any individual desiring a copy of this regulation and the policy and procedure that is being adopted by reference, if applicable, may obtain a copy from our website, www.ksinsurance.org, under the Legal Issues link or by contacting Deletria Nash by phone at (785)296-4140 or via email at dnash@ksinsurance.org. The charge for copies is fifty cents per page.