39-719e. Medical benefit plan providers to provide information identifying covered medical assistance recipients; procedures; enforcement.
39-719e
39-719e. Medical benefit plan providers to provide information identifyingcovered medical assistance recipients; procedures; enforcement.(a) Upon the request of the secretary of social andrehabilitation services, each medical benefit plan provider that provides ormaintains a medical benefit plan, that provides any hospital or medicalservices or any other health care or othermedical benefits or services, or both, in Kansas, shall provide the secretarywith information, to the extent known by the medical benefit plan provider,identifying each person who is covered by such medical benefit plan or who isotherwise provided any such hospital or medical services or any other suchhealth care or other medical benefits or services, or both, in Kansas undersuch medical benefit plan. Theinformation shall be provided in suchformas is prescribed by the secretary for the purpose of comparingsuch information with medicaid beneficiary information maintainedby the secretary to assist in identifying other health care or medical benefitcoverage available to medicaid beneficiaries. The secretary shallreimburse each medical benefit plan provider that provides information underthissection for the reasonable cost of providing such information.
(b) Allinformation provided by medical benefit plan providers under this sectionshall be confidential and shall not be disclosed pursuant to theprovisions of the open records act or under the provisions of anyother law.Such information may be used solely for the purpose of determining whethermedical assistance has been paid or is eligible to be paid by the secretary forwhich a recovery from a medical benefit plan provider is due under K.S.A.39-719a and amendments thereto.
(c) Failure to provide information pursuant to a request by thesecretary of social and rehabilitation services under this section shallconstitute a failure to reply to an inquiry of the commissioner ofinsurance and shall be subject to the penalties applicable thereto underK.S.A. 40-226 and amendments thereto [*]. If a medical plan providerfailstoprovide information to the secretary of social and rehabilitation servicespursuant to a request under this section, the secretary shall notify thecommissioner of such failure. The commissioner of insurance may pursue eachsuch failure to provide such information in accordance with K.S.A. 40-226and amendments thereto.
(d) As used in this section:
(1) "Medical benefit plan" means anyaccident and health insurance or any other policy, contract, plan oragreement that provides benefits or services, or both, for any hospital ormedical services or any other health care or medical benefits or services,or both, in Kansas, whether or not such benefits or services, or both, areprovided pursuant to individual, group, blanket or certificates of accidentand sickness insurance, any other insurance providing any accident andhealth insurance, or any other policy, contract, plan or agreementproviding any such benefits or services, or both, in Kansas, and includesany policy, plan, contract or agreement offered in Kansas pursuant to thefederal employee retirement income security act of 1974 (ERISA) thatprovides any hospital or medical services or any other health care ormedical benefits or services, or both, in Kansas; and
(2) "medical benefit plan provider" means any insurance company,nonprofit medical and hospital service corporation, health maintenanceorganization, fraternal benefit society, municipal group-funded pool,group-funded workers compensation pool or any other entity providing ormaintaining a medical benefit plan.
(e) No medicaid provider who rendered professional services to a medicaidbeneficiary and was paid by the secretary for such services shall be liable tothe medical benefit plan provider for any amounts recovered pursuant to thisact or pursuant to the provisions of K.S.A. 39-719a and amendments thereto.
History: L. 1997, ch. 91, § 1; Apr. 17.