Bulletin 2015-2

BULLETIN 2015-2 TO: All Health Insurers, Municipal Group-Funded Pools Authorized to Transact Health Insurance Business in Kansas and All Other Interested Parties FROM: Ken Selzer, CPA, Commissioner of Insurance SUBJECT: 2014 House Bill No. 2668 (Ch. 109 of the 2014 Session Laws) Date: June 1, 2015 The purpose of this bulletin is to call your attention to the requirements found in 2014 House Bill No. 2668 and to assist you as you work toward compliance with this House Bill. Section 1 of House Bill No. 2668 shall be known as the predetermination of health care benefits act and requires among other things that health plans that receive an electronic health care predetermination request consistent with the requirements set forth in the bill shall provide to the requesting healthcare provider information on the amounts of expected benefits coverage on the procedures specified in the request that is accurate at the time of the health plan’s response. This electronic request and response transaction shall be known as the health care predetermination request and response which shall be conducted in accordance with the transactions and code sets standards promulgated pursuant to HIPAA, specifically, the ASC X12 837 health care predetermination. The health plan’s response shall be returned using the same transmission method as that of the submission. Section 2 of House Bill No. 2668 includes that the bill shall take effect and be in force from and after July 1, 2017 and its publication in the statute book. Questions about the requirements stated in this Bulletin should be addressed to Julie Holmes, Kansas Insurance Department, 420 SW 9th Street, Topeka, Kansas 66612, by phone at 785-296-7850, or via email at jholmes@ksinsurance.org.