Article 19c.--NONPROFIT MEDICAL AND HOSPITAL SERVICE CORPORATIONS
40-19c04.Contracts.A corporation organized under the provisions of the nonprofit medical andhospital service corporation act is empowered and authorized to enter intocontracts to provide professional and hospital service for its subscriberswith health care providers licensed to practice in the state of Kansas and withhospitals, including municipal, county, proprietary and charitable hospitals,as may be licensed by the secretary of health and environment for such typesand kinds of service such corporation may determine. The governing bodies ofmunicipal or county hospitals are hereby authorized and empowered to contractwith corporations organized under this act to provide hospital service for thesubscribers of such corporations. Such contracts shall constitute directobligations of the participating health care providers and hospitals to thesubscribers. Nothing in any contract to be made by any such corporation with aparticipating health care provider, participating hospital or subscriber shallhave the effect of imposing upon any participating health care provider orhospital any obligation or liability for any act, omission or default of anyother participating health care providers or hospitals or of such corporation.
Such corporations may also enter into contracts with any healthmaintenance organization, partnership, domestic or foreign corporation orassociation in the state of Kansas or in other states, territories,possessions of the United States or in Canada, or with any local, state orfederal governments or units thereof, so that:
(1) Reciprocity of benefits may be provided to subscribers of suchcorporations;
(2) transfer of subscribers from one corporation to another may beeffected to conform to the subscriber's place of residence;
(3) uniform benefits may be provided for all employees and thedependents of such employees of corporations and other organizationstransacting business in Kansas and elsewhere, and a composite rate (arate representing the composite experience) of the areas involved may becharged for such employees and their dependents;
(4) service or indemnity benefits for medical care or other healthservices for the subscribers, members or policyholders of such corporationsor associations may be provided but not to exceed reasonable and customarycharges that a subscriber may incur for these services;
(5) administrative, accounting, data processing, cost control,marketing, claims processing, fiscal and other services may be providedfor a hospital care or other health service plan with any agency,instrumentality or political subdivision of the United States or thestate of Kansas, or with any person, corporation, health maintenanceorganization, partnership, group, or association providing such hospitalcare or other health service plan under any applicable state or federallaw. Such contract may authorize such corporation to accept, receive,and administer in trust, funds directly or indirectly made available forthe purposes set forth in said contract;
(6) reinsurance or joint assumption of risks may be undertaken betweentwo or more corporations organized under the provisions of this act. Suchcontracts may provide for experience rating, the sharing of premiums,claims and expenses by the participating corporation, or for acceptanceor ceding of the whole or portions of the risk on a reinsurance basis;
(7) administrative, accounting, data processing, cost control,marketing, claims processing, fiscal and other services may be providedto employers or voluntary employees' beneficiary associations where suchemployers or voluntary employees' beneficiary associations provideindemnity for hospital care or other health services to their employeesor members under the terms of a plan of indemnification. Such contractmay authorize such corporation to accept, receive and administer intrust, funds directly or indirectly made available for the purposes setforth in said contract. Contracts entered into pursuant to theprovisions of this subsection shall provide for recoupment of allexpenses incurred by the corporation in performing the services requiredby said contract and shall not adversely affect the interests ofsubscribers. Such corporation may enter into contracts with participatinghospitals and health care providers to provide hospital services, professionalservices and other health services for such employees or members; and
(8) experimental and demonstration projects may be undertaken to determinethe relative advantages and disadvantages of various alternative methodsof providing service or indemnity benefits for hospital care or other healthservices. Such projects may include payment systems to providers designedto encourage providers to use their facilities and personnel more efficientlyand thereby to reduce the total costs of hospital care, professional servicesand other health services involved without adversely affecting the qualityof such services.
History: L. 1980, ch. 137, § 22; L. 1990, ch. 168, § 2; July 1.
Article 19c.--NONPROFIT MEDICAL AND HOSPITAL SERVICE CORPORATIONS
40-19c04.Contracts.A corporation organized under the provisions of the nonprofit medical andhospital service corporation act is empowered and authorized to enter intocontracts to provide professional and hospital service for its subscriberswith health care providers licensed to practice in the state of Kansas and withhospitals, including municipal, county, proprietary and charitable hospitals,as may be licensed by the secretary of health and environment for such typesand kinds of service such corporation may determine. The governing bodies ofmunicipal or county hospitals are hereby authorized and empowered to contractwith corporations organized under this act to provide hospital service for thesubscribers of such corporations. Such contracts shall constitute directobligations of the participating health care providers and hospitals to thesubscribers. Nothing in any contract to be made by any such corporation with aparticipating health care provider, participating hospital or subscriber shallhave the effect of imposing upon any participating health care provider orhospital any obligation or liability for any act, omission or default of anyother participating health care providers or hospitals or of such corporation.
Such corporations may also enter into contracts with any healthmaintenance organization, partnership, domestic or foreign corporation orassociation in the state of Kansas or in other states, territories,possessions of the United States or in Canada, or with any local, state orfederal governments or units thereof, so that:
(1) Reciprocity of benefits may be provided to subscribers of suchcorporations;
(2) transfer of subscribers from one corporation to another may beeffected to conform to the subscriber's place of residence;
(3) uniform benefits may be provided for all employees and thedependents of such employees of corporations and other organizationstransacting business in Kansas and elsewhere, and a composite rate (arate representing the composite experience) of the areas involved may becharged for such employees and their dependents;
(4) service or indemnity benefits for medical care or other healthservices for the subscribers, members or policyholders of such corporationsor associations may be provided but not to exceed reasonable and customarycharges that a subscriber may incur for these services;
(5) administrative, accounting, data processing, cost control,marketing, claims processing, fiscal and other services may be providedfor a hospital care or other health service plan with any agency,instrumentality or political subdivision of the United States or thestate of Kansas, or with any person, corporation, health maintenanceorganization, partnership, group, or association providing such hospitalcare or other health service plan under any applicable state or federallaw. Such contract may authorize such corporation to accept, receive,and administer in trust, funds directly or indirectly made available forthe purposes set forth in said contract;
(6) reinsurance or joint assumption of risks may be undertaken betweentwo or more corporations organized under the provisions of this act. Suchcontracts may provide for experience rating, the sharing of premiums,claims and expenses by the participating corporation, or for acceptanceor ceding of the whole or portions of the risk on a reinsurance basis;
(7) administrative, accounting, data processing, cost control,marketing, claims processing, fiscal and other services may be providedto employers or voluntary employees' beneficiary associations where suchemployers or voluntary employees' beneficiary associations provideindemnity for hospital care or other health services to their employeesor members under the terms of a plan of indemnification. Such contractmay authorize such corporation to accept, receive and administer intrust, funds directly or indirectly made available for the purposes setforth in said contract. Contracts entered into pursuant to theprovisions of this subsection shall provide for recoupment of allexpenses incurred by the corporation in performing the services requiredby said contract and shall not adversely affect the interests ofsubscribers. Such corporation may enter into contracts with participatinghospitals and health care providers to provide hospital services, professionalservices and other health services for such employees or members; and
(8) experimental and demonstration projects may be undertaken to determinethe relative advantages and disadvantages of various alternative methodsof providing service or indemnity benefits for hospital care or other healthservices. Such projects may include payment systems to providers designedto encourage providers to use their facilities and personnel more efficientlyand thereby to reduce the total costs of hospital care, professional servicesand other health services involved without adversely affecting the qualityof such services.
History: L. 1980, ch. 137, § 22; L. 1990, ch. 168, § 2; July 1.
Article 19c.--NONPROFIT MEDICAL AND HOSPITAL SERVICE CORPORATIONS
40-19c04.Contracts.A corporation organized under the provisions of the nonprofit medical andhospital service corporation act is empowered and authorized to enter intocontracts to provide professional and hospital service for its subscriberswith health care providers licensed to practice in the state of Kansas and withhospitals, including municipal, county, proprietary and charitable hospitals,as may be licensed by the secretary of health and environment for such typesand kinds of service such corporation may determine. The governing bodies ofmunicipal or county hospitals are hereby authorized and empowered to contractwith corporations organized under this act to provide hospital service for thesubscribers of such corporations. Such contracts shall constitute directobligations of the participating health care providers and hospitals to thesubscribers. Nothing in any contract to be made by any such corporation with aparticipating health care provider, participating hospital or subscriber shallhave the effect of imposing upon any participating health care provider orhospital any obligation or liability for any act, omission or default of anyother participating health care providers or hospitals or of such corporation.
Such corporations may also enter into contracts with any healthmaintenance organization, partnership, domestic or foreign corporation orassociation in the state of Kansas or in other states, territories,possessions of the United States or in Canada, or with any local, state orfederal governments or units thereof, so that:
(1) Reciprocity of benefits may be provided to subscribers of suchcorporations;
(2) transfer of subscribers from one corporation to another may beeffected to conform to the subscriber's place of residence;
(3) uniform benefits may be provided for all employees and thedependents of such employees of corporations and other organizationstransacting business in Kansas and elsewhere, and a composite rate (arate representing the composite experience) of the areas involved may becharged for such employees and their dependents;
(4) service or indemnity benefits for medical care or other healthservices for the subscribers, members or policyholders of such corporationsor associations may be provided but not to exceed reasonable and customarycharges that a subscriber may incur for these services;
(5) administrative, accounting, data processing, cost control,marketing, claims processing, fiscal and other services may be providedfor a hospital care or other health service plan with any agency,instrumentality or political subdivision of the United States or thestate of Kansas, or with any person, corporation, health maintenanceorganization, partnership, group, or association providing such hospitalcare or other health service plan under any applicable state or federallaw. Such contract may authorize such corporation to accept, receive,and administer in trust, funds directly or indirectly made available forthe purposes set forth in said contract;
(6) reinsurance or joint assumption of risks may be undertaken betweentwo or more corporations organized under the provisions of this act. Suchcontracts may provide for experience rating, the sharing of premiums,claims and expenses by the participating corporation, or for acceptanceor ceding of the whole or portions of the risk on a reinsurance basis;
(7) administrative, accounting, data processing, cost control,marketing, claims processing, fiscal and other services may be providedto employers or voluntary employees' beneficiary associations where suchemployers or voluntary employees' beneficiary associations provideindemnity for hospital care or other health services to their employeesor members under the terms of a plan of indemnification. Such contractmay authorize such corporation to accept, receive and administer intrust, funds directly or indirectly made available for the purposes setforth in said contract. Contracts entered into pursuant to theprovisions of this subsection shall provide for recoupment of allexpenses incurred by the corporation in performing the services requiredby said contract and shall not adversely affect the interests ofsubscribers. Such corporation may enter into contracts with participatinghospitals and health care providers to provide hospital services, professionalservices and other health services for such employees or members; and
(8) experimental and demonstration projects may be undertaken to determinethe relative advantages and disadvantages of various alternative methodsof providing service or indemnity benefits for hospital care or other healthservices. Such projects may include payment systems to providers designedto encourage providers to use their facilities and personnel more efficientlyand thereby to reduce the total costs of hospital care, professional servicesand other health services involved without adversely affecting the qualityof such services.
History: L. 1980, ch. 137, § 22; L. 1990, ch. 168, § 2; July 1.
