40-22a04. Same; standards; rules and regulations; certificate; conditions; annual fee; suspension or revocation of certificate.
40-22a04
40-22a04. Same; standards; rules and regulations;certificate; conditions; annual fee; suspension or revocation ofcertificate.(a) The commissioner shall adopt rules and regulations, withtheadvice of the advisory committee created by K.S.A. 40-22a05,establishing standards governing the conduct of utilization review activitiesperformed in this state or affecting residents of this state by utilizationreview organizations. Unless granted an exemption under K.S.A.40-22a06, noutilization review organization may conduct utilization review services in thisstate or affecting residents of this state on or after May 1, 1995, withoutfirst obtaining a certificate from the commissioner.
(b) The commissioner shall not issue a certificate to a utilization revieworganization until the applicant:
(1) Files a formal application for certification in such form and detail asrequired by the commissioner and such application has been executed under oathby the chief executive officer of the applicant;
(2) files with the commissioner a certified copy of its charter or articlesof incorporation and bylaws, if any;
(3) states the location of the office or offices of the utilization revieworganization where utilization review affecting residents or health careproviders of this state will be principally performed;
(4) provides a summary of the qualifications and experience of personsperforming utilization review affecting the persons and at the locationsidentified pursuant to paragraph (3);
(5) makes payment of a certification fee of $100 to the commission; and
(6) provides such other information or documentation as the commissionerrequires.
(c) Certificates issued by the commissioner pursuant to this act shallremain effective until suspended, surrendered or revoked subject to payment ofan annual continuation fee of $50.
(d) The commissioner with the advice of the advisory committee may suspendor revoke the certificate or any exemption from certification requirements upondetermination that the interests of Kansas insureds are not being properlyserved under such certificate or exemption. Any such action shall be takenonly after a hearing conducted in accordance with the provisions of the Kansasadministrative procedure act.
History: L. 1994, ch. 238, § 4; July 1.