Women's Health Rights and Cancer Act - Kansas

Summary of differences between federal and state regulations

Employee health plans are generally covered under the federal jurisdiction of the Employee Retirement Income Security Act (ERISA). Laws for women specifically include the Women’s Health and Cancer Rights Act of 1998, and Newborns’ and Mothers’ Health Protection Act of 1996. State insurance laws, however, do apply. The federal laws regarding women’s health rights include the following provisions:

• If the plan covers mastectomies, it must cover all stages of reconstruction of the breast on which the mastectomy has been performed; surgery and reconstruction of the other breast to produce a symmetrical appearance; and prostheses and physical complications of mastectomy, including lymphedemas in a manner determined in consultation with the attending physician and the patient. (Women’s Health Rights and Cancer Act)
• If the group health plan provides maternity coverage, it must cover at least a 48-hour hospital stay following childbirth (96-hour stay in the case of Cesarean section). (Newborns' and Mothers' Health Protection Act)

The state laws include the following provisions:

• Like the federal requirement, health plans that provide coverage for maternity services, including benefits for childbirth, must provide coverage for at least 48 hours of inpatient care following a normal delivery and at least 96 hours of inpatient care following delivery by caesarean section for a mother and newly born child. (§40-2,160)
• Like the federal requirements, plans must provide, for participants who are receiving benefits in connection with a mastectomy and who elect breast reconstruction in connection with such mastectomy, coverage for:
  Reconstruction of the breast on which the mastectomy has been performed;
  
  • Reconstruction of the breast on which the mastectomy has been performed;
  • surgery and reconstruction of the other breast to produce a symmetrical appearance; and
  • prostheses and physical complications in all stages of mastectomy, including lymphedemas. (§40-2,166)
• Plans cannot deny reimbursement or indemnification for mammograms or pap smears. (§40-2230)
• Women must be allowed to visit an in-network obstetrician or gynecologist for routine gynecological care one time each calendar year without referral from a primary care provider. (§40-4609)

State

Contact

Kansas Insurance Department

Regulations

Kansas Statutes

§40-2, 160 Coverage for minimum inpatient care following birth of child.

§40-2, 166 Coverage of reconstructive breast surgery.

§40-2230 Same; when reimbursement or indemnification required; deductibles, coinsurance and other limitations permissible.

§40-4609 Same; gynecological care.

Federal

Contact

Employee Benefits Security Administration (EBSA)

Regulations

See the text of the Women’s Health and Cancer Rights Act under Acts/Laws, Title 1, Subtitle B, Part 7, Subpart B; and the U.S. Code, Title 29, chapter 18, §1185b.

See also U. S. Code Title 29, chapter 18, §1185 for laws regarding mothers.

29 CFR 1604.10 (Employment policies relating to pregnancy and childbirth)

29 CFR chapter XXV (Parts 2509 – 2590)