Read the full stored bill text
HOUSE BILL No. 2223
AN A CT concerning health professions and practices; relating to optometry; modifying
certain provisions of the optometry law related to scope of practice, definitions and
credentialing requirements; amending K.S.A. 40-3402, 40-3403, 65-1501, 65-1509a,
65-1512, 65-1523 , 74-1504 and 74-1505 and K.S.A. 2025 Supp. 65-1501a and 65-
1505 and repealing the existing sections; also repealing K.S.A. 65-1514.
Be it enacted by the Legislature of the State of Kansas:
Section 1. K.S.A. 40-3402 is hereby amended to read as follows:
40-3402. (a) Prior to January 1, 2022, a policy of professional liability
insurance approved by the commissioner and issued by an insurer duly
authorized to transact business in this state in which the limit of the
insurer's liability is not less than $200,000 per claim, subject to not less
than a $600,000 annual aggregate for all claims made during the policy
period, shall be maintained in effect by each resident healthcare provider
as a condition of active licensure or other statutory authorization to
render professional service as a healthcare provider in this state, unless
such healthcare provider is a self-insurer. For all new policies and
policies that renew on and after January 1, 2022, a policy of professional
liability insurance approved by the commissioner and issued by an
insurer duly authorized to transact business in this state in which the
limit of the insurer's liability is not less than $500,000 per claim, subject
to not less than a $1,500,000 annual aggregate for all claims made
during the policy period, shall be maintained by each resident healthcare
provider as a condition of active licensure or other statutory
authorization to render professional service as a healthcare provider in
this state, unless such healthcare provider is a self-insurer. This provision
shall not apply to optometrists , except as provided in subsection (f), and
pharmacists on and after July 1, 1991, to physical therapists on and after
July 1, 1995, or to health maintenance organizations on and after July 1,
1997. Such policy shall provide as a minimum coverage for claims made
during the term of the policy that were incurred during the term of such
policy or during the prior term of a similar policy. Any insurer offering
such policy of professional liability insurance to any healthcare provider
may offer to such healthcare provider a policy as prescribed in this
section with deductible options. Such deductible shall be within such
policy limits.
(1) Each insurer providing basic coverage shall, within 30 days
after the effective date of any policy issued in accordance with this
subsection, notify the board of governors that such coverage is or will be
in effect. Such notification shall be on a form approved by the board of
governors and shall include information identifying the professional
liability policy issued or to be issued, the name and address of all
healthcare providers covered by the policy, the amount of the annual
premium, the effective and expiration dates of the coverage and such
other information as the board of governors shall require. A copy of the
notice required by this subsection shall be furnished to the named
insured.
(2) In the event of termination of basic coverage by cancellation,
nonrenewal, expiration or otherwise by either the insurer or named
insured, notice of such termination shall be furnished by the insurer to
the board of governors, the state agency which licenses, registers or
certifies the named insured and the named insured. Such notice shall be
provided no less than 30 days prior to the effective date of any
termination initiated by the insurer or within 10 business days after the
date coverage is terminated at the request of the named insured and shall
include the name and address of the healthcare provider or providers for
whom basic coverage is terminated and the date basic coverage will
cease to be in effect. No basic coverage shall be terminated by
cancellation or failure to renew by the insurer unless such insurer
provides a notice of termination as required by this subsection.
(3) Any professional liability insurance policy issued, delivered or
in effect in this state on and after July 1, 1976, shall contain or be
endorsed to provide basic coverage as required by subsection (a).
Notwithstanding any omitted or inconsistent language, any contract of
professional liability insurance shall be construed to obligate the insurer
to meet all the mandatory requirements and obligations of this act. The
HOUSE BILL No. 2223—page 2
liability of an insurer for claims made prior to July 1, 1984, shall not
exceed those limits of insurance provided by such policy prior to July
1, 1984.
(b) A nonresident healthcare provider shall not be licensed to
actively render professional service as a healthcare provider in this state
unless such healthcare provider maintains continuous coverage in effect
as prescribed by subsection (a), except such coverage may be provided
by a nonadmitted insurer who has filed the form required by subsection
(b)(1). This provision shall not apply to optometrists , except as
provided in subsection (f), and pharmacists on and after July 1, 1991, or
to physical therapists on and after July 1, 1995.
(1) Every insurance company authorized to transact business in
this state, that is authorized to issue professional liability insurance in
any jurisdiction, shall file with the commissioner, as a condition of its
continued transaction of business within this state, a form prescribed by
the commissioner declaring that its professional liability insurance
policies, wherever issued, shall be deemed to provide at least the
insurance required by this subsection when the insured is rendering
professional services as a nonresident healthcare provider in this state.
Any nonadmitted insurer may file such a form.
(2) Every nonresident healthcare provider that is required to
maintain basic coverage pursuant to this subsection shall pay the
surcharge levied by the board of governors pursuant to K.S.A. 40-
3404(a), and amendments thereto, directly to the board of governors
and shall furnish to the board of governors the information required in
subsection (a)(1).
(c) Every healthcare provider that is a self-insurer, the university
of Kansas medical center for persons engaged in residency training, as
described in K.S.A. 40-3401(r)(1), and amendments thereto, the
employers of persons engaged in residency training, as described in
K.S.A. 40-3401(r)(2), and amendments thereto, the private practice
corporations or foundations and their full-time physician faculty
employed by the university of Kansas medical center or a medical care
facility or mental health center for self-insurers under K.S.A. 40-
3414(e), and amendments thereto, shall pay the surcharge levied by the
board of governors pursuant to K.S.A. 40-3404(a), and amendments
thereto, directly to the board of governors and shall furnish to the board
of governors the information required in subsections (a)(1) and (a)(2).
(d) In lieu of a claims made policy otherwise required under this
section, a person engaged in residency training who is providing
services as a healthcare provider but, while providing such services, is
not covered by the self-insurance provisions of K.S.A. 40-3414(d), and
amendments thereto, may obtain basic coverage under an occurrence
form policy, if such policy provides professional liability insurance
coverage and limits that are substantially the same as the professional
liability insurance coverage and limits required by K.S.A. 40-3402(a),
and amendments thereto. Where such occurrence form policy is in
effect, the provisions of the healthcare provider insurance availability
act referring to claims made policies shall be construed to mean
occurrence form policies.
(e) In lieu of a claims made policy otherwise required under this
section, a nonresident healthcare provider employed pursuant to a
locum tenens contract to provide services in this state as a healthcare
provider may obtain basic coverage under an occurrence form policy, if
such policy provides professional liability insurance coverage and
limits that are substantially the same as the professional liability
insurance coverage and limits required by K.S.A. 40-3402, and
amendments thereto. Where such occurrence form policy is in effect,
the provisions of the healthcare provider insurance availability act
referring to claims made policies shall be construed to mean occurrence
form policies.
(f) (1) Except as provided in paragraph (2), an optometrist shall
be subject to the professional liability insurance requirements of
subsection (a) if such optometrist has been credentialed to provide the
HOUSE BILL No. 2223—page 3
incision and curettage of a chalazion, removal and biopsy of skin
lesions, laser capsulotomy and laser trabeculoplasty.
(2) An optometrist shall not be subject to the requirements of
subsection (a) if the initial surcharge to participate in the healthcare
stabilization fund exceeds 15%.
(3) This subsection shall take effect on and after January 1, 2028.
Sec. 2. K.S.A. 40-3403 is hereby amended to read as follows: 40-
3403. (a) For the purpose of paying damages for personal injury or
death arising out of the rendering of or the failure to render professional
services by a healthcare provider, self-insurer or inactive health care
provider subsequent to the time that such healthcare provider or self-
insurer has qualified for coverage under the provisions of this act, there
is hereby established the healthcare stabilization fund. The fund shall
be held in trust in the state treasury and accounted for separately from
other state funds. The board of governors shall administer the fund or
contract for the administration of the fund with an insurance company
authorized to do business in this state.
(b) (1) There is hereby created a board of governors that shall be
composed of such members and shall have such powers, duties and
functions as are prescribed by this act. The board of governors shall:
(A) Administer the fund and exercise and perform other powers,
duties and functions required of the board under the healthcare provider
insurance availability act;
(B) provide advice, information and testimony to the appropriate
licensing or disciplinary authority regarding the qualifications of a
healthcare provider;
(C) prepare and publish, on or before October 1 of each year, a
report for submission to the healthcare stabilization fund oversight
committee that includes a summary of the fund's activity during the
preceding fiscal year, including, but not limited to, the amount
collected from surcharges, the highest and lowest surcharges assessed,
the amount paid from the fund, the number of judgments paid from the
fund, the number of settlements paid from the fund and the fund
balance at the end of the fiscal year; and
(D) have the authority to grant temporary exemptions from the
provisions of K.S.A. 40-3402 and 40-3404, and amendments thereto, to
healthcare providers who have exceptional circumstances and verify in
writing that the healthcare provider will not render professional
services in this state during the period of exemption. Whenever the
board grants such an exemption, the board shall notify the state agency
that licenses the exempted healthcare provider.
(2) The board shall consist of 11 12 persons appointed by the
commissioner of insurance, as provided by this subsection and as
follows:
(A) Three members who are on a list of nominees submitted to the
commissioner by the Kansas medical society, at least two of whom are
doctors of medicine who are licensed to practice medicine and surgery
in Kansas;
(B) three members who are on a list of nominees submitted to the
commissioner by the Kansas hospital association and who are
representatives of Kansas hospitals;
(C) two members who are on a list of nominees submitted to the
commissioner by the Kansas association of osteopathic medicine, who
are licensed to practice medicine and surgery in Kansas and who are
doctors of osteopathic medicine;
(D) one member who is on a list of nominees submitted to the
commissioner by the Kansas chiropractic association and who is
licensed to practice chiropractic in Kansas;
(E) one member who is on a list of nominees submitted to the
commissioner by the Kansas association of nurse anesthetists and who
is a licensed professional nurse authorized to practice as a registered
nurse anesthetist; and
(F) one member who is on a list of nominees submitted to the
commissioner by statewide associations comprised of members who
HOUSE BILL No. 2223—page 4
represent adult care homes and who is a representative of adult care
homes; and
(G) one member who is on a list of nominees submitted to the
commissioner by the Kansas optometric association and who is a
licensed optometrist authorized to practice as an optometrist.
(3) When a vacancy occurs in the membership of the board of
governors created by this act, the commissioner shall appoint a
successor of like qualifications from a list of three nominees submitted
to the commissioner by the professional society or association
prescribed by this section for the category of healthcare provider
required for the vacant position on the board of governors. All
appointments made shall be for a term of office of four years, but no
member shall be appointed for more than two successive four-year
terms. Each member shall serve until a successor is appointed and
qualified. Whenever a vacancy occurs in the membership of the board
of governors created by this act for any reason other than the expiration
of a member's term of office, the commissioner shall appoint a
successor of like qualifications to fill the unexpired term. In each case
of a vacancy occurring in the membership of the board of governors,
the commissioner shall notify the professional society or association
that represents the category of healthcare provider required for the
vacant position and request a list of three nominations of healthcare
providers from which to make the appointment.
(4) The board of governors shall organize in July of each year and
shall elect a chairperson and vice chairperson from among its
membership. Meetings shall be called by the chairperson or by a
written notice signed by three members of the board.
(5) The board of governors, in addition to other duties imposed by
this act, shall study and evaluate the operation of the fund and make
such recommendations to the legislature as may be appropriate to
ensure the viability of the fund.
(6) (A) The board shall appoint an executive director who shall be
in the unclassified service under the Kansas civil service act and may
employ attorneys and other employees who shall also be in the
unclassified service under the Kansas civil service act. Such executive
director, attorneys and other employees shall receive compensation
fixed by the board, in accordance with appropriation acts of the
legislature, not subject to approval of the governor.
(B) The board may provide all office space, services, equipment,
materials and supplies, and all budgeting, personnel, purchasing and
related management functions required by the board in the exercise of
the powers, duties and functions imposed or authorized by the
healthcare provider insurance availability act or may enter into a
contract with the commissioner of insurance for the provision, by the
commissioner, of all or any part thereof.
(7) The commissioner shall:
(A) Provide technical and administrative assistance to the board of
governors with respect to administration of the fund upon request of the
board; and
(B) provide such expertise as the board may reasonably request
with respect to evaluation of claims or potential claims.
(c) Except as otherwise provided by any other provision of this
act, the fund shall be liable to pay:
(1) Any amount due from a judgment or settlement that is in
excess of the basic coverage liability of all liable resident healthcare
providers or resident self-insurers for any personal injury or death
arising out of the rendering of or the failure to render professional
services within or without this state;
(2) subject to the provisions of subsection (f), any amount due
from a judgment or settlement that is in excess of the basic coverage
liability of all liable nonresident healthcare providers or nonresident
self-insurers for any such injury or death arising out of the rendering or
the failure to render professional services within this state but in no
event shall the fund be obligated for claims against nonresident
HOUSE BILL No. 2223—page 5
healthcare providers or nonresident self-insurers who have not
complied with this act or for claims against nonresident healthcare
providers or nonresident self-insurers that arose outside of this state;
(3) subject to the provisions of subsection (f), any amount due
from a judgment or settlement against a resident inactive healthcare
provider for any such injury or death arising out of the rendering of or
failure to render professional services;
(4) subject to the provisions of subsection (f), any amount due
from a judgment or settlement against a nonresident inactive healthcare
provider for any injury or death arising out of the rendering or failure to
render professional services within this state, but in no event shall the
fund be obligated for claims against nonresident inactive healthcare
providers:
(A) Who have not complied with this act; or
(B) for claims that arose outside of this state, unless such
healthcare provider was a resident healthcare provider or resident self-
insurer at the time such act occurred;
(5) subject to K.S.A. 40-3411(b), and amendments thereto,
reasonable and necessary expenses for attorney fees, depositions,
expert witnesses and other costs incurred in defending the fund against
claims, and such expenditures shall not be subject to the provisions of
K.S.A. 75-3738 through 75-3744, and amendments thereto;
(6) any amounts expended for reinsurance obtained to protect the
best interests of the fund purchased by the board of governors, which
purchase shall be subject to the provisions of K.S.A. 75-3738 through
75-3744, and amendments thereto, but shall not be subject to the
provisions of K.S.A. 75-4101, and amendments thereto;
(7) reasonable and necessary actuarial expenses incurred in
administering the act, including expenses for any actuarial studies
contracted for by the legislative coordinating council, and such
expenditures shall not be subject to the provisions of K.S.A. 75-3738
through 75-3744, and amendments thereto;
(8) periodically to the plan or plans, any amount due pursuant to
K.S.A. 40-3413(a)(3), and amendments thereto;
(9) reasonable and necessary expenses incurred by the board of
governors in the administration of the fund or in the performance of
other powers, duties or functions of the board under the healthcare
provider insurance availability act;
(10) surcharge refunds payable when the notice of cancellation
requirements of K.S.A. 40-3402, and amendments thereto, are met;
(11) subject to K.S.A. 40-3411(b), and amendments thereto,
reasonable and necessary expenses for attorney fees and other costs
incurred in defending a person engaged or who was engaged in
residency training or the private practice corporations or foundations
and their full- time physician faculty employed by the university of
Kansas medical center or any nonprofit corporation organized to
administer the graduate medical education programs of community
hospitals or medical care facilities affiliated with the university of
Kansas school of medicine from claims for personal injury or death
arising out of the rendering of or the failure to render professional
services by such healthcare provider;
(12) any amount due from a judgment or settlement for an injury
or death arising out of the rendering of or failure to render professional
services by a person engaged or who was engaged in residency training
or the private practice corporations or foundations and their full-time
physician faculty employed by the university of Kansas medical center
or any nonprofit corporation organized to administer the graduate
medical education programs of community hospitals or medical care
facilities affiliated with the university of Kansas school of medicine;
(13) subject to the provisions of K.S.A. 65-429, and amendments
thereto, reasonable and necessary expenses for the development and
promotion of risk management education programs and for the medical
care facility licensure and risk management survey functions carried
out under K.S.A. 65-429, and amendments thereto;
HOUSE BILL No. 2223—page 6
(14) any amount, but not less than the required basic coverage
limits, owed pursuant to a judgment or settlement for any injury or
death arising out of the rendering of or failure to render professional
services by a person, other than a person described in paragraph (12),
who was engaged in a postgraduate program of residency training
approved by the state board of healing arts but who, at the time the
claim was made, was no longer engaged in such residency program;
(15) subject to K.S.A. 40-3411(b), and amendments thereto,
reasonable and necessary expenses for attorney fees and other costs
incurred in defending a person described in paragraph (14);
(16) expenses incurred by the commissioner in the performance of
duties and functions imposed upon the commissioner by the healthcare
provider insurance availability act, and expenses incurred by the
commissioner in the performance of duties and functions under
contracts entered into between the board and the commissioner as
authorized by this section; and
(17) periodically to the state general fund reimbursements of
amounts paid to members of the healthcare stabilization fund oversight
committee for compensation, travel expenses and subsistence expenses
pursuant to K.S.A. 40-3403b(e), and amendments thereto.
(d) All amounts for which the fund is liable pursuant to subsection
(c) shall be paid promptly and in full except that, if the amount for
which the fund is liable is $500,000 or more, it shall be paid by
installment payments of $500,000 or 10% of the amount of the
judgment including interest thereon, whichever is greater, per fiscal
year, the first installment to be paid within 60 days after the fund
becomes liable and each subsequent installment to be paid annually on
the same date of the year the first installment was paid, until the claim
has been paid in full.
(e) In no event shall the fund be liable to pay in excess of
$3,000,000 pursuant to any one judgment or settlement against any one
healthcare provider relating to any injury or death arising out of the
rendering of or the failure to render professional services on and after
July 1, 1984, and before July 1, 1989, subject to an aggregate limitation
for all judgments or settlements arising from all claims made in any one
fiscal year in the amount of $6,000,000 for each healthcare provider.
(f) In no event shall the fund be liable to pay in excess of the
amounts specified in the option selected by an active or inactive
healthcare provider pursuant to subsection (l) for judgments or
settlements relating to injury or death arising out of the rendering of or
failure to render professional services by such healthcare provider on or
after July 1, 1989.
(g) A healthcare provider shall be deemed to have qualified for
coverage under the fund:
(1) On and after July 1, 1976, if basic coverage is then in effect;
(2) subsequent to July 1, 1976, at such time as basic coverage
becomes effective; or
(3) upon qualifying as a self-insurer pursuant to K.S.A. 40-3414,
and amendments thereto.
(h) A healthcare provider who is qualified for coverage under the
fund shall have no vicarious liability or responsibility for any injury or
death arising out of the rendering of or the failure to render professional
services inside or outside this state by any other healthcare provider
who is also qualified for coverage under the fund. The provisions of
this subsection shall apply to all claims filed on or after July 1, 1986.
(i) Notwithstanding the provisions of K.S.A. 40-3402, and
amendments thereto, if the board of governors determines due to the
number of claims filed against a healthcare provider or the outcome of
those claims that an individual healthcare provider presents a material
risk of significant future liability to the fund, the board of governors is
authorized by a vote of a majority of the members thereof, after notice
and an opportunity for hearing in accordance with the provisions of the
Kansas administrative procedure act, to terminate the liability of the
fund for all claims against the healthcare provider for damages for
HOUSE BILL No. 2223—page 7
death or personal injury arising out of the rendering of or the failure to
render professional services after the date of termination. The date of
termination shall be 30 days after the date of the determination by the
board of governors. The board of governors, upon termination of the
liability of the fund under this subsection, shall notify the licensing or
other disciplinary board having jurisdiction over the healthcare
provider involved of the name of the healthcare provider and the
reasons for the termination.
(j) (1) Subject to the provisions of paragraph (7), upon the
payment of moneys from the healthcare stabilization fund pursuant to
subsection (c)(11), the board of governors shall certify to the secretary
of administration the amount of such payment, and the secretary of
administration shall transfer an amount equal to the amount certified,
reduced by any amount transferred pursuant to paragraph (3) or (4),
from the state general fund to the healthcare stabilization fund.
(2) Subject to the provisions of paragraph (7), upon the payment
of moneys from the healthcare stabilization fund pursuant to subsection
(c)(12), the board of governors shall certify to the secretary of
administration the amount of such payment that is equal to the basic
coverage liability of self-insurers, and the secretary of administration
shall transfer an amount equal to the amount certified, reduced by any
amount transferred pursuant to paragraph (3) or (4), from the state
general fund to the healthcare stabilization fund.
(3) The university of Kansas medical center private practice
foundation reserve fund is hereby established in the state treasury. If the
balance in such reserve fund is less than $500,000 on July 1 of any
year, the private practice corporations or foundations referred to in
K.S.A. 40- 3402(c), and amendments thereto, shall remit the amount
necessary to increase such balance to $500,000 to the state treasurer for
credit to such reserve fund as soon after such July 1 date as is
practicable. Upon receipt of each such remittance, the state treasurer
shall credit the same to such reserve fund. When compliance with the
foregoing provisions of this paragraph have been achieved on or after
July 1 of any year in which the same are applicable, the state treasurer
shall certify to the board of governors that such reserve fund has been
funded for the year in the manner required by law. Moneys in such
reserve fund may be invested or reinvested in accordance with the
provisions of K.S.A. 40- 3406, and amendments thereto, and any
income or interest earned by such investments shall be credited to such
reserve fund. Upon payment of moneys from the healthcare
stabilization fund pursuant to subsection (c)(11) or (c)(12) with respect
to any private practice corporation or foundation or any of its full-time
physician faculty employed by the university of Kansas, the secretary
of administration shall transfer an amount equal to the amount paid
from the university of Kansas medical center private practice
foundation reserve fund to the healthcare stabilization fund or, if the
balance in such reserve fund is less than the amount so paid, an amount
equal to the balance in such reserve fund.
(4) The graduate medical education administration reserve fund is
hereby established in the state treasury. If the balance in such reserve
fund is less than $40,000 on July 1 of any year, the nonprofit
corporations organized to administer the graduate medical education
programs of community hospitals or medical care facilities affiliated
with the university of Kansas school of medicine shall remit the amount
necessary to increase such balance to $40,000 to the state treasurer for
credit to such reserve fund as soon after such July 1 date as is
practicable. Upon receipt of each such remittance, the state treasurer
shall credit the same to such reserve fund. When compliance with the
foregoing provisions of this paragraph have been achieved on or after
July 1 of any year in which the same are applicable, the state treasurer
shall certify to the board of governors that such reserve fund has been
funded for the year in the manner required by law. Moneys in such
reserve fund may be invested or reinvested in accordance with the
provisions of K.S.A. 40-3406, and amendments thereto, and any
HOUSE BILL No. 2223—page 8
income or interest earned by such investments shall be credited to such
reserve fund. Upon payment of moneys from the healthcare
stabilization fund pursuant to subsection (c)(11) or (c)(12) with respect
to any nonprofit corporations organized to administer the graduate
medical education programs of community hospitals or medical care
facilities affiliated with the university of Kansas school of medicine the
secretary of administration shall transfer an amount equal to the amount
paid from the graduate medical education administration reserve fund
to the healthcare stabilization fund or, if the balance in such reserve
fund is less than the amount so paid, an amount equal to the balance in
such reserve fund.
(5) Upon payment of moneys from the healthcare stabilization
fund pursuant to subsection (c)(14) or (c)(15), the board of governors
shall certify to the secretary of administration the amount of such
payment, and the secretary of administration shall transfer an amount
equal to the amount certified from the state general fund to the
healthcare stabilization fund.
(6) Transfers from the state general fund to the healthcare
stabilization fund pursuant to this subsection shall not be subject to the
provisions of K.S.A. 75-3722, and amendments thereto.
(7) The funds required to be transferred from the state general
fund to the healthcare stabilization fund pursuant to paragraphs (1) and
(2) for the fiscal years ending June 30, 2010, June 30, 2011, June 30,
2012, and June 30, 2013, shall not be transferred prior to July 1, 2013.
The secretary of administration shall maintain a record of the amounts
certified by the board of governors pursuant to paragraphs (1) and (2)
for the fiscal years ending June 30, 2010, June 30, 2011, June 30, 2012,
and June 30, 2013. Beginning July 1, 2013, in addition to any other
transfers required pursuant to subsection (j), the state general fund
transfers that are deferred pursuant to this paragraph shall be
transferred from the state general fund to the healthcare stabilization
fund in the following manner: On July 1, 2013, and annually thereafter
through July 1, 2018, an amount equal to 20% of the total amount of
state general fund transfers deferred pursuant to this paragraph for the
fiscal years ending June 30, 2010, June 30, 2011, June 30, 2012, and
June 30, 2013. The amounts deferred pursuant to this paragraph shall
not accrue interest thereon.
(k) Notwithstanding any other provision of the healthcare provider
insurance availability act, no psychiatric hospital licensed under K.S.A.
39-2001 et seq., and amendments thereto, shall be assessed a premium
surcharge or be entitled to coverage under the fund if such hospital has
not paid any premium surcharge pursuant to K.S.A. 40-3404, and
amendments thereto, prior to January 1, 1988.
(l) (1) On or after July 1, 1989, and prior to January 1, 2022, every
healthcare provider shall make an election to be covered by one of the
following options provided in subparagraph (A) that shall limit the
liability of the fund with respect to judgments or settlements relating to
injury or death arising out of the rendering of or failure to render
professional services on or after July 1, 1989. On and after January 1,
2022, every healthcare provider shall make an election to be covered by
one of the following options provided in subparagraph (B) that shall
limit the liability of the fund with respect to judgments or settlements
relating to injury or death arising out of the rendering of or failure to
render professional services on or after January 1, 2022. Such election
shall be made at the time the healthcare provider renews the basic
coverage, or, if basic coverage is not in effect, such election shall be
made at the time such coverage is acquired pursuant to K.S.A. 40-3402,
and amendments thereto. A medical care facility or a healthcare facility
deemed qualified as a self-insurer under K.S.A. 40-3414(a), and
amendments thereto, may opt out of the requirements set forth in
subparagraph (B) if such medical care facility or healthcare facility
substantially meets the minimum coverage requirements of this section
through coverage provided by the captive insurance company of such
medical care facility or healthcare facility. Notice of the election shall
HOUSE BILL No. 2223—page 9
be provided by the insurer providing the basic coverage in the manner
and form prescribed by the board of governors and shall continue to be
effective from year to year unless modified by a subsequent election
made prior to the anniversary date of the policy. The healthcare
provider may at any subsequent election reduce the dollar amount of
the coverage for the next and subsequent fiscal years, but may not
increase the same, unless specifically authorized by the board of
governors. Any election of fund coverage limits, whenever made, shall
be with respect to judgments or settlements relating to injury or death
arising out of the rendering of or failure to render professional services
on or after the effective date of such election of fund coverage limits.
Such election shall be made for persons engaged in residency training
and persons engaged in other postgraduate training programs approved
by the state board of healing arts at medical care facilities or mental
health centers in this state by the agency or institution paying the
surcharge levied under K.S.A. 40-3404, and amendments thereto, for
such persons. The election of fund coverage limits for a nonprofit
corporation organized to administer the graduate medical education
programs of community hospitals or medical care facilities affiliated
with the university of Kansas school of medicine shall be deemed to be
effective at the highest option. Such options shall be as follows:
(A) (i) OPTION 1. The fund shall not be liable to pay in excess of
$100,000 pursuant to any one judgment or settlement for any party
against such healthcare provider, subject to an aggregate limitation for
all judgments or settlements arising from all claims made in the fiscal
year in an amount of $300,000 for such provider.
(ii) OPTION 2 . The fund shall not be liable to pay in excess of
$300,000 pursuant to any one judgment or settlement for any party
against such healthcare provider, subject to an aggregate limitation for
all judgments or settlements arising from all claims made in the fiscal
year in an amount of $900,000 for such provider.
(iii) OPTION 3 . The fund shall not be liable to pay in excess of
$800,000 pursuant to any one judgment or settlement for any party
against such healthcare provider, subject to an aggregate limitation for
all judgments or settlements arising from all claims made in the fiscal
year in an amount of $2,400,000 for such healthcare provider.
(B) (i) OPTION 1. The fund shall not be liable to pay in excess of
$500,000 pursuant to any one judgment or settlement for any party
against such healthcare provider, subject to an aggregate limitation for
all judgments or settlements arising from all claims made in the fiscal
year in an amount of $1,500,000 for such healthcare provider.
(ii) OPTION 2. The fund shall not be liable to pay in excess of
$1,500,000 pursuant to any one judgment or settlement for any party
against such healthcare provider, subject to an aggregate limitation for
all judgments or settlements arising from all claims made in the fiscal
year in an amount of $4,500,000 for such healthcare provider.
(2) The board of governors shall have the authority to adjust the
amounts provided in subparagraph (B) as the board deems necessary to
effectuate the provisions of the healthcare provider insurance
availability act, except that the minimum coverage for a healthcare
provider shall not be less than $1,000,000 per claim and $3,000,000 in
the aggregate.
(m) In the event of a claim against a healthcare provider for
personal injury or death arising out of the rendering of or the failure to
render professional services by such healthcare provider, the liability of
the fund shall be limited to the amount of coverage selected by the
healthcare provider at the time of the incident giving rise to the claim.
(n) Notwithstanding anything in article 34 of chapter 40 of the
Kansas Statutes Annotated, and amendments thereto, to the contrary,
the fund shall in no event be liable for any claims against any
healthcare provider based upon or relating to the healthcare provider's
sexual acts or activity, but in such cases the fund may pay reasonable
and necessary expenses for attorney fees incurred in defending the fund
against such claim. The fund may recover all or a portion of such
HOUSE BILL No. 2223—page 10
expenses for attorney fees if an adverse judgment is returned against
the healthcare provider for damages resulting from the healthcare
provider's sexual acts or activity.
Sec. 3. K.S.A. 65-1501 is hereby amended to read as follows: 65-
1501. (a) The practice of optometry means:
(1) The examination of the human eye and its adnexae adnexa and
the employment of objective or subjective means or methods ,
(including the administering, prescribing or dispensing , of topical
pharmaceutical drugs), for the purpose of diagnosing the refractive,
muscular, or pathological condition thereof;
(2) the use of medical devices and the prescribing, dispensing or
adapting of lenses , (including any ophthalmic lenses which are
classified as drugs by any law of the United States or of this state ),
prisms, low vision rehabilitation services, orthoptic exercises and visual
training therapy for the relief of any insufficiencies or abnormal
conditions of the human eye and its adnexae adnexa; and
(3) the use of medical devices and the prescribing, administering
or dispensing of topical pharmaceutical drugs and oral drugs through
all routes of administration, except intraocular injections, for the
examination, diagnosis and treatment of ocular conditions and any
insufficiencies or abnormal conditions of the human eye and its
adnexae including adult open-angle glaucoma adnexa;
(4) the removal of non‐perforating foreign bodies from the cornea,
conjunctiva or eyelids, removal of eyelashes, scraping the cornea for
diagnostic tests, smears or cultures, the dilation, probing, irrigation or
closing the tear drainage structure of the eye, expression of
conjunctival follicles or cysts, debridement of the corneal epithelium,
incision and curettage of a chalazion, removal and biopsy of skin
lesions without known malignancy, laser capsulotomy and laser
trabeculoplasty; and
(5) the performance of additional procedures that are not
otherwise prohibited by subsection (b) that are within the scope of a
licensee's education and training for the treatment of any
insufficiencies or abnormal conditions of the human eye and its adnexa
as authorized pursuant to rules and regulations adopted by the board .
The board shall not adopt a rule and regulation authorized pursuant to
this paragraph without first receiving a recommendation from the
interprofessional advisory committee that such procedure is
appropriate for an optometrist to perform.
(b) The practice of optometry shall not include the performance of
the following procedures: (1) The management and treatment of
glaucoma, except as provided in subsection (a); (2) the performance of
surgery, including the use of lasers for surgical purposes, except that
licensees may remove non-perforating foreign bodies from the cornea ,
conjunctiva or eyelids; remove eyelashes; scrape the cornea for
diagnostic tests, smears or cultures; dilate, probe, irrigate or close by
punctal plug the tear drainage structures of the eye; express
conjunctival follicles or cysts; debridement of the corneal epithelium
and co-management of post-operative care; or (3) the performance of
procedures requiring anesthesia administered by injection or general
anesthesia Retinal surgery, penetrating keratoplasty or corneal
transplant, administration of or surgery performed under general
anesthesia, surgery related to the removal of the eye from a living
human being, surgical extraction of the crystalline lens, surgical
intraocular implants, incisional or excisional surgery of the
extraocular muscles, surgery of the bony orbit, laser‐assisted in situ
keratomileusis or photorefractive keratectomy, YAG laser vitreolysis,
and surgery of the eyelid for cosmetic or mechanical repair of
blepharochalasis, ptosis and tarsorrhaphy. However, an optometrist
may provide pre-operative and post-operative care for the procedures
in this subsection.
(c) A licensee shall be held to a standard of care in the diagnosis
and treatment of adult open-angle glaucoma commensurate to , the
performance of incision and curettage of a chalazion, removal and
HOUSE BILL No. 2223—page 11
biopsy of skin lesions, laser capsulotomy and laser trabeculoplasty
with that of a person licensed to practice medicine and surgery, who
exercises that degree of skill and proficiency commonly exercised by
an ordinary, skillful, careful and prudent person licensed to practice
medicine and surgery.
(d) Under the direction and supervision of a licensee, a licensed
professional nurse, licensed practical nurse, licensed physical therapist
and licensed occupational therapist may assist in the provision of low
vision rehabilitation services in addition to such other services which
that such licensed professional nurse, licensed practical nurse, licensed
physical therapist and licensed occupational therapist is authorized by
law to provide under subsection (d) of K.S.A. 65-1113 (d), subsection
(h) of K.S.A. 65-1124(h), subsection (b) of K.S.A. 65-2901 (b) and
subsection (b) of K.S.A. 65-5402(b), and amendments thereto.
Sec. 4. K.S.A. 2025 Supp. 65-1501a is hereby amended to read as
follows: 65-1501a. For the purposes of this act the following terms
shall have the meanings respectively ascribed to them As used in the
optometry law, unless the context requires otherwise:
(a) "Board" means the board of examiners in optometry
established under K.S.A. 74-1501, and amendments thereto.
(b) "License" means a license to practice optometry granted under
the optometry law.
(c) "Licensee" means a person licensed under the optometry law
to practice optometry.
(d) "Adapt" means the determination, selection, fitting or use of
lenses, prisms, orthoptic exercises or visual training therapy or the
modification of lenses using light or other means for the aid of any
insufficiencies or abnormal conditions of the eyes after or by
examination or testing.
(e) "Lenses" means any type of ophthalmic lenses, which are
lenses prescribed or used for the aid of any insufficiencies or abnormal
conditions of the eyes.
(f) "Prescription" means a verbal, written or electronic order
transmitted directly or by electronic means from a licensee giving or
containing the name and address of the prescriber, the license
registration number of the licensee, the name and address of the patient,
the specifications and directions for lenses, prisms, orthoptic exercises,
low vision rehabilitation services or visual training therapy to be used
for the aid of any insufficiencies or abnormal conditions of the eyes,
including instructions necessary for the fabrication or use thereof and
the date of issue.
(g) "Prescription for topical pharmaceutical drugs or oral drugs "
means a verbal , written or electronic order transmitted directly or by
electronic means from a licensee giving or containing the name and
address of the prescriber, the license registration number of the
licensee, the name and address of the patient, the name and quantity of
the drug prescribed, directions for use, the number of refills permitted,
the date of issue and expiration date.
(h) "Topical pharmaceutical drugs" means drugs administered
topically and not by other means.
(i) "Dispense" means to deliver prescription-only medication or
ophthalmic lenses to the ultimate user pursuant to the lawful
prescription of a licensee and dispensing of prescription-only
medication by a licensee shall be limited to a twenty-four hour 24-hour
supply or minimal quantity necessary until a prescription can be filled
by a licensed pharmacist, except that the twenty-four hour 24-hour
supply or minimal quantity shall not apply to lenses described in
subsection (a)(2) of K.S.A. 65-1501(a)(2), and amendments thereto.
(j)(i) "False advertisement" means any advertisement which that is
false, misleading or deceptive in a material respect. In determining
whether any advertisement is misleading, there shall be taken into
account not only representations made or suggested by statement,
word, design, device, sound or any combination thereof, but also the
extent to which the advertisement fails to reveal facts material in the
HOUSE BILL No. 2223—page 12
light of such representations made.
(k)(j) "Advertisement" means all representations disseminated in
any manner or by any means, for the purpose of inducing, or which are
likely to induce, directly or indirectly, the purchase of professional
services or ophthalmic goods.
(l)(k) "Health careHealthcare provider" shall have the meaning
ascribed to that term means the same as defined in subsection (f) of
K.S.A. 40-3401(f), and amendments thereto.
(m)(l) "Medical facility" shall have the meaning ascribed to that
term means the same as defined in subsection (c) of K.S.A. 65-411(c),
and amendments thereto.
(n)(m) "Medical care facility" shall have the meaning ascribed to
that term means the same as defined in K.S.A. 65-425 , and
amendments thereto.
(o)(n) "Ophthalmologist" means a person licensed to practice
medicine and surgery by the state board of healing arts who specializes
in the diagnosis and medical and surgical treatment of diseases and
defects of the human eye and related structures.
(p)(o) "Low vision rehabilitation services" means the evaluation,
diagnosis, management and care of the low vision patient including low
vision rehabilitation therapy, education and interdisciplinary
consultation under the direction and supervision of an ophthalmologist
or optometrist.
(q) "Oral drugs" means oral antibacterial drugs, oral antiviral
drugs, oral antihistamines, oral analgesic drugs, oral steroids, oral
antiglaucoma drugs and other oral drugs with clinically accepted ocular
uses.
Sec. 5. K.S.A. 2025 Supp. 65-1505 is hereby amended to read as
follows: 65-1505. (a) Persons entitled to practice optometry in Kansas
shall be those persons licensed in accordance with the provisions of the
optometry law. A person shall be qualified to be licensed and to receive
a license as an optometrist: (1) Who is of good moral character; and in
determining the moral character of any such person, the board may take
into consideration any felony conviction of such person, but such
conviction shall not automatically operate as a bar to licensure; (2) who
has graduated from a school or college of optometry approved by the
board; and (3) who successfully meets and completes the requirements
set by the board and passes an examination given by the board.
(b) All applicants for licensure, in addition to successfully
completing all other requirements for licensure, shall submit evidence
satisfactory to the board of professional liability insurance in an amount
acceptable to the board.
(c) Any person applying for examination by the board shall fill out
and swear to an application furnished by the board, accompanied by a
fee fixed by the board by rules and regulations in an amount of not to
exceed $450, and file the same with the secretary of the board at least
30 days prior to the holding of the examination. At such examinations
the board shall examine each applicant in subjects taught in schools or
colleges of optometry approved by the board, as may be required by the
board. If such person complies with the other qualifications for
licensing and passes such examination, such person shall receive from
the board, upon the payment of a fee fixed by the board by rules and
regulations in an amount of not to exceed $150, a license entitling such
person to practice optometry. In the event of the failure on the part of
the applicant to pass the first examination, such person may, with the
consent of the board, within 18 months, by filing an application
accompanied by a fee fixed by the board by rules and regulations in an
amount of not to exceed $150, take a second examination; for the third
and each subsequent examination a fee fixed by the board by rules and
regulations in an amount of not to exceed $150. Any examination fee
and license fee fixed by the board under this subsection which is in
effect on the day preceding the effective date of this act shall continue
in effect until the board adopts rules and regulations under this
subsection fixing a different fee therefor.
HOUSE BILL No. 2223—page 13
(d) Any applicant for reciprocal licensure may in the board's
discretion be licensed and issued a license without examination if the
applicant has been in the active practice of optometry in another state
for at least the three-year period immediately preceding the application
for reciprocal licensure and the applicant:
(1) Presents a certified copy of a certificate of registration or
license which that has been issued to the applicant by another state
where the requirements for licensure are deemed by the board to be
equivalent to the requirements for licensure under this act, if such state
accords a like privilege to holders of a license issued by the board;
(2) submits a sworn statement of the licensing authority of such
other state that the applicant's license has never been limited,
suspended or revoked and that the applicant has never been censured or
had other disciplinary action taken;
(3) successfully passes an examination of Kansas law
administered by the board and such clinical practice examination as the
board deems necessary; and
(4) pays the reciprocal license fixed by the board by rules and
regulations in an amount of not to exceed $450. The reciprocal license
fee fixed by the board under this subsection which that is in effect on
the day preceding the effective date of this act shall continue in effect
until the board adopts rules and regulations under this subsection fixing
a different fee therefor.
(e) The board shall adopt rules and regulations establishing the
criteria which that a school or college of optometry shall satisfy in
meeting the requirement of approval by the board established under
subsection (a). The board may send a questionnaire developed by the
board to any school or college of optometry for which the board does
not have sufficient information to determine whether the school or
college meets the requirements for approval and rules and regulations
adopted under this act. The questionnaire providing the necessary
information shall be completed and returned to the board in order for
the school or college to be considered for approval. The board may
contract with investigative agencies, commissions or consultants to
assist the board in obtaining information about schools or colleges. In
entering such contracts the authority to approve schools or colleges
shall remain solely with the board.
(f) (1) The board may require an applicant for licensure or a
licensee in connection with an investigation of the licensee to be
fingerprinted and submit to a state and national criminal history record
check in accordance with K.S.A. 2024 2025 Supp. 22-4714, and
amendments thereto.
(2) (A) The board shall fix a fee for fingerprinting applicants or
licensees in an amount necessary to reimburse the board for the cost of
the fingerprinting. Fees collected under this subsection shall be
deposited in the criminal history and fingerprinting fund.
(B) There is hereby created in the state treasury the criminal
history and fingerprinting fund. All moneys credited to the fund shall
be used to pay all costs and fees associated with processing of
fingerprints and criminal history checks for the board of examiners in
optometry. The fund shall be administered by the board. All
expenditures from the fund shall be made in accordance with
appropriation acts upon warrants of the director of accounts and reports
issued pursuant to vouchers approved by the president of the board or a
person designated by the president.
(g) Any licensee applying for credentialing by the board shall
complete and swear to an application form furnished by the board
accompanied by an additional fee fixed by the board by rules and
regulations in an amount necessary to reimburse the board for the cost
of credentialing.
Sec. 6. K.S.A. 65-1509a is hereby amended to read as follows: 65-
1509a. (a) In addition to the payment of the license renewal fee, each
licensee applying for license renewal shall furnish to the secretary of
the board satisfactory evidence of successfully completing a minimum
HOUSE BILL No. 2223—page 14
of 24 hours of continuing education annually, five hours of which shall
relate to ocular pharmacology, therapeutics or related topics of study,
approved by the board in the year just preceding such application for
the renewal of the license. The board, in its discretion, may increase the
required hours of continuing education by rules and regulations
adopted by the board. On or before April 1 of each year, the secretary
of the board shall send a written notice of continuing education
requirements to this effect to every person holding a valid license to
practice optometry within the state as provided in subsection (a) of
K.S.A. 65-1509(a), and amendments thereto.
(b) (1) A licensee who seeks to administer or perform a procedure
referenced by K.S.A. 65-1501(a)(4) or (5), and amendments thereto,
that requires the use of injections or lasers shall be required to receive
credentialing as follows:
(A) A licensee who graduated from an accredited college or
school of optometry on or after July 1, 2020, shall be granted such
credentialing by the board upon submitting a request to the board; or
(B) a licensee who graduated from an accredited college or school
of optometry prior to July 1, 2020, shall be granted credentialing when
the board receives proof of successful completion of a 32-hour
certification program that:
(i) Includes both didactic and clinical or laboratory experiences
and testing approved by the board; and
(ii) is presented by a school or college of optometry or school of
medicine that is approved by the board.
(2) (A) A licensee that has received credentialing under
paragraph (1) shall submit a report to the board on a quarterly basis
that contains:
(i) The name of the optometrist;
(ii) the total number of procedures performed during that quarter;
(iii) the location where each procedure was performed; and
(iv) the outcome for each procedure or patient.
(B) A reporting optometrist shall certify the accuracy of the
information contained in the report.
(C) Beginning July 1, 2027, and annually thereafter, the board
shall compile and make public the information contained in reports
received under this subsection, but shall redact any personally
identifiable information prior to making such reports public.
(D) The provisions of this paragraph shall expire on July 1, 2031.
Sec. 7. K.S.A. 65-1512 is hereby amended to read as follows: 65-
1512. This actThe provisions of article 15 of chapter 65 of the Kansas
Statutes Annotated, and amendments thereto, shall be known and may
be cited as the optometry law.
Sec. 8. K.S.A. 65-1523 is hereby amended to read as follows: 65-
1523. The board in its discretion, in addition to any other remedies
provided in this act, may apply to a court of competent jurisdiction for
injunctive relief against any person to restrain violations of the
provisions of this act, and the lawful rules and regulations promulgated
by the board under authority of this act.
Sec. 9. K.S.A. 74-1504 is hereby amended to read as follows: 74-
1504. (a) The board shall administer and enforce the provisions of the
optometry law, and the board is hereby granted such specific powers as
are necessary for the purpose of administering and enforcing such law.
In addition, the board may:
(1) Employ agents, attorneys and inspectors under such rules and
regulations as the board may prescribe in accordance with the
provisions of the optometry law, except that no state officer shall be
eligible for employment by the board.
(2) Make all necessary disbursements , to carry out the provisions
of this act, including payment for stationery supplies, acquire and
acquiring all necessary optical instruments to be used in the conducting
of examination, print and distribute to all optometrists in the state a
yearbook of the names and addresses of all optometrists licensed by the
board maintain and make available to the public a directory including
HOUSE BILL No. 2223—page 15
the names and addresses of all optometrists licensed by the board.
(3) Grant all licenses as seem just and proper and to suspend,
limit, revoke or refuse to renew any such licenses granted for any of the
causes specified under K.S.A. 65-1506, and amendments thereto.
(4) Administer oaths and take testimony upon granting or refusing
to grant, revoking, limiting or suspending licenses.
(5) Issue subpoenas, compel the attendance of witnesses and the
production of any papers, books, accounts, documents and testimony,
and to cause the deposition of witnesses, either residing within or
without the state, to be taken in the manner prescribed by law for taking
depositions in civil actions in the district courts. In case of disobedience
on the part of any person to comply with any subpoena issued in behalf
of the board, or on the refusal of any witness to testify to any matters
regarding which such witness may be lawfully interrogated, the judge
of the district court of any county, on application of a member of the
board, may compel obedience by proceedings for contempt, as in the
case of disobedience of the requirements of a subpoena issued from
such court or a refusal to testify in such court. Each witness who
appears before the board by the board's order or subpoena, other than a
state officer or employee, shall receive for attendance the fees and
mileage provided for witnesses in civil cases in courts of record which
that shall be audited and paid upon the presentation of proper vouchers
sworn to by such witnesses and approved by the president and
secretary-treasurer of the board.
(6) Adopt rules and regulations for the procedure and conduct of
the board and for the administration of the optometry law , which rules
and regulations shall that are not be inconsistent consistent with the
provisions of the optometry law.
(b) The board shall meet at least annually for the purpose of
examining applicants for licensure. Such meetings shall be held in
Topeka. At least 30 days prior to the examination, the board shall cause
a special notice to be published in the Kansas register stating the date
and hour for holding such examination. Special meetings shall be held
at such times and places as the board may direct.
(c) The board shall preserve an accurate record of all meetings and
proceedings of the board including receipts and disbursements with
vouchers therefor and complete minutes of all prosecutions and
violations of the optometry law and of examinations held under the
provisions of the optometry law and an accurate inventory of all
property of the board. All such records shall be kept in the office of the
board and made accessible to the public.
Sec. 10. K.S.A. 74-1505 is hereby amended to read as follows: 74-
1505. (a) The board shall appoint a seven-member committee to be
known as the interprofessional advisory committee which, as requested
by the board, shall make recommendations on clinical or practice
related issues, including procedure coding matters and appropriate
treatments for ocular diseases and conditions may review new
technologies to make recommendations for consideration by the board.
The board may request that the committee meet to review a procedure
and make a recommendation whether or not the procedure is
appropriate for an optometrist to perform.
(b) The interprofessional advisory committee shall consist of one
member of the board appointed by the board who shall serve as a
nonvoting chair, together with three optometrists licensed to practice
optometry in this state chosen by the board from those nominated by
the Kansas optometric association and three ophthalmologists licensed
to practice in this state chosen by the board from those nominated by
the Kansas medical society and the Kansas association of osteopathic
medicine of eye physicians and surgeons.
The Kansas optometric association and the Kansas medical society of
HOUSE BILL No. 2223—page 16
eye physicians and surgeons shall submit six nominees to the board.
The Kansas association of osteopathic medicine shall submit two
nominees to the board. Persons appointed to the committee shall serve
terms of three years and without compensation. All expenses of the
committee shall be paid by the board.
(c) This section shall a be part of and supplemental to the
optometry law.
Sec. 11. K.S.A. 40-3402, 40-3403, 65-1501, 65-1509a, 65-1512,
65-1514, 65-1523, 74-1504 and 74-1505 and K.S.A. 2025 Supp. 65-
1501a and 65-1505 are hereby repealed.
Sec. 12. This act shall take effect and be in force from and after its
publication in the statute book.
I hereby certify that the above BILL originated in the House,
and passed that body
HOUSE concurred in
SENATE amendments __________________________________________________________________
Speaker of the House.
Chief Clerk of the House.
Passed the SENATE
as amended
President of the Senate.
Secretary of the Senate.
APPROVED ________________________________________
Governor.