Medical Malpractice Settlement Agreement (Kansas)

MEDICAL MALPRACTICE SETTLEMENT AGREEMENT AND RELEASE

(Kansas — Health Care Stabilization Fund Coordination Template)

1. PARTIES

This Settlement Agreement and Release (the "Agreement") is entered into as of [EFFECTIVE DATE] by and between:

Each, a "Party"; collectively, the "Parties."

2. RECITALS

A. Claimant filed or asserted a medical malpractice claim styled [CAPTION], Case No. [__________], in the District Court of [____________] County, Kansas (the "Litigation"), arising from medical care rendered on or about [DATE(S) OF CARE].
B. The Litigation alleges [brief description of alleged negligence and injuries].
C. Released Provider is a Kansas "health care provider" as defined by K.S.A. § 40-3401(f), maintains a primary policy with Primary Insurer, and participates in the HCSF.
D. The Parties wish to resolve all claims arising from the alleged care without admission of liability.

3. SETTLEMENT CONSIDERATION

3.1 Total Settlement Amount

In consideration of this Agreement and the releases set forth herein, the following sums shall be paid to Claimant or Claimant's counsel's trust account:

3.2 Allocation

☐ Economic damages (medical expenses, lost wages, future care): $[__________]
☐ Noneconomic damages (pain, suffering, loss of consortium): $[__________]
☐ Wrongful death / survival (if applicable): $[__________]

3.3 Payment Terms

☐ Lump-sum payment within [thirty (30)] days after the latest of: (a) execution by all Parties; (b) HCSF Board of Governors approval (if applicable); (c) court approval (if minor / wrongful death / incapacitated claimant); (d) satisfaction of all lien-resolution conditions.
☐ Structured settlement: see Schedule A (annuity issuer, payment stream).

3.4 HCSF Approval

☐ This Agreement is contingent on approval by the Kansas Health Care Stabilization Fund Board of Governors to the extent any HCSF contribution is involved. K.S.A. § 40-3403.

3.5 Court Approval

☐ Required: Claimant is a [minor / incapacitated adult] — court approval required.
☐ Required: wrongful-death apportionment among heirs at law under K.S.A. § 60-1903 / § 60-1905.
☐ Not required.

4. RELEASE OF CLAIMS

4.1 General Release

Upon receipt of the consideration in § 3, Claimant fully and forever releases, acquits, and discharges Released Provider, Released Entity, Primary Insurer, HCSF (to the extent of its contribution), and each of their respective officers, directors, employees, agents, attorneys, insurers, affiliates, predecessors, successors, and assigns (collectively, the "Released Parties") from any and all claims, demands, causes of action, damages, costs, attorney's fees, and liabilities of every kind, whether known or unknown, arising from or in any way related to the care described in § 2 and the Litigation.

4.2 Unknown Claims

Claimant expressly assumes the risk of unknown or later-discovered injuries and damages and intends this release to extend to such claims to the fullest extent permitted by Kansas law.

4.3 No Admission

This Agreement is a compromise of disputed claims. Released Parties expressly deny liability, fault, or wrongdoing. K.S.A. § 60-452 (offers of compromise inadmissible).

4.4 Dismissal with Prejudice

Within [ten (10)] business days after receipt of the consideration, Claimant shall cause the Litigation to be dismissed with prejudice, with each Party bearing its own costs and fees except as set forth herein.

5. LIENS, SUBROGATION, AND THIRD-PARTY INTERESTS

5.1 Claimant's Representations

Claimant represents and warrants that Claimant has identified all of the following with respect to the claims released herein:

☐ Medicare conditional payments (42 U.S.C. § 1395y(b)(2); MSP) — Final Demand Letter attached or to be obtained;
☐ Medicare Set-Aside (MSA), if future Medicare-covered care reasonably anticipated;
☐ Medicaid (KanCare / Kansas Department of Health and Environment) third-party recovery (42 U.S.C. § 1396k; K.S.A. § 39-719a);
☐ ERISA / employer health-plan subrogation;
☐ TRICARE / VA / Indian Health Service;
☐ Workers' compensation subrogation (K.S.A. § 44-504);
☐ Hospital/provider liens (K.S.A. § 65-406 et seq. — hospital liens);
☐ Child-support liens / income-withholding orders.

5.2 Lien Resolution

Claimant and Claimant's counsel shall satisfy all liens and reimbursement obligations from the settlement proceeds and indemnify the Released Parties from any failure to do so. § 7 indemnity governs.

5.3 Set-Aside / MSA (if applicable)

☐ MSA funded in the amount of $[__________] and administered by [self-administered / professional administrator: __________].

6. NPDB AND REGULATORY REPORTING

6.1 NPDB Acknowledgment

Claimant and counsel acknowledge that any payment made by or on behalf of a licensed practitioner in settlement of a medical malpractice claim is reportable to the National Practitioner Data Bank under 42 U.S.C. § 11131 and 45 C.F.R. Part 60.

6.2 Kansas Board Reporting

The Released Provider and/or insurer may have separate reporting obligations to the Kansas State Board of Healing Arts under K.S.A. § 40-2,156 (insurer reporting) and applicable board regulations.

6.3 Cooperation

The Parties shall cooperate with required NPDB and Kansas board reporting and shall not include any term in this Agreement that purports to waive or modify mandatory reporting.

7. CONFIDENTIALITY; NON-DISPARAGEMENT

7.1 Confidentiality

☐ The Parties agree that the existence, terms, and amount of this Agreement shall remain confidential, except as required by: (a) NPDB / Kansas board reporting; (b) tax authorities; (c) lien holders; (d) court order; (e) disclosure to immediate family, counsel, accountants, and financial advisors bound by like confidentiality.
☐ Confidentiality does NOT prohibit Claimant from communicating with any state or federal regulatory agency, including the Kansas Board of Healing Arts, regarding the underlying care. Any such restriction would be void as against public policy.

7.2 Non-Disparagement

The Parties agree not to make any false or disparaging statement of fact about any other Party. This provision does not restrict truthful statements to regulatory bodies, in legal proceedings, or as otherwise required by law.

8. TAX TREATMENT

8.1 IRC § 104(a)(2)

The Parties intend that the portion of the settlement allocated to compensation for personal physical injuries or sickness be excludable from Claimant's gross income under 26 U.S.C. § 104(a)(2). Amounts allocated to punitive damages, prejudgment interest on non-physical damages, and certain emotional-distress claims may be taxable.

8.2 No Tax Advice

No Released Party has provided tax advice. Claimant has consulted, or has had the opportunity to consult, an independent tax advisor.

8.3 Reporting

The Parties shall issue any required Forms 1099 consistent with the allocation in § 3.2 and applicable IRS guidance.

9. INDEMNIFICATION

Claimant shall indemnify, defend, and hold harmless the Released Parties from any claim, demand, lien, or cause of action brought by any third party (including Medicare, Medicaid, ERISA plans, hospital lienholders, or other subrogees) seeking recovery from the Released Parties for amounts already paid under this Agreement, up to but not exceeding the amount Claimant received hereunder.

10. REPRESENTATIONS AND WARRANTIES

Each Party represents that:
☐ It has the full power and authority to enter into this Agreement;
☐ It has read the Agreement and consulted counsel of its choice;
☐ No assignments of claims have been made except as disclosed in § 5;
☐ Claimant is not a Medicare beneficiary, OR is a Medicare beneficiary and has complied with MSP obligations (strike one).

11. GENERAL PROVISIONS

11.1 Governing Law and Venue

This Agreement is governed by Kansas law. Venue for enforcement lies in the District Court of [____________] County, Kansas.

11.2 Entire Agreement

This Agreement constitutes the entire understanding of the Parties and supersedes all prior negotiations.

11.3 Amendment

Any amendment must be in writing signed by all Parties (and approved by HCSF if HCSF funds are involved).

11.4 Severability

If any provision is unenforceable, the remainder remains in full force.

11.5 Counterparts; Electronic Signatures

Executable in counterparts, including electronic signature consistent with K.S.A. § 16-1601 et seq. (Kansas UETA).

11.6 Construction

This Agreement was jointly drafted; no presumption shall apply against any Party as drafter.

12. EXECUTION

NOTARY ACKNOWLEDGMENT (CLAIMANT)

STATE OF KANSAS )
) ss.
COUNTY OF [____________] )

On this [___] day of [__________], 20[___], before me personally appeared [CLAIMANT NAME], known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing instrument, and acknowledged that he/she executed the same for the purposes therein contained.

____________________
Notary Public — State of Kansas
My commission expires: [__/__/____]

SCHEDULES

• Schedule A — Structured Settlement Annuity Terms (if applicable)
• Schedule B — Medicare / Medicaid Lien Resolution Documentation
• Schedule C — MSA Allocation Report (if applicable)
• Schedule D — Wrongful Death Apportionment (K.S.A. § 60-1905) (if applicable)
• Schedule E — Court Approval Order (minor/incapacitated) (if applicable)

SOURCES AND REFERENCES

• K.S.A. § 60-19a02 (noneconomic damages cap): https://ksrevisor.gov/statutes/chapters/ch60/060_019a_0002.html
• Hilburn v. Enerpipe Ltd., 309 Kan. 1127, 442 P.3d 509 (2019)
• Miller v. Johnson, 295 Kan. 636, 289 P.3d 1098 (2012) (prior med-mal cap holding)
• K.S.A. § 40-3401 et seq. — Health Care Stabilization Fund Act
• Kansas Health Care Stabilization Fund: https://hcsf.kansas.gov/
• 42 U.S.C. § 11131; 45 C.F.R. Part 60 — NPDB reporting
• 42 U.S.C. § 1395y(b)(2) — Medicare Secondary Payer
• 26 U.S.C. § 104(a)(2) — federal income-tax exclusion
• K.S.A. § 65-406 et seq. — Kansas hospital liens
• K.S.A. § 60-1903, § 60-1905 — wrongful death apportionment