CA AB907

Requires health care service plans and health insurance policies issued, amended, or renewed on or after January 1, 2024, to cover prophylaxis, diagnosis, and treatment of PANDAS and PANS prescribed by a treating physician.

Covered treatments include antibiotics, medications, behavioral therapies for neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy.

Prohibits cost sharing (copayments, coinsurance, deductibles) for PANDAS and PANS coverage that exceeds cost sharing applied to other benefits.

Prohibits health plans and insurers from denying or delaying coverage based on prior treatment for these conditions or treatment under different diagnostic names, including autoimmune encephalopathy.

Exempts specialized dental and vision plans and Medicare supplement policies from these requirements.