HB 24-1382 Summary

• Requires all individual and group health benefit plans in Colorado to cover prophylaxis, diagnosis, and treatment of PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections).

• Mandates coverage of specific treatments including antibiotics, psychological and behavioral therapies, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy as prescribed by treating health-care providers.

• Allows coverage of up to six immunomodulatory courses of intravenous immunoglobulin therapy when less intensive treatments were ineffective, not tolerated, or did not result in sustained symptom improvement, and recommended by a pediatric or adult subspecialist.

• Prohibits carriers from imposing different deductibles, copayments, or coinsurance for PANS/PANDAS compared to other covered services, and prevents denial or delay of coverage based on prior treatment or different diagnostic names.

• Implementation timeline: large employer plans effective January 1, 2025; individual and small group plans effective January 1, 2026, pending federal confirmation that coverage does not constitute an additional benefit requiring state funding.