HB2846 Summary

• Amends the Illinois Insurance Code to require group and individual health insurance policies and managed care plans to cover treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS), including intravenous immunoglobulin therapy.

• Establishes that PANDAS and PANS shall be coded as autoimmune encephalitis for billing and diagnosis purposes until the American Medical Association and Centers for Medicare and Medicaid Services create a specific diagnostic code for these conditions.

• Allows PANDAS and PANS to be coded as autoimmune encephalitis, PANDAS, or PANS once a specific code is created by medical coding authorities.

• Exempts the State from coverage requirements if federal Health and Human Services rules or guidance require the State to defray costs under the Affordable Care Act, except for coverage authorized under Medicaid.

• Takes effect upon becoming law.