IL SB0101

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

Prohibits insurers from denying or delaying coverage for medically necessary treatment solely because the insured previously received the same or similar treatment, or because they have been diagnosed with or receive treatment for another condition.

Requires coverage to follow treatment recommendations developed by medical professional consortiums based on evidence of positive patient outcomes, with no lifetime limits unless the patient is no longer benefiting from treatment.

Directs that these conditions 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.

Renders the coverage requirement inoperative if federal regulations under the Affordable Care Act would require the State to defray costs, except for coverage authorized under Medicaid.