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OH HB488

Bill

Status

Introduced

1/30/2020

Primary Sponsor

Candice Keller

Click for details

Origin

House of Representatives

133rd General Assembly (2019-2020)

AI Summary

  • Designates October 9 as "PANDAS and PANS Awareness Day" in Ohio.

  • Requires health benefit plans issued, delivered, or renewed after the effective date to cover screening, diagnosis, and treatment of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome).

  • Mandates coverage for comprehensive diagnostic evaluation, immunomodulatory therapies (immunoglobulin, corticosteroids, plasmapheresis, rituximab), antimicrobial treatment, and therapeutic services (speech, occupational, physical therapy).

  • Prohibits step therapy protocols and prior authorization requirements for PANDAS and PANS coverage and makes coverage independent of symptom severity thresholds or immunodeficiency status.

  • Allows PANDAS and PANS conditions to be coded as autoimmune encephalitis for billing purposes if specific diagnostic codes have not been created, and prohibits plan issuers from rejecting claims based on this coding practice.

Legislative Description

Cover treatment of pediatric autoimmune neuropsychiatric disorder

Health and Human Services : Health Care

Last Action

Refer to Committee: Health

2/4/2020

Committee Referrals

Health2/4/2020

Full Bill Text

No bill text available