H.B. No. 142 Summary

• Designates October 9 as "PANDAS and PANS Awareness Day" to recognize pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS).

• Requires all health benefit plans issued, delivered, or renewed after the effective date to provide coverage for screening, diagnosis, and treatment of PANDAS and PANS without step therapy protocols or prior authorization requirements.

• Mandates coverage of comprehensive diagnostic evaluation, immunomodulatory therapies (including immunoglobulin, corticosteroids, plasmapheresis, and rituximab), antimicrobial treatment, and therapeutic services from licensed speech, occupational, and physical therapists.

• Requires cost-sharing for PANDAS/PANS coverage to be no less favorable than cost-sharing for other medical and surgical benefits, and prohibits coverage contingent upon symptom severity thresholds or immunodeficiency status.

• Applies the same coverage requirements to the Ohio Medicaid program with an exception that if the state is required to defray costs under federal law (42 U.S.C. 18031(d)(3)(B)), the requirement becomes inoperative.