AB 907 – CaliforniaStatus: In Process
Year Introduced: 2023
Coverage for PANDAS and PANS. This bill would require a health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2024, to provide coverage for treatment of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) prescribed or ordered by a provider. The bill would prohibit coverage for PANDAS and PANS from being subject to a copayment, coinsurance, deductible, or other cost sharing that is greater than that applied to other similar benefits. The bill would prohibit a plan or insurer from denying or delaying coverage for medically necessary treatment of PANDAS or PANS solely because the enrollee or insured previously received treatment for PANDAS or PANS or has been diagnosed with or received treatment for the condition under a different diagnostic name. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.
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