Dr. Patrick Whelan, Associate Professor of Pediatrics with UCLA shared that he is treating almost 500 families now affected with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS).
Assembly Bill 907 (Lowenthal) 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 the prophylaxis, diagnosis, and treatment of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) that is prescribed or ordered by the treating physician and surgeon. 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 benefits. The bill would prohibit a plan or insurer from denying or delaying coverage for PANDAS or PANS therapies because the enrollee or insured previously received treatment for PANDAS or PANS or was 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.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
Organizations that support AB 907:
California Coalition for PANS/PANDAS Advocacy (source)
Alliance to Solve Pans & Immune-related Encephalopathies Autoimmune Registry
California Children’s Hospital Association
California Federation of Teachers AFL-CIO
California Health Coalition Advocacy
California Life Sciences
California School Nurses Organization
California Teamsters Public Affairs Council
International Longshore and Warehouse Union
Memorial Care Health System
Moleculera Labs
Northwest PANDAS/PANS Network
PANDAS Physicians Network
SAG-AFTRA
Stand Up Sacramento County
The Alex Manfull Fund
The European Immuno-Neuropsychiatric Association
The PACE Foundation
Virginia Alliance for Pans Pandas Action
Footnote: CMA did support the bill but were originally opposed unless amended. The necessary amendments were added.
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