VirginiaState plan for medical assistance services and health insurance; pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.
What it does
State plan for medical assistance services and health insurance; pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome. Directs the Board of Medical Assistance Services to amend the state plan for medical assistance services to include a provision for payment of medical assistance for the prophylaxis, diagnosis, and treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS) that includes payment for treatment using antimicrobials, medication, and behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy.The bill also requires each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services to provide coverage for the prophylaxis, diagnosis, and treatment of PANDAS and PANS. The bill requires such coverage to include coverage for treatment using antimicrobials, medication, and behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy.The bill prohibits an insurer, corporation, or organization from (i) denying or delaying the coverage of PANDAS or PANS because the enrollee previously received treatment or because the enrollee was diagnosed with or received treatment for his condition under a different diagnostic name, including autoimmune encephalopathy; (ii) limiting coverage of immunomodulating therapies for the treatment of PANDAS or PANS in a manner that is inconsistent with the treatment guidelines developed by a consortium convened for the purposes of researching, identifying, and publishing best practice standards for diagnosis and treatment of PANDAS or PANS that are accessible for medical professionals and are based on evidence of positive patient outcomes; (iii) requiring a trial of therapies that treat only neuropsychiatric symptoms before authorizing coverage of immunomodulating therapies for the treatment of PANDAS or PANS; or (iv) denying coverage for out-of-state treatment if the service is not available within the Commonwealth.
More detail
This bill is a recommendation of the Health Insurance Reform Commission.
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Where it stands
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2025
- Mar 18Acts of Assembly Chapter text (CHAP0008)Latest
- Mar 18Approved by Governor Glenn Youngkin-Chapter 8 (Effective 07/01/25)Became Law
- Mar 11Governor's Action Deadline 11:59 p.m., March 24, 2025To Governor
- Mar 11Enrolled Bill communicated to Governor on (date)Minor
- Mar 10Signed by PresidentMajor
- Mar 7Signed by SpeakerMajor
- Mar 7Fiscal Impact Statement from Department of Planning and Budget (HB1641)
- Mar 7Bill text as passed House and Senate (HB1641ER)Major
- Mar 7EnrolledMinor
- Feb 18Passed Senate (40-Y 0-N)Major
- Vote recorded Passed Senate (40-Y 0-N). Result: pass.Upper
- Feb 18Read third timeMinor
- Feb 17Passed by for the day
- Vote recorded Constitutional reading dispensed (on 2nd reading) (39-Y 0-N). Result: pass.Upper
- Feb 17Constitutional reading dispensed (on 2nd reading) (39-Y 0-N)
- Feb 17Rules suspended
- Feb 14Reported from Finance and Appropriations (14-Y 0-N)Minor
- Vote recorded Reported from Finance and Appropriations (14-Y 0-N). Result: pass.Upper
- Feb 10Reported from Commerce and Labor and rereferred to Finance and Appropriations (15-Y 0-N)Minor
- Vote recorded Reported from Commerce and Labor and rereferred to Finance and Appropriations (15-Y 0-N). Result: pass.Upper
- Feb 5Referred to Committee on Commerce and LaborMinor
- Feb 5Constitutional reading dispensed (on 1st reading)
- Feb 4Passed House (99-Y 0-N)Passed Senate
- Vote recorded Passed House (99-Y 0-N). Result: pass.Lower
- Vote recorded Read third time and passed House (97-Y 0-N). Result: pass.Lower
- Feb 4Reconsideration of passage agreed to by House
- Feb 4Read third time and passed House (97-Y 0-N)Passed House
- Feb 3Read second time and engrossedMinor
- Feb 2Read first timeMinor
- Jan 31Reported from Appropriations (22-Y 0-N)Minor
- Vote recorded Reported from Appropriations (22-Y 0-N). Result: pass.Lower
- Jan 29Subcommittee recommends reporting (6-Y 0-N)
- Vote recorded Subcommittee recommends reporting (6-Y 0-N). Result: pass.Lower
- Jan 22Fiscal Impact Statement from Department of Planning and Budget (HB1641)
- Jan 17Assigned Approps sub: Health & Human ResourcesMinor
- Jan 16Reported from Labor and Commerce and referred to Appropriations (22-Y 0-N)Minor
- Vote recorded Reported from Labor and Commerce and rereferred to Appropriations (22-Y 0-N). Result: pass.Lower
- Jan 14Subcommittee recommends reporting and referred to Appropriations (7-Y 0-N)
- Vote recorded Subcommittee recommends reporting and referred to Appropriations (7-Y 0-N). Result: pass.Lower
- Jan 10Assigned L & C sub: Subcommittee #1Minor
- Jan 3Referred to Committee on Labor and CommerceMinor
- Jan 3Prefiled and ordered printed; Offered 01-08-2025 25101763DIntroduced