SB 884
Requiring coverage of treatment for certain pediatric autoimmune neuropsychiatric disorders in certain circumstances
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- Passed Senate
- Passed House of Delegates
- To Governor
- Became Law
Bill overview
This bill requires West Virginia’s Public Employees Insurance Act (PEIA), Medicaid, and other health insurance plans to cover treatment for certain pediatric autoimmune neuropsychiatric disorders, specifically those associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome. To receive coverage, physicians must obtain prior authorization demonstrating that all other available treatments have been exhausted. The changes will take effect on January 1, 2027.
Key provisions
- Requires coverage for intravenous immunoglobulin therapy for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.
- Requires coverage for treatment of pediatric acute onset neuropsychiatric syndrome.
- Mandates prior authorization for treatment of these disorders.
- Requires physicians to demonstrate that all other treatments have been exhausted before coverage is granted.
- Applies to PEIA, Medicaid, and other health insurance plans.
- The coverage requirements will take effect on January 1, 2027.
Who is affected
- West Virginia Public Employees Insurance Act (PEIA) beneficiaries
- Medicaid recipients
- Individuals covered by other health insurance plans in West Virginia
- Parents of affected children
- Healthcare providers treating these disorders
Notable changes
- Introduces specific coverage requirements for pediatric autoimmune neuropsychiatric disorders.
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