HF 3254

as introduced - 90th Legislature (2017 - 2018) Posted on 04/12/2018 04:40pm

A bill for an act
relating to health insurance; requiring health plan coverage for treatment for
pediatric autoimmune neuropsychiatric disorders associated with streptococcal
infections and pediatric acute-onset neuropsychiatric syndrome; requiring reports;
proposing coding for new law in Minnesota Statutes, chapter 62A.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

new text begin [62A.3096] COVERAGE FOR TREATMENT FOR PEDIATRIC
AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS ASSOCIATED WITH
STREPTOCOCCAL INFECTIONS (PANDAS) AND PEDIATRIC ACUTE-ONSET
NEUROPSYCHIATRIC SYNDROME (PANS).
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) The definitions in this subdivision apply to this section.
new text end

new text begin (b) "Pediatric acute-onset neuropsychiatric syndrome" means a class of acute-onset
obsessive compulsive or tic disorders or other behavioral changes presenting in children
and adolescents that are not otherwise explained by another known neurologic or medical
disorder.
new text end

new text begin (c) "Pediatric autoimmune neuropsychiatric disorders associated with streptococcal
infections" means a condition in which a streptococcal infection in a child or adolescent
causes the abrupt onset of clinically significant obsessions, compulsions, tics, or other
neuropsychiatric symptoms or behavioral changes, or a relapsing and remitting course of
symptom severity.
new text end

new text begin Subd. 2. new text end

new text begin Scope of coverage. new text end

new text begin This section applies to all health plans that provide coverage
to Minnesota residents.
new text end

new text begin Subd. 3. new text end

new text begin Required coverage. new text end

new text begin Every health plan included in subdivision 2 must provide
coverage for treatment for pediatric autoimmune neuropsychiatric disorders associated with
streptococcal infections (PANDAS) and for treatment for pediatric acute-onset
neuropsychiatric syndrome (PANS). Treatments that must be covered according to this
section must be recommended by the insured's licensed health care professional and include
but are not limited to antibiotics, medication and behavioral therapies to manage
neuropsychiatric symptoms, plasma exchange, and immunoglobulin.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2019, and applies to health
plans offered, sold, issued, or renewed on or after that date.
new text end

Sec. 2. new text begin REPORT; DENIALS OF COVERAGE FOR TREATMENT FOR PEDIATRIC
AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS ASSOCIATED WITH
STREPTOCOCCAL INFECTIONS (PANDAS) AND PEDIATRIC ACUTE-ONSET
NEUROPSYCHIATRIC SYNDROME (PANS).
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) The definitions in this subdivision apply to this section.
new text end

new text begin (b) "Health carrier" has the meaning given in Minnesota Statutes, section 62A.011,
subdivision 2.
new text end

new text begin (c) "Health plan" has the meaning given in Minnesota Statutes, section 62A.011,
subdivision 3.
new text end

new text begin (d) "Pediatric acute-onset neuropsychiatric syndrome" and "pediatric autoimmune
neuropsychiatric disorders associated with streptococcal infections" have the meanings
given in Minnesota Statutes, section 62A.3096, subdivision 1.
new text end

new text begin Subd. 2. new text end

new text begin Report required. new text end

new text begin (a) A health carrier that offers a health plan providing coverage
to Minnesota residents must report the following to the commissioner of health by October
1, 2018:
new text end

new text begin (1) the number of times the health carrier has denied coverage for treatment for pediatric
autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)
or for treatment for pediatric acute-onset neuropsychiatric syndrome (PANS); and
new text end

new text begin (2) for each denial of coverage, the specific treatment for which coverage was denied.
new text end

new text begin (b) The commissioner of health shall compile the information submitted under this
subdivision into a single report and shall post that report to the department's Web site by
November 1, 2018. The posted report must identify each reporting health carrier and must
specify, for each carrier, the number of coverage denials for each specific treatment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment.
new text end