VirginiaHB16412025 Regular SessionHouse

State plan for medical assistance services and health insurance; pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.

Sponsored By: Patrick A. Hope (Democratic)

To Governor

Summary

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. This bill is a recommendation of the Health Insurance Reform Commission.

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Bill Overview

No Economic Impacts Identified for this Bill

Sponsors & Cosponsors

Sponsor

  • Patrick A. Hope

    Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 361 • No: 0

Senate vote • 2/18/2025

Passed Senate Block Vote

Yes: 40 • No: 0

Senate vote • 2/17/2025

Constitutional reading dispensed Block Vote (on 2nd reading)

Yes: 39 • No: 0

Senate vote • 2/14/2025

Reported from Finance and Appropriations

Yes: 14 • No: 0

Senate vote • 2/10/2025

Reported from Commerce and Labor and rereferred to Finance and Appropriations

Yes: 15 • No: 0

House vote • 2/4/2025

Read third time and passed House Block Vote

Yes: 97 • No: 0

House vote • 2/4/2025

Passed House Block Vote

Yes: 99 • No: 0

House vote • 1/31/2025

Reported from Appropriations

Yes: 22 • No: 0

House vote • 1/29/2025

Subcommittee recommends reporting

Yes: 6 • No: 0 • Other: 1

House vote • 1/16/2025

Reported from Labor and Commerce and referred to Appropriations

Yes: 22 • No: 0

House vote • 1/14/2025

Subcommittee recommends reporting and referred to Appropriations

Yes: 7 • No: 0 • Other: 1

Actions Timeline

  1. Acts of Assembly Chapter text (CHAP0008)

    3/18/2025Governor
  2. Approved by Governor-Chapter 8 (Effective 07/01/25)

    3/18/2025Governor
  3. Governor's Action Deadline 11:59 p.m., March 24, 2025

    3/11/2025Governor
  4. Enrolled Bill communicated to Governor on (date)

    3/11/2025House
  5. Signed by President

    3/10/2025Senate
  6. Fiscal Impact Statement from Department of Planning and Budget (HB1641)

    3/7/2025House
  7. Bill text as passed House and Senate (HB1641ER)

    3/7/2025House
  8. Enrolled

    3/7/2025House
  9. Signed by Speaker

    3/7/2025House
  10. Passed Senate Block Vote (40-Y 0-N)

    2/18/2025Senate
  11. Read third time

    2/18/2025Senate
  12. Constitutional reading dispensed Block Vote (on 2nd reading) (39-Y 0-N)

    2/17/2025Senate
  13. Passed by for the day

    2/17/2025Senate
  14. Rules suspended

    2/17/2025Senate
  15. Reported from Finance and Appropriations (14-Y 0-N)

    2/14/2025Senate
  16. Reported from Commerce and Labor and rereferred to Finance and Appropriations (15-Y 0-N)

    2/10/2025Senate
  17. Referred to Committee on Commerce and Labor

    2/5/2025Senate
  18. Constitutional reading dispensed (on 1st reading)

    2/5/2025Senate
  19. Passed House Block Vote (99-Y 0-N)

    2/4/2025House
  20. Reconsideration of passage agreed to by House

    2/4/2025House
  21. Read third time and passed House Block Vote (97-Y 0-N)

    2/4/2025House
  22. Read second time and engrossed

    2/3/2025House
  23. Read first time

    2/2/2025House
  24. Reported from Appropriations (22-Y 0-N)

    1/31/2025House
  25. Subcommittee recommends reporting (6-Y 0-N)

    1/29/2025House

Bill Text

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