BILL NUMBER: S2655
SPONSOR: STEC
 
TITLE OF BILL:
An act to amend the insurance law, in relation to requiring certain
health insurance policies to cover costs for pediatric acute-onset
neuropsychiatric syndrome
 
PURPOSE:
This bill will require certain health insurance policies to cover costs
associated with pediatric acute-onset neuropsychiatric syndrome
 
SUMMARY OF PROVISIONS:
Section I : Subsection (i) of section 3216 of the insurance law is
amended by adding a new paragraph 34
Section 2: Subsection (k) of section 3221 of the insurance law is
amended by adding a new paragraph 22
Section 3: Section 4303 of the insurance law is amended by adding a new
subsection (00)
 
JUSTIFICATION:
Pediatric acute-onset neuropsychiatric syndrome (PANS) is a misdirected
immune response, often with an encephalitic onset, which negatively
affects neurologic functioning, resulting in a rapid, acute onset of
OCD, restricted food intake or tics along with other neuropsychiatric
conditions. Treating PANS must be carried out thoroughly to yield posi-
tive results.
Symptoms often begin to improve within one week of antibiotic treatment.
However, further interventions are often required to fully heal the
underlying causes and alleviate all the symptoms. If treated promptly
and thoroughly, symptoms can remit completely. If left untreated and
symptoms persist, permanent neurological injury can occur.
Currently insurance providers do not cover costs associated with pedia-
tric acute-onset neuropsychiatric syndrome which can cause a huge finan-
cial burden for families living with this diagnosis. One of the most
expensive treatments is an Intravenous Immunoglobulin or IVIG, which is
widely accepted as a treatment for PANS, along with long term antibiotic
regiments that families currently have to pay for out of pocket. This
bill would help to relieve this burden and give these families a
resource to treat the syndrome.
 
LEGISLATIVE HISTORY:
2023-2024: S3038 referred to Insurance; A2823 referred to Insurance
2022/2021: S5332 referred to Insurance; A877 referred to Insurance
2020/2019: S1994 referred to Insurance; A2897 referred to Insurance
2018/2017: S7256 referred to Insurance; A8839 referred to Insurance
 
FISCAL IMPLICATIONS:
To be determined.
 
EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become a law and shall apply according to
its terms to all policies, contracts and certificates issued, renewed,
modified, altered or amended on or after such effective date.

Statutes affected:
S2655: 3216 insurance law, 3216(i) insurance law, 3221 insurance law, 3221(k) insurance law, 4303 insurance law