This bill aims to expand access to treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome by mandating health carriers to provide coverage for specific immunomodulatory therapies. Effective January 1, 2027, health plans, excluding those for public employees, must cover three monthly courses of intravenous immunoglobulin therapy, with additional courses available as deemed medically necessary by the treating provider. Coverage is contingent upon the failure or intolerance of two less intensive treatments and a recommendation from the patient's provider.

Furthermore, the bill prohibits health carriers from denying or delaying coverage based on prior treatments or diagnoses, limiting coverage inconsistently with established treatment guidelines, requiring trials of therapies that only address neuropsychiatric symptoms, denying out-of-state treatment when unavailable in-state, or denying coverage based on the patient's age. This legislation seeks to ensure that affected children receive timely and appropriate care without unnecessary barriers.