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 coverage for these conditions under certain health plans. Effective January 1, 2027, health carriers are required to provide coverage for prophylaxis, diagnosis, and treatment, which includes antibiotics, psychological therapies, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy. The bill specifies that health carriers must cover three initial courses of intravenous immunoglobulin therapy, with additional courses as deemed medically necessary, provided that certain conditions regarding previous treatments and provider recommendations are met.

Furthermore, the bill prohibits health carriers from denying or delaying coverage based on prior treatments or different diagnostic names, and it restricts limitations on immunomodulatory therapy coverage that do not align with established treatment guidelines. It also ensures that coverage cannot be denied based on the patient's age or the availability of services within the state. However, the provisions of this section do not apply to small group health plans or health plans for public employees and their dependents.