This bill aims to amend the Code of West Virginia by introducing new sections that mandate coverage for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome. Specifically, it requires that health insurance plans, including those under the Public Employees Insurance Act (PEIA), Medicaid, and other health insurance providers, provide coverage for intravenous immunoglobulin therapy for these conditions. However, coverage will only be granted if the insured's physician obtains prior authorization, demonstrating that all other treatment options have been exhausted.

The new provisions will take effect for plans issued or renewed after specific dates in 2027, ensuring that the necessary protocols for prior authorization are in place. The bill includes multiple insertions across various chapters of the West Virginia Code, establishing a comprehensive framework for the required coverage while emphasizing the need for prior authorization to ensure that alternative treatments have been considered.

Statutes affected:
Introduced Version: 5-16-7h, 9-5-34, 33-15-4y, 33-16-3ii, 33-24-7z, 33-25-8w, 33-25A-8z