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) and Medicaid, 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 January 1, 2027. The bill includes multiple insertions across various chapters of the West Virginia Code, establishing the requirement for coverage and the prior authorization process. This legislative change is intended to ensure that affected children receive necessary medical treatment while also implementing a protocol for healthcare providers to follow before administering specific therapies.

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