Bill > S4444

This bill mandates that various types of health insurance providers in New Jersey must cover diagnosis and treatment for two specific pediatric neurological disorders: PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-onset Neuropsychiatric Syndrome), when prescribed by a treating physician. The bill applies to multiple types of health insurance contracts, including hospital service corporations, medical service corporations, health service corporations, individual and group health insurance policies, individual health benefits plans, small employer health benefits plans, health maintenance organizations, and state and school employee health benefit programs. The required coverage includes a comprehensive range of treatments such as antibiotics, behavioral therapies, neuropsychiatric medications, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy. All these treatments must be provided at the same level of coverage as any other medical condition, and the bill will take effect six months after enactment, applying to all health insurance contracts delivered or renewed after that date. This legislation aims to ensure that children diagnosed with these complex neurological disorders receive necessary medical care without facing additional financial barriers.

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https://www.njleg.state.nj.us/bill-search/2024/S4444