Bill > HB5004

This bill mandates that health insurance plans and the Medicaid program in West Virginia must provide coverage for the diagnosis and treatment of Pediatric Acute-Onset Neuroimmune Disorders, which include Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), as recognized by the National Institutes of Health. This coverage is required for medically necessary services ordered by a licensed physician and supported by established medical literature or standards of care, and can encompass diagnostic testing, clinical evaluations, pharmaceutical treatments, immune-modulating therapies, and behavioral, psychiatric, and rehabilitative services. Importantly, coverage cannot be denied or restricted due to the behavioral or psychiatric symptoms associated with these disorders, and must adhere to mental health parity laws. The bill also directs the Bureau for Public Health to educate Medicaid providers about the symptoms and characteristics of PANS and PANDAS to improve early identification and treatment rates.

Health and Social Services

http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=5004&year=2026&sessiontype=RS&btype=bill