Bill Text: NH HB1751 | 2018 | Regular Session | Introduced
Bill Title: Relative to insurance coverage for pediatric autoimmune neuropsychiatric disorders.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2018-09-18 - Executive Session: 10/02/2018 01:30 PM Legislative Office Building302 [HB1751 Detail]
Download: New_Hampshire-2018-HB1751-Introduced.html
HB 1751-FN - AS INTRODUCED
2018 SESSION
18-2563
01/10
HOUSE BILL 1751-FN
AN ACT relative to insurance coverage for pediatric autoimmune neuropsychiatric disorders.
SPONSORS: Rep. Messmer, Rock. 24; Rep. W. Marsh, Carr. 8; Rep. Campion, Graf. 12; Rep. Fothergill, Coos 1; Rep. Knirk, Carr. 3; Rep. McConnell, Ches. 12; Rep. Fraser, Belk. 1; Sen. Fuller Clark, Dist 21; Sen. Carson, Dist 14; Sen. Hennessey, Dist 5
COMMITTEE: Commerce and Consumer Affairs
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ANALYSIS
This bill requires insurance coverage for treatment for pediatric autoimmune neuropsychiatric disorders.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
18-2563
01/10
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Eighteen
AN ACT relative to insurance coverage for pediatric autoimmune neuropsychiatric disorders.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 New Section; Coverage for Treatment for Pediatric Autoimmune Neuropsychiatric Disorders; Individual. Amend RSA 415 by inserting after section 6-u the following new section:
415:6-v Coverage for Treatment for Pediatric Autoimmune Neuropsychiatric Disorders. Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses shall provide to persons covered by such insurance who are residents of this state coverage for the costs of treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, including the use of intravenous immunoglobulin therapy. The coverage under this section shall not be excluded due to a diagnosis of autoimmune encephalopathy or autoimmune encephalitis. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.
2 New Section; Coverage for Pediatric Autoimmune Neuropsychiatric Disorders; Group. Amend RSA 415 by inserting after section 18-z the following new section:
415:18-aa Coverage for Pediatric Autoimmune Neuropsychiatric Disorders. Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the costs of treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, including the use of intravenous immunoglobulin therapy. The coverage under this section shall not be excluded due to a diagnosis of autoimmune encephalopathy or autoimmune encephalitis. Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.
3 Health Services Corporations; Applicable Statutes. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
4 Health Services Corporations; Applicable Statutes; Effective January 1, 2021. Amend RSA 420-A:2 to read as follows:
420-A:2 Applicable Statutes. Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:6-v, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415:18-aa, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included. Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.
5 Health Maintenance Organizations; Statutory Construction. Amend RSA 420-B:20, III to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
6 Health Maintenance Organizations; Statutory Construction; Effective January 1, 2021. Amend RSA 420-B:20, III to read as follows:
III. The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:6-v, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415:18-aa, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.
I. Sections 4 and 6 of this act shall take effect January 1, 2021 at 12:02 a.m.
II. The remainder of this act shall take effect 60 days after its passage.
18-2563
11/16/17
HB 1751-FN- FISCAL NOTE
AS INTRODUCED
AN ACT relative to insurance coverage for pediatric autoimmune neuropsychiatric disorders.
FISCAL IMPACT: [ X ] State [ X ] County [ X ] Local [ ] None
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STATE: | FY 2019 | FY 2020 | FY 2021 | FY 2022 |
Appropriation | $0 | $0 | $0 | $0 |
Revenue | Indeterminable | Indeterminable | Indeterminable | Indeterminable |
Expenditures | $0 | $0 | $0 | $0 |
Funding Source: | [ X ] General [ ] Education [ ] Highway [ ] Other | |||
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COUNTY: |
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Revenue | $0 | $0 | $0 | $0 |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable |
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LOCAL: |
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Revenue | $0 | $0 | $0 | $0 |
Expenditures | Indeterminable | Indeterminable | Indeterminable | Indeterminable |
METHODOLOGY:
This bill mandates insurance coverage for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute onset neuropsychiatric syndrome, including the use of intravenous immunoglobulin therapy. The Department of Health and Human Services states it does not have the information to estimate the prevalence and current cost to the Medicaid program as there are no specific diagnosis codes for this disorder. The Department states the treatments associated with PANDAS are covered under the New Hampshire Medicaid program. Additionally, the New Hampshire Medicaid program, under Early and Periodic Screening, Diagnosis and Treatment, will cover plasmapheresis and immunoglobulin treatment based on medical necessity in accordance with treatment guidelines of the PANDAS physicians network for moderate to severe levels of the illness. Based on these assumptions, the Department states this bill will not have a fiscal impact on the New Hampshire Medicaid program.
The Insurance Department has no knowledge as to the prevalence or claims severity associated with this coverage or the prevailing coverage practices of New Hampshire's participating insurance carriers. As a result the Department is not able to predict the impact this bill will have on premiums or the premium tax base.
The Insurance Department states this bill would be eligible for external review pursuant to RSA 400-A:39-b (review and evaluation of proposed insurance mandated benefit proposals under RSA 281-A, RSA 415, RSA 420-A, and RSA 420-B). If a review is requested, the Department would have an increase in its operating expenditures during FY 2018.
AGENCIES CONTACTED:
Insurance Department and Department of Health and Human Services