Virginia House Bill 513 (Prior Session Legislation)

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Spectrum: Strong Partisan Bill (Democrat 12-1)
Status: Introduced on January 8 2024 - 25% progression
Action: 2024-02-13 - Left in Labor and Commerce
Pending: House Labor and Commerce Committee
Text: Latest bill text (Prefiled) [HTML]

State plan for medical assistance services and health insurance; pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome. Directs the Board of Medical Assistance Services to amend the state plan for medical assistance services to include a provision for payment of medical assistance for the prophylaxis, diagnosis, and treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS) that includes payment for treatment using antimicrobials, medication and behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy. State plan for medical assistance services and health insurance; pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome. Directs the Board of Medical Assistance Services to amend the state plan for medical assistance services to include a provision for payment of medical assistance for the prophylaxis, diagnosis, and treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS) that includes payment for treatment using antimicrobials, medication and behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy. The bill also requires each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services to provide coverage for the prophylaxis, diagnosis, and treatment of PANDAS and PANS. The bill requires such coverage to include coverage for treatment using antibiotics, medication, and behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy. The bill prohibits an insurer, corporation, or organization from (i) denying or delaying the coverage of PANDAS or PANS because the enrollee previously received treatment or because the enrollee was diagnosed with or received treatment for his condition under a different diagnostic name, including autoimmune encephalopathy; (ii) limiting coverage of immunomodulating therapies for the treatment of PANDAS or PANS in a manner that is inconsistent with the treatment guidelines developed by a consortium convened for the purposes of researching, identifying, and publishing best practice standards for diagnosis and treatment of PANDAS or PANS that are accessible for medical professionals and are based on evidence of positive patient outcomes; (iii) requiring a trial of therapies that treat only neuropsychiatric symptoms before authorizing coverage of immunomodulating therapies for the treatment of PANDAS or PANS; or (iv) denying coverage for out-of-state treatment if the service is not available within the Commonwealth.

Medical assistance services and health insurance; state plan for payment for PANDAS and PANS.

Del. Patrick Hope [D]	Del. Elizabeth Bennett-Parker [D]	Del. Nadarius Clark [D]	Del. Laura Jane Cohen [D]
Del. Joshua Cole [D]	Del. Debra Gardner [D]	Del. Rozia Henson [D]	Del. Marty Martinez [D]
Del. Adele McClure [D]	Del. Robert Orrock [R]	Del. Irene Shin [D]	Del. Shelly Simonds [D]
Del. Richard Sullivan [D]

2024-02-06 - House - House: Subcommittee recommends laying on the table (7-Y 0-N) (Y: 7 N: 0 NV: 0 Abs: 0) [PASS]

Date	Chamber	Action
2024-02-13	House	Left in Labor and Commerce
2024-02-06	House	Subcommittee recommends laying on the table (7-Y 0-N)
2024-01-23	House	Assigned L & C sub: Subcommittee #1
2024-01-18	House	Referred to Committee on Labor and Commerce
2024-01-18	House	Referred from Health and Human Services by voice vote
2024-01-08	House	Referred to Committee on Health and Human Services
2024-01-08	House	Prefiled and ordered printed; offered 01/10/24 24104920D

Chapter	Article	Section	Citation Type	Statute Text
32	1	325	(n/a)	See Bill Text
38	2	3418.22	(n/a)	See Bill Text
38	2	4319	(n/a)	See Bill Text

Type	Source
Summary	https://lis.virginia.gov/cgi-bin/legp604.exe?241+sum+HB513
Text	https://lis.virginia.gov/cgi-bin/legp604.exe?241+ful+HB513+hil
Supplement	https://lis.virginia.gov/cgi-bin/legp604.exe?241+oth+HB513F122+PDF
Roll Call	https://lis.virginia.gov/cgi-bin/legp604.exe?241+vot+H1401V0029+HB0513