Virginia PANS PANDAS Updates
Virginia Alliance for PANS/PANDAS Action (VA4PA) is leading legislative efforts. Please contact them directly for more information. Their website is VA4PA and their email is info.vaforpa@gmail.com. Please follow their Instagram and/or Facebook, which they update frequently with updates and information.
General Legislative Information
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2025 Legislation
HB1641 Unanimously Passes the Senate!
Bill HB164: Status
Bill HB164: Language
Introduced by: Patrick A. Hope (Chief Patron)
A BILL to amend and reenact §§ 32.1-325 and 38.2-4319 of the Code of Virginia and to amend the Code of Virginia by adding a section numbered 38.2-3418.22, relating to the state plan for medical assistance services and health insurance; pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.
Summary As Introduced
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. This bill is a recommendation of the Health Insurance Reform Commission.
Previous Bills
HB513
Medical assistance services and health insurance; state plan for payment for PANDAS and PANS.
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.
HB 513 Summary Page: Link
Introduced by: Patrick A. Hope
HB514
Pediatric Autoimmune Neuropsychiatric Disorders Assoc. w/ Strep Infections, Adv. Council on; sunset.
Advisory Council on Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections and Pediatric Acute-Onset Neuropsychiatric Syndrome; sunset. Extends from July 1, 2020, to July 1, 2028, the sunset of the Advisory Council on Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections and Pediatric Acute-Onset Neuropsychiatric Syndrome.
HB 514 Summary Page: Link
Introduced by: Patrick A. Hope
In the News
From Press Release
New VA General Assembly Legislation Targets Devastating Illness Hitting Young People
“The toll of these illnesses on our young people and families is just extraordinary,” says Del. Hope, a health policy expert recently re-elected to his 8th term. “This is a crisis no one knows about…until you know. Hearing the stories from constituents across the state, I’ve been struck not only by the devastating impact of the illness, but more egregiously, the impact of insurance denial of coverage for diagnosis and treatment, particularly when early intervention is so critical. The cost of inaction is untenable,” Delegate Hope says. “This illness literally robs young people of their lives and creates an unconscionable and unsustainable burden on them and their families. I call on my fellow legislators as public servants whose duty it is to protect all our citizens, especially the young and most vulnerable, to join me in this critical effort.”
Previous Calls to Action
Currently, VA4PA has bills almost ready to present to the VA General Assembly. They are requesting Virginia residents to contact their state legislators to let them know about PANS/PANDAS and the upcoming bills. You can find your state representatives via our State Legislator Finder.
VA4PA has a sample letter for you to work from.
Gabriella True
