HB2824
Mandating insurance coverage for pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).
Bill Information: Bill Status – Died in Committee
HB2110 Report
KANSAS STATE EMPLOYEES HEALTH CARE COMMISSION
Report on Insurance Coverage for PANS and PANDAS
Pilot – Required by 2022 House Bill 2110
Read Report: Download
Conclusion: To pilot the PANS and PANDAS coverage, the SEHP coverage required modification to add coverage. Coverage for services related to PANS and PANDAS was initiated January 1, 2023. The coverage pilot had some impact on the SEHP.
- During Plan Year 2023, the SEHP had sixty-eight (68) unique members who incurred claims under the rider.
- Forty-seven (47) of these members incurred claims for PANDAS.
- Twenty-six (26) of these members incurred claims for PANS.
- Some of these unique members incurred claims for both PANS and PANDAS.
- For claims incurred during Plan Year 2023, the total allowed amount was $82,159.
- The SEHP has continued the PANS and PANDAS Pilot Program for Plan Year 2024.
- As members and providers become more aware of the services eligible for coverage under the PANS and PANDAS coverage mandate, it is expected more claims will be experienced by the plan in future years.
ASPIRE comment:
The benefits to the patients and families in the pilot program were life-saving and life-changing despite the estimated cost of coverage being less than 1/5 of a percent of the 2021 total projected plan cost. Therefore, the cost of coverage for PANS and PANDAS had minimal impact.
HB2110 Passed
HB2110 is a pilot program that provides coverage for PANS and PANDAS under the state health care benefits program and collects data on the impact, utilization, and cost of coverage. After that, legislators will decide whether or not to mandate PANS and PANDAS coverage for health insurance plans.
Bill: HB2110 – Requiring insurance coverage for PANS and PANDAS by the state health care benefits program and requiring the state employee health care commission to submit an impact report on such coverage to the legislature.
Bill Information: Link
HB 2210 Bill: Link
Bill Update: HB2110 was passed on March 23, 2022. Passed; Yea: 32 Nay: 4
House Bill No. 2110 would require the state health care benefits program to implement
coverage for the diagnosis and prescribed treatment of pediatric acute-onset neuropsychiatric
syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with
streptococcal infections (PANDAS), beginning in plan year 2022.
Pursuant to the test tract statute, K.S.A. 40-2249a, on or before March 1, 2023, the
Kansas state employees health care commission shall submit a report regarding the mandated
coverage for PANS and PANDAS with information pertaining to the mandated coverage for PANS
and PANDAS provided during the plan year commencing on January 1, 2023, and ending on December 31, 2023.
(1) The impact that the mandated coverage has had on the state health care benefits
program;
(2) data on the utilization of coverage for PANS and PANDAS and the cost of such
coverage; and
(3) a recommendation whether such mandated coverage should continue for the state
health care benefits program or whether additional data is required.
At the next legislative session following receipt of the report, the legislature may consider
whether or not to require PANS and PANDAS coverage be mandated for health insurance plans
on or after July 1, 2024.
The bill becomes effective upon publication in the statute book.
Gabriella True
