Oregon PANS PANDAS Updates

For up-to-date information on Oregon’s legislative action: Make sure to follow NWPPN’s Facebook page for updates and questions.  To contact NWWP directly, please email them – NWPPN’s Email.

Health Evidence Review Commission (HERC) Coverage Guidance: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS)

On May 19, 2022, Oregon’s Health Evidence Review Committee voted to ADOPT the guidance put forth for IVIG Coverage for PANDAS/PANS!  It is anticipated to go into effect 1/1/2023.  The Oregon HERC is the body responsible for determining what will be covered by Medicaid and what will not.  

Oregon Herc Coverage Guidance for PANS & PANDASRead the full document


Previous Legislative Action

Upcoming Hearings – Thursday, May 19th
Two Committee Meetings
  • Values-Based Subcommittee
  • Health Evidence Review Committee
This COULD BE THE FINAL STRETCH  BUT… We NEED YOUR HELP for what we hope will be the FINAL PUSH. 
Call to Action
Send a statement of support for the current guidance which allows access and coverage by Medicaid for IVIG and Plasma Exchange with one sub-specialist consultation.
Please email: HERC.Info@dhsoha.state.or.us by 12:00 pm PST on Tuesday, May 17th
Thank you for all of your support this far. We believe we can get this done in Oregon and we know other states and stakeholders are paying close attention. 
ASPIRE Board Testimony Letters

Oregon’s next Health Evidence Review Commission has PANDAS/PANS on its April 7th agenda.  Join NWPPN in support as we continue to advocate specifically for children on Medicaid to have access to ‘medically necessary’ care. Health disparity should NOT be perpetuated in the State of Oregon by ‘fail first’ requirements and a 2 specialist requirement when such specialists have no expertise and are not treating these disorders in our state.
Public Meeting: Thursday, April 7th from 2-5 p.m. PST

Purpose: PANDAS/PANS review of public comments is on the agenda

Current Guidance Report Recommendation:

  • Option #1 – Requires 2 failed treatments before progression to IVIG or Plasma Exchange which has to be recommended by 2 Physician Subspecialties (Neurology, Psychiatry, Rheumatology, Neurodevelopmental)

To Watch: Join Zoom Gov Meeting at https://www.zoomgov.com/j/1603991133?pwd=YzR2NHIrUOIvN05ITC9PSzhEM2lvQT09

To Testify: Sign up by 4/5 at Survey Monkey

About the HERC: The Health Evidence Review Commission reviews medical evidence in order to prioritize health spending in the Oregon Health Plan and to promote evidence-based medical practice statewide through comparative effectiveness reports, including coverage guidances and multisector interventions, health technology assessments and evidence-based practice guidelines. 

The commission uses a transparent public process to ensure that its decisions are made in the best interest of patients and taxpayers while considering input from providers and members of the public, including those affected by the conditions discussed.

The Oregon HERC is the body responsible for determining what will be covered by Medicaid and what will not.  They will not release their revised guidance until 11/24 so it is difficult for us to prepare how to respond until we see this. You are welcome to write a letter of support and/or to tune into the meeting.

ASPIRE Board and Professional Advisory Board Testimony Letters

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