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Subcommittee approves bill directing coverage for PANS/PANDAS and refers it to appropriations

2118626 · January 14, 2025
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Summary

HB 1641, which asks the Board of Medical Assistance Services and insurers to cover PANS/PANDAS diagnosis and treatment, passed the subcommittee and will be referred to appropriations; families testified about delays and denials and some medical groups raised concerns about specific therapies.

Delegate Hope presented HB 1641, a bill directing inclusion of PANS/PANDAS-related diagnosis and treatment in the state plan administered by the Board of Medical Assistance Services and requesting parity from private insurers. The bill follows a HERC recommendation and substantial public comment from affected families.

Why it matters: Testimony from families described lengthy denials, out-of-state care and significant out-of-pocket costs; supporters and advocacy groups argued early diagnosis and treatment are critical. Several parents described children who suffered severe symptoms and delayed access to treatments. The sponsor said HERC reviewed the matter and recommended action.

Opponents or cautioning witnesses included Doug Gray of the Virginia Association of Health Plans, who noted the American Academy of Pediatrics does not recommend some therapies listed in the bill (for example, IVIG) and urged caution. Supporters countered that denials and coverage gaps have forced families into debt and out-of-state care.

The committee voted to report the bill and refer it to the Appropriations Committee; a recorded vote showed passage 7-0. The transcript shows multiple family testimonies, including a detailed account from Erin Hollerbach and other advocates, and supporters provided written petitions and online comments.