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Committee backs bill to require insurance coverage for PANS/PANDAS treatment
Summary
The House Insurance Committee voted to advance House Bill 124, which would require coverage for pediatric acute neuropsychiatric syndromes (PANS/PANDAS) under state-regulated plans including the State Employees' Health Benefit Plan; sponsors said the measure responds to narrow clinical needs and that insurers showed no objection in earlier talks.
The Georgia House Insurance Committee voted to advance House Bill 124, a measure that would require coverage for pediatric acute neuropsychiatric syndromes known as PANS and PANDAS under provisions of Title 33 and Title 45, including the State Employees' Health Benefit Plan.
Representative Scoggins, sponsor of House Bill 124, told the committee the bill would amend provisions in Title 33 (insurance) and Title 45 (state employees' health benefits) to require coverage for PANS and PANDAS. "We're asking to require coverage for PANDAS and PANS," Scoggins said, and described the conditions as pediatric autoimmune neuropsychiatric disorders often triggered by infections such as strep, influenza or COVID-19.
Scoggins said the bill addresses a narrow set of services and that insurers he spoke with indicated no objection. He described the typical clinical approach as early detection and treatment—often beginning with antibiotics—and cited a diagnostic test, the Cunningham panel, that he said "is about a thousand dollars for the test." Scoggins said PANS and PANDAS most commonly affect children from about age 3 through the early teens and that untreated cases can lead to long-term neuropsychiatric symptoms.
Committee members who spoke said the measure is important to constituents. One member noted that early treatment can reduce longer-term costs and harms; another member said constituents in their district had raised the issue. A motion to "do pass" carried by voice vote after a motion and second; the transcript does not record a roll-call tally or individual named votes.
The sponsor provided an LC number for the original draft (LC520603) and told the committee he had discussed the measure with insurance providers and clinicians. He identified Dr. Jill Dickerson of Newnan as a local clinician who has treated children with PANS/PANDAS and said she was among a small number of physicians in the state who specialize in the condition. The transcript shows the bill was previously heard in subcommittee and that committee members requested clarifying information during that earlier review.
