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Committee adopts amendment and approves PANDAS/PANS insurance coverage bill
Summary
Senate Bill 6‑39, amended to narrow coverage and require prior approval tied to a pediatric center of excellence, was adopted by the committee. Sponsor said the amendment was crafted with an insurer to avoid open-ended obligations while allowing coverage for IVIG and related treatment for children diagnosed with PANDAS/PANS.
The Senate Insurance & Commerce Committee adopted an amendment and passed Senate Bill 6‑39, a measure to create an insurance-payment pathway for specific treatments for children diagnosed with PANDAS/PANS.
Senator Hammer said the amendment was developed with input from a major insurance carrier to avoid an open-ended mandate that could force insurers to pay for high-cost therapies without controls. "This bill is modeled after what we did with another bill dealing with the PAN and PANDAS diagnosis," he said, noting the amendment limits coverage to a specified drug and requires prior approval from a designated center of excellence affiliated with Children's Hospital and the University of Arkansas for Medical Sciences.
Hammer explained that the process would allow a treating clinician at the center of excellence to recommend treatment and seek prior approval from the insurer, which would limit the chance of runaway costs. He added that Representative Dr. Joe Cloud, who served on the advisory committee, is named in the amendment for his involvement.
The committee approved the amendment by voice vote and then voted to "do pass as amended." The transcript records the passage but does not include a roll-call tally in the committee record excerpt.
