Image: New Jersey Capitol, Our Home State
STATE PUBLIC POLICY: PANS AND PANDAS
To access tables with state statutes pertaining to PANS and PANDAS and pending state legislation, including links to the text of legislation, please click on the button below. The status of pending legislation is updated weekly.
state health insurance coverage laws
DIAGNOSIS AND TREATMENT OF PANS AND PANDAS
Currently the following 17 states require individual and group health insurers to cover the diagnosis and treatment for PANS and PANDAS such as antibiotics, anti-inflammatories, and immunodulatory therapy, including intravenous immunoglobulin, or IVIG:
Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Illinois, Indiana, Louisiana, Maryland, Massachusetts, Minnesota, Nebraska, New Hampshire, Oregon, Rhode Island, Virginia
Cost-Benefit Analysis of PANS/PANDAS Treatment Coverage
Rhode Island Office of the Health Insurance Commissioner’s Report
The Rhode Island OHIC Report published in December 2024 concluded the following: “using the information and data that OHIC has collected from health insurance carriers and other sources, OHIC has determined that it is likely that PANS/PANDAS treatment coverage has only a minimal effect on health insurance premiums.” Examples of responses in the report include: (1) “Based on the information that United Healthcare has available, PANS/PANDAS costs approximately $0.12 per member per month in fully insured. This is immaterial and therefore United Healthcare did not build any costs into our projections/rate filings;” and (2) in 2023 The California Health Benefits Review Program (CHBRP) "analyzed and issued a report on California Assembly Bill 907, which would require health plans to provide coverage for the prophylaxis, diagnosis, and treatment of PANDAS/PANS. CHBRP estimated that premiums would increase by 0.001%, or $0.01 per member per month.”
Federal Advocacy: The National Alliance for PANS PANDAS Action (NAPPA)
NAPPA is a steering committee assembled to lead federal PANS and PANDAS legislative efforts. NAPPA is led by Executive Director Amanda Crowley. Alissa is proud to be a co-founding member alongside Ramesh Allen, Dr. Bibiana Castaneda, Monika Gruter Cheney, Sheila Gauch, Wendy Nawarra and Blake Poggi.