Vermont S 251: An act relating to divestment of State pension funds from fossil fuel companies

Bill Text

BILL AS INTRODUCED S.251
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VT LEG #385003 v.1
S.251 1
Introduced by Senator Chittenden 2
Referred to Committee on 3
Date: 4
Subject: Health; health insurance; diagnosis and treatment of certain pediatric 5
neuropsychiatric conditions 6
Statement of purpose of bill as introduced: This bill proposes to health 7
insurance coverage for diagnosis and treatment of Pediatric Autoimmune 8
Neuropsychiatric Disorders Associated with Streptococcal Infections 9
(PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). 10
An act relating to health insurance coverage for diagnosis and treatment of 11
certain pediatric neuropsychiatric conditions 12
It is hereby enacted by the General Assembly of the State of Vermont: 13
Sec. 1. 8 V.S.A. § 4085 is added to read: 14
§ 4085. DIAGNOSIS AND TREATMENT OF CERTAIN PEDIATRIC 15
NEUROPSYCHIATRIC CONDITIONS 16
(a) As used in this section: 17
(1) “PANDAS” means Pediatric Autoimmune Neuropsychiatric 18
Disorders Associated with Streptococcal Infections (PANDAS). 19

BILL AS INTRODUCED S.251
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VT LEG #385003 v.1
(2) “PANS” means Pediatric Acute-onset Neuropsychiatric Syndrome 1
(PANS). 2
(b)(1) A health insurance plan shall provide coverage for the medically 3
necessary diagnosis and treatment of PANDAS and PANS that is prescribed or 4
ordered by the covered individual’s treating health care professional. Covered 5
treatments shall include antibiotics, medication therapy and mental health 6
services to manage neuropsychiatric symptoms, immunomodulating 7
medicines, plasma exchange, and intravenous immunoglobulin therapy. 8
(2) Coverage for PANDAS and PANS shall adhere to the treatment 9
recommendations set forth in current clinical practice guidelines published in 10
peer-reviewed medical literature or endorsed by organizations composed of 11
expert treating health care professionals. 12
(c) A health insurance plan shall not impose greater coinsurance, co-13
payment, deductible, or other cost-sharing requirements for coverage of the 14
diagnosis or treatment of PANDAS or PANS than apply to the diagnosis and 15
treatment of any other physical or mental condition under the plan. 16
(d) For billing and diagnosis purposes, PANDAS and PANS may be coded 17
as autoimmune encephalitis until such time as the American Medical 18
Association and the Centers for Medicare and Medicaid Services create and 19
assign a specific code for PANDAS and PANS. After a specific code has been 20
established, PANDAS and PANS may be coded as autoimmune encephalitis, 21

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VT LEG #385003 v.1
PANDAS, or PANS. If PANDAS or PANS is known by a different common 1
name in the future, that name may be used for coding purposes and this section 2
shall apply to that disorder or syndrome. 3
Sec. 2. EFFECTIVE DATE 4
This act shall take effect on January 1, 2027, and shall apply to all health 5
insurance plans issued on and after January 1, 2027, on such date as a health 6
insurer offers, issues, or renews the health insurance plan, but in no event later 7
than January 1, 2028. 8