Human services: medical services; coverage for the prophylaxis, diagnosis, and treatment of certain pediatric autoimmune neuropsychiatric disorders; require. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 109v.

HB 5136 requires Michigan's Medicaid program (medical assistance) to cover preventive care, diagnosis, and treatment for children with PANDAS (pediatric autoimmune neuropsychiatric disorders associated with strep) and PANS (pediatric acute onset neuropsychiatric syndrome). It mandates no higher copays or deductibles than other Medicaid services, requires timely coverage for urgent cases, and prohibits denials based on prior treatments or different diagnoses. The bill also bans lifetime limits on covered treatments like antibiotics, behavioral therapy, or IVIG therapy. This directly affects Medicaid-enrolled children diagnosed with these specific conditions.