Requiring coverage for certain pediatric autoimmune neuropsychiatric disorders in certain circumstances

This West Virginia bill (SB 297) requires most health insurance plans to cover intravenous immunoglobulin (IVIG) therapy for children diagnosed with specific conditions: pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute onset neuropsychiatric syndrome (PANS). Insurers must cover this treatment only after a physician obtains prior authorization by confirming all other treatments have been exhausted. The requirement applies to all private insurance plans, Medicaid, and public employee health plans issued or renewed after January 1, 2026 (with public employee plans effective July 1, 2026). It directly affects families seeking coverage for these complex neurological conditions and insurers providing pediatric care.