Requiring coverage for certain pediatric autoimmune neuropsychiatric disorders

SB 71 requires health insurance plans in West Virginia to cover intravenous immunoglobulin therapy for pediatric patients diagnosed with specific conditions: pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), pediatric acute onset neuropsychiatric syndrome (PANS), and related autoimmune encephalopathies. This applies to all health insurance plans (including Medicaid) issued or renewed after January 1, 2027 (Medicaid) or July 1, 2027 (other plans). The key provision mandates that coverage is only available after a physician obtains prior authorization by demonstrating all other treatments have been exhausted. The bill directly affects children with these conditions and their families, ensuring access to this specific treatment while adding a step to verify medical necessity.