HB1751 (2018) Detail

Relative to insurance coverage for pediatric autoimmune neuropsychiatric disorders.


HB 1751-FN - AS INTRODUCED

 

 

2018 SESSION

18-2563

01/10

 

HOUSE BILL 1751-FN

 

AN ACT relative to insurance coverage for pediatric autoimmune neuropsychiatric disorders.

 

SPONSORS: Rep. Messmer, Rock. 24; Rep. W. Marsh, Carr. 8; Rep. Campion, Graf. 12; Rep. Fothergill, Coos 1; Rep. Knirk, Carr. 3; Rep. McConnell, Ches. 12; Rep. Fraser, Belk. 1; Sen. Fuller Clark, Dist 21; Sen. Carson, Dist 14; Sen. Hennessey, Dist 5

 

COMMITTEE: Commerce and Consumer Affairs

 

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ANALYSIS

 

This bill requires insurance coverage for treatment for pediatric autoimmune neuropsychiatric disorders.

 

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

18-2563

01/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Eighteen

 

AN ACT relative to insurance coverage for pediatric autoimmune neuropsychiatric disorders.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

1  New Section; Coverage for Treatment for Pediatric Autoimmune Neuropsychiatric Disorders; Individual.  Amend RSA 415 by inserting after section 6-u the following new section:

415:6-v  Coverage for Treatment for Pediatric Autoimmune Neuropsychiatric Disorders.  Each insurer that issues or renews any individual policy, plan, or contract of accident or health insurance providing benefits for medical or hospital expenses shall provide to persons covered by such insurance who are residents of this state coverage for the costs of treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, including the use of intravenous immunoglobulin therapy.  The coverage under this section shall not be excluded due to a diagnosis of autoimmune encephalopathy or autoimmune encephalitis.  Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.

2  New Section; Coverage for Pediatric Autoimmune Neuropsychiatric Disorders; Group.  Amend RSA 415 by inserting after section 18-z the following new section:

415:18-aa  Coverage for Pediatric Autoimmune Neuropsychiatric Disorders.  Each insurer that issues or renews any policy of group or blanket accident or health insurance providing benefits for medical or hospital expenses shall provide to each group, or to the portion of each group comprised of certificate holders of such insurance who are residents of this state, coverage for the costs of treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome, including the use of intravenous immunoglobulin therapy.  The coverage under this section shall not be excluded due to a diagnosis of autoimmune encephalopathy or autoimmune encephalitis.  Benefits provided under this section shall not be subject to any greater co-payment, deductible, or coinsurance than any other similar benefits provided by the insurer.

3  Health Services Corporations; Applicable Statutes.  Amend RSA 420-A:2 to read as follows:

420-A:2  Applicable Statutes.  Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included.  Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.

4  Health Services Corporations; Applicable Statutes; Effective January 1, 2021.  Amend RSA 420-A:2 to read as follows:

420-A:2  Applicable Statutes.  Every health service corporation shall be governed by this chapter and the relevant provisions of RSA 161-H, and shall be exempt from this title except for the provisions of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415-A, RSA 415-F, RSA 415:6, II(4), RSA 415:6-g, RSA 415:6-k, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:6-v, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-j, RSA 415:18-o, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415:18-aa, RSA 415:22, RSA 417, RSA 417-E, RSA 420-J, and all applicable provisions of title XXXVII wherein such corporations are specifically included.  Every health service corporation and its agents shall be subject to the fees prescribed for health service corporations under RSA 400-A:29, VII.

5  Health Maintenance Organizations; Statutory Construction.  Amend RSA 420-B:20, III to read as follows:

III.  The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-t, RSA 415:6-u, RSA 415:6-v, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-y, RSA 415:18-z, RSA 415:18-aa, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.

6  Health Maintenance Organizations; Statutory Construction; Effective January 1, 2021.  Amend RSA 420-B:20, III to read as follows:

III.  The requirements of RSA 400-A:39, RSA 401-B, RSA 402-C, RSA 404-F, RSA 415:6-g, RSA 415:6-m, RSA 415:6-o, RSA 415:6-r, RSA 415:6-u, RSA 415:6-v, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-j, RSA 415:18-r, RSA 415:18-t, RSA 415:18-u, RSA 415:18-v, RSA 415:18-w, RSA 415:18-z, RSA 415:18-aa, RSA 415-A, RSA 415-F, RSA 420-G, and RSA 420-J shall apply to health maintenance organizations.

7  Effective Date.

I.  Sections 4 and 6 of this act shall take effect January 1, 2021 at 12:02 a.m.

II.  The remainder of this act shall take effect 60 days after its passage.

 

LBAO

18-2563

11/16/17

 

HB 1751-FN- FISCAL NOTE

AS INTRODUCED

 

AN ACT relative to insurance coverage for pediatric autoimmune neuropsychiatric disorders.

 

FISCAL IMPACT:      [ X ] State              [ X ] County               [ X ] Local              [    ] None

 

 

 

Estimated Increase / (Decrease)

STATE:

FY 2019

FY 2020

FY 2021

FY 2022

   Appropriation

$0

$0

$0

$0

   Revenue

Indeterminable

Indeterminable

Indeterminable

Indeterminable

   Expenditures

$0

$0

$0

$0

Funding Source:

  [ X ] General            [    ] Education            [    ] Highway           [    ] Other

 

 

 

 

 

COUNTY:

 

 

 

 

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable

Indeterminable

Indeterminable

Indeterminable

 

 

 

 

 

LOCAL:

 

 

 

 

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable

Indeterminable

Indeterminable

Indeterminable

 

METHODOLOGY:

This bill mandates insurance coverage for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute onset neuropsychiatric syndrome, including the use of intravenous immunoglobulin therapy.  The Department of Health and Human Services states it does not have the information to estimate the prevalence and current cost to the Medicaid program as there are no specific diagnosis codes for this disorder.  The Department states the treatments associated with PANDAS are covered under the New Hampshire Medicaid program.  Additionally, the New Hampshire Medicaid program, under Early and Periodic Screening, Diagnosis and Treatment, will cover plasmapheresis and immunoglobulin treatment based on medical necessity in accordance with treatment guidelines of the PANDAS physicians network for moderate to severe levels of the illness.  Based on these assumptions, the Department states this bill will not have a fiscal impact on the New Hampshire Medicaid program.

 

The Insurance Department has no knowledge as to the prevalence or claims severity associated with this coverage or the prevailing coverage practices of New Hampshire's participating insurance carriers.  As a result the Department is not able to predict the impact this bill will have on premiums or the premium tax base.

 

The Insurance Department states this bill would be eligible for external review pursuant to RSA 400-A:39-b (review and evaluation of proposed insurance mandated benefit proposals under RSA 281-A, RSA 415, RSA 420-A, and RSA 420-B).  If a review is requested, the Department would have an increase in its operating expenditures during FY 2018.

 

AGENCIES CONTACTED:

Insurance Department and Department of Health and Human Services

 

 

Links

HB1751 at GenCourtMobile

Action Dates

Date Body Type
Jan. 16, 2018 House Hearing
Feb. 20, 2018 House Exec Session

Bill Text Revisions

HB1751 Revision: 2372 Date: Nov. 20, 2017, 8:53 a.m.

Docket

Date Status
Jan. 3, 2018 Introduced 01/03/2018 and referred to Commerce and Consumer Affairs HJ 1 P. 22
Jan. 16, 2018 Public Hearing: 01/16/2018 02:00 PM LOB 302
Jan. 30, 2018 Subcommittee Work Session: 01/30/2018 01:15 PM LOB 302
Feb. 20, 2018 Subcommittee Work Session: 02/20/2018 09:30 AM LOB 302
Feb. 21, 2018 Subcommittee Work Session: 02/21/2018 09:30 AM LOB 302
Feb. 20, 2018 Executive Session: 02/20/2018 LOB 302
Committee Report: Refer for Interim Study (Vote 20-0; CC)
March 6, 2018 Committee Report: Refer for Interim Study for 03/06/2018 (Vote 20-0; CC) HC 9 P. 11
March 6, 2018 Refer for Interim Study: MA VV 03/06/2018 HJ 6 P. 20