Bill Text - SB224 (2019)

Relative to insurance coverage for pediatric autoimmune neuropsychiatric disorders.


Revision: March 8, 2019, 12:40 p.m.

SB 224-FN - AS AMENDED BY THE SENATE

 

03/07/2019   0590s

2019 SESSION

19-1020

01/10

 

SENATE BILL 224-FN

 

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

 

SPONSORS: Sen. Rosenwald, Dist 13; Sen. Fuller Clark, Dist 21; Sen. Hennessey, Dist 5; Sen. Chandley, Dist 11; Sen. Sherman, Dist 24; Rep. Nordgren, Graf. 12; Rep. Marsh, Carr. 8; Rep. Campion, Graf. 12; Rep. Cushing, Rock. 21; Rep. Berrien, Rock. 18

 

COMMITTEE: Commerce

 

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Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

03/07/2019   0590s 19-1020

01/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Nineteen

 

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-w the following new section:

415:6-x  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 if ordered by a physician.  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-aa the following new section:

415:18-bb  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 if ordered by a physician.  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 415:6-w, RSA 415:6-x, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-i, 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 415:18-bb, 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 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 415:6-w, RSA 415:6-x, RSA 415:18, V, RSA 415:18, XVI and XVII, RSA 415:18, VII-a, RSA 415:18-a, RSA 415:18-i, 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 415:18-bb, 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 415:6-w, RSA 415:6-x, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-i, 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 415:18-bb, 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 415:6-w, RSA 415:6-x, RSA 415:18, VII-a, RSA 415:18, XVI and XVII, RSA 415:18-i, 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 415:18-bb, 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 12:03 a.m.

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

 

LBAO

19-1020

Amended 3/8/19

 

SB 224-FN- FISCAL NOTE

AS AMENDED BY THE SENATE (AMENDMENT #2019-0590s)

 

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 2020

FY 2021

FY 2022

FY 2023

   Appropriation

$0

$0

$0

$0

   Revenue

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

   Expenditures

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Funding Source:

  [ X ] General            [    ] Education            [    ] Highway           [ X ] Other - Insurance Administrative Fund

 

 

 

 

 

COUNTY:

 

 

 

 

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

 

 

 

 

 

LOCAL:

 

 

 

 

   Revenue

$0

$0

$0

$0

   Expenditures

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

 

METHODOLOGY:

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

 

The Insurance Department has not performed an analysis of the prevalence or claims severity associated with this coverage and the Department has no formal or documented knowledge on the prevailing practices among New Hampshire's participating insurance carriers.  Therefore, the Department cannot determine the potential impact on insurance premiums or insurance premium tax revenue.  The Department assumes the cost of this coverage for exchange based coverage would have to be paid for by the State general fund pursuant to the Affordable Care Act.

 

The Department of Administrative Services indicates the bill would have no impact on the State health benefit plan for employees and retirees because the plan is a governmental self- insured plan and is not governed by managed care law.

 

The Department of Health and Human Services assumes that children covered under the Medicaid program are eligible for the recommended treatments for pediatric autoimmune neuropsychiatric disorders, the bill would not result in additional costs to the Medicaid program.

 

AGENCIES CONTACTED:

Departments of Insurance, Administrative Services and Health and Human Services