An Act To Ensure Health Insurance Coverage for Treatment for Childhood Postinfectious Neuroimmune Disorders Including Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections and Pediatric Acute-onset Neuropsychiatric Syndrome
Maine Legislature, Session 129, LD 1138
Committee: Health Coverage, Insurance and Financial Services
Sponsors: BAILEY, DESCHAMBAULT, DENK, BELLOWS
Amends: 24-A MRSA §4320-L

Legislative Document
No. 1138
H.P. 827
House of Representatives, March 7, 2019
An Act To Ensure Health Insurance Coverage for Treatment for 
Childhood Postinfectious Neuroimmune Disorders Including 
Pediatric Autoimmune Neuropsychiatric Disorders Associated with 
Streptococcal Infections and Pediatric Acute-onset Neuropsychiatric 
Syndrome
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative BAILEY of Saco.
Cosponsored by Senator DESCHAMBAULT of York and
Representative: DENK of Kennebunk, Senator: BELLOWS of Kennebec.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA §4320-L is enacted to read:
§4320-L.  Coverage for treatment of childhood postinfectious neuroimmune 
disorders including pediatric autoimmune neuropsychiatric disorders 
associated 
with 
streptococcal 
infections 
and 
pediatric 
acute-onset 
neuropsychiatric syndrome
1.  Required coverage.  A carrier offering a health plan in this State shall provide 
coverage for treatment of childhood postinfectious neuroimmune disorders including 
pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections 
and pediatric acute-onset neuropsychiatric syndrome.  Treatments that must be covered 
include, but are not limited to, long-term antibiotics, intravenous immunoglobulin 
therapy, steroids, plasmapheresis and psychopharmacological interventions.  Coverage 
may not be excluded due to the diagnosis of autoimmune encephalopathy or autoimmune 
encephalitis.
2.  Application.  The requirements of this section apply to all policies, contracts and 
certificates executed, delivered, issued for delivery, continued or renewed in this State. 
For purposes of this section, all contracts are deemed to be renewed no later than the next 
yearly anniversary of the contract date.
Sec. 2.  Application.  The requirements of this Act apply to all policies, contracts 
and certificates executed, delivered, issued for delivery, continued or renewed in this 
State on or after January 1, 2020.  For purposes of this Act all contracts are deemed to be 
renewed no later than the next yearly anniversary of the contract date.
SUMMARY
This bill requires health insurance coverage for treatment of childhood postinfectious 
neuroimmune disorders, a group of medical conditions that includes autoinflammatory 
encephalopathic conditions including pediatric autoimmune neuropsychiatric disorders 
associated with streptococcal infections and pediatric acute-onset neuropsychiatric 
syndrome.  The treatments authorized include certain treatments described as the standard 
of care in a series of articles in the 2017 Journal of Child and Adolescent 
Psychopharmacology, Volume 27, Number 7.  The requirements apply to all individual 
and group policies and contracts issued or renewed on or after January 1, 2020.