An Act to Require Health Insurance Coverage for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections and Pediatric Acute-onset Neuropsychiatric Syndrome
Maine Legislature, Session 131, LD 0663
Committee Amendment CA_A_H916 (House)
Amends: 24-A MRSA §4320-W

COMMITTEE AMENDMENT" A'' to H.P. 432, L.D. 663, "An Act to Require 
Health Insurance Coverage for Pediatric Autoimmune Neuropsychiatric Disorders 
Associated with Streptococcal Infections and Pediatric Acute-onset Neuropsychiatric 
Syndrome" 
Amend the bill by striking out everything after the enacting clause and inse1ting the 
following: 
'Sec, 1. 24-A MRSA §4320-W is enacted to read: 
§4320-W. Coverage for pediatric autoimmune neuropsychiatric disorders associated 
with streptococcal infections and pediatric acute-onset neuropsychiatric 
syndrome 
A carrier offering a health plan in this State shall provide coverage for treatment of 
pediatric 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. 
Sec. 2. Application. The requirements of this Act apply to all policies, contracts and 
ce1tificates executed, delivered, issued for delivery, continued or renewed in this State on 
or after January 1, 2025. For purposes of this Act all contracts are deemed to be renewed 
no later than the next yearly anniversary of the contract date. 
Sec. 3. 
Appropriations and allocations. The following appropriations and 
allocations are made. 
ADMINISTRATIVE AND FINANCIAL SERVICES, DEPARTMENT OF 
State Benefit Mandate Defrayal Z373 
Initiative: Provides ongoing funding for the cost of the benefit mandate providing coverage 
for treatment of pediatric postinfectious neuroimmune disorders including pediatric 
COMMITTEE AMENDMENT 
,.. 
8' 
(J:= 
COMMITTEE AMENDMENT"}\--" to H.P. 432, L.D. 663 
autoimmune neuropsychiatric disorders associated with streptococcal infections and 
pediatric acute-onset neuropsychiatric syndrome, beginning January 1, 2025. 
GENERAL FUND 
2023-24 
All Other 
$0 
GENERAL FUND TOTAL 
$0 
2024-25 
$395,000 
$395,000 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section 
number to read consecutively. 
SUMMARY 
This amendment is the minority report of the committee. The amendment changes the 
applicability date for the requirements in the bill to be incorporated into health plans to 
those health plans issued or renewed on or after January 1, 2025 and changes the statutory 
allocation. The amendment also adds an appropriation to provide ongoing funding for the 
costs of the benefit mandate defrayal required by federal law, 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Revised: 03/28/24 feae!. 
LD663 
LR1074(02) 
An Act to Require Health Insurance Coverage for Pediatric Autoimmune Neuropsychiatric Disorders 
Associated with Streptococcal Infections and Pediatric Acute-onset Neuropsychiatric Syndrome 
Fiscal Note for Bill as Amended by Committee Amendment 'rt' {r+Jrl tp) 
Committee: Health Coverage, Insurance and Financial Services 
Net Cost (Savings) 
General Fund 
Highway Fund 
Appropriations/Allocations 
General Fund 
Highway Fund 
Fiscal Detail and Notes 
Fiscal Note Required: Yes 
Fiscal Note 
FY 2023-24 
FY 2024-25 
$0 
$0 
$0 
$0 
$395,000 
$0 
$395,000 
$0 
Projections 
FY2025-26 
$873,852 
$30,947 
$873,852 
$30,947 
Projections 
FY 2026-27 
$873,852 
$30,947 
$873,852 
$30,947 
This bill requires carriers offering health plans in this State to provide coverage for treatment of pediatric 
postinfectious neurohmnune disorders including pediatric autoimmune neuropsychiatric disorders associated with 
streptococcal infections and pediatric acute-onset neuropsychiatric syndrome. The requirements of the bill apply to 
health plans issued or renewed on or after January 1, 2025. The bill includes General Fund appropriations to the 
Department of Administrative and Financial Services of $395,000 for the estimated cost to reimburse insurance 
carriers for 6 months of the State's defrayal cost of this new mandate. The mandate will go into effect on all health 
insurance.plans on the marketplace beginning January 1, 2025 and is estimated to cost $790,000 annually thereafter. 
The State Employee Health Plan's first impacted plan year will be SFY 2026 and is estimated to cost $185,724 
annually thereafter. The costs are split across the General Fund ($83,852), Highway Funds ($30,947) and all other 
funds ($70,925).