44-7,125.

Coverage for pediatric autoimmune neuropsychiatric disorder and pediatric acute-onset neuropsychiatric syndrome; requirements.

(1) Notwithstanding section 44-3,131, on or after January 1, 2027, (a) any individual or group sickness and accident insurance policy or subscriber contract delivered, issued for delivery, or renewed in this state and any hospital, medical, or surgical expense-incurred policy, except for policies that provide coverage for a specified disease or other limited-benefit coverage, and (b) any self-funded employee benefit plan to the extent not preempted by federal law shall provide coverage for treatment of pediatric autoimmune neuropsychiatric disorder associated with a Group A streptococcal infection and pediatric acute-onset neuropsychiatric syndrome. Treatments required by this section shall be recommended by the patient's licensed physician and shall include, but not be limited to, antibiotics, medication and behavioral therapies to manage neuropsychiatric symptoms, plasma exchange, and immunoglobulin.

(2) For purposes of this section:

(a) Pediatric acute-onset neuropsychiatric syndrome means a class of acute-onset obsessive-compulsive or tic disorders or other behavioral changes presenting in a child or adolescent that are not otherwise explained by another known neurologic or medical disorder; and

(b) Pediatric autoimmune neuropsychiatric disorder associated with a Group A streptococcal infection means a condition in which a streptococcal infection in a child or adolescent causes the abrupt onset of clinically significant obsessions, compulsions, tics, or other neuropsychiatric symptoms or behavioral changes, or a relapsing and remitting course of symptom severity.