Tennessee House Bill HB2484

Tennessee 2023-2024 Regular Session

• Introduced: 1/30/24
• Refer: 2/1/24

Caption

AN ACT to amend Tennessee Code Annotated, Title 8; Title 56 and Title 71, relative to pediatric medical disorders.

Impact

The potential effects of HB 2484 are significant, as it establishes a legal requirement for health insurance plans to recognize and indelibly cover these specific pediatric conditions. This move could improve access to medical care for affected children and alleviate the financial strain on families seeking treatment. Insurers will be prohibited from denying or delaying coverage due to prior treatments or different diagnostic names, thereby promoting a more inclusive approach to health coverage for pediatric neuropsychiatric disorders.

Summary

House Bill 2484 aims to amend Tennessee Code Annotated to ensure that health insurance providers offer coverage for treatments related to pediatric autoimmune neuropsychiatric disorders, specifically PANDAS and PANS. The bill mandates that every group health insurance contract delivered or amended in Tennessee after January 1, 2025, must cover such treatments when prescribed by a physician. This includes a range of treatments such as antibiotics, medications, behavioral therapies, immunomodulating medicines, and more, ensuring that patients have access to medically necessary services without greater financial burden than similar benefits.

Contention

While the bill emphasizes the necessity of coverage for PANDAS and PANS, it may face scrutiny and pushback from insurance providers concerning the financial implications of such mandates. They might argue about the cost burden this bill imposes in terms of coverage requirements and how it aligns with existing treatment guidelines. Additionally, there may be debate surrounding the specificity of the disorders and the challenges in defining the treatment protocols, especially if coding for these disorders is complex or not universally recognized within the medical community.