AN ACT to amend Tennessee Code Annotated, Title 8; Title 56 and Title 71, relative to pediatric medical disorders.
Impact
The implementation of SB2402 will have a far-reaching impact on how pediatric autoimmune neuropsychiatric disorders are treated under Tennessee's healthcare system. By mandating that MCOs offer coverage for necessary treatments without imposing higher costs compared to similar benefits, the bill aims to ensure equitable healthcare access for affected children. Additionally, it prohibits denial of treatment based solely on a diagnosis history, thus reforming previous limitations that may have hindered patients from accessing required care.
Summary
Senate Bill 2402 aims to amend the Tennessee Code Annotated regarding coverage for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, specifically PANDAS and PANS. The bill requires managed care organizations (MCOs) participating in the TennCare program to provide coverage for treatments deemed medically necessary for these conditions, effective from January 1, 2025. This includes various forms of therapy and medications intended to manage neuropsychiatric symptoms, reflecting a significant development in the state's healthcare policies for children with these disorders.
Contention
Notable points of contention surrounding this bill include concerns regarding its implications for healthcare costs and insurance coverage administration. While proponents argue that mandated coverage is essential for improving health outcomes for children suffering from these disorders, critics may worry about the financial viability for MCOs and whether this could lead to increased premiums or diminished resources for other medical coverage areas. Another area of contention is the coding and billing practices; the bill stipulates that until specific codes are created for PANDAS and PANS, these conditions must be coded under autoimmune encephalitis, potentially complicating diagnosis and treatment tracking in medical settings.
A bill for an act establishing a veterans recovery pilot program and fund for the reimbursement of expenses related to providing hyperbaric oxygen treatment to eligible veterans.(See HF 574.)