A bill for an act relating to health insurance coverage for specified pediatric autoimmune neuropsychiatric disorders and postinfectious autoimmune encephalopathy.

SF 242 requires Iowa health insurance companies to cover diagnosis and treatment for pediatric acute-onset neuropsychiatric syndrome (PANS), PANDAS (a strep-related subset of PANS), and postinfectious autoimmune encephalopathy as medically necessary. It mandates coverage for treatments like antibiotics, behavioral therapy, and immunotherapies without denying or delaying care based on prior treatment for these conditions or unrelated health issues. The law applies to most individual, group, and small group health insurance plans issued in Iowa on or after January 1, 2026, but excludes accident-only, dental, vision, and other specified coverage types. Insurance companies may still request treatment notes from healthcare providers to verify medical necessity.