Insurance: insurers; coverage for certain pediatric autoimmune neuropsychiatric disorders; require. Amends 1956 PA 218 (MCL 500.100 - 500.8302) by adding sec. 3406pp.

This bill requires health insurance policies in Michigan to cover the diagnosis, treatment, and prevention of pediatric autoimmune neuropsychiatric disorders linked to streptococcal infections, commonly known as PANDAS and PANS. It mandates that insurers provide equal cost-sharing for these treatments compared to other benefits and prohibits denying coverage based on a patient's medical history or the specific name used for the diagnosis. The legislation also ensures timely authorization for urgent care, bans requirements to try symptom-only medications before approving immunomodulating therapies, and sets billing codes for these conditions. Additionally, it directs insurance appeals to follow evidence-based treatment guidelines developed by medical professionals.