Michigan 2025-2026 Regular Session

Michigan House Bill HB5226

Introduced

11/6/25

Refer

11/6/25

Caption

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

Impact

If enacted, HB5226 would modify existing health insurance policies, mandating that coverage for the aforementioned pediatric conditions be provided. This change would broaden the scope of coverage for health insurance providers, thereby enhancing access to necessary treatments for affected families. It sets a legal precedent that might influence future health insurance regulations and enhance scrutiny over insurers' obligations toward pediatric care.

Summary

House Bill 5226 proposes an amendment to the Michigan insurance code requiring health insurance policies to include coverage for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, as well as pediatric acute-onset neuropsychiatric syndrome. This would encompass specific treatments, notably intravenous immunoglobulin therapy, among other options. The bill is aimed at ensuring that children suffering from these conditions receive necessary medical care without facing excessive out-of-pocket costs attributable to insurance limitations.

Contention

While the bill aims to address a critical need within pediatric healthcare, potential points of contention include the cost implications for insurance companies and, subsequently, for policyholders. Opponents may argue that adding coverage requirements could lead to increased premiums, impacting the affordability of insurance. Proponents counter that ensuring coverage for necessary medical conditions ultimately benefits public health and reduces long-term healthcare costs by addressing these disorders early.

Companion Bills

No companion bills found.

Previously Filed As

MI SB0447

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

MI SB205

Insurance; pediatric autoimmune neuropsychiatric disorders; require coverage for healthcare services

MI HB124

Insurance; require coverage for healthcare services for pediatric autoimmune neuropsychiatric disorders; provisions

MI SF242

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

MI HF2314

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

MI HB5136

Human services: medical services; coverage for the prophylaxis, diagnosis, and treatment of certain pediatric autoimmune neuropsychiatric disorders; require. Amends 1939 PA 280 (MCL 400.1 - 400.119b) by adding sec. 109v.

MI HB2549

Mandating insurance coverage of pediatric acute-onset neuropsychiatric syndrome (PANS) and pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).

MI H5625

Removes the sunset provision of all statutory law requiring coverage for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome.

MI HB4464

Insurance: health insurers; compliance with affordable care act coverage; modify. Amends secs. 3403, 3406z, 3406bb, 3406hh & 3406ii of 1956 PA 218 (MCL 500.3403 et seq.).

MI S0473

Extends coverage for treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome by removing the sunset date of December 31, 2025, and mandating such coverage.

Similar Bills

No similar bills found.