New York 2025-2026 Regular Session

New York Senate Bill S02655

Introduced

1/22/25

Refer

1/22/25

Refer

1/7/26

Caption

Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

Impact

The proposed legislation would directly affect health insurance policies within the state by broadening the scope of mandated coverage for mental health conditions, which aligns with contemporary views on children's health needs. By covering PANS, the law aims to improve access to treatment, promote better health outcomes for affected children, and reduce long-term societal costs associated with untreated mental health issues. The enforcement of this mandate would be contingent upon the effective certification of treatment necessity by licensed medical professionals, creating a structured process for families seeking help.

Summary

Bill S02655 aims to amend the New York insurance law to mandate that health insurance policies cover the costs associated with rehabilitative treatment for participants or beneficiaries diagnosed with pediatric acute-onset neuropsychiatric syndrome (PANS). The bill specifies that health plans and insurance issuers must provide coverage upon certification of medical necessity by the attending physician. This initiative seeks to address a critical gap in health insurance for children suffering from this severe mental health condition, ensuring they have access to necessary treatments without financial burden to their families.

Contention

While the bill is poised to provide significant benefits to children and their families, it may also generate contention among insurance providers regarding the potential increase in costs associated with expanded coverage. Critics might express concerns about the implications for policy premiums and the financial sustainability of health plans in light of new mandates. Furthermore, there could be discussions around the definition and scope of PANS, especially regarding its diagnosis and the nature of covered treatments, influencing how broadly the law will be interpreted and implemented.

Companion Bills

NY A03362

Same As Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

NY A09659

Same As Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

Previously Filed As

NY S10208

Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

NY A09659

Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

NY A03362

Requires health insurance policies to cover costs for pediatric acute-onset neuropsychiatric syndrome rehabilitation treatment.

NY HB408

Requires health insurance coverage relative to pediatric acute-onset neuropsychiatric syndrome and related conditions (EN INCREASE GF EX See Note)

NY HB2549

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

NY 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.

NY HB587

Creates the Pediatric Acute-onset Neuropsychiatric Syndrome specialty license plate

NY 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.

NY SB205

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

NY HB124

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

Similar Bills

No similar bills found.