VT
Vermont Senate Bill S0251
Vermont 2025-2026 Regular Session
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Vermont 2025-2026 Regular Session

Vermont Senate Bill S0251

Introduced
1/14/26  

Caption

An act relating to health insurance coverage for diagnosis and treatment of certain pediatric neuropsychiatric conditions

Impact

If enacted, S0251 would significantly impact how health insurance plans approach coverage for neuropsychiatric disorders in children. The bill prohibits insurers from imposing higher cost-sharing requirements for PANDAS and PANS than for any other physical or mental health conditions, thereby promoting equal treatment under health insurance policies. This aligns with broader efforts to address gaps in care and ensure that children with these conditions receive appropriate, necessary support without financial burden.

Summary

Bill S0251 aims to ensure health insurance coverage for the diagnosis and treatment of Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). The legislation mandates that health insurance plans provide coverage for medically necessary treatments, which may include antibiotics, medication therapy, and various mental health services. These treatments must be prescribed by a licensed healthcare professional, adhering to clinical practice guidelines recognized in peer-reviewed literature.

Contention

Discussion surrounding S0251 may reveal points of contention primarily related to the classification and treatment recommendations for PANDAS and PANS. Some stakeholders could argue that the bill is too prescriptive regarding the treatment options that must be covered, while others might assert that these conditions require designated attention in health policies. Concerns could also arise over the costs associated with implementation for insurance providers and whether the bill effectively addresses the specific needs of affected children.

Companion Bills

No companion bills found.

Previously Filed As

VT HB408

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

VT SB205

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

VT HB2549

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

VT HB124

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

VT 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.

VT SF242

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

VT HF2314

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

VT HB1641

State plan for medical assistance services and health insurance; pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.

VT SB71

Requiring coverage for certain pediatric autoimmune neuropsychiatric disorders

VT SB0447

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

Similar Bills

No similar bills found.