HB2846 EngrossedLRB101 09717 RAB 54817 b

1    AN ACT concerning regulation.
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
4    Section 5. The Illinois Insurance Code is amended by
5changing Section 356z.25 as follows:
6    (215 ILCS 5/356z.25)
7    Sec. 356z.25. Coverage for treatment of pediatric
8autoimmune neuropsychiatric disorders associated with
9streptococcal infections and pediatric acute onset
10neuropsychiatric syndrome. A group or individual policy of
11accident and health insurance or managed care plan that is
12amended, delivered, issued, or renewed after July 18, 2017 (the
13effective date of Public Act 100-24) shall provide coverage for
14treatment of pediatric autoimmune neuropsychiatric disorders
15associated with streptococcal infections and pediatric
16acute-onset neuropsychiatric syndrome, including, but not
17limited to, the use of intravenous immunoglobulin therapy. A
18treatment that is administered or prescribed after July 18,
192017 shall be covered.
20    For billing and diagnosis purposes, pediatric autoimmune
21neuropsychiatric disorders associated with streptococcal
22infections and pediatric acute onset neuropsychiatric syndrome
23shall be coded as autoimmune encephalitis until a code is



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1assigned. Coverage under this Section may not be denied due to
2a diagnosis of autoimmune encephalopathy or autoimmune
4    If, at any time, the Secretary of the United States
5Department of Health and Human Services, or its successor
6agency, promulgates rules or regulations to be published in the
7Federal Register or publishes a comment in the Federal Register
8or issues an opinion, guidance, or other action that would
9require the State, pursuant to any provision of the Patient
10Protection and Affordable Care Act (Public Law 111-148),
11including, but not limited to, 42 U.S.C. 18031(d)(3)(B) or any
12successor provision, to defray the cost of any coverage for
13pediatric autoimmune neuropsychiatric disorders associated
14with streptococcal infections and pediatric acute onset
15neuropsychiatric syndrome outlined in this Section, then the
16requirement that an insurer cover pediatric autoimmune
17neuropsychiatric disorders associated with streptococcal
18infections and pediatric acute onset neuropsychiatric syndrome
19is inoperative other than any such coverage authorized under
20Section 1902 of the Social Security Act, 42 U.S.C. 1396a, and
21the State shall not assume any obligation for the cost of
22coverage for pediatric autoimmune neuropsychiatric disorders
23associated with streptococcal infections and pediatric acute
24onset neuropsychiatric syndrome.
25(Source: P.A. 100-24, eff. 7-18-17; 100-863, eff. 8-14-18.)
26    Section 99. Effective date. This Act takes effect upon



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1becoming law.