Coverage of PANS/PANDAS
Posted on September 30, 2021
Massachusetts Department of Insurance (DOI) Bulletin 2021-06
Per state mandate (Chapter 260, Acts of 2020), and effective for Commercial Fully Funded plans that are issued or renewed on or after January 1, 2022, Health New England is required to provide coverage for the treatment and diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS). This includes treatment with intravenous immunoglobulin (IVIg) therapy.*
In order for us to service our members, we are requesting that providers who offer PANDAS and PANS services, including treatment with IVIg therapy, fill out this availability assessment to confirm they provide these services.
This information will only be used with our services teams if we should receive a call from one of our members. We will not be indicating anything within our provider searches. If possible, we would like to receive this information by November 1, 2021, or sooner.
For more information, please do not hesitate to call your Provider Relations Representative at (800) 842-4464, extension 5000, or send us an email at providerrelations@hne.com.
*Prior authorization is required for IVIg therapy with PANS/PANDAS diagnosis.
