H-0883.2

HOUSE BILL 1741

ByRepresentatives Thai, Leavitt, Paul, Simmons, Couture, Parshley, Fey, Duerr, Nance, and Davis

AN ACT Relating to expanding access to treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome; and adding a new section to chapter 48.43 RCW.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1. A new section is added to chapter 48.43 RCW to read as follows:

(1) For health plans other than health plans offered to public employees and dependents under chapter 41.05 RCW issued or renewed on or after January 1, 2026, health carriers shall provide initial coverage of three monthly immunomodulatory courses of intravenous immunoglobulin therapy for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome, and subsequent courses as deemed medically necessary by the treating provider, when the following conditions are met:

(a) Clinically appropriate trials, which may be done concurrently, of two or more less intensive treatments were:

(i) Not effective;

(ii) Not tolerated; or

(iii) Did not result in sustained improvement in symptoms, as measured by a lack of clinically meaningful improvement on a validated instrument directed at the patient's primary symptom complex; and

(b) A pediatric subspecialist is consulted and the pediatric subspecialist and the patient's primary care provider recommend the treatment. For an adolescent or adult patient, the consultation may be with an adult subspecialist. The subspecialist consultation may be a teleconsultation.

(2) The health carrier may require that the patient be clinically reevaluated at three-month intervals.

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