Subdivision 1. Definitions. (a) The definitions in this subdivision apply to this section.
(b) "Pediatric acute-onset neuropsychiatric syndrome" means a class of acute-onset obsessive compulsive or tic disorders or other behavioral changes presenting in children and adolescents that are not otherwise explained by another known neurologic or medical disorder.
(c) "Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections" means a condition in which a streptococcal infection in a child or adolescent causes the abrupt onset of clinically significant obsessions, compulsions, tics, or other neuropsychiatric symptoms or behavioral changes, or a relapsing and remitting course of symptom severity.
Subd. 2. Scope of coverage. This section applies to all health plans that provide coverage to Minnesota residents.
Subd. 3. Required coverage. Every health plan included in subdivision 2 must provide coverage for treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and for treatment for pediatric acute-onset neuropsychiatric syndrome (PANS). Treatments that must be covered under this section must be recommended by the insured's licensed health care professional and include but are not limited to antibiotics, medication and behavioral therapies to manage neuropsychiatric symptoms, plasma exchange, and immunoglobulin.
Subd. 4. Reimbursement. The commissioner of commerce shall reimburse health carriers for coverage under this section. Reimbursement is available only for coverage that would not have been provided by the health carrier without the requirements of this section. Each fiscal year an amount necessary to make payments to health carriers to defray the cost of providing coverage under this section is appropriated to the commissioner of commerce. Health carriers shall report to the commissioner quantified costs attributable to the additional benefit under this section in a format developed by the commissioner. The commissioner shall evaluate submissions and make payments to health carriers as provided in Code of Federal Regulations, title 45, section 155.170.
1Sp2019 c 9 art 8 s 2
Structure Minnesota Statutes
Chapters 59A - 79A — Insurance
Chapter 62A — Accident And Health Insurance
Section 62A.011 — Definitions.
Section 62A.02 — Policy Forms.
Section 62A.021 — Health Care Policy Rates.
Section 62A.023 — Notice Of Rate Change.
Section 62A.024 — Explanations Of Rate Increases; Attribution To Statutory Changes.
Section 62A.03 — General Provisions Of Policy.
Section 62A.04 — Standard Provisions.
Section 62A.041 — Maternity Benefits.
Section 62A.0411 — Maternity Care.
Section 62A.042 — Family Coverage; Coverage Of Newborn Infants.
Section 62A.043 — Dental And Podiatric Coverage.
Section 62A.044 — Payments To Governmental Institutions.
Section 62A.045 — Payments On Behalf Of Enrollees In Government Health Programs.
Section 62A.046 — Coordination Of Benefits.
Section 62A.047 — Children's Health Supervision Services And Prenatal Care Services.
Section 62A.048 — Dependent Coverage.
Section 62A.049 — Limitation On Preauthorizations; Emergencies.
Section 62A.05 — Construction Of Provisions.
Section 62A.06 — Statements In Application.
Section 62A.07 — Rights Of Insurer, When Not Waived.
Section 62A.08 — Coverage Of Policy, Continuance In Force.
Section 62A.081 — Payments To Facilities Operated By State Or Local Government.
Section 62A.082 — Nondiscrimination In Access To Transplants.
Section 62A.095 — Subrogation Clauses Regulated.
Section 62A.096 — Notice To Insurer Of Subrogation Claim Required.
Section 62A.10 — Group Insurance.
Section 62A.105 — Coverages; Transfers To Substantially Similar Products.
Section 62A.11 — Blanket Accident And Sickness Insurance.
Section 62A.13 — Commercial Traveler Insurance Companies.
Section 62A.135 — Fixed Indemnity Policies; Minimum Loss Ratios.
Section 62A.136 — Hearing, Dental, And Vision Plan Coverage.
Section 62A.14 — Disabled Children.
Section 62A.141 — Coverage For Disabled Dependents.
Section 62A.145 — Survivor; Definition.
Section 62A.146 — Continuation Of Benefits To Survivors.
Section 62A.147 — Disabled Employees' Benefits; Definitions.
Section 62A.148 — Group Insurance; Provision Of Benefits For Disabled Employees.
Section 62A.149 — Benefits For Alcoholics And Drug Dependents.
Section 62A.15 — Coverage Of Certain Licensed Health Professional Services.
Section 62A.151 — Health Insurance Benefits For Emotionally Disabled Children.
Section 62A.152 — Benefits For Ambulatory Mental Health Services.
Section 62A.153 — Outpatient Medical And Surgical Services.
Section 62A.154 — Benefits For Des Related Conditions.
Section 62A.155 — Coverage For Services Provided To Ventilator-dependent Persons.
Section 62A.16 — Scope Of Certain Continuation And Conversion Requirements.
Section 62A.17 — Termination Of Or Layoff From Employment; Continuation And Conversion Rights.
Section 62A.18 — Prohibition Against Disability Offsets.
Section 62A.19 — Prohibition Against Nondiagnostic X-rays.
Section 62A.20 — Continuation Coverage Of Current Spouse And Children.
Section 62A.21 — Continuation And Conversion Privileges For Insured Former Spouses And Children.
Section 62A.22 — Refusal To Provide Coverage Because Of Option Under Workers' Compensation.
Section 62A.23 — Group Disability Income Coverage; Termination Without Prejudice; Definitions.
Section 62A.24 — Continuation Of Benefits.
Section 62A.25 — Reconstructive Surgery.
Section 62A.26 — Coverage For Phenylketonuria Treatment.
Section 62A.265 — Coverage For Lyme Disease.
Section 62A.27 — Coverage Of Adopted Children.
Section 62A.28 — Coverage For Scalp Hair Prostheses.
Section 62A.285 — Prohibited Underwriting; Breast Implants.
Section 62A.29 — Surety Bond Or Security For Certain Health Benefit Plans.
Section 62A.30 — Coverage For Diagnostic Procedures For Cancer.
Section 62A.302 — Coverage Of Dependents.
Section 62A.3021 — Coverage Of Dependents By Plans Other Than Health Plans.
Section 62A.303 — Prohibition; Severing Of Groups.
Section 62A.304 — Coverage For Port-wine Stain Elimination.
Section 62A.305 — Fibrocystic Condition; Termination Or Reduction Of Coverage.
Section 62A.306 — Use Of Gender Prohibited.
Section 62A.307 — Prescription Drugs; Equal Treatment Of Prescribers.
Section 62A.3075 — Cancer Chemotherapy Treatment Coverage.
Section 62A.308 — Hospitalization And Anesthesia For Dental Procedures.
Section 62A.3091 — Nondiscriminate Coverage Of Tests.
Section 62A.3092 — Equal Treatment Of Surgical First Assisting Services.
Section 62A.3093 — Coverage For Diabetes.
Section 62A.3094 — Coverage For Autism Spectrum Disorders.
Section 62A.3095 — Prescription Eye Drops Coverage.
Section 62A.3099 — Definitions.
Section 62A.31 — Medicare Supplement Benefits; Minimum Standards.
Section 62A.315 — Extended Basic Medicare Supplement Plan; Coverage.
Section 62A.316 — Basic Medicare Supplement Plan; Coverage.
Section 62A.3161 — Medicare Supplement Plan With 50 Percent Coverage.
Section 62A.3162 — Medicare Supplement Plan With 75 Percent Coverage.
Section 62A.3163 — Medicare Supplement Plan With 50 Percent Part A Deductible Coverage.
Section 62A.3164 — Medicare Supplement Plan With $20 And $50 Co-payment Medicare Part B Coverage.
Section 62A.3165 — Medicare Supplement Plan With High Deductible Coverage.
Section 62A.317 — Standards For Claims Payment.
Section 62A.318 — Medicare Select Policies And Certificates.
Section 62A.36 — Loss Ratio Standards.
Section 62A.37 — Government Certifications, Approvals, And Endorsements.
Section 62A.38 — Notice Of Free Examination.
Section 62A.40 — Replacement Regulated.
Section 62A.42 — Rulemaking Authority.
Section 62A.421 — Demonstration Projects.
Section 62A.43 — Limitations On Sales.
Section 62A.436 — Commissions.
Section 62A.44 — Applications.
Section 62A.451 — Definitions.
Section 62A.4511 — Certificate Of Authority Required.
Section 62A.4512 — Application For Certificate Of Authority.
Section 62A.4513 — Issuance Of Certificate Of Authority; Denial.
Section 62A.4514 — Filing Requirements For Authorized Entities.
Section 62A.4515 — Material Modifications.
Section 62A.4516 — Evidence Of Coverage.
Section 62A.4517 — Construction With Other Laws.
Section 62A.4518 — Nonduplication Of Coverage.
Section 62A.4519 — Complaint System.
Section 62A.4520 — Examination Of Organization.
Section 62A.4521 — Investments.
Section 62A.4523 — Protection Against Insolvency; Deposit.
Section 62A.4524 — Officer's And Employee's Fidelity Bond.
Section 62A.4526 — Suspension Or Revocation Of Certificate Of Authority.
Section 62A.4528 — Rehabilitation, Conservation, Or Liquidation.
Section 62A.48 — Long-term Care Policies.
Section 62A.49 — Home Care Services Coverage.
Section 62A.50 — Disclosures And Representations.
Section 62A.52 — Review Of Plan Of Care.
Section 62A.54 — Prohibited Practices.
Section 62A.60 — Retroactive Denial Of Expenses.
Section 62A.616 — Coverage For Nursing Home Care For Terminally Ill And Other Services.
Section 62A.62 — Demonstration Project.
Section 62A.64 — Health Insurance; Prohibited Agreements.
Section 62A.65 — Individual Market Regulation.
Section 62A.673 — Coverage Of Services Provided Through Telehealth.