Senate passes Lawson bill to make pediatric autoimmune coverage permanent

 

STATE HOUSE — The Senate passed a bill today sponsored by Senate Majority Leader Valarie Lawson that would make permanent a pilot program passed in 2022 that requires insurance coverage for treatment of pediatric autoimmune neuropsychiatric syndrome.

According to the National Institute of Mental Health, children may be diagnosed with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) when obsessive-compulsive disorder (OCD), tic disorder or both suddenly appear following a streptococcal infection, such as strep throat or scarlet fever. The symptoms are usually dramatic, happen “overnight and out of the blue,” and can include motor or vocal tics or both and obsessions, compulsions or both. In addition to these symptoms, children may become moody or irritable, experience anxiety attacks or show concerns about separating from parents or loved ones.

“We have seen this pilot program work. It is time to make it permanent so families have peace of mind that their coverage will continue,” said Senator Lawson (D-Dist. 14, East Providence). “The stress and uncertainty that arises with PANDAS can be extremely challenging for children and their families. Removing the sunset provision of this bill will make sure that children suffering from PANDAS get the medical help they need regardless of their family’s ability to pay out-of-pocket.”

In 2022, the General Assembly passed and the governor signed legislation (2022-S 2203B, 2022-H 7503Baa) mandating insurance coverage for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute onset neuropsychiatric syndrome. This requirement, however, is set to expire on Dec. 31, 2025. Senator Lawson’s legislation (2025-S 0473) would make this coverage permanent.

Matthew H., an East Bay resident who has suffered from OCD, provided testimony in support of the bill to the Senate Health and Human Services Committee.

“When I finally started outpatient treatment at Butler Hospital, I noticed multiple peers who traced their OCD back to physical sickness. I now think about whether their symptoms began as children who contracted strep throat or scarlet fever, but whose symptoms began before the initial legislation’s enactment. It upsets me to think that an inability to pay for treatment might have prolonged their suffering, and could do the same for children if mandated coverage is allowed to expire,” said Matthew. “No one deserves psychological distress from contracting strep throat, least of all children because their parents cannot pay for treatment. Removing this sunset provision will prevent this injustice and allow more children to live freer and fuller lives.”

The bill now heads to the House for consideration where Rep. Matthew S. Dawson (D-Dist. 65, East Providence) has introduced similar legislation (2025-H 5625).

 

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