New Virginia Law Mandates Medicaid and Health Insurance Coverage for Severe Neuroimmune Disorders in Youth

Law to take effect July 1

ARLINGTON, VA, UNITED STATES, March 20, 2025 /EINPresswire.com/ -- The Commonwealth of Virginia made history with the signing of a new law mandating coverage by state medical assistance services and private health insurers for the diagnosis and treatment of PANS/PANDAS–Infection-Associated Neuroimmune Psychiatric Disorders. Virginia became the 13th state to require such coverage.

PANS and PANDAS are conditions triggered by infections like strep throat and even common colds. After the infection, the immune system mistakenly targets healthy brain tissue, causing severe brain inflammation and leading to debilitating physical and mental health symptoms. These conditions primarily affect young people, and if left untreated, can result in lifelong disabilities and even loss of life.

“Insurers typically deny coverage for doctor-prescribed treatment, despite the fact that available treatments have been shown to heal patients and delays can lead to permanent disability--or worse,” says Dr. Daniela Sosa-Sarkar, co-founder of the Virginia Alliance for PANS/PANDAS Action. “This new law will be a game-changer for hundreds of young people and their families across the state grappling with the medical and insurance fallout of these devastating conditions.”

HB1641, introduced by Delegate Patrick Hope (D-1), passed unanimously in both the House of Delegates and Virginia Senate during the 2025 session. Governor Glenn Youngkin signed the bill into law on March 18. The bill had a total of 37 sponsors representing both sides of the aisle, a testament to the urgent need to help young people and their families dealing with these traumatic disorders.

The Health Insurance Reform Commission fast-tracked review of the bill in 2024 and voted unanimously to send the legislation, with the addition of Medicaid coverage, back to the General Assembly. Their recommendation was backed by a Board of Insurance estimate that insurance coverage would cost just $0.0046 cents per member per month–less than half a cent—a negligible cost far outweighed by the risks of denying and delaying treatment.

“Working with VA4PA, families and patients across Virginia has given me a deep appreciation for the devastation faced by all those affected by PANS/PANDAS,” says Hope, an 8-term veteran who is up for re-election this year. “The more you know about this illness, the more you understand the need to act swiftly to get a diagnosis and treatment as early as possible. I’m pleased that my colleagues also understood what was at stake and joined me in securing passage of this critical bill.”

Lack of diagnosis and treatment affects not just patients, but also places a burden on schools, police, health care systems, and even insurers, who pay for unnecessary treatments that attempt to address only symptoms rather than the root cause.

“VA4PA is indebted to our Patron Delegate Patrick Hope and all of our supporters throughout the General Assembly,” says Dr. Sosa-Sarkar. “This is a very happy day for those of us who have been dealing with the heartbreak of insurance denial of treatment for our loved ones, some for more than a decade. But it’s more than just us. Everyone stands to benefit from this new law.”

As of end-2024, 12 states–Arkansas, California, Delaware, Illinois, Indiana, Kansas, Maryland, Massachusetts, Minnesota, New Hampshire, Oregon, and Rhode Island–have passed laws requiring health insurance companies to cover treatment costs for PANS/PANDAS. More than a dozen other states, including Georgia, New Jersey and Tennessee, have introduced or are working on similar legislation.

The passage of HB1641 marks the second successful collaboration between VA4PA and Delegate Hope, who successfully ushered through introduction and passage of a bill in 2024 calling for the reintroduction of the Governor’s PANDAS/PANS Advisory Council to advance awareness, education, and research on these diseases.
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BACKGROUND ON PANS/PANDAS

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) occur after an infection, such as strep throat and other bacterial, viral, or environmental irritants. The immune system misdirects its response, attacking healthy brain tissue and setting the stage for inflammation in the brain. Symptoms vary and typically include obsessive compulsive behaviors, restrictive eating or tics. Other symptoms may include cognitive decline, learning difficulties, headache, nerve, muscle and joint pain, behavioral issues, anxiety, insomnia, loss of motor control, and urinary frequency and incontinence. For many, the onset is sudden and dramatic. Untreated, these disorders impact and compromise the quality of life of young people suffering from PANS/PANDAS. Yet few doctors are trained to identify and treat PANS/PANDAS. There's grossly insufficient federal research on the disorder, and insurance companies often deny prescribed treatments, despite the critical need for early intervention.

Angie Gentile
Virginia Alliance for PANS/PANDAS Action (VA4PA)
+1 571-243-0972
email us here
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