HB 2196 — Expanding access to PANDAS PANS treatment.

ENGROSSEDH-2443.2 SUBSTITUTE HOUSE BILL 2196 State of Washington 69th Legislature 2026 Regular Session By House Health Care & Wellness (originally sponsored by Representatives Simmons, Low, Leavitt, Paul, Nance, Duerr, Stonier, Couture, Davis, Stuebe, and Lekanoff)Lekanoff READPrefiled FIRST12/24/25. TIME 02/04/26.

Read first time 01/12/26.

Referred to Committee on Health Care & Wellness.

(1)(a)(1) ForExcept nongrandfatheredas groupprovided in subsection (3) of this section, 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, 2027, health carriers shall provide initial coverage forof thethree prophylaxis,monthly diagnosis,immunomodulatory andcourses of intravenous immunoglobulin therapy for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome.syndrome, and subsequent courses as deemed medically necessary by the treating provider, when the following conditions are met:

Coverage(a) forClinically treatmentappropriate oftrials, pediatricwhich autoimmunemay neuropsychiatricbe disordersdone associatedconcurrently, withif streptococcaltwo infectionsless andintensive pediatrictreatments: acute-onset neuropsychiatric syndrome must include, but is not limited to, antibiotics, medication and psychological and behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy.

(b)(i) ExceptWere asnot providedeffective; in subsection (3) of this section, health carriers must cover three initial monthly immunomodulatory courses of intravenous immunoglobulin therapy for the treatment of pediatric p.

1(ii) ESHBWere 2196not autoimmunetolerated; 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:

(i)or Clinicallyp. appropriate trials, which may be done concurrently, if two less intensive treatments:

(A)1 WereHB 2196 (iii) Did not effective;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;

(B)and Were(b) notThe tolerated;patient's treating provider recommends the treatment.

or(2) (C)The Didhealth notcarrier resultmay inrequire sustainedthat improvementthe inpatient symptoms,be as measured by a lack of clinically meaningfulreevaluated improvement on a validated instrument directed at thethree-month patient'sintervals. primary symptom complex;

and (ii) The patient's treating provider recommends the treatment.

(2) When providing coverage of intravenous immunoglobulin therapy required under subsection (1)(b) of this section, the health carrier may require that the patient be clinically reevaluated at three-month intervals.

p.(d) Deny coverage for out-of-state treatment if the service is not available within the state;

2 ESHB 2196 (d) Deny coverage for out-of-state treatment if the service is not available within the state;

(4) This section does not apply to small group health plans or health plans offered to public employees and their dependents under chapter 41.05 RCW.

32 ESHBHB 2196