PANDAS Workgroup

General Information


PANDAS: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections

House Bill 15 was introduced during the 2019 legislative session to mandate treatments for PANDAS in all regulated markets, i.e. large group, small group and individual. The Maryland Insurance Administration was asked to form a workgroup to get information from stakeholders concerning PANDAS and the problems with obtaining coverage of treatment from commercial health benefit plans.

2019 Meeting Schedule

July 24, 2019 2:00 pm - 5:00pm

Maryland Insurance Administration
200 St. Paul Place
Baltimore, MD 21202
Hearing Room – 24th floor
Conference Call Telephone number: 1-319-343-8935
‬ PIN: 806 312 274 #
 No Additional Meetings are Scheduled
Previous Meeting:
June 26, 2019  2:00 pm - 5:00 pm

June 6, 2019

MIA Staff Questions To Interested Parties



QUESTIONS (June 14, 2019)​ 

  1. What are the policies and criteria to determine if IVIG or Rituximab will be covered to treat PANDAS that has not responded to antibiotics?
  2. How are the criteria developed?
  3. How many requests for authorization are received, and how many are approved?
  4. What medical specialty is considered appropriate to make a decision to approve or disapprove a request?
  5. How many physicians are in the network to treat PANDAS? How many facilities will provide infusion or other services to treat PANDAS?
  6. How many requests for referrals under § 15-830 of the Insurance Article are received? How many are granted?
  7. What is the estimated prevalence of PANDAS?
MIA staff would appreciate your comments on the above. Please respond before the next workgroup meting June 26, 2019 to the e-mail below.

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Documents Submitted By Interested Parties

Final Report

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