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HB 411

TennCare - As enacted, enacts "Lucca's Law," which addresses TennCare coverage of treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS). - Amends TCA Title 8; Title 56 and Title 71.

114th Regular Session (2025-2026) Introduced by Susan Lynn

Tennessee requires TennCare to cover treatments for sudden-onset neuropsychiatric conditions in children linked to strep infections (PANDAS/PANS).

Pub. Ch. 482
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Bill Summary · HB 411

Legislative bill overview

HB 411, known as "Lucca's Law," mandates that Tennessee's TennCare program cover treatments for PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) and PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome). The bill amends Tennessee's insurance and health code to require coverage of these conditions, which cause sudden-onset psychiatric and neurological symptoms in children, typically following streptococcal infections.

Why is this important

Many children with PANDAS/PANS experience debilitating psychiatric symptoms (OCD, anxiety, tics) that emerge suddenly following strep infections, yet insurance coverage for specialized treatments has been inconsistent or denied. This legislation ensures Tennessee's Medicaid beneficiaries have access to recognized treatments, reducing barriers for lower-income families seeking care. The law directly impacts families struggling to afford expensive diagnostic testing and immunological treatments not always covered by standard insurance plans.

Potential points of contention

  • Medical consensus concerns: While PANDAS/PANS are increasingly recognized, some medical organizations remain cautious about diagnostic criteria and evidence-based treatments, potentially creating disagreements over which therapies qualify for mandatory coverage
  • Cost implications: Mandating coverage of specialized treatments—including immunoglobulin therapy, plasmapheresis, and psychiatric care—increases TennCare expenditures, which may pressure other program funding
  • Diagnostic gatekeeping: Without clear coverage guidelines, disputes may arise over which children qualify and which treatments insurers must fund under the mandate

Compiled from official sources — confirm details with the bill’s official record.

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