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SB 1426

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 Bo Watson

Tennessee mandates TennCare coverage for treatments of rare pediatric infections PANDAS and PANS, expanding access for low-income families but potentially increasing state healthcare costs.

Comp. became Pub. Ch. 482
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Bill Summary · SB 1426

Legislative bill overview

SB 1426 ("Lucca's Law") mandates that Tennessee's TennCare program cover evidence-based treatments for PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) and PANS (pediatric acute-onset neuropsychiatric syndrome). The bill amends Tennessee's healthcare statutes to establish coverage requirements and treatment guidelines for these rare pediatric conditions affecting behavior, movement, and cognitive function following infection or symptom onset.

Why is this important

These conditions can severely impact children's functioning but remain poorly understood and often underdiagnosed, leaving affected families with limited treatment access and significant out-of-pocket costs. By mandating TennCare coverage, the bill could expand treatment access for low-income Tennessee children whose families cannot afford specialized care, though implementation costs to the state healthcare program merit consideration.

Potential points of contention

  • Medical evidence debate: The scientific community remains divided on PANDAS/PANS diagnostic criteria and treatment effectiveness; some experts view certain treatments as experimental, raising questions about coverage justification
  • Cost implications: Expanded TennCare coverage could increase state healthcare expenditures; fiscal impact and sustainability weren't explicitly detailed in available information
  • Treatment scope: Unclear which specific treatments qualify for mandatory coverage (antibiotics, immunotherapies, psychiatric interventions), potentially creating disputes between providers, families, and insurers over what TennCare must pay for

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

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