Oregon § 743A.315 Treatment for pediatric autoimmune neuropsychiatric disorders

Oregon Statutes

§ 743A.315 — Treatment for pediatric autoimmune neuropsychiatric disorders

Oregon § 743A.315

Vol.18

Title 56Insurance

Ch. 743AHealth Insurance: Reimbursement of Claims

This text of Oregon § 743A.315 (Treatment for pediatric autoimmune neuropsychiatric disorders) is published on Counsel Stack Legal Research, covering Oregon primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Or. Rev. Stat. § 743A.315 (2026).

Text

(1)A health benefit plan, as defined in ORS 743B.005, must cover the cost of up to three monthly immunomodulatory courses of intravenous immunoglobulin therapy for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome, when the following conditions have been met:

(a)Clinically appropriate trials, which may be done concurrently, of two or more less-intensive treatments were:

(A)Not effective;

(B)Not tolerated; or

(C)Did not 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; and

(b)A pediatric subspecialist was consulted and the pediatric subspecialist and

Free access — add to your briefcase to read the full text and ask questions with AI

(1) A health benefit plan, as defined in ORS 743B.005, must cover the cost of up to three monthly immunomodulatory courses of intravenous immunoglobulin therapy for the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and pediatric acute-onset neuropsychiatric syndrome, when the following conditions have been met:
(a) Clinically appropriate trials, which may be done concurrently, of two or more less-intensive treatments were:
(A) Not effective;
(B) Not tolerated; or
(C) Did not 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; and
(b) A pediatric subspecialist was consulted and the pediatric subspecialist and the patient’s primary care provider recommend the treatment. For an adolescent patient, the consultation may be with an adult subspecialist.
(2) The health benefit plan may require that the patient be clinically reevaluated at three-month intervals.
(3) This section is exempt from ORS 743A.001.