House Resolution 528 was revised to shift study priorities toward insurance decision-making and update preamble citations to reflect clinical guidance.

The amended resolution replaces the original preamble with references to American Academy of Pediatrics clinical report findings on PANS and PANDAS. It modifies the Joint State Government Commission's study directives, replacing topics on misdiagnoses and state agency resources with requirements to examine insurance coverage justifications and diagnostic timelines. It also expands the list of medical subspecialists and advocacy groups to consult and clarifies that completed reports will be transmitted upon completion.

• Preamble: Rewrote the resolution's preamble to cite American Academy of Pediatrics findings on diagnosis complexity and multidisciplinary care, removing references to specific psychiatric misdiagnoses and PARDAC advisory resources.
• Study Directives (Item 2): Replaced the directive to examine existing Commonwealth and PARDAC resources with an examination of 'insurance company decision making regarding coverage... including the justification for coverage decisions.'
• Study Directives (Item 4): Replaced the evaluation of common misdiagnoses and their outcomes with calculating 'the estimated length of time between the onset of symptoms and a diagnosis of PANS.'
• Study Directives (Items 1 & 3): Added 'psychiatric and behavioral interventions' to the list of evaluated treatments and added 'rheumatologists' to the list of health care practitioners to estimate.
• Consultation Clause: Expanded required consultation to explicitly include specific pediatric subspecialists (such as rheumatology, infectious diseases, and developmental-behavioral pediatrics) and added the advocacy group ASPIRE.
• Report Transmittal Clause: Changed the final directive so that copies of the final study report, rather than the initial resolution, are sent upon issuance to state departments and consulted organizations.