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                                                      PRINTER'S NO. 1889



No. 1534 Session of 2005

           LEVDANSKY, ROSS AND MAJOR, MAY 5, 2005


                                     AN ACT

     1  Establishing a task force on Lyme disease and related maladies;
     2     and providing for powers and duties of the task force, the
     3     Department of Health, the Department of Conservation and
     4     Natural Resources and the Pennsylvania Game Commission, for
     5     certain antibiotic therapies and for misconduct proceedings.

     6     The General Assembly of the Commonwealth of Pennsylvania
     7  hereby enacts as follows:
     8  Section 1.  Short title.
     9     This act shall be known and may be cited as the Lyme and
    10  Related Tick-Borne Disease Education, Prevention and Treatment
    11  Act.
    12  Section 2.  Findings.
    13     The General Assembly finds and declares as follows:
    14         (1)  Lyme disease and other tick-borne diseases are
    15     carried primarily by ticks and pose a serious threat to the

     1     quality of life of many Pennsylvanians.
     2         (2)  The most common way to acquire Lyme disease is to be
     3     bitten by a tick that carries the spirochete.
     4         (3)  The number of cases reported in Pennsylvania
     5     increased 42% from 2001 to 2002.
     6         (4)  Pennsylvania ranks third in the nation in the rate
     7     of incidence of Lyme disease.
     8         (5)  Lyme disease is most prevalent in southeastern
     9     Pennsylvania but is found across this Commonwealth.
    10         (6)  With proper precaution taken while engaged in
    11     outdoor activities, people can greatly reduce their chances
    12     of tick pathogen transmission by making sure that frequent
    13     tick checks are made and ticks are removed and disposed of
    14     promptly and properly.
    15         (7)  The early clinical diagnosis and appropriate
    16     treatment of these tick-borne disorders and diseases can
    17     greatly reduce the risks of continued, diverse and chronic
    18     signs and symptoms which can affect every system and organ of
    19     the human body and often every aspect of their lives.
    20         (8)  Left untreated, Lyme disease can cause a number of
    21     signs and symptoms which can become quite severe.
    22         (9)  Because the rate of progress of the disease and
    23     differing individual response to treatment, some patients may
    24     have signs and symptoms that linger for months or even years
    25     following treatment.
    26  Section 3.  Definitions.
    27     The following words and phrases when used in this act shall
    28  have the meanings given to them in this section unless the
    29  context clearly indicates otherwise:
    30     "Board."  The State Board of Medicine or the State Board of
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     1  Osteopathic Medicine.
     2     "Department."  The Department of Health of the Commonwealth.
     3     "Licensee."  A licensed physician or doctor of osteopathy.
     4     "Long-term antibiotic or antimicrobial therapy."
     5  Administration of oral, intramuscular or intravenous antibiotics
     6  or antimicrobial medications, singly or in combination, for
     7  periods of more than four weeks.
     8     "Lyme disease."  The clinical diagnosis of the presence in a
     9  patient of signs and symptoms compatible with acute infection
    10  with Borrelia burgdorferi or related Borrelioses, or with the
    11  signs and symptoms of late stage or chronic infection with
    12  Borrelia burgdorferi, or with complications related to such an
    13  infection. The term includes infection which meets the
    14  surveillance criteria set forth by the United States Centers for
    15  Disease Control and Prevention and also includes other acute and
    16  chronic manifestations of such an infection as determined by the
    17  physician.
    18     "Related tick-borne illnesses."  Cases of Bartonellosis,
    19  Babesiosis/Piroplasmosis and other tick-transmissible illnesses
    20  as may be empirically associated with Lyme disease.
    21     "Therapeutic purpose."  The use of antibiotics to control a
    22  patient's symptoms or signs determined by the physician as
    23  reasonably related to Lyme disease and its sequelae or related
    24  tick-borne illnesses.
    25  Section 4.  Legislative intent.
    26     It is the intent of the General Assembly to provide the
    27  public with information and education to create greater public
    28  awareness of the dangers of and measures available to prevent
    29  Lyme disease and related maladies.
    30  Section 5.  Task force.
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     1     (a)  Establishment.--The department shall establish a task
     2  force on Lyme disease and related tick-borne diseases.
     3     (b)  Purpose.--The task force shall investigate and make
     4  recommendations to the department regarding:
     5         (1)  The prevention of Lyme disease and associated tick-
     6     borne diseases in this Commonwealth.
     7         (2)  Raising awareness about the long-term effects of the
     8     misdiagnosis of Lyme disease.
     9         (3)  Development of a program of general public
    10     information and education regarding Lyme disease.
    11         (4)  Cooperation with the Pennsylvania Game Commission to
    12     disseminate the information required under paragraph (3) to
    13     licensees of the commission and the general public.
    14         (5)  Cooperation with the Department of Conservation and
    15     Natural Resources to disseminate the information required
    16     under paragraph (3) to the general public and visitors of
    17     State parks and lands.
    18     (c)  Composition.--The task force shall be composed of the
    19  following individuals:
    20         (1)  The Secretary of Health or a designee.
    21         (2)  The Insurance Commissioner or a designee.
    22         (3)  The Deputy Secretary for Conservation and
    23     Engineering Services in the Department of Conservation and
    24     Natural Resources or a designee.
    25         (4)  The Director of the Bureau of Information and
    26     Education of the Pennsylvania Game Commission or a designee.
    27         (5)  Two physicians licensed in Pennsylvania who are
    28     knowledgeable concerning treatment of early and late stage
    29     Lyme disease and who are members of the International Lyme
    30     and Associated Diseases Society.
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     1         (6)  An epidemiologist licensed in Pennsylvania having
     2     expertise in spirochetes and related infectious diseases.
     3         (7)  Two individuals representing Lyme disease support
     4     groups.
     5     (d)  Convening.--The task force shall convene within 90 days
     6  after all appointments have been made, and shall meet at least
     7  quarterly.
     8     (e)  Compensation and expenses.--The members of the task
     9  force shall receive no compensation for their services but shall
    10  be allowed their actual and necessary expenses incurred in
    11  performance of their duties. Reimbursement shall be provided by
    12  the department.
    13     (f)  Department.--The department shall have the following
    14  powers and duties:
    15         (1)  Develop a program of general public information and
    16     education regarding Lyme disease.
    17         (2)  Cooperate with the Pennsylvania Game Commission to
    18     disseminate the information required under paragraph (1) to
    19     licensees of the Pennsylvania Game Commission and the general
    20     public.
    21         (3)  Cooperate with the Department of Conservation and
    22     Natural Resources to disseminate the information required
    23     under paragraph (1) to the general public and visitors of
    24     State parks and lands.
    25         (4)  Cooperate with the professional associations of
    26     health care professionals to provide the education program
    27     for professionals required under paragraph (1).
    28  Section 6.  Required coverage.
    29     (a)  Tick-borne illnesses.--Except as provided in subsection
    30  (b), every health care policy which is delivered, issued for
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     1  delivery, renewed, extended or modified in this Commonwealth by
     2  a health insurer must cover prescribed treatment for Lyme
     3  disease or related tick-borne illness if the diagnosis and
     4  treatment plan are documented in the patient's medical record,
     5  including long-term therapies and treatment as prescribed by the
     6  patient's attending physician.
     7     (b)  Exception.--Subsection (a) shall not apply to any of the
     8  following types of insurance:
     9         (1)  Hospital indemnity.
    10         (2)  Accident.
    11         (3)  Specified disease.
    12         (4)  Disability income.
    13         (5)  Dental.
    14         (6)  Vision.
    15         (7)  Civilian Health and Medical Program of the Uniformed
    16     Services (CHAMPUS) supplement.
    17         (8)  Medicare supplement.
    18         (9)  Long-term care.
    19         (10)  Other limited insurance benefit plans.
    20  Section 7.  Long-term antibiotic therapy.
    21     (a)  Long-term antibiotic and microbial treatment.--
    22         (1)  A licensee may prescribe, administer or dispense
    23     antibiotic or antimicrobial therapy for therapeutic purposes
    24     to a person diagnosed with and having symptoms or signs of
    25     Lyme disease or related tick-borne illnesses if this
    26     diagnosis and treatment plan have been documented in the
    27     licensee's medical record for that patient.
    28         (2)  No licensee shall be subject to professional
    29     misconduct proceedings or to disciplinary action by the board
    30     solely for prescribing, administering or dispensing long-term
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     1     antibiotic or antimicrobial therapy for a therapeutic purpose
     2     for a patient clinically diagnosed with Lyme disease or
     3     related tick-borne illnesses if this diagnosis and treatment
     4     plan have been documented in the licensee's medical record
     5     for that patient.
     6     (b)  Denial, revocation or suspension of license or
     7  discipline of licensee.--Nothing in this section shall diminish
     8  the right of the board to deny, revoke or suspend the license of
     9  a licensee or discipline a licensee who prescribes, administers
    10  or dispenses long-term antibiotic or antimicrobial therapy for a
    11  nontherapeutic purpose, who fails to monitor the ongoing care of
    12  a patient receiving long-term antibiotic or antimicrobial
    13  therapy or who fails to keep complete and accurate ongoing
    14  records of the diagnosis and treatment of a patient receiving
    15  long-term antibiotic or antimicrobial therapy.
    16  Section 8.  Professional misconduct proceedings.
    17     (a)  General rule.--Whenever the board initiates or has
    18  initiated investigations or professional misconduct proceedings
    19  against a licensee as a result of a complaint filed by an
    20  insurance company, pharmacy benefit manager or comprehensive
    21  health services plan pursuant to this act, which in whole or in
    22  part concerns the licensee's diagnosis or treatment of Lyme
    23  disease or any related tick-borne illness, a copy of the
    24  complaint shall be provided to the licensee within ten days
    25  after the licensee's request.
    26     (b)  Requirements of charges.--Whenever charges are made
    27  which, in whole or in part, concern a licensee's diagnosis or
    28  treatment of Lyme disease or any related tick-borne illness, the
    29  charges shall contain a statement of facts sufficient to allow a
    30  judicial determination as to whether the charges are proper
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     1  under this section.
     2     (c)  Notice of hearing.--Whenever a notice of hearing is
     3  served in which the charges or allegations against the licensee,
     4  in whole or in part, concern the licensee's diagnosis or
     5  treatment of Lyme disease or any related tick-borne illness or
     6  the administration of long-term antibiotic or antimicrobial
     7  therapy or concern any patient who has been diagnosed with Lyme
     8  disease or any related tick-borne illness, the notice shall
     9  contain the identity of any experts consulted by the board or to
    10  be called to testify by the board and the substance of the
    11  opinion of each such expert.
    12  Section 19.  Applicability.
    13     This act shall apply to proceedings pending on or after the
    14  effective date of this act.
    15  Section 20.  Effective date.
    16     This act shall take effect immediately.

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