THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY PHILLIPS, BAKER, HENNESSEY, ADOLPH, BELFANTI, BOBACK, CALTAGIRONE, CAUSER, CLYMER, COHEN, CONKLIN, CREIGHTON, CUTLER, DENLINGER, DRUCKER, J. EVANS, FABRIZIO, FAIRCHILD, FLECK, GEIST, GEORGE, GODSHALL, GOODMAN, GROVE, GRUCELA, HARRIS, HESS, M. KELLER, MAJOR, MARSICO, METZGAR, MILLARD, MILLER, MOUL, MUNDY, MURT, O'NEILL, PEIFER, PETRARCA, PICKETT, PYLE, QUINN, READSHAW, ROCK, ROHRER, ROSS, SANTONI, SCAVELLO, SIPTROTH, STABACK, STERN, WALKO, WATSON, YOUNGBLOOD, GINGRICH, HELM, FREEMAN, WANSACZ, HARPER, HOUGHTON, BRADFORD AND CARROLL, MARCH 12, 2009

AS RE-REPORTED FROM COMMITTEE ON APPROPRIATIONS, HOUSE OF REPRESENTATIVES, AS AMENDED, JUNE 23, 2010

AN ACT

Establishing a task force on Lyme disease and related maladies;

and providing for powers and duties of the task force, the

Department of Health, the Department of Conservation and

Natural Resources and the Pennsylvania Game Commission, for

certain antibiotic therapies and for misconduct proceedings.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Lyme and

Related Tick-Borne Disease Education, Prevention and Treatment

Act.

Section 2.  Findings.

The General Assembly finds and declares as follows:

(1)  Lyme disease and other tick-borne diseases are

carried primarily by ticks and pose a serious threat to the

quality of life of many citizens of this Commonwealth.

(2)  The most common way to acquire Lyme disease is to be

bitten by a tick that carries the spirochete.

(3)  In 2007, 3,994 cases of Lyme disease were reported

in Pennsylvania.

(4)  Lyme disease is most prevalent in southeastern

Pennsylvania, but it is found across this Commonwealth.

(5)  With proper precaution taken while engaged in

outdoor activities, people can greatly reduce their chances

of tick pathogen transmission by making sure that frequent

tick checks are made and ticks are removed and disposed of

promptly and properly.

(6)  The early clinical diagnosis and appropriate

treatment of these tick-borne disorders and diseases can

greatly reduce the risks of continued, diverse and chronic

signs and symptoms which can affect every system and organ of

the human body and often every aspect of life.

(7)  Left untreated, Lyme disease can cause a number of

signs and symptoms which can become quite severe.

(8)  Because the rate of progress of the disease and

differing individual responses to treatment, some patients

may have signs and symptoms that linger for months or even

years following treatment.

Section 3.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Board."  The State Board of Medicine or the State Board of

Osteopathic Medicine.

"Department."  The Department of Health of the Commonwealth.

"Licensee."  A licensed physician or doctor of osteopathy.

"Long-term antibiotic or antimicrobial therapy."

Administration of oral, intramuscular or intravenous antibiotics

or antimicrobial medications, singly or in combination, for

periods of more than four weeks.

"Lyme disease."  The clinical diagnosis of the presence in a

patient of signs and symptoms compatible with acute infection

with Borrelia burgdorferi or related Borrelioses, or with the

signs and symptoms of late stage or chronic infection with

Borrelia burgdorferi, or with complications related to such an

infection. The term includes infection which meets the

surveillance criteria set forth by the United States Centers for

Disease Control and Prevention and also includes other acute and

chronic manifestations of such an infection as determined by the

physician.

"Related tick-borne illnesses."  Cases of Bartonellosis,

Babesiosis/Piroplasmosis and other tick-transmissible illnesses

as may be empirically associated with Lyme disease.

"Therapeutic purpose."  The use of antibiotics to control a

patient's symptoms or signs determined by the physician as

reasonably related to Lyme disease and its sequelae or related

tick-borne illnesses.

Section 4.  Legislative intent.

It is the intent of the General Assembly to provide the

public with information and education to create greater public

awareness of the dangers of and measures available to prevent

Lyme disease and related maladies.

Section 5.  Task force.

(a)  Establishment.--The department shall establish, to the

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extent funds are appropriated specifically for the purposes of

this act, a task force on Lyme disease and related tick-borne

diseases.

(b)  Purpose.--The task force shall investigate and make

recommendations to the department regarding:

(1)  The prevention of Lyme disease and associated tick-

borne diseases in this Commonwealth.

(2)  Raising awareness about the long-term effects of the

misdiagnosis of Lyme disease.

(3)  Development of a program of general public

information and education regarding Lyme disease.

(4)  Cooperation with the Pennsylvania Game Commission to

disseminate the information required under paragraph (3) to

licensees of the commission and the general public.

(5)  Cooperation with the Department of Conservation and

Natural Resources to disseminate the information required

under paragraph (3) to the general public and visitors of

State parks and lands.

(c)  Composition.--The task force shall be composed of the

following individuals:

(1)  The Secretary of Health or a designee.

(2)  The Insurance Commissioner or a designee.

(3)  The Deputy Secretary for Conservation and

Engineering Services in the Department of Conservation and

Natural Resources or a designee.

(4)  The Director of the Bureau of Information and

Education of the Pennsylvania Game Commission or a designee.

(5)  Two physicians licensed in Pennsylvania who are

knowledgeable concerning treatment of early and late stage

Lyme disease and who are members of the International Lyme

and Associated Diseases Society.

(6)  An epidemiologist licensed in Pennsylvania having

expertise in spirochetes and related infectious diseases.

(7)  Two individuals representing Lyme disease support

groups.

(d)  Convening.--The task force shall convene within 90 days

after all appointments have been made and shall meet at least

quarterly.

(e)  Compensation and expenses.--The members of the task

force shall receive no compensation for their services but shall

be allowed their actual and necessary expenses incurred in

performance of their duties. Reimbursement shall be provided by

the department.

(f)  Department.--The department shall, to the extent funds

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are appropriated specifically for the purposes of this act, have

the following powers and duties:

(1)  Develop a program of general public information and

education regarding Lyme disease.

(2)  Cooperate with the Pennsylvania Game Commission to

disseminate the information required under paragraph (1) to

licensees of the Pennsylvania Game Commission and the general

public.

(3)  Cooperate with the Department of Conservation and

Natural Resources to disseminate the information required

under paragraph (1) to the general public and visitors of

State parks and lands.

(4)  Cooperate with the professional associations of

health care professionals to provide the education program

for professionals required under paragraph (1).

Section 6.  Required coverage.

(a)  Tick-borne illnesses.--Except as provided in subsection

(b), every health care policy which is delivered, issued for

delivery, renewed, extended or modified in this Commonwealth by

a health insurer must cover prescribed treatment for Lyme

disease or related tick-borne illness if the diagnosis and

treatment plan are documented in the patient's medical record,

including long-term therapies and treatment as prescribed by the

patient's attending physician.

(b)  Exception.--Subsection (a) shall not apply to any of the

following types of insurance:

(1)  Hospital indemnity.

(2)  Accident.

(3)  Specified disease.

(4)  Disability income.

(5)  Dental.

(6)  Vision.

(7)  Civilian Health and Medical Program of the Uniformed

Services (CHAMPUS) supplement.

(8)  Medicare supplement.

(9)  Long-term care.

(10)  Other limited insurance benefit plans.

Section 7.  Long-term antibiotic therapy.

(a)  Long-term antibiotic and microbial treatment.--

(1)  A licensee may prescribe, administer or dispense

antibiotic or antimicrobial therapy for therapeutic purposes

to a person diagnosed with and having symptoms or signs of

Lyme disease or related tick-borne illnesses if this

diagnosis and treatment plan have been documented in the

licensee's medical record for that patient.

(2)  No licensee shall be subject to professional

misconduct proceedings or to disciplinary action by the board

solely for prescribing, administering or dispensing long-term

antibiotic or antimicrobial therapy for a therapeutic purpose

for a patient clinically diagnosed with Lyme disease or

related tick-borne illnesses if this diagnosis and treatment

plan have been documented in the licensee's medical record

for that patient.

(b)  Denial, revocation or suspension of license or

discipline of licensee.--Nothing in this section shall diminish

the right of the board to deny, revoke or suspend the license of

a licensee or discipline a licensee who prescribes, administers

or dispenses long-term antibiotic or antimicrobial therapy for a

nontherapeutic purpose, who fails to monitor the ongoing care of

a patient receiving long-term antibiotic or antimicrobial

therapy or who fails to keep complete and accurate ongoing

records of the diagnosis and treatment of a patient receiving

long-term antibiotic or antimicrobial therapy.

Section 8.  Professional misconduct proceedings.

(a)  General rule.--Whenever the board initiates or has

initiated investigations or professional misconduct proceedings

against a licensee as a result of a complaint filed by an

insurance company, pharmacy benefit manager or comprehensive

health services plan pursuant to this act, which in whole or in

part concerns the licensee's diagnosis or treatment of Lyme

disease or any related tick-borne illness, a copy of the

complaint shall be provided to the licensee within ten days

after the licensee's request.

(b)  Requirements of charges.--Whenever charges are made

which, in whole or in part, concern a licensee's diagnosis or

treatment of Lyme disease or any related tick-borne illness, the

charges shall contain a statement of facts sufficient to allow a

judicial determination as to whether the charges are proper

under this section.

(c)  Notice of hearing.--Whenever a notice of hearing is

served in which the charges or allegations against the licensee,

in whole or in part, concern the licensee's diagnosis or

treatment of Lyme disease or any related tick-borne illness or

the administration of long-term antibiotic or antimicrobial

therapy or concern any patient who has been diagnosed with Lyme

disease or any related tick-borne illness, the notice shall

contain the identity of any experts consulted by the board or to

be called to testify by the board and the substance of the

opinion of each such expert.

Section 19.  Applicability.

This act shall apply to proceedings pending on or after the

effective date of this section.

Section 20.  Effective date.

This act shall take effect immediately.