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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| SENATE BILL |
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| INTRODUCED BY GREENLEAF, WASHINGTON, STOUT, RAFFERTY, GORDNER, BAKER, BOSCOLA, FONTANA, O'PAKE, MUSTO, M. WHITE, ERICKSON, COSTA, TARTAGLIONE, DINNIMAN, LEACH, ALLOWAY, BROWNE AND FERLO, JANUARY 26, 2010 |
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| REFERRED TO BANKING AND INSURANCE, JANUARY 26, 2010 |
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| AN ACT |
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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 to |
5 | execute prevention and education strategies and ensure |
6 | patient access to appropriate care and treatment. |
7 | The General Assembly of the Commonwealth of Pennsylvania |
8 | hereby enacts as follows: |
9 | Section 1. Short title. |
10 | This act shall be known and may be cited as the Lyme and |
11 | Related Tick-Borne Disease Education, Prevention and Treatment |
12 | Act. |
13 | Section 2. Findings. |
14 | The General Assembly finds that: |
15 | (1) Lyme disease and other tick-borne diseases are |
16 | carried primarily by ticks and pose a serious threat to the |
17 | health and quality of life of many citizens of this |
18 | Commonwealth. |
19 | (2) The most common way to acquire Lyme disease is to be |
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1 | bitten by a tick that carries the spirochete. |
2 | (3) In 2007, 3,994 cases of Lyme disease were reported |
3 | in Pennsylvania. |
4 | (4) Lyme disease is most prevalent in Southeastern |
5 | Pennsylvania, but it is found across this Commonwealth. |
6 | (5) With proper precautions taken while engaged in |
7 | outdoor activities, people can greatly reduce their chances |
8 | of tick pathogen transmission by making sure that frequent |
9 | tick checks are made and ticks are removed and disposed of |
10 | promptly and properly. |
11 | (6) The early clinical diagnosis and appropriate |
12 | treatment of these tick-borne disorders and diseases can |
13 | greatly reduce the risks of continued, diverse and chronic |
14 | signs and symptoms which can affect every system and organ of |
15 | the human body and often every aspect of life. |
16 | (7) Left untreated, Lyme disease can cause a number of |
17 | signs and symptoms which can become quite severe. |
18 | (8) Because of differences in the rate of progress of |
19 | the disease and in individual responses to the disease and |
20 | treatment, some patients may have signs and symptoms for |
21 | months or years. |
22 | Section 3. Legislative intent. |
23 | It is the intent of the General Assembly: |
24 | (1) To provide the public with information and education |
25 | to create greater public awareness of the dangers of and |
26 | measures available to prevent, diagnose and treat Lyme |
27 | disease and related maladies. |
28 | (2) To ensure that: |
29 | (i) Physicians, insurers, patients and governmental |
30 | agencies are educated that multiple standards of care |
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1 | exist. |
2 | (ii) Physicians and other medical professionals |
3 | provide patients with sufficient information about all |
4 | standards of care to enable patients to make an informed |
5 | choice as part of informed consent and respect the |
6 | autonomy of that choice. |
7 | (iii) Insurance reimbursement be provided for |
8 | treatment rendered in accordance with the standard of |
9 | care chosen. |
10 | (iv) Pennsylvania government agencies provide |
11 | unbiased information regarding multiple standards of |
12 | care. |
13 | Section 4. Definitions. |
14 | The following words and phrases when used in this act shall |
15 | have the meanings given to them in this section unless the |
16 | context clearly indicates otherwise: |
17 | "Board." The State Board of Medicine or the State Board of |
18 | Osteopathic Medicine. |
19 | "Department." The Department of Health of the Commonwealth. |
20 | "Licensee." A licensed physician or doctor of osteopathy. |
21 | "Long-term antibiotic or antimicrobial therapy." |
22 | Administration of oral, intramuscular or intravenous antibiotics |
23 | or antimicrobial medications, singly or in combination, for |
24 | periods of more than four weeks. |
25 | "Lyme disease." The clinical diagnosis of the presence in a |
26 | patient of signs and symptoms compatible with acute infection |
27 | with Borrelia burgdorferi or related Borrelioses, or with the |
28 | signs and symptoms of late stage or chronic infection with |
29 | Borrelia burgdorferi, or with complications related to such an |
30 | infection. The term includes infection which meets the |
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1 | surveillance criteria set forth by the United States Centers for |
2 | Disease Control and Prevention and also includes other acute and |
3 | chronic manifestations of such an infection as determined by the |
4 | treating physician. |
5 | "Related tick-borne illnesses." Cases of Bartonella, |
6 | babesiosis/piroplasmosis, anaplasmosis, ehrlichiosis and other |
7 | tick-transmissible illnesses. The terms do not include Lyme |
8 | disease. |
9 | "Standard of care." All established recognized clinical |
10 | practice guidelines for the treatment of Lyme disease listed in |
11 | the National Guideline Clearinghouse or subsequent database. |
12 | "Therapeutic purpose." The use of antibiotics to control a |
13 | patient's symptoms or signs determined by the treating physician |
14 | as reasonably related to Lyme disease and related tick-borne |
15 | illnesses. |
16 | Section 5. Task force. |
17 | (a) Establishment.--The department shall establish a task |
18 | force on Lyme disease and related tick-borne diseases. |
19 | (b) Purpose.--The task force shall investigate and make |
20 | recommendations to the department regarding: |
21 | (1) The prevention of Lyme disease and related tick- |
22 | borne illnesses in this Commonwealth. |
23 | (2) Raising awareness about the long-term effects of the |
24 | misdiagnosis of Lyme disease. |
25 | (3) Development of a program of general public |
26 | information and education regarding Lyme disease which shall |
27 | include the broad spectrum of scientific and treatment views |
28 | regarding Lyme disease and related tick-borne illnesses, |
29 | including multiple standards of care available for all stages |
30 | of Lyme disease and related tick-borne illnesses. |
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1 | (4) Cooperation with the Pennsylvania Game Commission to |
2 | disseminate the information required under paragraph (3) to |
3 | licensees of the commission and the general public. |
4 | (5) Cooperation with the Department of Conservation and |
5 | Natural Resources to disseminate the information required |
6 | under paragraph (3) to the general public and visitors of |
7 | State parks and lands. |
8 | (6) Cooperation with the Department of Education to: |
9 | (i) Disseminate the information required under |
10 | paragraph (3) to school officials, teachers, staff, |
11 | parents, guardians and students. |
12 | (ii) Determine what role schools may play in the |
13 | prevention of Lyme disease, including, but not limited |
14 | to, prompt removal and reporting of tick removals to |
15 | State officials. |
16 | (iii) Adopt policies to recognize chronic Lyme |
17 | disease as a health condition potentially requiring |
18 | accommodations. |
19 | (c) Composition.--The task force shall be composed of the |
20 | following individuals: |
21 | (1) The Secretary of Health or a designee. |
22 | (2) The Insurance Commissioner or a designee. |
23 | (3) The Secretary of Education or a designee. |
24 | (4) The Deputy Secretary for Conservation and |
25 | Engineering Services in the Department of Conservation and |
26 | Natural Resources or a designee. |
27 | (5) The Director of the Bureau of Information and |
28 | Education of the Pennsylvania Game Commission or a designee. |
29 | (6) Two physicians licensed in this Commonwealth who are |
30 | knowledgeable concerning treatment of early and late stage |
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1 | chronic or persistent Lyme disease and who are members of the |
2 | International Lyme and Associated Diseases Society. |
3 | (7) An epidemiologist licensed in this Commonwealth who |
4 | has expertise in spirochetes and related infectious diseases. |
5 | (8) Two individuals who represent Lyme disease patient |
6 | groups who may be a Lyme disease patient or a family member |
7 | of a Lyme disease patient. |
8 | (9) One individual who is a Lyme disease patient or |
9 | family member of a Lyme disease patient. |
10 | (d) Convening.--The task force shall convene within 90 days |
11 | after all appointments have been made and shall meet at least |
12 | quarterly. |
13 | (e) Compensation and expenses.--The members of the task |
14 | force shall receive no compensation for their services but shall |
15 | be allowed their actual and necessary expenses incurred in |
16 | performance of their duties. Reimbursement shall be provided by |
17 | the department. |
18 | (f) Department.--The department shall have the following |
19 | powers and duties: |
20 | (1) Develop a program of general public information and |
21 | education regarding Lyme disease which shall include the |
22 | broad spectrum of scientific and treating views regarding |
23 | Lyme disease and related tick-borne illnesses, including |
24 | multiple standards of care available for all stages of Lyme |
25 | disease and related tick-borne illnesses. |
26 | (2) Cooperate with the Pennsylvania Game Commission to |
27 | disseminate the information required under paragraph (1) to |
28 | licensees of the Pennsylvania Game Commission and the general |
29 | public. |
30 | (3) Cooperate with the Department of Conservation and |
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1 | Natural Resources to disseminate the information required |
2 | under paragraph (1) to the general public and visitors of |
3 | State parks and lands. |
4 | (4) Cooperate with the Department of Education to: |
5 | (i) Disseminate the information required under |
6 | paragraph (1) to school officials, teachers, staff, |
7 | parents, guardians and students. |
8 | (ii) Determine what role schools may play in the |
9 | prevention of Lyme disease, including, but not limited |
10 | to, prompt removal and reporting of tick removals to |
11 | State officials. |
12 | (iii) Adopt policies to recognize chronic Lyme |
13 | disease as a health condition potentially requiring |
14 | accommodations. |
15 | (5) Cooperate with the professional associations of |
16 | health care professionals to provide the education program |
17 | for professionals required under paragraph (1). |
18 | Section 6. Required coverage. |
19 | (a) General rule.--Except as provided in subsection (b), |
20 | every health care policy which is delivered, issued for |
21 | delivery, renewed, extended or modified in this Commonwealth by |
22 | a health insurer must cover prescribed treatment for Lyme |
23 | disease and related tick-borne illness rendered in accordance |
24 | with the standard of care and documented in the physician's |
25 | medical record for that patient and with the informed choice and |
26 | consent of the patient. |
27 | (b) Exception.--Subsection (a) shall not apply to any of the |
28 | following types of insurance: |
29 | (1) Hospital indemnity. |
30 | (2) Accident. |
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1 | (3) Specified disease. |
2 | (4) Disability income. |
3 | (5) Dental. |
4 | (6) Vision. |
5 | (7) Civilian Health and Medical Program of the Uniformed |
6 | Services (CHAMPUS) supplement. |
7 | (8) Medicare supplement. |
8 | (9) Long-term care. |
9 | (10) Other limited insurance benefit plans. |
10 | Section 7. Licensee's right to diagnose and treat lyme disease |
11 | and related tick-borne illnesses. |
12 | (a) Rights included.-- |
13 | (1) A licensee may prescribe, administer or dispense |
14 | antibiotic or antimicrobial therapy for therapeutic purposes |
15 | to a person diagnosed with and having symptoms or signs of |
16 | Lyme disease or related tick-borne illnesses if the diagnosis |
17 | and standard of care have been documented in the licensee's |
18 | medical record for that patient. |
19 | (2) No licensee shall be subject to professional |
20 | misconduct proceedings or to disciplinary action by the board |
21 | solely for prescribing, administering or dispensing long-term |
22 | antibiotic or antimicrobial therapy for a therapeutic purpose |
23 | for a patient clinically diagnosed with Lyme disease or |
24 | related tick-borne illnesses if the diagnosis and standard of |
25 | care have been documented in the licensee's medical record |
26 | for that patient. |
27 | (b) Denial, revocation or suspension of license or |
28 | discipline of licensee.--Nothing in this section shall diminish |
29 | the right of the board to deny, revoke or suspend the license of |
30 | a licensee or discipline a licensee who: |
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1 | (1) prescribes, administers or dispenses long-term |
2 | antibiotic or antimicrobial therapy for a nontherapeutic |
3 | purpose; |
4 | (2) fails to monitor the ongoing care of a patient |
5 | receiving long-term antibiotic or antimicrobial therapy; or |
6 | (3) fails to keep complete and accurate ongoing records |
7 | of the diagnosis and treatment of a patient receiving long- |
8 | term antibiotic or antimicrobial therapy. |
9 | Section 8. Professional misconduct proceedings. |
10 | (a) General rule.--Whenever the board initiates, or has |
11 | initiated, investigations or professional misconduct proceedings |
12 | against a licensee as a result of a complaint filed by an |
13 | insurance company, pharmacy benefit manager or comprehensive |
14 | health services plan under this act, which in whole or in part |
15 | concerns the licensee's diagnosis or treatment of Lyme disease |
16 | or a related tick-borne illness, a copy of the complaint shall |
17 | be provided to the licensee within ten days after the licensee's |
18 | request. |
19 | (b) Requirements of charges.--Whenever charges are made |
20 | which, in whole or in part, concern a licensee's diagnosis or |
21 | treatment of Lyme disease or a related tick-borne illness, the |
22 | charges shall contain a statement of facts sufficient to allow a |
23 | judicial determination as to whether the charges are proper |
24 | under this section. |
25 | (c) Notice of hearing.--Whenever a notice of hearing is |
26 | served in which the charges or allegations against the licensee, |
27 | in whole or in part, concern the licensee's diagnosis or |
28 | treatment of Lyme disease or a related tick-borne illness or the |
29 | administration of long-term antibiotic or antimicrobial therapy |
30 | or concern any patient who has been diagnosed with Lyme disease |
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1 | or a related tick-borne illness, the notice shall contain the |
2 | identity of any expert consulted by the board or to be called to |
3 | testify by the board and the substance of the opinion of the |
4 | expert. |
5 | Section 9. Applicability. |
6 | This act shall apply to proceedings pending on or after the |
7 | effective date of this section. |
8 | Section 10. Effective date. |
9 | This act shall take effect immediately. |
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