PRINTER'S NO. 917
No. 798 Session of 2007
INTRODUCED BY PHILLIPS, BAKER, BELFANTI, ARGALL, BASTIAN, BOYD, CALTAGIRONE, CAPPELLI, CLYMER, COHEN, COX, DALEY, DALLY, DENLINGER, FABRIZIO, FAIRCHILD, GEIST, GEORGE, GIBBONS, GINGRICH, GRUCELA, HARRIS, HENNESSEY, HERSHEY, HESS, JAMES, KILLION, KULA, MAJOR, MARKOSEK, MARSICO, McILHATTAN, MILLARD, R. MILLER, MURT, NAILOR, PEIFER, PETRARCA, PICKETT, PYLE, REICHLEY, ROHRER, ROSS, RUBLEY, SAYLOR, SCAVELLO, SIPTROTH, SONNEY, STABACK, STERN, SURRA, WALKO, WANSACZ, WATSON, WOJNAROSKI AND YOUNGBLOOD, MARCH 19, 2007
REFERRED TO COMMITTEE ON HEALTH AND HUMAN SERVICES, MARCH 19, 2007
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 life. 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 responses to treatment, some patients 24 may have signs and symptoms that linger for months or even 25 years 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 20070H0798B0917 - 2 -
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. 20070H0798B0917 - 3 -
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. 20070H0798B0917 - 4 -
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 20070H0798B0917 - 5 -
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 20070H0798B0917 - 6 -
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 20070H0798B0917 - 7 -
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. L14L35VDL/20070H0798B0917 - 8 -