HB 629 — An Act providing for patient access to diagnostics and treatments for Lyme disease and related tick-borne illnesses; and requiring health care policies to provide certain coverage.

PRIOR PRINTER'S NO.

624 PRINTER'STHE NO.GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

1090 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

MILLER, JOZWIAK, FREEMAN, BOBACK, MACKENZIE, OTTEN, DeLUCA, CAUSER, PICKETT, LAWRENCE, B.

MILLER, GILLEN, GABLER,GABLER MASSER, ECKER, RAVENSTAHL, HANBIDGE, MILLARD, EVERETT, EMRICK AND FRITZ,MASSER, FEBRUARY 28, 2019 ASREFERRED REPORTEDTO FROM COMMITTEE ON HEALTH, HOUSEFEBRUARY OF28, REPRESENTATIVES, AS AMENDED, MARCH 25, 2019 AN ACT Providing for patient access to diagnostics and treatments for Lyme disease and related tick-borne illnesses;

(1) From 2002 1990 to 2017, Pennsylvania reported 79,283 <-- 116,824 confirmed cases of Lyme disease and in 2017 reported <-- 10,001 11,900 new cases, ranking highest in the nation in <-- confirmed cases for the last seven years.

BECAUSE THE UNITED <-- STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL AND PREVENTION ESTIMATES CASES MAY BE UNDERREPORTED BY A FACTOR OF 10, IT IS ESTIMATED THAT THE NUMBER OF LYME DISEASE CASES IN PENNSYLVANIA IN 2017 WAS CLOSER TO 119,000.

yet, in 2016, the National Guideline <-- Clearinghouse (NGC) maintains only the International Lyme and Associated Diseases Society's (ILADS) guidelines, which guidelines were updated in 2015 and met the more stringent evidence criteria introduced by the NGC in 2014.

The Infectious Diseases Society of America's (IDSA) guidelines were removed from the NGC in 2015 because they were "outdated and not in compliance with current standards.".standards." (6) A 2013 Centers for Disease Control and Prevention (CDC) study found that only 39% of individuals with Lyme disease were treated using short-term antibiotic recommendations from the IDSA guidelines.

<--The (6)majority A 2013 Centers for Disease Control and Prevention (CDC) study found that only 39% of the individuals with Lyme 20190HB0629PN1090 - 2 - disease were treated usingfor short-termlonger antibioticperiods, <--more recommendationsin fromline with the IDSAILADS guidelinesrecommendations. ANTIBIOTICS.

The <-- majority of the individuals were treated for longer periods, <-- more in line with the ILADS recommendations.

20190HB0629PN0624 - 2 - Section 3.

(i) The act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921,1921. INCLUDING SECTION <-- 630 AND ARTICLE XXIV OF THE ACT.

(2) The term does not include accident only, fixed indemnity, limited benefit, credit, dental, vision, specified 20190HB0629PN1090 - 3 - disease, Medicare supplement, Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement, long- term care or disability income, workers' compensation or automobile medical payment insurance.

20190HB0629PN0624 - 3 - mayonii, B.

The health care practitioner must document the 20190HB0629PN1090 - 4 - diagnosis and treatment in the patient's medical records.

(1) Every health insurance policy which is delivered, issued for delivery, renewed, extended or modified in this Commonwealth shall cover the prescribed treatment for Lyme disease and related tick-borne illnesses if the diagnosis and treatment plan are documented in the patient's medical 20190HB0629PN0624 - 4 - record.

(2) Coverage of longer-term antibiotic treatment shall <-- MAY not be denied solely because the treatment may be <-- characterized as unproven, experimental or investigational in nature for the treatment of Lyme disease and related tick- borne illnesses.

(b) Construction.--Nothing in this section shall be construed to deny the right of a licensing board to deny, revoke or suspend the license of or to discipline any health care 20190HB0629PN1090 - 5 - practitioner who:

or (3) fails to keep complete and accurate records of the diagnosis, treatment and response to treatment of a patient receiving longer-term antibiotic treatment relating to Lyme 20190HB0629PN0624 - 5 - disease or a related tick-borne illness.

SECTIONSection 7.

APPLICABILITY.

<-- (A) HEALTH INSURANCE POLICIES.--THIS ACT SHALL APPLY TO HEALTH INSURANCE POLICIES AS FOLLOWS:

(1) FOR A HEALTH INSURANCE POLICY FOR WHICH EITHER RATES OR FORMS ARE REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT OR THE INSURANCE DEPARTMENT, THIS ACT SHALL APPLY TO ANY POLICY FOR WHICH A FORM OR RATE IS FIRST FILED ON OR AFTER 180 DAYS AFTER THE DATE OF ENACTMENT OF THIS ACT.

(2) FOR A HEALTH INSURANCE POLICY FOR WHICH NEITHER RATES NOR FORMS ARE REQUIRED TO BE FILED WITH THE FEDERAL GOVERNMENT OR THE INSURANCE DEPARTMENT, THIS ACT SHALL APPLY TO ANY POLICY ISSUED OR RENEWED ON OR AFTER 180 DAYS AFTER THE DATE OF ENACTMENT OF THIS ACT.

(B) CONTRACTS.--THIS ACT SHALL APPLY TO CONTRACTS BETWEEN HEALTH CARE PRACTITIONERS AND INSURERS THAT ARE EXECUTED OR RENEWED ON OR AFTER 180 DAYS AFTER THE DATE OF ENACTMENT OF THIS ACT.

Section 7 8.

<-- This act shall take effect in 180 days.

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