Mass. Lawmakers Propose Lyme Disease Insurance Bill

The measure would require insurance coverage for the clinical diagnosis and treatment of Lyme disease., a non-profit that calls themselves a “central voice for Lyme patients across the nation through advocacy, education and research,” has put out the call through the Massachusetts Legislative Lyme Task Force for residents and members to support a newly filed bill: House Docket No. 469/Senate Docket No. 985.

The bill, which was filed January 13, is titled “An Act Relative to Lyme Disease Treatment Coverage.” Filed in the House by Rep. David Linsky D-Natick, and in the Senate by Sen. Anne Gobi D-Spencer, the legislation aims to “provide insurance coverage for the clinical diagnosis and treatment of Lyme disease, when ordered by a licensed physician.”

Specifically, the bill’s language reads as follows:

Any policy, contract, agreement, plan or certificate of insurance issued, delivered or renewed within the Commonwealth that provides medical expense coverage shall provide coverage for long-term antibiotic therapy of Lyme disease when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient’s symptoms, diagnostic test results, or response to treatment. Long-term antibiotic therapy otherwise eligible for benefits pursuant to this section shall not be denied solely because such treatment may be characterized as unproven, experimental, or investigational in nature.

This is important legislation for the Commonwealth. According to the Mass. Dept. of Health and Human Services, Lyme disease is considered endemic in all parts of the state, especially in the eastern half, where there are areas of “high incidence.” In fact, Lyme disease rates grew 12 percent between 2012 and 2013 (the last year where the information is updated and available).

In 2013, the Globe reported that not only is Lyme disease controversial, it’s incredibly misunderstood. As the disease’s numbers have increased so has the divide between patients and the medical community over “whether the disease is chronic and antibiotics should be used long-term to manage symptoms,” the Globe reported.

This bill would set a standard to cover long-term antibiotic therapy and, perhaps, bridge some of that divide.