An Act To Implement the Recommendations of the Joint Standing Committee on Insurance and Financial Services Regarding Reporting on Lyme Disease and Other Tick-borne Illnesses
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 22 MRSA c. 266-B is enacted to read:
CHAPTER 266-B
LYME DISEASE AND OTHER TICK-BORNE ILLNESSES
1. Report contents. The Maine Center for Disease Control and Prevention shall, on an ongoing basis, monitor, review and evaluate Lyme disease and other tick-borne illnesses in this State and shall submit an annual report in accordance with this subsection and subsection 2. The report must include at a minimum and to the extent information is available: A. The incidence of Lyme disease and other tick-borne illnesses in this State;
B. The treatment guidelines for Lyme disease recommended by the Maine Center for Disease Control and Prevention and the federal Centers for Disease Control and Prevention;
C. A scientific review of peer-reviewed medical literature and studies for the treatment of Lyme disease and other tick-borne illnesses, including, but not limited to, the recognition of chronic Lyme disease and the use of long-term antibiotic treatment;
D. The education, training and guidance provided by the Maine Center for Disease Control and Prevention to health care professionals on the current methods of diagnosing and treating Lyme disease and other tick-borne illnesses;
E. The education and public awareness activities conducted by the Maine Center for Disease Control and Prevention for the prevention of Lyme disease and other tick-borne illnesses; and
F. The laws of other states related to the diagnosis, treatment and insurance coverage for Lyme disease and other tick-borne illnesses.
2. Annual report. Beginning February 1, 2009 and annually by February 1st thereafter, the Maine Center for Disease Control and Prevention shall submit a report to the joint standing committee of the Legislature having jurisdiction over health and human services matters and the joint standing committee of the Legislature having jurisdiction over health insurance matters. In addition to the information required under subsection 1, the report may include recommendations for legislation to address public health programs for the prevention and treatment of Lyme disease and other tick-borne illnesses in this State.
Sec. 2. 24-A MRSA §4302, sub-§5 is enacted to read:
5. Annual report; claims for treatment of Lyme disease and other tick-borne illnesses. By February 1st of each year, all carriers shall file with the superintendent for the most recent calendar year for all covered individuals in the State the total claims made for the treatment of Lyme disease and other tick-borne illnesses. The filing must include information on the number of claims made for the treatment of Lyme disease and other tick-borne illnesses, the total dollar amount of those claims, the number of claim denials and the reasons for those denials, the number and outcome of internal appeals and the number of external appeals related to the treatment of Lyme disease and other tick-borne illnesses. The superintendent shall compile from all carriers this data in an annual report and submit the report by March 15th of each year to the joint standing committee of the Legislature having jurisdiction over health insurance matters.
SUMMARY
This bill is a recommendation of the majority of the Joint Standing Committee on Insurance and Financial Services, and is the result of the committee’s study and review of issues regarding Lyme disease and other tick-borne illnesses, which took place between the First Regular Session and Second Regular Session of the 123rd Legislature. The bill requires the Department of Health and Human Services, Maine Center for Disease Control and Prevention to report annually beginning February 1, 2009 to the Legislature on the incidence of Lyme disease and other tick-borne illnesses in the State, the recommended treatment guidelines for Lyme disease, medical studies on the treatment of Lyme disease and other tick-borne illnesses and the activities of the Maine Center for Disease Control and Prevention focused on education, prevention and treatment of Lyme disease and other tick-borne illnesses. The bill also requires that health insurers and the Superintendent of Insurance report annually on health insurance claims for the treatment Lyme disease and other tick-borne illnesses, including information on the number of approved claims, claim denials and the outcome of both internal and external appeals processes.