UNOFFICIAL COPY OF SENATE BILL 596
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By: Senators Colburn, Dyson, Jacobs, and Stoltzfus Stoltzfus, Hollinger,
Conway, Britt, Brochin, Greenip, Grosfeld, Harris, Kittleman, and
Pinsky
Introduced and read first time: February 4, 2005
Assigned to: Education, Health, and Environmental Affairs and Finance
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Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 24, 2005
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CHAPTER_______
1 AN ACT concerning
2 Licensed Physicians - Treatment of Lyme Disease - Discipline - Insurance
3 Coverage
4 State Board of Physicians - Information Regarding Lyme Disease and Other
5 Tick-Borne Illness
6 FOR the purpose of allowing certain licensed physicians to prescribe or dispense
7 certain treatment for certain individuals with lyme disease if certain
8 requirements are met; altering certain circumstances when the State Board of
9 Physician Quality Assurance may initiate certain disciplinary actions and
10 professional misconduct proceedings against certain licensed physicians;
11 requiring the Board to provide certain complaints to certain license physicians
12 within a certain time; establishing certain criteria for certain charges;
13 establishing certain requirements for certain notice of certain charges; requiring
14 certain insurance coverage for certain treatment; defining certain terms;
15 providing for the application of this Act; and generally relating to discipline and
16 insurance coverage for licensed physicians who provide treatment for lyme
17 disease requiring the State Board of Physicians to develop and disseminate a
18 document to certain licensees regarding certain diagnosis and treatment
19 information for Lyme disease and other tick-borne illness; requiring the
20 document developed and disseminated by the Board to include certain
21 information regarding the use of certain antibiotic or antimicrobial therapy;
22 requiring the document to be distributed annually; and generally relating to the
23 development and dissemination of information regarding Lyme disease and
24 other tick-borne illness.
2 UNOFFICIAL COPY OF SENATE BILL 596
1 BY adding to
2 Article - Health Occupations
3 Section 14-508
4 Annotated Code of Maryland
5 (2000 Replacement Volume and 2004 Supplement)
6 BY adding to
7 Article - Insurance
8 Section 15-841
9 Annotated Code of Maryland
10 (2002 Replacement Volume and 2004 Supplement)
11 BY adding to
12 Article - Health - General
13 Section 19-706(ddd)
14 Annotated Code of Maryland
15 (2000 Replacement Volume and 2004 Supplement)
16 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
17 MARYLAND, That the Laws of Maryland read as follows:
18 Article - Health Occupations
19 14-508.
20 (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
21 INDICATED.
(2) (I) "CLINICAL DIAGNOSIS" MEANS THE OBSERVATION OF SIGNS
23 AND SYMPTOMS COMPATIBLE WITH ACUTE INFECTION OR OTHER CHRONIC
24 MANIFESTATIONS OF LYME DISEASE BY A LICENSED PHYSICIAN.
25 (II) "CLINICAL DIAGNOSIS" INCLUDES THE OBSERVATION OF
26 SURVEILLANCE CRITERIA SET FORTH BY THE UNITED STATES CENTERS FOR
27 DISEASE CONTROL AND PREVENTION.
28 (3) (I) "LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY"
29 MEANS THE ADMINISTRATION OF ORAL, INTRAMUSCULAR, OR INTRAVENOUS
30 ANTIBIOTICS OR ANTIMICROBIAL MEDICATIONS FOR A PERIOD GREATER THAN 4
31 WEEKS.
32 (II) "LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY"
33 INCLUDES SEPARATE AND COMBINATION ADMINISTRATION OF ANTIBIOTIC AND
34 ANTIMICROBIAL MEDICATIONS.
35 (4) "LYME DISEASE" MEANS AN ACUTE INFECTION WITH BORRELIA
36 BURGDORFERI OR RELATED BORRELIOSES.
3 UNOFFICIAL COPY OF SENATE BILL 596
1 (5) "RELATED TICK-BORNE ILLNESS" MEANS BARTONELLOSIS,
2 BABESIOSIS, OR PIROPLASMOSIS, OR OTHER TICK-TRANSMITTABLE ILLNESS THAT
3 MAY BE ASSOCIATED WITH LYME DISEASE.
4 (6) "THERAPEUTIC PURPOSE" MEANS THE USE OF ANTIBIOTICS TO
5 CONTROL THE SYMPTOMS OF LYME DISEASE AND OTHER RELATED TICK-BORNE
6 ILLNESSES AFTER CLINICAL DIAGNOSIS.
7 (B) IF AN INDIVIDUAL'S CLINICAL DIAGNOSIS AND TREATMENT PLAN ARE
8 DOCUMENTED IN THE INDIVIDUAL'S MEDICAL RECORD, A LICENSED PHYSICIAN MAY
9 PRESCRIBE OR DISPENSE LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY
10 FOR THERAPEUTIC PURPOSES TO THE INDIVIDUAL.
11 (C) IF A LICENSED PHYSICIAN PRESCRIBES OR DISPENSES LONG-TERM
12 ANTIBIOTIC OR ANTIMICROBIAL THERAPY UNDER SUBSECTION (B) OF THIS SECTION,
13 THE LICENSED PHYSICIAN MAY NOT BE SUBJECT TO A PROFESSIONAL MISCONDUCT
14 PROCEEDING OR A DISCIPLINARY ACTION BY THE BOARD.
15 (D) THIS SECTION DOES NOT PROHIBIT THE BOARD FROM DENYING,
16 REVOKING, OR SUSPENDING A LICENSE, DISCIPLINING, OR INITIATING A
17 PROFESSIONAL MISCONDUCT PROCEEDING AGAINST A LICENSED PHYSICIAN:
18 (1) FOR PRESCRIBING OR DISPENSING LONG-TERM ANTIBIOTIC OR
19 ANTIMICROBIAL THERAPY FOR A NONTHERAPEUTIC PURPOSE;
20 (2) FOR FAILING TO MONITOR THE ONGOING CARE OF AN INDIVIDUAL
21 RECEIVING LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY; OR
22 (3) FOR FAILING TO KEEP COMPLETE AND ACCURATE RECORDS OF THE
23 CLINICAL DIAGNOSIS AND TREATMENT OF AN INDIVIDUAL RECEIVING LONG-TERM
24 ANTIBIOTIC OR ANTIMICROBIAL THERAPY.
25 (E) (1) IF THE BOARD INITIATES A PROFESSIONAL MISCONDUCT
26 PROCEEDING AGAINST A LICENSED PHYSICIAN BASED ON A COMPLAINT FILED BY
27 AN INSURANCE COMPANY, PHARMACY BENEFIT MANAGER, OR COMPREHENSIVE
28 HEALTH SERVICES PLAN THAT WHOLLY OR PARTLY CONCERNS THE CLINICAL
29 DIAGNOSIS OR TREATMENT OF LYME DISEASE OR OTHER RELATED TICK-BORNE
30 ILLNESS, THE BOARD SHALL PROVIDE A COPY OF THE COMPLAINT TO THE LICENSED
31 PHYSICIAN WITHIN 10 DAYS AFTER RECEIVING THE LICENSED PHYSICIAN'S
32 REQUEST.
33 (2) IF CHARGES FOR PROFESSIONAL MISCONDUCT ARE FILED THAT
34 WHOLLY OR PARTLY CONCERN THE CLINICAL DIAGNOSIS OR TREATMENT OF LYME
35 DISEASE OR A RELATED TICK-BORNE ILLNESS, THE CHARGES SHALL CONTAIN A
36 STATEMENT OF FACTS SUFFICIENT TO ALLOW A JUDICIAL DETERMINATION ON
37 WHETHER THE CHARGES ARE PROPER UNDER THIS SECTION.
38 (3) NOTICE OF CHARGES FOR PROFESSIONAL MISCONDUCT THAT
39 WHOLLY OR PARTLY CONCERN THE CLINICAL DIAGNOSIS OR TREATMENT OF LYME
40 DISEASE OR A RELATED TICK-BORNE ILLNESS, SHALL INCLUDE THE IDENTITY OF
4 UNOFFICIAL COPY OF SENATE BILL 596
1 THE EXPERTS CONSULTED BY THE BOARD OR WHO WILL BE CALLED TO TESTIFY BY
2 THE BOARD AND THE SUBSTANCE OF EACH EXPERT'S OPINION.
3 Article - Insurance
4 15-841.
5 (A) THIS SECTION APPLIES TO:
6 (1) INSURERS AND NONPROFIT HEALTH SERVICE PLANS THAT PROVIDE
7 HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS ON AN
8 EXPENSE-INCURRED BASIS UNDER HEALTH INSURANCE POLICIES OR CONTRACTS
9 THAT ARE ISSUED OR DELIVERED IN THE STATE; AND
10 (2) HEALTH MAINTENANCE ORGANIZATIONS THAT PROVIDE HOSPITAL,
11 MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS UNDER CONTRACTS
12 THAT ARE ISSUED OR DELIVERED IN THE STATE.
13 (B) AN ENTITY SUBJECT TO THIS SECTION SHALL PROVIDE COVERAGE FOR
14 THE LONG-TERM ANTIBIOTIC AND ANTIMICROBIAL TREATMENT OF LYME DISEASE
15 AND RELATED TICK-BORNE ILLNESSES AS PROVIDED FOR UNDER § 14-508(B) OF THE
16 HEALTH OCCUPATIONS ARTICLE.
17 Article - Health - General
18 19-706.
19 (DDD) THE PROVISIONS OF § 15-841 OF THE INSURANCE ARTICLE SHALL APPLY
20 TO HEALTH MAINTENANCE ORGANIZATIONS.
21 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all
22 applicable disciplinary actions and professional misconduct proceedings pending on or
23 before the effective date of this Act and all proceedings initiated thereafter.
24 (A) THE BOARD SHALL DEVELOP AND DISSEMINATE A DOCUMENT TO ALL
25 LICENSEES REGARDING THE MOST RECENT DIAGNOSIS AND TREATMENT
26 INFORMATION FOR LYME DISEASE AND OTHER RELATED TICK-BORNE ILLNESS.
27 (B) THE DOCUMENT DEVELOPED AND DISSEMINATED UNDER SUBSECTION
28 (A) OF THIS SECTION SHALL:
29 (1) INCLUDE THE MOST RECENT INFORMATION REGARDING THE USE OF
30 LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY; AND
31 (2) BE DISTRIBUTED ANNUALLY.
32 SECTION 3. 2. AND BE IT FURTHER ENACTED, That this Act shall take
33 effect July 1, 2005.
5 UNOFFICIAL COPY OF SENATE BILL 596