Maryland SB 596
The original bill (SB 596) was gutted by the Senate Health Committee (Senators Harris and Hollinger from Hopkins on committee), was totally rewritten and was then combined with another bill that would have established a Task Force on Lyme Disease. The resulting "mess" was eventually killed by patients and health care providers in order to protect residents with Lyme and those who would have contracted Lyme in the future. See comparison below.
Gutted & Rewritten Bill
http://mlis.state.md.us/2005rs/bills/sb/sb0596t.pdf
Original Bill- One of Two That Were Combined
UNOFFICIAL COPY OF SENATE BILL 596
J2 5lr2231
CF 5lr2230
____________________________________________________________________________________
By: Senators Colburn, Dyson, Jacobs, and Stoltzfus
Introduced and read first time: February 4, 2005
Assigned to: Education, Health, and Environmental Affairs and Finance
_____________________________________________________________________________________
A BILL ENTITLED
1 AN ACT concerning
2 Licensed Physicians - Treatment of Lyme Disease - Discipline - Insurance
3 Coverage
4 FOR the purpose of allowing certain licensed physicians to prescribe or dispense
5 certain treatment for certain individuals with lyme disease if certain
6 requirements are met; altering certain circumstances when the State Board of
7 Physician Quality Assurance may initiate certain disciplinary actions and
8 professional misconduct proceedings against certain licensed physicians;
9 requiring the Board to provide certain complaints to certain license physicians
10 within a certain time; establishing certain criteria for certain charges;
11 establishing certain requirements for certain notice of certain charges; requiring
12 certain insurance coverage for certain treatment; defining certain terms;
13 providing for the application of this Act; and generally relating to discipline and
14 insurance coverage for licensed physicians who provide treatment for lyme
15 disease.
16 BY adding to
17 Article - Health Occupations
18 Section 14-508
19 Annotated Code of Maryland
20 (2000 Replacement Volume and 2004 Supplement)
21 BY adding to
22 Article - Insurance
23 Section 15-841
24 Annotated Code of Maryland
25 (2002 Replacement Volume and 2004 Supplement)
26 BY adding to
27 Article - Health - General
28 Section 19-706(ddd)
29 Annotated Code of Maryland
30 (2000 Replacement Volume and 2004 Supplement)
2 UNOFFICIAL COPY OF SENATE BILL 596
1 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
2 MARYLAND, That the Laws of Maryland read as follows:
3 Article - Health Occupations
4 14-508.
5 (A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
6 INDICATED.
7 (2) (I) "CLINICAL DIAGNOSIS" MEANS THE OBSERVATION OF SIGNS
8 AND SYMPTOMS COMPATIBLE WITH ACUTE INFECTION OR OTHER CHRONIC
9 MANIFESTATIONS OF LYME DISEASE BY A LICENSED PHYSICIAN.
10 (II) "CLINICAL DIAGNOSIS" INCLUDES THE OBSERVATION OF
11 SURVEILLANCE CRITERIA SET FORTH BY THE UNITED STATES CENTERS FOR
12 DISEASE CONTROL AND PREVENTION.
13 (3) (I) "LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY"
14 MEANS THE ADMINISTRATION OF ORAL, INTRAMUSCULAR, OR INTRAVENOUS
15 ANTIBIOTICS OR ANTIMICROBIAL MEDICATIONS FOR A PERIOD GREATER THAN 4
16 WEEKS.
17 (II) "LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY"
18 INCLUDES SEPARATE AND COMBINATION ADMINISTRATION OF ANTIBIOTIC AND
19 ANTIMICROBIAL MEDICATIONS.
20 (4) "LYME DISEASE" MEANS AN ACUTE INFECTION WITH BORRELIA
21 BURGDORFERI OR RELATED BORRELIOSES.
22 (5) "RELATED TICK-BORNE ILLNESS" MEANS BARTONELLOSIS,
23 BABESIOSIS, OR PIROPLASMOSIS, OR OTHER TICK-TRANSMITTABLE ILLNESS THAT
24 MAY BE ASSOCIATED WITH LYME DISEASE.
25 (6) "THERAPEUTIC PURPOSE" MEANS THE USE OF ANTIBIOTICS TO
26 CONTROL THE SYMPTOMS OF LYME DISEASE AND OTHER RELATED TICK-BORNE
27 ILLNESSES AFTER CLINICAL DIAGNOSIS.
28 (B) IF AN INDIVIDUAL'S CLINICAL DIAGNOSIS AND TREATMENT PLAN ARE
29 DOCUMENTED IN THE INDIVIDUAL'S MEDICAL RECORD, A LICENSED PHYSICIAN MAY
30 PRESCRIBE OR DISPENSE LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY
31 FOR THERAPEUTIC PURPOSES TO THE INDIVIDUAL.
32 (C) IF A LICENSED PHYSICIAN PRESCRIBES OR DISPENSES LONG-TERM
33 ANTIBIOTIC OR ANTIMICROBIAL THERAPY UNDER SUBSECTION (B) OF THIS SECTION,
34 THE LICENSED PHYSICIAN MAY NOT BE SUBJECT TO A PROFESSIONAL MISCONDUCT
35 PROCEEDING OR A DISCIPLINARY ACTION BY THE BOARD.
3 UNOFFICIAL COPY OF SENATE BILL 596
1 (D) THIS SECTION DOES NOT PROHIBIT THE BOARD FROM DENYING,
2 REVOKING, OR SUSPENDING A LICENSE, DISCIPLINING, OR INITIATING A
3 PROFESSIONAL MISCONDUCT PROCEEDING AGAINST A LICENSED PHYSICIAN:
4 (1) FOR PRESCRIBING OR DISPENSING LONG-TERM ANTIBIOTIC OR
5 ANTIMICROBIAL THERAPY FOR A NONTHERAPEUTIC PURPOSE;
6 (2) FOR FAILING TO MONITOR THE ONGOING CARE OF AN INDIVIDUAL
7 RECEIVING LONG-TERM ANTIBIOTIC OR ANTIMICROBIAL THERAPY; OR
8 (3) FOR FAILING TO KEEP COMPLETE AND ACCURATE RECORDS OF THE
9 CLINICAL DIAGNOSIS AND TREATMENT OF AN INDIVIDUAL RECEIVING LONG-TERM
10 ANTIBIOTIC OR ANTIMICROBIAL THERAPY.
11 (E) (1) IF THE BOARD INITIATES A PROFESSIONAL MISCONDUCT
12 PROCEEDING AGAINST A LICENSED PHYSICIAN BASED ON A COMPLAINT FILED BY
13 AN INSURANCE COMPANY, PHARMACY BENEFIT MANAGER, OR COMPREHENSIVE
14 HEALTH SERVICES PLAN THAT WHOLLY OR PARTLY CONCERNS THE CLINICAL
15 DIAGNOSIS OR TREATMENT OF LYME DISEASE OR OTHER RELATED TICK-BORNE
16 ILLNESS, THE BOARD SHALL PROVIDE A COPY OF THE COMPLAINT TO THE LICENSED
17 PHYSICIAN WITHIN 10 DAYS AFTER RECEIVING THE LICENSED PHYSICIAN'S
18 REQUEST.
19 (2) IF CHARGES FOR PROFESSIONAL MISCONDUCT ARE FILED THAT
20 WHOLLY OR PARTLY CONCERN THE CLINICAL DIAGNOSIS OR TREATMENT OF LYME
21 DISEASE OR A RELATED TICK-BORNE ILLNESS, THE CHARGES SHALL CONTAIN A
22 STATEMENT OF FACTS SUFFICIENT TO ALLOW A JUDICIAL DETERMINATION ON
23 WHETHER THE CHARGES ARE PROPER UNDER THIS SECTION.
24 (3) NOTICE OF CHARGES FOR PROFESSIONAL MISCONDUCT THAT
25 WHOLLY OR PARTLY CONCERN THE CLINICAL DIAGNOSIS OR TREATMENT OF LYME
26 DISEASE OR A RELATED TICK-BORNE ILLNESS, SHALL INCLUDE THE IDENTITY OF
27 THE EXPERTS CONSULTED BY THE BOARD OR WHO WILL BE CALLED TO TESTIFY BY
28 THE BOARD AND THE SUBSTANCE OF EACH EXPERT'S OPINION.
29 Article - Insurance
30 15-841.
31 (A) THIS SECTION APPLIES TO:
32 (1) INSURERS AND NONPROFIT HEALTH SERVICE PLANS THAT PROVIDE
33 HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS ON AN
34 EXPENSE-INCURRED BASIS UNDER HEALTH INSURANCE POLICIES OR CONTRACTS
35 THAT ARE ISSUED OR DELIVERED IN THE STATE; AND
36 (2) HEALTH MAINTENANCE ORGANIZATIONS THAT PROVIDE HOSPITAL,
37 MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS UNDER CONTRACTS
38 THAT ARE ISSUED OR DELIVERED IN THE STATE.
4 UNOFFICIAL COPY OF SENATE BILL 596
1 (B) AN ENTITY SUBJECT TO THIS SECTION SHALL PROVIDE COVERAGE FOR
2 THE LONG-TERM ANTIBIOTIC AND ANTIMICROBIAL TREATMENT OF LYME DISEASE
3 AND RELATED TICK-BORNE ILLNESSES AS PROVIDED FOR UNDER § 14-508(B) OF THE
4 HEALTH OCCUPATIONS ARTICLE.
5 Article - Health - General
6 19-706.
7 (DDD) THE PROVISIONS OF § 15-841 OF THE INSURANCE ARTICLE SHALL APPLY
8 TO HEALTH MAINTENANCE ORGANIZATIONS.
9 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all
10 applicable disciplinary actions and professional misconduct proceedings pending on or
11 before the effective date of this Act and all proceedings initiated thereafter.
12 SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
13 July 1, 2005.
Bill gutted....
J2
5lr2231 CF 5lr2230
UNOFFICIAL COPY OF SENATE BILL 596
____________________________________________________________________________________ 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 _____________________________________________________________________________________ Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 24, 2005 _____________________________________________________________________________________
CHAPTER_______