2010 HB 290
Maryland HB-290
Update- For many reasons HB 290 was not supported by the majority of Maryland patients, the Lyme Disease Education and Support Groups of Maryland (LDESGM), the International Lyme and Associated Diseases Society (ILADS), the Maryland Board of Physicians, MEDCHI (Maryland State Medical Society), the Maryland Department of Health and Mental Hygiene (DHMH), the national Lyme Disease Association (LDA) and at least 22 additional Lyme disease support groups across the county.
HB 290 received an Unfavorable Report and was Withdrawn before it could advance out of the House Health and Government Operations Committee. Vote 23-0.
http://mlis.state.md.us/2010rs/votes_comm/hb0290_hgo.pdf
HB 290 (Bill Wording)
http://mlis.state.md.us/2010rs/bills/hb/hb0290f.pdf
Fiscal and Policy Note
http://mlis.state.md.us/2010rs/fnotes/bil_0000/hb0290.pdf
House Action
1/27
First Reading Health and Government Operations
Hearing 2/9 at 1:00 p.m.
1/29
Hearing cancelled
2/3
Hearing 2/11 at 1:00 p.m.
2/12
Hearing 2/17 at 1:00 p.m.
2/23
Unfavorable Report by Health and Government Operations Withdrawn
Bill Information:
http://mlis.state.md.us/2010rs/billfile/hb0290.htm
Letter to House Members
February 9, 2010
The Honorable Joseline A. Pena-Melnyk
cc: Maryland Health and Government Operations Committee Members
House Office Building
Room 209
6 Bladen Street
Annapolis, MD 21401
Dear Representative Pena-Melnyk,
I am contacting you on behalf of the undersigned organizations concerning HB 290, the Licensed Physicians – Treatment of Lyme Disease – Discipline bill. We learned about this bill a few days ago and attempted to contact your office, but severe weather conditions forced many offices to close. Thus, we were unsuccessful in communicating with you, and the hearing date was imminent. For that reason, we have proceeded to share our concerns with you and the entire committee through this letter.
Although we appreciate the rationale behind HB 290 and the intent of Maryland legislators to protect Lyme disease treating physicians and the patients they serve, the bill at this time is unnecessary, and rather than providing a remedy for a problem that is fairly well regulated in Maryland, this bill could place doctors in additional jeopardy.
Like all other physicians licensed in the State, those who treat Lyme patients can have their files examined if a complaint is filed, but there has not been a problem in Maryland to date with physicians being charged and sanctioned for long-term Lyme disease treatment. One of the main reasons for the status quo is that the same issues covered in HB 290 (doctor protection and ability to treat) have previously been addressed by the Maryland Board of Physicians, which has clearly stated its policies in the Fall 2005 Board of Physicians,Lyme Disease Advisory Subcommittee Report (pg 7). [i]
“The Maryland Board of Physicians ("the Board") is not targeting or restricting the treatment of Lyme Disease. There has never been a disciplinary action initiated against any physician for their treatment of Lyme Disease… The Maryland Board of Physicians does not support the concept of "immunization" of any physician from scrutiny because of the particular disease that he or she treats, the particular group of patients treated, or the location in which he or she practices. The Board, in its mission to license and regulate the practice of medicine in Maryland generally does not create, promulgate, or endorse in advance specific diagnostic or treatment guidelines regarding any disease state.”
Additionally, the Maryland Department of Health and Mental Hygiene (DHMH) in the March 2007, Report of the Lyme Disease Subcommittee of the Maryland Vector-Borne Disease Interagency Task Force to the Maryland Department of Health and Mental Hygiene (p. 12- Policy Issues)[ii] stated:
“In its Fall 2005 Newsletter5, the Board clarified that: § It does not target or restrict the treatment of LD. § It does not support the concept of “immunization” of any physician from scrutiny because of the particular disease, patients treated or location of practice. § The Board does not create, promulgate, or endorse in advance specific guidelines regarding any disease state.
Besides the fact that the issues addressed in HB 290 are presently covered in Maryland policy, there are unresolved legal issues that we anticipate may alter or possibly reverse current Lyme disease policies set forth by the Infectious Diseases Society of America (IDSA), which in turn could essentially modify the climate surrounding Lyme disease. The IDSA Lyme disease guidelines development process (two of its authors from Johns Hopkins) was investigated by Connecticut Attorney General Richard Blumenthal. His report included the following significant findings:
"The IDSA's 2006 Lyme disease guideline panel undercut its credibility by allowing individuals with financial interests -- in drug companies, Lyme disease diagnostic tests, patents and consulting arrangements with insurance companies -- to exclude divergent medical evidence and opinion. … The IDSA portrayed another medical association's Lyme disease guidelines [Neurology] as corroborating its own when it knew that the two panels shared several authors, including the chairmen of both groups, and were working on guidelines at the same time.” [iii]
The following section is included in a settlement agreement between Mr. Blumenthal and the IDSA, which requires IDSA to reconvene a new guidelines panel to assess whether the existent guidelines should stand or be changed. "… the [IDSA] panel will conduct an open scientific hearing at which it will hear scientific and medical presentations from interested parties... Once the panel has acted on each recommendation, it will have three options: make no changes, modify the guidelines in part or replace them entirely." [iv] That process is still unfinished.
The IDSA Guideline Review Panel met as required in Washington, DC on July 30, 2009. Over 1900 pages of analysis strongly contesting the IDSA Lyme disease recommendations were submitted by the International Lyme and Associated Diseases Society (ILADS). [v] The national Lyme Disease Association and numerous groups across the country submitted a rebuttal, as did the Lyme Disease Education and Support Groups of Maryland. To date, nothing has been forthcoming from the new panel, and a Freedom of Information Request (FOIA) on behalf of patients to the Attorney General of Connecticut regarding IDSA compliance has uncovered information that the panel appears to have violated the terms of the settlement agreement.
All these issues affect patient care. Therefore, we request that Maryland legislators at this time do not pass HB 290 which is currently unnecessary in Maryland, does not help chronic Lyme disease patients or their doctors, and is being considered while the state of Lyme disease is in flux. It is premature to enact Lyme-related laws in Maryland that could inadvertently prove to be counterproductive to the policies which are currently offering doctors protection.
The Lyme Disease Association (LDA) has worked with the Maryland legislature in the past providing testimony and also on March 9, 2007, providing a 20 minute presentation to the Maryland House Rural Caucus, where 40 delegates had requested an overview of Lyme disease, types of research being carried out on the disease in Maryland, and examples of why Maryland patients often cannot get diagnosed or treated. LDA hopes it can again through education and advocacy be a part of the process of protecting our patients in Maryland and the physicians who treat them.
Sincerely,
Patricia V. Smith
President, Lyme Disease Association for herself & the undersigned organizations
Lyme Disease Education & Support Groups of Maryland
Harford County Lyme Disease Support Group, Inc.
Mid-Shore Lyme Disease Association, Inc
Central Maryland Lyme Disease Support Group
Lyme Disease Association of Southeastern Pennsylvania, Inc.
Lyme Disease Association, Southeast Florida Chapter
Time for Lyme, Inc.
Brookfield/Wolfeboro, NH Lyme Support
Family Connections Center for Counseling
Lyme Disease Association, Corning/Finger Lakes Area Chapter
Lyme Disease Association, Pennsylvania Chapter
California Lyme Disease Association
Florida Lyme Advocacy
Hudson Valley Lyme Disease Association
Lyme Association of Greater Kansas City, Inc.
Lyme Disease Association, Rhode Island Chapter
Mid Missouri Tick Illness Coalition
Georgia Lyme Disease Association
Newton Lyme Disease Task Force
Minnesota Lyme Action Support Group
Texas Lyme Disease Association
Lyme Disease Association, Cape Cod Chapter
Ridgefield Lyme Disease Task Force
Footnotes/References
[i] Lyme Disease Advisory Subcommittee Report (pg 7)
http://www.mbp.state.md.us/forms/fall05.pdf
[ii] Report of the Lyme Disease Subcommittee of the Maryland Vector-Borne Disease Interagency Task Force to the Maryland Department of Health and Mental Hygiene (p. 12- Policy Issues)
http://www.edcp.org/vet_med/pdf/Recommendations_LD_Plan07.pdf
[iii] Attorney General Richard Blumenthal Press Release
http://www.ct.gov/ag/cwp/view.asp?a=2795&q=414284
iv Attorney General Richard Blumenthal Press Release
http://www.ct.gov/ag/cwp/view.asp?a=2795&q=414284
[v] IL[v] Attorney General Richard Blumenthal Press Release
http://www.ct.gov/ag/cwp/view.asp?a=2795&q=414284ADS Submits