Speliotis Files Bill to Require Health Insurers Expand Coverage for Lyme Disease

You can likely get Lyme disease insurance coverage for your horse, but humans aren't so fortunate in most states across the country.

State Rep. Ted Speliotis, who represents West Peabody along with Danvers and part of Middleton, is hoping to change that situation in Massachusetts. He has introduced a bill that would require health insurers to cover long-term treatment (antibiotics) doctors may prescribe for patients with Lyme disease.

As it is now, insurers generally cover up to 28 days of treatment, but can deny coverage for Lyme disease, forcing patients to pay those full costs out of their own pockets.

Earlier this year, Speliotis hosted a Lyme Disease Awareness Day at the State House where he was joined by Danvers resident Susan Fairbank-Pitzer, Lyme disease organizations from across the state and numerous experts on the disease.

“I’m amazed at how many people’s lives are affected by this very serious disease. Lyme disease is often misdiagnosed and many people suffer for very long periods of time before they are diagnosed and treated properly,” said Speliotis at the time. “Our current laws fall far short in ensuring that folks get covered for the treatment they need.”

The event was aimed at drawing attention to what these organizations say is an "insidious tick-borne disease that is a burgeoning health threat to the people of Massachusetts."

They say thousands of cases are reported each year in the Bay State and many more go unreported because tick-borne diseases are often tricky to properly diagnose. Lyme disease and related co-infections, if not treated properly, can cause long-term physical and neurological problems.

House Bill 989: "An Act relative to Lyme Disease treatment coverage" will now be heard before the legislature's Joint Committee on Financial Services Wednesday afternoon. The hearing is scheduled for 1 p.m. (Hearing Room A-2).

Speliotis said Wednesday there were about 5,000 cases reported last year, but advocates tell him the number of infections might have really been 50,000-60,000 due to unreported cases or misdiagnoses.

Speliotis says, yes, early detection and diagnosis can mean the difference between a short-lived and very treatable illness and months or years of debilitating sickness, but the point of this bill is to make sure those people who have been misdiagnosed can get the treatment they need.

Part of the legislative process will also be to generate a cost analysis.

This past May, Gov. Deval Patrick did declare May to be Lyme Disease Awareness Month, and in 2010, Patrick also signed legislation to allow doctors to clinically diagnose and treat patients long-term for Lyme Disease.

The law also prevents the state medical board from bringing charges against a physician for prescribing long-term antibiotic treatment for those patients.

"The advocates are calling this a patient-protection act," Speliotis said, noting the aforementioned law for physicians. "They'd [patients] like to be protected too."

The law he is proposing now is open-ended on duration for treatment, which is in line with existing laws in other states (Connecticut and Rhode Island), Speliotis said, but he is open to refining the language to "get a good bill."

He believes there's a broad base of support for the effort, but says there is a certain element within the medical community that believes the disease is properly treated and dealt with now.

Speliotis said his main goal is to bring health insurers, lawmakers, patients and other stakeholders together on the issue and make sure people get the treatment they need.
 
You can find out more information about Lyme disease and legislation here.