Chapter
04-034
2004 -- H 7240
Enacted 06/08/04
A N A C T
RELATING
TO HEALTH AND SAFETY -- LYME DISEASE AND TREATMENT
Introduced
By: Representatives Gallison, Giannini, Winfield, Anguilla, and Enos
Date
Introduced: January 15, 2004
It
is enacted by the General Assembly as follows:
SECTION
1. Section 5-37.5-5 of the General Laws in Chapter 5-37.5 entitled "Lyme
Disease
Diagnosis and Treatment" is hereby amended to read as follows:
5-37.5-5.
Mandatory coverage for certain Lyme disease treatments. [Effective until
December
31, 2004.] -- Every individual or group hospital or medical expense
insurance policy
or
individual or group hospital or medical services plan contract delivered,
issued for delivery, or
renewed
in this state on or after January 1, 2004, shall provide for Lyme disease
treatment as
provided
in chapters 27-18, 27-19, 27-20, and 27-41 of the general laws.
SECTION
2. Section 27-18-62 of the General Laws in Chapter 27-18 entitled
"Accident
and
Sickness Insurance Policies" is hereby amended to read as follows:
27-18-62.
Mandatory coverage for certain lyme disease treatments. [Effective until
December
31, 2004.] -- Every individual or group hospital or medical expense insurance
policy
or
individual or group hospital or medical services plan contract delivered,
issued for delivery, or
renewed
in this state on or after January 1, 2004 shall provide coverage for diagnostic
testing and
long-term
antibiotic treatment of chronic lyme disease when determined to be medically
necessary
and ordered by a physician acting in accordance with chapter 37.5 of title 5
entitled
"lyme
disease diagnosis and treatment" after making a thorough evaluation of the
patient's
symptoms,
diagnostic test results and response to treatment. Treatment otherwise eligible
for
benefits
pursuant to this section shall not be denied solely because such treatment may
be
characterized
as unproven, experimental, or investigational in nature. Provided, however,
this
section
shall not apply to insurance coverage providing benefits for:
(1) Hospital confinement indemnity;
(2) Disability income;
(3) Accident only;
(4) Long-term care;
(5) Medicare supplement;
(6) Limited benefit health;
(7) Specified disease indemnity;
(8) Sickness or bodily injury or death by accident or both; and
(9) Other limited benefit policies.
SECTION
3. Section 27-19-53 of the General Laws in Chapter 27-19 entitled
"Nonprofit
Hospital
Service Corporations" is hereby amended to read as follows:
27-19-53.
Mandatory coverage for certain lyme disease treatments. [Effective until
December
31, 2004.] -- Every individual or group hospital or medical expense
insurance policy
or individual
or group hospital or medical services plan contract delivered, issued for
delivery, or
renewed
in this state on or after January 1, 2004 shall provide coverage for diagnostic
testing and
long
term antibiotic treatment of chronic lyme disease when determined to be
medically
necessary
and ordered by a physician acting in accordance with chapter 37.5 of title 5
entitled
"lyme
disease diagnosis and treatment" after making a thorough evaluation of the
patient's
symptoms,
diagnostic test results and response to treatment. Treatment otherwise eligible
for
benefits
pursuant to this section shall not be denied solely because such treatment may
be
characterized
as unproven, experimental, or investigational in nature.
SECTION
4. Section 27-20-48 of the General Laws in Chapter 27-20 entitled
"Nonprofit
Medical
Service Corporations" is hereby amended to read as follows:
27-20-48.
Mandatory coverage for certain lyme disease treatments. [Effective until
December
31, 2004.] -- Every individual or group hospital or medical expense
insurance policy
or
individual or group hospital or medical services plan contract delivered,
issued for delivery, or
renewed
in this state on or after January 1, 2004 shall provide coverage for diagnostic
testing and
long-term
antibiotic treatment of chronic lyme disease when determined to be medically
necessary
and ordered by a physician acting in accordance with chapter 37.5 of title 5
entitled
"lyme
disease diagnosis and treatment" after making a thorough evaluation of the
patient's
symptoms,
diagnostic test results and response to treatment. Treatment otherwise eligible
for
benefits
pursuant to this section shall not be denied solely because such treatment may
be
characterized
as unproven, experimental, or investigational in nature.
SECTION
5. Section 27-41-65 of the General Laws in Chapter 27-41 entitled "Health
Maintenance
Organizations" is hereby amended to read as follows:
27-41-65.
Mandatory coverage for certain lyme disease treatments. [Effective until
December
31, 2004.] -- Subscribers to any health maintenance organization plan
shall be
afforded
coverage under that plan on or after January 1, 2004 for diagnostic testing and
long term
antibiotic
treatment of chronic lyme disease when determined to be medically necessary and
ordered
by a physician acting in accordance with chapter 37.5 of title 5 entitled
"lyme disease
diagnosis
and treatment" after making a thorough evaluation of the patient's
symptoms,
diagnostic
test results and response to treatment. Treatment otherwise eligible for
benefits
pursuant
to this section shall not be denied solely because such treatment may be
characterized as
unproven,
experimental, or investigational in nature.
SECTION
6. Section 7 of chapter 113 of the Rhode Island Public Laws 2003 is hereby
amended
to read as follows:
Section
7. This act shall take effect upon passage. and shall expire on
December 31,
2004.
SECTION
7. Section 7 of chapter 114 of the Rhode Island Public Laws 2003 is hereby
amended
to read as follows:
Section
7. This act shall take effect upon passage. and shall expire on
December 31,
2004.
SECTION
8. This act shall take effect upon passage.
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LC00689
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