What's happening
This bill requires health insurance to cover more comprehensive Lyme disease testing, including both ELISA and western blot tests, when ordered by a doctor.
Why it matters
Reduces barriers to Lyme disease diagnosis. By requiring insurance to cover both ELISA and western blot tests whenever a doctor orders them, this bill eliminates some of the common insurance hurdles that can delay or prevent timely diagnosis and treatment for patients with suspected Lyme disease.
Empowers doctors to order comprehensive testing. Coverage is based solely on a doctor's order, not on previous test results or whether tests are done sequentially or together. This gives healthcare providers more flexibility to use their clinical judgment and potentially improves the accuracy of Lyme disease detection.
Addresses insurance inconsistencies. The bill closes loopholes that let insurers deny coverage for certain Lyme tests or require strict testing sequences, which can help ensure that patients receive the full range of recommended diagnostic tools as part of their covered benefits.
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Who cares
Headline styles
Expand Lyme Disease Testing
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to insurance
Full text
1 pageUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
7753
IN SENATE
February 16, 2018
Introduced by Sen. RITCHIE -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law, in relation to requiring that more expansive Lyme disease testing be offered as part of most laboratory tests covered by health insurance
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Subsection (i) of section 3216 of the insurance law is amended by adding a new paragraph 34 to read as follows:
(34) For the purposes of this subsection, whenever laboratory tests shall be required to be covered, such tests shall include testing for Lyme disease. Coverage shall include at minimum both the enzyme-linked immunosorbent assay (ELISA) and western blot tests, regardless of whether they were conducted consecutively or simultaneously. Coverage shall not be contingent on such results of either test. Rather, coverage shall be contingent only on such test having been administered pursuant to a doctor's order.
§ 2. This act shall take effect on the one hundred twentieth day after it shall have become a law; provided however, that effective immediately, the addition, amendment, and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized to be made and completed on or before such effective date.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD14212-01-8
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Sponsor's memo
Title of bill
An act to amend the insurance law, in relation to requiring that more expansive Lyme disease testing be offered as part of most laboratory tests covered by health insurance
Purpose
To reduce the long-term effects of Lyme disease due to patients going undiagnosed, by requiring insurance coverage for Lyme disease tests whenever laboratory testing is required to be covered under the insur- ance law.
Summary of provisions
Section 1 adds a new paragraph to the insurance law, requiring that Lyme disease testing shall be included as covered by insurance whenever labo- ratory testing is required to be covered under the insurance law. The section requires both enzyme-linked immunosorbent assay tests and west- ern blot tests be covered at minimum, and requires coverage whenever a doctor orders the test, regardless of the outcome of the test.
Section 2 provides the effective date.
Justification
The Center for Disease Control estimates that Lyme disease is the fast- est growing vector borne infectious disease in the United States. Each year, 30,000 cases of Lyme disease are reported to the Center for Disease Control by state health departments, but most researchers agree that only a fraction of the individuals infected are ever actually diag- nosed. Two national studies undertaken by researchers for the Center for Disease Control estimated that 300,000 people are actually infected with the disease each year.
The underreporting of Lyme disease cases, especially among individuals in the Northeastern United States, where the disease is most prevalent, results in serious long-term complications for millions of people infected with the disease who go undiagnosed. Over 40 percent of people infected with Lyme disease suffer long-term health problems because their infection went undetected. Unfortunately, the average patient sees five doctors over nearly two years before being diagnosed and tested for the disease.
Providing physicians with the means to regularly test for the disease is critically important to help doctors diagnose the disease early enough to allow treatment that can prevent many of the long-term complications that are common when Lyme disease is not detected at its early stages.
This legislation amending the insurance law to require that the costs of Lyme disease testing be included in health insurance coverage for labo- ratory testing will insure that the costs of testing are covered by insurance, making it possible for patients to learn whether they have contracted the disease. Prompt diagnosis and proper treatment are crit- ical to preventing medical complications of Lyme disease.
Legislative history
New Bill.
Fiscal implications
None to the state.
Effective date
This act shall take effect on the one hundred twentieth day after it shall have become a law; provided however, that effective immediately, the addition, amendment, and/or repeal of any rule or regulation neces- sary for the implementation of this act on its effective date are authorized to be made and completed on or before such effective date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.