What's happening
This bill requires insurance and workers' compensation to cover long-term treatment for Lyme disease and other tick-borne illnesses.
Why it matters
Expands medical coverage for chronic Lyme and tick-borne illnesses beyond standard care. , mandating insurance to pay for extended antibiotic treatments (minimum 30 days IV, 60 days oral, and more if a NY-licensed physician recommends), which could help patients with persistent or severe symptoms who often struggle to get care covered.
Recognizes Lyme and other tick-borne diseases as valid causes for disability under workers’ compensation. , especially for those whose work involves outdoor activity or animal treatment, potentially making it easier for affected workers to access benefits and job protections.
Shifts decision-making power to treating physicians regarding the length and type of treatment. , limiting insurance companies’ ability to deny or restrict care based on rigid protocols, which could improve patient outcomes but may also impact insurance costs or premiums.
Addresses a significant gap for patients whose symptoms persist after short-term treatment. a group often caught in medical and insurance disputes—by guaranteeing coverage for continued care if medically justified, which could reduce personal financial burdens and improve quality of life.
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Who cares
Headline styles
Mandate Lyme Disease Coverage
Plain English, a few words. Used as the page title.
Sponsors
2 Co-sponsors
History
- Referred to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Cover Lyme Disease Treatment
In Assembly Committee · Insurance · Sponsor Monica P. Wallace
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
4186
2019-2020 Regular Sessions
IN SENATE
March 4, 2019
Introduced by Sen. KENNEDY -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance
AN ACT to amend the insurance law and the workers' compensation law, in relation to coverage of long term medical care for Lyme disease and other tick borne related pathogens
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 35 to read as follows:
(35) Every insurer issuing a policy of accident and health insurance for delivery in this state shall provide coverage for all costs for treatment of Lyme disease (Lyme borreliosis) and other tick borne related pathogens. Such treatment shall include not less than thirty days of intravenous antibiotic therapy, sixty days of oral antibiotic therapy, or both, and shall provide further treatment if recommended by a physician licensed to practice medicine in the state of New York.
§ 2. Subsection (l) of section 3221 of the insurance law is amended by adding a new paragraph 21 to read as follows:
(21) Every group or blanket policy delivered or issued for delivery in this state which provides hospital, surgical or medical coverage shall provide coverage for all costs for treatment of Lyme disease (Lyme borreliosis) and other tick borne related pathogens. Such treatment shall include not less than thirty days of intravenous antibiotic therapy, sixty days of oral antibiotic therapy, or both, and shall provide further treatment if recommended by a physician licensed to practice medicine in the state of New York.
§ 3. Section 4303 of the insurance law is amended by adding a new subsection (ss) to read as follows:
(ss) Every medical expense indemnity corporation, hospital service corporation and health service corporation which provides coverage for medical, surgical or major medical care shall provide coverage for all
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00383-01-9
S. 4186 2
costs for treatment of Lyme disease (Lyme borreliosis) and other tick borne related pathogens. Such treatment shall include not less than thirty days of intravenous antibiotic therapy, sixty days of oral antibiotic therapy, or both, and shall provide further treatment if recommended by a physician licensed to practice medicine in the state of New York.
§ 4. Paragraph 30 of subdivision 2 of section 3 of the workers' compensation law, as renumbered by chapter 665 of the laws of 1971, is renumbered paragraph 31 and a new paragraph 30 is added to read as follows:
30. Lyme disease 30. Any process involving
(Lyme borreliosis) outdoor activity or
and other tick borne treatment of animals.
related pathogens.
§ 5. The closing paragraph of subdivision 2 of section 3 of the workers' compensation law, as amended by chapter 666 of the laws of 1971, is amended to read as follows:
Nothing in paragraph [thirty] thirty-one of this subdivision shall be construed to apply to any disability or death due to any disease described in paragraph twenty-nine of this subdivision.
§ 6. Subdivision 9 of section 201 of the workers' compensation law is amended by adding a new paragraph C to read as follows:
C. "Disability" also includes disability caused by or in connection with Lyme disease (Lyme borreliosis) and other tick borne related pathogens.
§ 7. This act shall take effect on the one hundred twentieth day after it shall have become a law. Effective immediately, the addition, amendment and/or repeal of any rules or regulations necessary for the implementation of this act on its effective date is authorized to be made on or before such effective date.
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 and the workers' compensation law, in relation to coverage of long term medical care for Lyme disease and other tick borne related pathogens
Purpose or general idea of bill
To require health insurers to provide coverage for long term medical care for Lyme disease and other tick borne related pathogens.
Summary of provisions
To require health insurers to provide coverage for long term medical care for Lyme disease and other tick borne related pathogens.
Summary of specific provisions
Section One will amend subsection (i) of section 3216 of the insurance law by adding a new paragraph 35, which requires every insurer issuing a policy of accident and health insurance cover all costs for the treat- ment of Lyme disease and other tick borne pathogens.
Section Two will amend subsection (1) of section 3221 of the insurance law by adding a new paragraph 21, which requires every group or blanket policy issued that provides hospital, surgical or medical coverage cover all costs for the treatment of Lyme disease and other tick borne patho- gens.
Section Three will amend section 4303 of the insurance law by adding a new subsection (ss), which requires every medical expense indemnity corporation, hospital service corporation and health service corporation which provides coverage for medical, surgical or major medical care shall cover all costs for the treatment of Lyme disease and other tick borne pathogens.
Section Four will amend paragraph 30 of subdivision 2 of section 3 of the workers' compensation law, as renumbered by chapter 665 of the laws of 1971, is renumbered paragraph 31 and a new paragraph 30 is added to include Lyme Disease as covered under workers' compen sation.
Section Five will amend closing paragraph of subdivision 2 of section 3 of the workers' compensation law to reflect renumbering of paragraphs
Section Six will amend subdivision 9 of section 201 of the workers' compensation law by adding a new paragraph C to reflect renumbering of paragraphs.
Section Seven sets the effective date.
Justification
Current law does not specifically stipulate that Lyme disease and other tick borne related pathogens be covered under individual and group health insurance policies or workers' compensation. Lyme disease is a life long illness that is exacerbated unless treated. New York remains one of the states with the highest incidence of Lyme disease. This bill would require this disease to be covered under the aforementioned insur- ance policies. The bill also requires that long term treatments of the disease be covered if so recommended by a physician licensed to practice in New York State.
Lyme disease strikes many New Yorkers each year. This bill ensures that their pain and suffering is not complicated by a lack of medical cover- age, including long term coverage, for care of the disease.
Prior legislative history
2017-2018:A.10621- Referred to Insurance 2013-2014:A.4978 -Referred to Insurance 2011-2012:A.7696 -Referred to Insurance 2009-2010:A.2100 -Held for Consideration in Insurance 2007-2008:A.1041 -Held for Consideration in Insurance 2005-2006:A.385A -Held for Consideration in Insurance 2003-2004:A.1914A- Held for Consideration in Insurance 2001-2002:A.9735 -Held for Consideration in Insurance
Fiscal implications for state and local governments
To be determined.
Effective date
This act shall take effect on the one hundred twentieth day after it shall have become law. Effective immediately, the addition, amendment and/or repeal of any rules or regulations necessary for the implementa- tion of the foregoing sections of this act on its effective date is authorized and directed to be made and completed on or before such date.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.