The controversial treatment of Lyme disease – and whether it should be covered by health insurance – was the topic of a public hearing held this week by the House Health and Human Services Committee.

“The number of Lyme disease cases in Pennsylvania continues to climb, and because this condition is difficult to diagnose and to treat, people need to be very aware of the effects of this tick-borne disease,” said Rep. Phillips. “My legislation would help raise awareness about this condition, make it easier for people to get treatment and prevent doctors from being discouraged from treating patients.”

Lyme disease is a potentially serious disease carried by deer ticks, and symptoms vary from one person to another. Usually, patients develop a rash that may have a ring-shaped appearance similar to a bull’s eye, along with flu-like achiness, fatigue, and low-grade fever. Some patients, however, never get the rash and other early symptoms, but may go on to develop arthritis, neurological disorders, heart problems, and visual impairments.

Some patients have lived with the disease for years before it is ultimately diagnosed.

Because Lyme disease is often difficult to diagnose and a complicated condition to treat, physicians may be reluctant to treat Lyme disease due to the potential for disciplinary action, even if they are practicing medicine with the best resources and information available to them, Rep. Phillips said.

House Bill 798 (Phillips-R-Northumberland) calls for the creation of a task force to help the state Department of Health investigate and make recommendations for the education, prevention and treatment of Lyme disease and other tick-borne diseases.

“Anyone who spends any amount of time outdoors, because of their occupation or for recreation, are at risk,” Rep. Phillips said.

Specifically, the task force would be charged with raising awareness of the long-term effects of the misdiagnosis of Lyme disease, developing a program of public information and education regarding Lyme disease and disseminating information on Lyme disease to the general public in cooperation with the Pennsylvania Game Commission and the Department of Conservation and Natural Resources.

In addition, the legislation calls for all health care policies to cover prescribed treatment for Lyme disease and related tick-borne diseases as prescribed by the patient’s attending physician.

The bill would also establish parameters for professional misconduct proceedings when an insurance provider or other professional or business entity files a complaint against a physician for treatment of Lyme disease. The physician will be informed of the complaint filed against him or her and receive a copy of the complaint upon request.

All those who testified agreed that public awareness and education is important, especially in preventing the tick-borne disease and in getting early diagnosis and treatment. Two separate treatments presently exist, with one calling for the use of long-term antibiotics, and that is where the controversy has arisen.

At issue during Thursday’s hearing was a provision in the bill calling for mandatory insurance coverage for the long-term use of antibiotics to treat Lyme disease. Four physicians who have collectively spent more than 100 years treating Lyme disease patients testified on Thursday.

The medical experts, from Philadelphia, Chester County, Harrisburg and New York, were divided on their support of the bill. Supporters of the bill believe that if a treatment works and helps a patient with Lyme disease recover, insurance should cover the cost.

However, critics argued that long-term antibiotic treatment carries risks for serious side effects as well as the growing threat of antibiotic resistance.

Supporters countered this by testifying that insurance companies that deny such coverage are essentially denying patients’ access to care. In addition, they contend that without such treatment, medical costs for Lyme disease patients run into the millions of dollars each year.

“The treatment that is being prescribed for Lyme disease should be a personal decision between the physician and the patient, not the insurance company,” Rep. Phillips said.

In addition to the physicians offering testimony, three patients who have suffered from the disease shared their stories and challenges with regard to diagnosis and coverage for treatment.

Rep. Phillips’ legislation has been passed in previous House sessions, but has not moved in the state Senate. The hearing was the second the Committee has held on the bill in the past couple of months.

Testimony was presented by: Dr. Michael Buckley and Dr. John Goldman for the Infectious Diseases Society of America, Dr. Ann Corson, member International Lyme and Associated Diseases Society, Dr. Donald Goldsmith, Pennsylvania Rheumatology Society, Dr. Daniel Cameron, International Lyme and Associated Diseases Society, Julia Wagner, Joseph Kamp and Nicole Lecrone offered comments on their family’s experience and Blue Cross of Northeastern Pennsylvania.

The chairs of the Health and Human Services Committee are Rep. Oliver (D-Philadelphia) and Rep. Kenny (R-Montgomery).

Visit the Department of Health’s Lyme Disease webpage for more information.

Link: Deer Population Growth, Development Caused Dramatic Increase in Lyme Disease

11/16/2007