https://www.nysenate.gov/newsroom/press-releases/pamela-helming/senator-helming-bill-study-lyme-disease-coverage-clears

Senator Helming: Bill to Study Lyme Disease Coverage Clears Legislature

GENEVA – Senator Pam Helming today announced that legislation she co-sponsored to review insurance coverage for the treatment of Lyme and tick-borne diseases has passed both the Senate and the Assembly unanimously. As a member of the Senate Task Force on Lyme and Tick-Borne Diseases, Senator Helming has been a strong advocate for those suffering from Lyme and tick-borne diseases and their loved ones and has fought for measures aimed at prevention, treatment, and awareness of these illnesses. Currently, health insurance companies are not required to cover long-term treatment for those who suffer from chronic Lyme and tick-borne diseases. This bill (S.4571/A.6146) calls for a study and report on the adequacy of such insurance coverage. The data gained through the study will help lawmakers make informed decisions about insurance.

“Lyme and other tick-borne diseases continue to be a prevalent threat across our region and around our state. Since taking office as State Senator, I have proudly advocated on behalf of those suffering from these illnesses as well as the medical and public health professionals working with them. Those suffering from chronic Lyme and tick-borne diseases can experience serious symptoms such as extreme and long-term fatigue, nausea, depression, and joint pain. However, insurance coverage is insufficient when it comes to helping patients pay for the treatments related to these illnesses and their related symptoms. That can be devastating to people who are already battling these debilitating diseases. This study will give us the data and facts we need to address this problem. As State Senator, I will keep working with my colleagues on both sides of the aisle as well as local grassroots organizations to work toward better prevention, treatment, and awareness of Lyme and tick-borne diseases. This legislation is a major step forward in this regard, and I thank the Senate and Assembly for supporting it in a bipartisan, unanimous manner. I am hopeful the Governor will sign it into law soon,” Senator Helming said.

The legislation directs the New York State Department of Financial Services, in consultation with the commissioner of the Department of Health, to study and report upon the adequacy of insurance coverage for the treatment of Lyme disease and other tick-borne related diseases. The study will provide insight into the current state of insurance coverage as it relates to Lyme and tick-borne diseases and recommend solutions to ensure all New Yorkers are adequately protected. Many areas of New York suffer from high incidence of Lyme and other tick-borne diseases, yet insufficient insurance coverage impacts many seeking care. Rhode Island and Connecticut are among the states that have recognized the toll these diseases take on victims by passing legislation that requires insurance to cover these diseases.

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Bill S4571: https://legislation.nysenate.gov/pdf/bills/2019/S4571

According to this 2014 article on the Massachusetts State Center for Health Information and Analysis, the cost of long-term Lyme disease care would only increase insurance polities by 13 cents: https://www.telegram.com/article/20140525/NEWS/305259757/1116.  The Bill would require insurance carriers to provide coverage for antibiotic treatment lasting beyond 28 days when it is determined by a physician to be medically necessary as well as insurance coverage for diagnostic testing for the tick-borne disease.