Flaws & Unintended Consequences of Massachusetts Lyme Physician Protection Law

[Guest guest]

On the surface this small amendment may look benign and helpful. However,

many of us do believe that in its application. impact and implementation,

which focuses on the CDC " Surveillance Criteria, " it will -- in effect ! --

be like handing a baseball bat to the insurance companies that will enable

them to more effectively badger and bully pcp's and new physicians into

using the " Surveillance Criteria " as a prerequisit for treating children and

families with Lyme disease -- as they have done so effectively for decades

in Massachusetts ! (It does't matter how we, ourselves, interpret this

bill. What matters, however, is what physicians choose to do following

demands by the insurance companies that payments for treating Lyme patients

are based on the prerequisit that they meet the requirements of the CDC

" Surveillance Criteria " which is reinforced, unfortunately, by the language

within this bill !)

The Massachusetts Lyme Physician Protection Amendment:

SECTION 92. Chapter 112 of the General Laws, as appearing in the 2008

Official Edition, is hereby amended by inserting after section 12CC the

following section:–

Section.12DD. As used in this section, long-term antibiotic therapy shall

be the administration of oral, intramuscular or intravenous antibiotics

singly or in combination, for periods of time in excess of 4 weeks. Lyme

disease is the clinical diagnosis by a physician licensed under section 2 of

chapter 112 of the presence in a patient of signs or symptoms compatible with

acute infection with

Borrelia burgdorferi or with late stage or persistent or chronic

infection with Borrelia burgdorferi or with complications related to such

infection

or with such other strains of Borrelia that after adoption of this bill,

are recognized by the national Centers for Disease Control and Prevention

(CDC) as a cause of Lyme disease. Lyme disease includes an infection that

meets the surveillance criteria set forth by said CDC, and it also includes a

clinical diagnosis of Lyme disease that does not meet the CDC surveillance

criteria but includes other acute and chronic signs and/or symptoms of Lyme

disease as determined by the treating physician. Such clinical diagnosis

is based on knowledge obtained through medical history and physical

examination alone, or in conjunction with testing that provides supportive

data

for such clinical diagnosis.

A licensed physician may prescribe, administer or dispense long-term

antibiotic therapy for a therapeutic purpose that eliminates such infection or

controls a patient‟s symptoms upon making a clinical diagnosis that such

patient has Lyme disease or displays symptoms consistent with a clinical

diagnosis of Lyme disease,

provided such clinical diagnosis and treatment are documented in the

patient‟s medical record by such licensed physician.

In the near future, it is my hope that ILADS will consider proposing their

own Lyme Western Blot Diagnostic Criteria.

In the interim re the Massachusetts Lyme Disease Physician Protection

Amendment:

1. Many of us here in Massachusetts and elsewhere (who were not privy to

the secret meetings drafting this legislation) feel very strongly that

" and " should have been changed to " or. "

2. We would also have liked to have seen the reference to the

" Surveillance Criteria " dropped. It has always been an epidemiological

definition

for geographical-tracking. Any insinuation that it is a diagnostic

definition is contrary to the CDC's own assertions and will only strengthen the

hand

of the insurance companies and help to perpetuate treatment denials for

Massachusetts patients. (This bill may also set the wrong precedent for

other states in the future.)

3. We would have suggested dropping the final portion of the last

sentence in para two which reads: " . . . or in conjunction with testing that

provides supportive data for such clinical diagnosis. " The testing obviously

refers back, once again, to the CDC Surveillance Criteria -- an additional

effort to diminish a real clinical diagnosis !

This may appear as a victory for some, but I fear that it may prove, in

the long run,

to be a great loss for families here in Massachusetts and, eventually,

many other states in the USA. A question also arises: who stands to gain

financially by the insertion within and/or the compromise in allowing the

" Surveillance Criteria " into such legislation -- those promoting a new Lyme

vaccine?

Coughlan

President

Massachusetts Lyme & Tick-Borne Disease Awareness Association

Mashpee, MA

[Guest guest]

Although I don't agree with most of your suggested changes, I do respect

your right to suggest them. No legislation is perfect, and there will

always be naysayers about any proposal. I just feel that continuing to

get " nothing " done is not an option. Many lives are being destroyed by

Lyme disease _at this moment_. Patients can't find treatment because

doctors are afraid of their state medical boards - _right now_. There

will never be any serious research into the disease without attention

from legislators, the medical community, and the public.

So, even though I'm nowhere near MA, I tip my hat to all of those

involved in this bill, and I thank them for some actual " action " on

behalf of lyme sufferers and their LLMD's.

Don

On 7/1/2010 8:01 AM, MassLyme@... wrote:

>

> On the surface this small amendment may look benign and helpful. However,

> many of us do believe that in its application. impact and implementation,

> which focuses on the CDC " Surveillance Criteria, " it will -- in effect ! --

> be like handing a baseball bat to the insurance companies that will enable

> them to more effectively badger and bully pcp's and new physicians into

> using the " Surveillance Criteria " as a prerequisit for treating children and

> families with Lyme disease -- as they have done so effectively for decades

> in Massachusetts ! (It does't matter how we, ourselves, interpret this

> bill. What matters, however, is what physicians choose to do following

> demands by the insurance companies that payments for treating Lyme patients

> are based on the prerequisit that they meet the requirements of the CDC

> " Surveillance Criteria " which is reinforced, unfortunately, by the language

> within this bill !)

>

> The Massachusetts Lyme Physician Protection Amendment:

>

> SECTION 92. Chapter 112 of the General Laws, as appearing in the 2008

> Official Edition, is hereby amended by inserting after section 12CC the

> following section:–

> Section.12DD. As used in this section, long-term antibiotic therapy shall

> be the administration of oral, intramuscular or intravenous antibiotics

> singly or in combination, for periods of time in excess of 4 weeks. Lyme

> disease is the clinical diagnosis by a physician licensed under section 2 of

> chapter 112 of the presence in a patient of signs or symptoms compatible with

> acute infection with

> Borrelia burgdorferi or with late stage or persistent or chronic

> infection with Borrelia burgdorferi or with complications related to such

infection

> or with such other strains of Borrelia that after adoption of this bill,

> are recognized by the national Centers for Disease Control and Prevention

> (CDC) as a cause of Lyme disease. Lyme disease includes an infection that

> meets the surveillance criteria set forth by said CDC, and it also includes

a

> clinical diagnosis of Lyme disease that does not meet the CDC surveillance

> criteria but includes other acute and chronic signs and/or symptoms of Lyme

> disease as determined by the treating physician. Such clinical diagnosis

> is based on knowledge obtained through medical history and physical

> examination alone, or in conjunction with testing that provides supportive

data

> for such clinical diagnosis.

> A licensed physician may prescribe, administer or dispense long-term

> antibiotic therapy for a therapeutic purpose that eliminates such infection or

> controls a patient‟s symptoms upon making a clinical diagnosis that such

> patient has Lyme disease or displays symptoms consistent with a clinical

> diagnosis of Lyme disease,

>

>

>

>

> provided such clinical diagnosis and treatment are documented in the

> patient‟s medical record by such licensed physician.

>

>

> In the near future, it is my hope that ILADS will consider proposing their

> own Lyme Western Blot Diagnostic Criteria.

>

> In the interim re the Massachusetts Lyme Disease Physician Protection

> Amendment:

>

> 1. Many of us here in Massachusetts and elsewhere (who were not privy to

> the secret meetings drafting this legislation) feel very strongly that

> " and " should have been changed to " or. "

>

> 2. We would also have liked to have seen the reference to the

> " Surveillance Criteria " dropped. It has always been an epidemiological

definition

> for geographical-tracking. Any insinuation that it is a diagnostic

> definition is contrary to the CDC's own assertions and will only strengthen

the hand

> of the insurance companies and help to perpetuate treatment denials for

> Massachusetts patients. (This bill may also set the wrong precedent for

> other states in the future.)

>

> 3. We would have suggested dropping the final portion of the last

> sentence in para two which reads: " . . . or in conjunction with testing that

> provides supportive data for such clinical diagnosis. " The testing obviously

> refers back, once again, to the CDC Surveillance Criteria -- an additional

> effort to diminish a real clinical diagnosis !

>

> This may appear as a victory for some, but I fear that it may prove, in

> the long run,

> to be a great loss for families here in Massachusetts and, eventually,

> many other states in the USA. A question also arises: who stands to gain

> financially by the insertion within and/or the compromise in allowing the

> " Surveillance Criteria " into such legislation -- those promoting a new Lyme

> vaccine?

>

> Coughlan

> President

> Massachusetts Lyme & Tick-Borne Disease Awareness Association

> Mashpee, MA

>

>

>

>