Rhode Island Lyme Disease Law

Chapter 04-035 – 2004 — S 2939 -Enacted06/08/04

A N A C T

RELATING TO HEALTH AND SAFETY — LYME DISEASE AND TREATMENT

Introduced By: Senators Damiani, Polisena, Sosnowski, Breene, and DaPonte

Date Introduced:February 11, 2004

It is enacted by the General Assembly as follows:

SECTION 1. Section 5-37.5-5 of the General Laws in Chapter 5-37.5 entitled “Lyme

Disease Diagnosis and Treatment” is hereby amended to read as follows:

5-37.5-5. Mandatory coverage for certain Lyme disease treatments. [Effective until

December 31, 2004.] — Every individual or group hospital or medical expense insurance policy

or individual or group hospital or medical services plan contract delivered, issued for delivery, or

renewed in this state on or afterJanuary 1, 2004, shall provide for Lyme disease treatment as

provided in chapters 27-18, 27-19, 27-20, and 27-41 of the general laws.

SECTION 2. Section 27-18-62 of the General Laws in Chapter 27-18 entitled “Accident

and Sickness Insurance Policies” is hereby amended to read as follows:

27-18-62. Mandatory coverage for certain lyme disease treatments. [Effective until

December 31, 2004.] — Every individual or group hospital or medical expense insurance policy

or individual or group hospital or medical services plan contract delivered, issued for delivery, or

renewed in this state on or afterJanuary 1, 2004shall provide coverage for diagnostic testing and

long-term antibiotic treatment of chronic lyme disease when determined to be medically

necessary and ordered by a physician acting in accordance with chapter 37.5 of title 5 entitled

“lyme disease diagnosis and treatment” after making a thorough evaluation of the patient’s

symptoms, diagnostic test results and response to treatment. Treatment otherwise eligible for

benefits pursuant to this section shall not be denied solely because such treatment may be

characterized as unproven, experimental, or investigational in nature. Provided, however, this

section shall not apply to insurance coverage providing benefits for:

(1) Hospital confinement indemnity;

(2) Disability income;

(3) Accident only;

(4) Long-term care;

(5) Medicare supplement;

(6) Limited benefit health;

(7) Specified disease indemnity;

(8) Sickness or bodily injury or death by accident or both; and

(9) Other limited benefit policies.

SECTION 3. Section 27-19-53 of the General Laws in Chapter 27-19 entitled “Nonprofit

Hospital Service Corporations” is hereby amended to read as follows:

27-19-53. Mandatory coverage for certain lyme disease treatments. [Effective until

December 31, 2004.] — Every individual or group hospital or medical expense insurance policy

or individual or group hospital or medical services plan contract delivered, issued for delivery, or

renewed in this state on or afterJanuary 1, 2004shall provide coverage for diagnostic testing and

long term antibiotic treatment of chronic lyme disease when determined to be medically

necessary and ordered by a physician acting in accordance with chapter 37.5 of title 5 entitled

“lyme disease diagnosis and treatment” after making a thorough evaluation of the patient’s

symptoms, diagnostic test results and response to treatment. Treatment otherwise eligible for

benefits pursuant to this section shall not be denied solely because such treatment may be

characterized as unproven, experimental, or investigational in nature.

SECTION 4. Section 27-20-48 of the General Laws in Chapter 27-20 entitled “Nonprofit

Medical Service Corporations” is hereby amended to read as follows:

27-20-48. Mandatory coverage for certain lyme disease treatments. [Effective until