An Act Concerning the Use of Long-term AJ;ltibiotics for the Treatment of Lyme Disease
Maine Legislature, Session 124, LD 1709
Committee: Insurance and Financial Services
Sponsors: LEGG, BOWMAN, BEAUDETTE, BERRY, BOLAND, CONNOR
Amends: 24 MRSA §2317, 24-A MRSA §2745-H, 24-A MRSA §4244-A

Legislative Document 
No. 1709 
. H.P.1210 
House of Representatives, January 6,2010 . 
An Act Concerning the Use of Long-term AJ;ltibiotics for the' 
Treatment of Lyme Disease 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203. 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative LEGG of Kennebunk . 
. Cosponsored by Senator BOWMAN of York and 
'77/~ /J7.17!tU~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: BEAUDETTE of Biddeford, BERRY of Bowdoinham, BOLAND of Sanford, 
CAMPBELL·ofNewfield, CONNOR of Kennebunk. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
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Sec. A-I. 24 MRSA §2317-:-B, sub-§9-A is enacted to read: 
9-A. Title 24-A, sections 2'745-H, 2837-1 and 4244-A. Coverage for certain Lyme 
disease treatments, Title 24-A, sections 2745-H, 2837-1 and 4244-A; 
Sec. A-2. 24-A MRSA §2745-H is enacted to read: 
§2745-H. Coverage for certain Lyme disease treatments 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. 
"Long-term antibiotic therapy" means the use of oral, intramuscular or. 
. intravenous antibiotics, singly or in combination, for periods of greater than 4 weeks. 
B .. "Lyme disease" means the clinical diagnosis by a physician of the presence in a 
patient of signs and symptoms compatible with acute infection with Borrelia 
burgdorferi, or with late stage or chron ic· infection with Borrel ia burgdorferi, or with 
complications related to such an infection. "Lyme disease" includes infection that 
meets the surveiIlance criteria set forth by the United States Centers for Disease 
Control and Prevention but also includes . other acute and chronic manifestations of 
such an infection as determined by the physician. 
2. Required coverage. AIl individual health insurance policies and contracts must 
provide coverage for diagnostic testing and long-term antibiotic therapy treatment of 
Lyme disease when determined to be medicaIly necessary and ordered by a physician 
acting in accordance with Title 32, section 3300-B 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 may not be denied solely because 
such treatment might be characterized as unproven, experimental or investigational In 
nature. 
3. Application. The requirements of this section apply to ali policies, contracts and 
certificates executed, delivered, issued for delivery, continued or renewed in this State. 
For purposes of this section, all contracts are deemed to be renewed no later than the next 
yearly anniversary of the contract date. 
. 
Sec. A-3. 24-AMRSA §2837;..I is enacted to read: 
§2837-1. Coverage for certain Lyme disease treatments 
1. Definitions. As used in this seCtion, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. 
"Long-term antibiotic therapy" means the use of oral, intramuscular or 
intravenous antibiotics, singly or in combination, for periods of greater than 4 weeks. 
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B. "Lyme disease" means the clinical diagnosis by a physician. of the presence in a 
patient of signs and symptoms compatible with. acute infection with Borrelia 
burgdorferi, or with late stage or chronic infection with Borrelia burgdorferi; or with 
complications related to such an infection. "Lyme disease" includes infection that 
meets the -surveillance criteria set forth by the United -States Centers for Disease 
Contro( and Prevention but also includes other acute and chronic manifestations of 
such an infection as determined by the physician. 
2. Required coverage. 
All group health insurance policies and contracts must 
provide coverage' for diagnostic testing and long-term antibiotic therapy treatment of 
Lyme disease when determined to be medically necessary and ordered by a physician 
acting in accordance with Title 32, section 3300-B 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 may not be denied solely because 
such treatrrient might be characterized as unproven, experimental or investigational in 
nature. 
3. Application. The requirements of this section apply to all policies, contracts and 
certificates executed, delivered, issued for delivery, continued or renewed in this State. 
For purposes of this section, all contracts are deemed to be renewed no later than the next 
yearly-anniversary of the contract date. 
. 
Sec. A-4. 24-A MRSA §4244-A is enacted to read: 
§4244-A. Coverage for certain Lyme disease treatments 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
f~lIowing terms have the following meanings. 
A. 
"Long-term antibiotic therapy" means the use of oral, intramuscular or 
intravenous antibiotics, singly or in combination, for periods of greater than 4 weeks. 
26B. "Lyme disease" means the clinical diagnosis by a physician of the presence in a 
patient of signs and' symptoms compatible with acute infection with· Borrelia 
burgdorferi, or with late stage or chronic infection with Borrelia burgdorferi, or with 
complications related to such an infection. "Lyme disease" includes infection that 
meets the- surveillance criteria set forth by the United States Centers for Disease 
Control and Prevention but also includes other acute and chronic manifestations of 
such an infection as determined by the physician. 
2. Required coverage. All health maintenance organization individual and group 
contracts must provide coverage for diagnostic testing and long-term antibiotic therapy 
treatment of Lyme dIsease when determined to be mediCally necessary and ordered by a 
physician acting in accordance with Title 32, section 3300-B 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 may not be denied 
solely because such treatment might be characterized as unproven, experimental or 
investigational in nature. 
3. Application. The requirements of this section apply to all policies, contracts and 
certificates executed, delivered, issued for delivery; continued or renewed in this State. 
For purposes of this section, all contracts are deemed to be renewed no later than the next 
yearly anniversary of the contract date. 
Sec. A-5.Application.· The requirements of this Paf1 apply to all policies, 
contracts and certificates executed, delivered, issued for delivery, continued or renewed 
in this State on or after January I, 2011. For purposes of this Part, all contracts are 
deemed to be renewed no later than the next yearly anniversary of the contract date. 
PARTB 
Sec. B-l. 32 MRS A §3300-B is enacted to read: 
§3300-B. Lyme disease diagnosis and treatment 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
' 
A. 
. "Long-term 
a~tibiotic therapy" means the use of oral, intramuscular or 
intravenous antibiotics, singly or in combination, for periods of greater than 4 weeks. 
B. "Lyme disease" means the clinical diagnosis by a physician of the presence in a 
patient of signs and symptoms compatible with acute infection· with Borrelia 
burgdorferi, or with late stage or chronic infection with Borrelia burgdorferi, or with 
complications related to such an infection. "Lyme disease" includes infection that 
meets the surveillance crite·ria set forth by the United States Centers for Disease 
Control and Prevention but also includes other acute and chronic manifestations of 
such an infection as determined by the physician. 
C. 
"Therapeutic purpose" means the use of antibiotics to control a patient's 
. symptoms determined by the physicfan as reas()oablyrelated to Lyme disease and its 
sequelae. 
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2. 
Long-term antibiotic therapy. 
A physician may prescribe, administer or 
dispense long.-term antibiotic therapy for a therapeutic purpose to a person diagnosed 
with and having symptoms of Lyme disease if this diagnosis and treatment plan has been 
documented in the physiciari'~ medical record for that patient. A physician may not be 
subject to disciplinary action by the board solely for prescribing, administering or 
dispensing long-term antibiotic therapy for a therapeutic purpose for a patient clinically 
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diagnosed with Lyme disease if this diagnosis and treatment plan has been documented in 
the physician's medical record for that patient. This subsection may not be construed to 
prohibit the right of the board to deny, revoke or suspend the license of any physician or 
discipline any physician who prescribes, administers or dispenses long-term antibiotic 
therapy for a nontherapeutic purpose, who fails to monitor the ongoing care of a patient 
receiving long-term antibiotic therapy or who fails to keep complete and accurate 
. ongoing.records of the diagnosis and treatment of a patient receiving long-term antibiotic 
therapy. 
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SUMMARY 
Part A of the bill requires health insurance companies to provide coverage for long-
term antibiotic therapy for patients with Lyme disease in all individual and group health 
insurance -policies. The health insurance provisions apply to all policies issued or renewed 
. on or after January 1, 2011. 
Pali B of the bill provides protection from a licensing disciplinary action for 
physicians that prescribe, administer or dispense long-term antibiotic therapy to patients 
with Lyme disease.