Bill > H4198

This bill mandates that various health insurance providers in Massachusetts, including those covering state employees and retirees, individual and group accident and sickness insurance policies, hospital service plans, medical service agreements, and health maintenance organizations, must provide coverage for long-term antibiotic therapy for Lyme disease. This coverage is required when a licensed physician deems the treatment medically necessary after a thorough evaluation of the patient's symptoms, diagnostic results, or response to treatment. Importantly, coverage cannot be denied simply because the treatment is considered unproven, experimental, or investigational. The bill defines "Lyme disease" and "long-term antibiotic therapy" by referencing an existing section of Massachusetts General Laws (M.G.L.) Chapter 112, Section 12DD, and this act is set to expire on November 1, 2021.