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Introduced Version House Bill 4568 History

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hb4568 intr
H. B. 4568


(By Delegates Ennis, Swartzmiller, Pethtel, Varner,
Yost, Perdue, Hatfield, Ashley, DeLong and Border)

[Introduced February 14, 2008; referred to the
Committee on the Judiciary.]



A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new section, designated §33-15-4j; to amend said code by adding thereto a new section, designated §33-16-3t; and to amend said code by adding thereto a new section, designated §33-25A-8i, all relating to requiring accident and sickness insurance providers and health maintenance organizations to cover the treatment for Lyme disease.

Be it enacted by the Legislature of West Virginia:
That the Code of West Virginia, 1931, as amended, be amended by adding thereto a new section, designated §33-15-4j; that said code be amended by adding thereto a new section, designated §33-16-3t; and that said code be amended by adding thereto a new section, designated §33-25A-8i, all to read as follows:
ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE.
§33-15-4j. Policies to cover certain Lyme disease treatments.

Any insurer who, on or after the first day of January, two thousand eight, delivers or issues a policy of accident and sickness insurance in this state under the provisions of this article shall make available as benefits to all subscribers and members coverage for
diagnostic testing and long-term antibiotic treatment of chronic Lyme disease when determined to be medically necessary and ordered by a physician 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, That this section does 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.
ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
§33-16-3t. Policies to cover certain Lyme disease treatments.
Any insurer who, on or after the first day of January, two thousand eight, delivers or issues a policy of group accident and sickness insurance in this state under the provisions of this article shall make available as benefits to all subscribers and members coverage for diagnostic testing and long-term antibiotic treatment of chronic Lyme disease when determined to be medically necessary and ordered by a physician 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, That this section does 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.
ARTICLE 25A. HEALTH MAINTENANCE ORGANIZATION ACT.
§33-25A-8i. Required coverage for certain Lyme disease treatments. A health maintenance organization issuing coverage in this state pursuant to the provisions of this article shall make available as benefits to all subscribers and members coverage for diagnostic testing and long-term antibiotic treatment of chronic Lyme disease when determined to be medically necessary and ordered by a physician 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, That this section does 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.






NOTE: The purpose of this bill is to require accident and sickness insurance providers and health maintenance organizations to cover certain Lyme disease treatments.

Strike-throughs indicate language that would be stricken from the present law, and underscoring indicates new language that would be added.
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