S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1306
 
                        2019-2020 Regular Sessions
 
                             I N  S E N A T E
 
                             January 14, 2019
                                ___________
 
 Introduced  by  Sens. SERINO, AMEDORE, CARLUCCI, FUNKE, HELMING, JACOBS,
   LAVALLE, LITTLE, O'MARA, RANZENHOFER, RITCHIE, SAVINO, SEWARD, TEDISCO
   -- read twice and ordered printed, and when printed to be committed to
   the Committee on Health
 
 AN ACT to amend the public health law, in relation to creating  a  pilot
   program for Lyme and tick-borne disease testing in children
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 206-b of the public health law, as added by chapter
 260 of the laws of 1988, is amended to read as follows:
   § 206-b. LYME AND TICK-BORNE DISEASE.  1.  Special  requirements  with
 respect to Lyme disease diagnosis.  [1.] A. Within thirty days after the
 effective  date  of  this  section,  the commissioner shall, in writing,
 order every physician practicing  in  Suffolk,  Westchester  and  Nassau
 counties  to  review  the  medical records of any patient such physician
 treated during the period commencing  January  first,  nineteen  hundred
 seventy-five and ending on the date of such order wherein such physician
 made  a  diagnosis  of  juvenile  rheumatoid arthritis and to review the
 circumstances of such diagnosis to reconsider whether such  patient  has
 suffered,  or  is  suffering,  from  the  complex, multi-system disorder
 caused by the bacterium Borrelia burgdorferi, which disease is transmit-
 ted by the Ixodes dammini tick and is  commonly  referred  to  as  "Lyme
 disease".  In any case where a hospital or other health care institution
 or provider has custody or control of the medical records for a  patient
 so  diagnosed,  upon  request such physician shall be entitled to review
 such medical records for purposes of complying with such  order  or  the
 commissioner  may  order any such hospital or other health care institu-
 tion or provider wherever situated  within  the  state  to  review  such
 records to reconsider a diagnosis of Lyme disease.
   [2.]  B.  The  commissioner, upon a showing that there is a reasonable
 basis to believe that  the  order  provided  for  herein  has  not  been
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD06975-01-9

 S. 1306                             2
 
 complied  with,  shall  be entitled to apply to a justice of the supreme
 court for an order requiring  any  such  physician  to  submit  for  the
 commissioner's  consideration  such  records,  charts or other pertinent
 data  which  will  enable  him  to determine whether there has been full
 compliance with such order.
   [3.] C. In any case where a review of such records  indicates  that  a
 patient  may  have been, or is, suffering from Lyme disease, such physi-
 cian shall, consistent with customary and acceptable medical  standards,
 take  such  action  he  deems necessary to inform such patient or in the
 case of a minor, his or her parent or guardian of his findings,  conduct
 additional  tests,  administer  other necessary treatments or refer such
 patient to another physician for further diagnosis and/or treatment.
   2. PILOT PROGRAM FOR LYME AND TICK-BORNE DISEASE TESTING IN  CHILDREN.
 A.  SUBJECT  TO  APPROPRIATION, THE COMMISSIONER IS HEREBY AUTHORIZED TO
 ESTABLISH A PILOT PROGRAM TO TEST FOR LYME AND  TICK-BORNE  DISEASES  IN
 CHILDREN  WITH  QUALIFYING  DIAGNOSES WHO PRESENT WITH SIMILAR SYMPTOMS.
 SUCH PROGRAM, SUBJECT TO THE RULES AND REGULATIONS OF THE  COMMISSIONER,
 SHALL  PROVIDE  FOR  A  TEST TO RULE OUT LYME AND TICK-BORNE DISEASES IN
 CHILDREN WITH A QUALIFYING DIAGNOSIS BY AN APPROVED NEW YORK STATE QUAL-
 IFIED MEDICAL RESEARCH INSTITUTION OR LABORATORY, AT THE  REQUEST  OF  A
 PATIENT, MEDICAL PROVIDER, PRACTITIONER, HOSPITAL, OR HEALTH CARE FACIL-
 ITY.  THE  QUALIFIED MEDICAL RESEARCH INSTITUTION OR LABORATORY SHALL BE
 RESPONSIBLE FOR CONDUCTING SEROLOGY TESTING, OR  OTHER  LYME  AND  TICK-
 BORNE DISEASE TESTS APPROVED BY THE COMMISSIONER, TO DETERMINE THE ESTI-
 MATED  RATE  OF  MISDIAGNOSIS  AND CO-INFECTIONS IN CHILDREN AND FOR THE
 DEVELOPMENT OF CONTINUING GRADUATE MEDICAL EDUCATION CURRICULUM ADDRESS-
 ING THE SYMPTOMS AND DIAGNOSTIC TOOLS  THAT  CAN  ASSIST  IN  ACCURATELY
 IDENTIFYING  AND  TESTING  FOR LYME AND TICK-BORNE DISEASES IN CHILDREN.
 THE QUALIFIED MEDICAL RESEARCH INSTITUTION OR LABORATORY MAY  WORK  WITH
 NOT-FOR-PROFITS,  PROFESSIONAL ASSOCIATIONS, OR ACADEMIC INSTITUTIONS TO
 DEVELOP THE CONTINUING GRADUATE MEDICAL EDUCATION CURRICULUM.
   B. FOR PURPOSES OF THIS SUBDIVISION, THE FOLLOWING  TERMS  SHALL  HAVE
 THE FOLLOWING MEANINGS:
   (I) "QUALIFIED MEDICAL RESEARCH INSTITUTION OR LABORATORY" MAY INCLUDE
 ACADEMIC  MEDICAL  INSTITUTIONS,  AGENCIES,  PUBLIC OR PRIVATE ORGANIZA-
 TIONS, PUBLIC OR PRIVATE LABORATORIES OR ANY OTHER INSTITUTION OR  LABO-
 RATORY APPROVED BY THE DEPARTMENT THAT IS CONDUCTING LYME AND TICK-BORNE
 DISEASE RESEARCH, INCLUDING BUT NOT LIMITED TO, TESTING FOR THE PRESENCE
 OF SUCH INFECTIONS;
   (II)  "QUALIFYING  DIAGNOSES" SHALL MEAN JUVENILE RHEUMATOID ARTHRITIS
 OR ANY OTHER COMMON MEDICAL DIAGNOSIS THAT PRESENTS WITH  SIMILAR  SYMP-
 TOMS  TO  LYME  AND  TICK-BORNE DISEASE INFECTIONS THAT THE COMMISSIONER
 DEEMS RELEVANT; AND
   (III) "CHILDREN" SHALL MEAN ALL INDIVIDUALS UNDER THE AGE OF  EIGHTEEN
 WHO HAVE A QUALIFYING DIAGNOSIS.
   C.  THE  COMMISSIONER  SHALL  REQUIRE  THE  QUALIFIED MEDICAL RESEARCH
 INSTITUTION OR LABORATORY UNDER THE PILOT PROGRAM TO  SUBMIT  AN  ANNUAL
 REPORT,  WHICH  SHALL  INCLUDE  DATA ANALYZING THE COST, EFFICIENCY, AND
 ACCURACY OF TESTS PROVIDED UNDER SUCH PROGRAM.  THE  REPORT  SHALL  ALSO
 INCLUDE  ESTIMATED  RATES  OF  MISDIAGNOSIS OR CO-INFECTIONS OF LYME AND
 TICK-BORNE DISEASES OF CHILDREN WITH QUALIFYING DIAGNOSES. ON OR  BEFORE
 DECEMBER THIRTY-FIRST, TWO THOUSAND TWENTY, AND ANNUALLY THEREAFTER, THE
 COMMISSIONER  SHALL  SUBMIT  SUCH  REPORT TO THE GOVERNOR, THE TEMPORARY
 PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY.
   D. PARTICIPATION IN THE PILOT PROGRAM SHALL BE VOLUNTARY  AND  SUBJECT
 TO  PARTICIPATION  GUIDELINES  ESTABLISHED BY THE DEPARTMENT. NOTHING IN

 S. 1306                             3
 
 THIS SUBDIVISION SHALL ESTABLISH LIABILITY FOR ANY  REASONABLE  ACTS  OR
 OMISSIONS ON THE PART OF A HOSPITAL, HEALTH CARE INSTITUTION, OR PROVID-
 ER PARTICIPATING IN THE PROGRAM.
   §  2.  This  act shall take effect on the ninetieth day after it shall
 have become a law.