S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4508
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             February 9, 2023
                                ___________
 
 Introduced  by  Sen.  STEC  --  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
 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09260-01-3
              

 S. 4508                             2
 
 commissioner's  consideration  such  records,  charts or other pertinent
 data which will enable him OR HER 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 OR SHE deems necessary to inform such patient or  in
 the  case  of a minor, his or her parent or guardian of his OR HER find-
 ings, 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-FOUR, AND ANNUALLY  THEREAFT-
 ER,  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
 THIS SUBDIVISION SHALL ESTABLISH LIABILITY FOR ANY  REASONABLE  ACTS  OR
 S. 4508                             3
 
 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.