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Bill

S 6862

Requires health insurers to provide coverage for long term medical care for Lyme disease and other tick borne related pathogens

2025 Regular Session Introduced by Lea Webb

Requires health insurers to cover long-term medical care for Lyme disease and other tick-borne pathogens, expanding access to ongoing diagnostics, meds, and therapies.

REFERRED TO INSURANCE
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Bill Summary · S 6862

Summary of Bill S 6862

Overview

Bill S 6862 would require health insurers to provide coverage for long-term medical care related to Lyme disease and other tick-borne pathogens. Introduced on March 25, 2025, the bill is currently in the Insurance committee stage (Referred to Insurance).

Purpose and Intent

  • To ensure that individuals diagnosed with Lyme disease or other tick-borne diseases have access to long-term medical care through their health insurance plans.
  • Addresses potential gaps in coverage for chronic or ongoing treatment associated with these infections.

Key Provisions (as stated)

  • The bill mandates that health insurers provide coverage for long-term medical care connected to Lyme disease and other tick-borne pathogens.
  • Specific scope, including which services are covered (e.g., diagnostics, medications, therapies, rehabilitation), duration of coverage, cost-sharing (co-pays/deductibles), preauthorization requirements, and any exclusions, would be defined in the bill’s text and implementing regulations.
  • Details regarding plan types (e.g., individual, small group, large group), timelines for compliance, and transitional rules are not provided in the available information and would rely on the enacted language.

Note: With limited publicly available text, the exact definitions of “long-term medical care,” covered services, and any carve-outs remain to be specified in the bill itself.

Affected Parties

  • Primary: Health insurers operating within the state jurisdiction.
  • Secondary: Policyholders and insured individuals diagnosed with Lyme disease or other tick-borne pathogens, healthcare providers delivering related care, and state regulatory bodies overseeing insurance mandates.

Procedural and Timeline Aspects

  • Introduced: March 25, 2025.
  • Current status: REFERRED TO INSURANCE (as of the provided information), indicating the bill is in the Insurance committee for review and potential amendments before advancing to floor consideration.
  • Legislative actions listed: Two entries for 2025-03-25 both showing “REFERRED TO INSURANCE,” suggesting initial committee referral.

Sponsors and Related Legislation

  • Primary Sponsor: Lea Webb.
  • Related bills from prior sessions (suggesting ongoing interest in Lyme disease coverage):
    • S 653
    • S 541
    • S 5354
    • S 670
    • S 4186
    • S 3896
    • S 3379

Potential Impacts and Considerations

  • For patients: Potential improved access to comprehensive, long-term treatment coverage.
  • For insurers: Possible changes to claims experience, premium considerations, and plan design requirements.
  • For regulators: Need to establish regulations and enforcement mechanisms to ensure compliance and determine what constitutes “long-term” care.
  • Overall: The bill could influence the standard of coverage for Lyme and tick-borne diseases, balancing patient access with insurer cost considerations.

If the full text becomes available, a more detailed provision-by-provision analysis could be provided, including definitions, covered services, exclusions, and any associated cost-sharing or transitional rules.

Compiled from official sources — confirm details with the bill’s official record.

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