MN Statute 62A.265 Coverage for Lyme Disease
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Health Insurance Coverage for Lyme Treatment in
Minnesota
- Patient information

Health Insurance Coverage for Lyme Disease in
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CA, explains some of the factors involved when a
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The CDC says: Surveillance case definitions
establish uniform criteria for disease reporting
and should not be used as:

* the sole criteria for establishing clinical
diagnoses;
* determining the standard of care necessary
for a particular patient;
* setting guidelines for quality assurance, or
providing standards for reimbursement.

Yet, doctors are inappropriately using CDC
surveillance criteria to diagnose, and insurance
companies are using the criteria to deny
reimbursement, thus patients are not getting
diagnosed and treated.
Minnesota Lyme Association
Advancing awareness through support and education
Commissioner Mike Rothman
Minnesota Department of Commerce
85 7th Place East, Suite 500
St. Paul, MN 55101

By fax: (651) 297-1959

Dear Commissioner Rothman:

I wanted to take this opportunity to highlight the fact that several
constituents have contacted me recently to share their concerns about
the fact that their health insurance providers have denied coverage for
IV antibiotics to treat Lyme disease.  In addition, Brenda Peltier,
president of the Minnesota Lyme Association, reached out to me to
bring to light the fact that their members are noticing more insurance
denials as well.  They are organizing an effort to send letters to
insurance companies to remind them of their obligations in Minnesota
Statutes § 62A.265 (Coverage for Lyme Disease):
Subdivision 1.Required coverage.

Every health plan, including a plan providing the coverage specified in
section 62A.011, subdivision 3, clause (10), must cover treatment for
diagnosed Lyme disease.
Subd. 2.Special restrictions prohibited.

No health plan included in subdivision 1 may impose a special
deductible, co-payment, waiting period, or other special restriction on
treatment for Lyme disease that the health plan does not apply to
nonpreventive treatment in general.

The number of Lyme disease cases has been increasing dramatically
since the 1990s. You may not be aware of the fact that my district is
ground-zero for Lyme disease and other tick-borne illnesses in
Minnesota. In fact, almost 12 percent of all Lyme disease cases in
Minnesota were reported in Crow Wing County. Cass County also ranks
among the highest for incidence of Lyme disease, representing 5
percent of all reported cases. That is why I have worked diligently to
combat Lyme disease in Minnesota with further efforts for prevention,
and legislation, enacted in 2010, allowing physicians to more
aggressively treat Lyme disease patients.



Today I am asking for your help.  Although I am aware that the
Minnesota Department of Commerce does not have jurisdiction over
self-insured plans, I hope that you will act on behalf of Lyme patients in
Minnesota and ensure that the insurance plans under your control meet
their obligations to cover the treatment methods the patient and doctor
determine is best for them.  Oftentimes, multiple treatment methods are
needed to attack this crippling disease and the most beneficial healing
method should be determined by medical professionals, not insurance
companies.

Thank you in advance for your time and attention to this serious
matter.  I look forward to receiving a response from you.  If you have
any questions, or if your policy staff feels that additional legislative
action is needed, please don’t hesitate to contact me at (651) 296-4333.


Sincerely,


John Ward

State Representative


Cc:      Brenda Peltier

      President, Minnesota Lyme Association

      bpeltier@spacecenterinc.com
Letter sent from Representative John Ward to Dept. of Commerce
commissioner Mike Rothman. We encourage you to write a letter to
the commissioner if you have been denied insurance reimbursement
for Lyme disease!