HF 2289 (LSB 5087YH (6) 90)

HOUSE FILE 2289

BY  BODEN

A BILL FOR

An Act relating to Lyme disease, including notice and consent provisions required for Lyme disease testing, and continuing education requirements for health care providers.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  135.194  Lyme disease —— laboratory test —— notice requirement and content —— cause of action —— licensee discipline.
   1.  A health care provider who draws the blood of a patient to perform a laboratory test for the presence of Lyme disease or a medical laboratory that performs a laboratory test for the presence of Lyme disease shall provide the following written notice to the patient at the time the patient’s blood is drawn:
   Your health care provider has ordered a laboratory test for the presence of Lyme disease for you. Current laboratory testing for Lyme disease can be problematic and standard laboratory tests often result in false negative and false positive results and, if performed too early, you may not have produced enough antibodies to be considered positive because your immune response requires time to develop antibodies. If you are tested for the presence of Lyme disease and the results are negative, this does not necessarily mean you do not have Lyme disease. If you continue to experience unexplained symptoms, you should contact your health care provider and inquire about the appropriateness of retesting or initial or additional treatment.

   2.  At any time, if the department determines there are significant differences between the content of the notice required by subsection 1 and the most recent medical evidence on Lyme disease testing, the department may adopt rules pursuant to chapter 17A to amend the content of the notice to reflect the most recent medical evidence.
   3.  The provision by a health care provider or medical laboratory of the notice required by this section shall not be the sole basis for a cause of action or licensee discipline.
   4.  For the purposes of this section:
   a.  “Health care provider” means an individual licensed under chapter 148, 148C, 148D, 152, or 152E, or any individual who provides medical services under the authorization of the licensee.
   b.  “Medical laboratory” means any facility, entity, or site that offers or performs tests or examinations in connection with the diagnosis and control of human diseases or the assessment of human health, nutritional, or medical conditions.
    Sec. 2.  NEW SECTION.  135.195  Continuing education —— treatment strategies for prolonged symptoms due to Lyme disease.
   Each licensing board for a health care provider as defined in section 135.194 shall develop, and a health care provider shall complete, continuing education requirements regarding treatment strategies to assist patients with prolonged symptoms due to Lyme disease in managing and recovering from these prolonged symptoms.
    Sec. 3.  Section 147.56, Code 2024, is amended to read as follows:
   147.56  Lyme disease treatment —— laboratory testing notice —— exemption from licensee discipline.
   1.  A person licensed by a board under this subtitle shall not be subject to discipline under this chapter or the board’s enabling statute based solely on the licensee’s recommendation or provision of a treatment method for Lyme disease or other tick-borne disease if the recommendation or provision of such treatment meets all the following criteria:
   1.  a.  The treatment is provided after an examination is performed and informed consent is received from the patient.
   2.  b.  The licensee identifies a medical reason for recommending or providing the treatment.
   3.  c.  The treatment is provided after the licensee informs the patient about other recognized treatment options and describes to the patient the licensee’s education, experience, and credentials regarding the treatment of Lyme disease or other tick-borne disease.
   4.  d.  The licensee uses the licensee’s own medical judgment based on a thorough review of all available clinical information and Lyme disease or other tick-borne disease literature to determine the best course of treatment for the individual patient.
   5.  e.  The treatment will not, in the opinion of the licensee, result in the direct and proximate death of or serious bodily injury to the patient.
   2.  A health care provider as defined in section 135.194 shall not be subject to licensee discipline under this chapter or the board’s enabling statute solely on the basis of the provision of the notice required by section 135.194.
    Sec. 4.  CODE EDITOR DIRECTIVE.  The Code editor is directed to create a new subchapter XXXVII in chapter 135 as follows:
   Subchapter XXXVII shall be entitled “LYME DISEASE TESTING —— NOTICE AND CONSENT REQUIREMENTS —— CONTINUING EDUCATION” and include sections 135.194 and 135.195.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill relates to notice and consent requirements for testing and treatment of Lyme disease.
   The bill provides that a health care provider who draws the blood of a patient to perform a laboratory test for the presence of Lyme disease or a medical laboratory that performs a laboratory test for the presence of Lyme disease shall provide the written notice prescribed in the bill to the patient at the time the patient’s blood is drawn. The notice must include statements that: current laboratory testing for the presence of Lyme disease can be problematic and standard laboratory tests often result in false negative and false positive results; that if testing is performed too early, the patient may not have produced enough antibodies to be considered positive because the patient’s immune response requires time to develop antibodies; that if the patient is tested for the presence of Lyme disease and the results are negative, this does not necessarily mean the patient does not have Lyme disease; and that if the patient continues to experience unexplained symptoms, the patient should contact the patient’s health care provider and inquire about the appropriateness of retesting or initial or additional treatment.
   If at any time the department of health and human services (HHS) finds there are significant differences between the content of the required notice and the most recent medical evidence on Lyme disease testing, HHS may adopt administrative rules to amend the content of the notice to reflect the most recent medical evidence. Additionally, the provision by a health care provider or medical laboratory of the notice required under the bill shall not be the sole basis for a cause of action or licensee discipline.
   “Health care provider” and “medical laboratory” are defined in the bill.
   The bill also requires professional licensing boards for health care providers to develop, and health care providers to complete, continuing education requirements regarding treatment strategies to assist patients with prolonged symptoms due to Lyme disease in managing and recovering from these prolonged symptoms.
   The bill also amends a Code provision relating to Lyme disease treatment and exemption from licensee discipline to provide that a health care provider as defined under the bill shall not be subject to licensee discipline under Code chapter 147 (general provisions, health-related professions) or the health licensing board’s enabling statute solely on the basis of the provision of the notice required under the bill.