H.F. 2591 Section 1. NEW SECTION . 135.194 Lyme disease —— laboratory 1 test —— notice requirement and content —— cause of action —— 2 licensee discipline. 3 1. A health care provider who draws the blood of a patient 4 to perform a laboratory test for the presence of Lyme disease 5 or a medical laboratory that performs a laboratory test for the 6 presence of Lyme disease shall provide the following written 7 notice to the patient at the time the patient’s blood is drawn: 8 Your health care provider has ordered a laboratory test 9 for the presence of Lyme disease for you. Current laboratory 10 testing for Lyme disease can be problematic and standard 11 laboratory tests often result in false negative and false 12 positive results and, if performed too early, you may not have 13 produced enough antibodies to be considered positive because 14 your immune response requires time to develop antibodies. 15 If you are tested for the presence of Lyme disease and the 16 results are negative, this does not necessarily mean you do not 17 have Lyme disease. If you continue to experience unexplained 18 symptoms, you should contact your health care provider and 19 inquire about the appropriateness of retesting or initial or 20 additional treatment. 21 2. At any time, if the department determines there are 22 significant differences between the content of the notice 23 required by subsection 1 and the most recent medical evidence 24 on Lyme disease testing, the department may adopt rules 25 pursuant to chapter 17A to amend the content of the notice to 26 reflect the most recent medical evidence. 27 3. The provision by a health care provider or medical 28 laboratory of the notice required by this section shall not be 29 the sole basis for a cause of action or licensee discipline. 30 4. For the purposes of this section: 31 a. “Health care provider” means an individual licensed 32 under chapter 148, 148C, 148D, 152, or 152E, or any individual 33 who provides medical services under the authorization of the 34 licensee. 35 -1- LSB 5087HV (3) 90 pf/ko 1/ 4

H.F. 2591 b. “Medical laboratory” means any facility, entity, or site 1 that offers or performs tests or examinations in connection 2 with the diagnosis and control of human diseases or the 3 assessment of human health, nutritional, or medical conditions. 4 Sec. 2. NEW SECTION . 135.195 Continuing education —— 5 treatment strategies for prolonged symptoms due to Lyme disease. 6 Each licensing board for a health care provider as defined 7 in section 135.194 shall develop continuing education 8 requirements regarding treatment strategies to assist patients 9 with prolonged symptoms due to Lyme disease in managing and 10 recovering from these prolonged symptoms. 11 Sec. 3. Section 147.56, Code 2024, is amended to read as 12 follows: 13 147.56 Lyme disease treatment —— laboratory testing notice —— 14 exemption from licensee discipline. 15 1. A person licensed by a board under this subtitle shall 16 not be subject to discipline under this chapter or the board’s 17 enabling statute based solely on the licensee’s recommendation 18 or provision of a treatment method for Lyme disease or other 19 tick-borne disease if the recommendation or provision of such 20 treatment meets all the following criteria: 21 1. a. The treatment is provided after an examination is 22 performed and informed consent is received from the patient. 23 2. b. The licensee identifies a medical reason for 24 recommending or providing the treatment. 25 3. c. The treatment is provided after the licensee informs 26 the patient about other recognized treatment options and 27 describes to the patient the licensee’s education, experience, 28 and credentials regarding the treatment of Lyme disease or 29 other tick-borne disease. 30 4. d. The licensee uses the licensee’s own medical 31 judgment based on a thorough review of all available clinical 32 information and Lyme disease or other tick-borne disease 33 literature to determine the best course of treatment for the 34 individual patient. 35 -2- LSB 5087HV (3) 90 pf/ko 2/ 4

H.F. 2591 5. e. The treatment will not, in the opinion of the 1 licensee, result in the direct and proximate death of or 2 serious bodily injury to the patient. 3 2. A health care provider as defined in section 135.194 4 shall not be subject to licensee discipline under this chapter 5 or the board’s enabling statute solely on the basis of the 6 provision of the notice required by section 135.194. 7 Sec. 4. CODE EDITOR DIRECTIVE. The Code editor is directed 8 to create a new subchapter XXXVII in chapter 135 as follows: 9 Subchapter XXXVII shall be entitled “LYME DISEASE TESTING —— 10 NOTICE AND CONSENT REQUIREMENTS —— CONTINUING EDUCATION” and 11 include sections 135.194 and 135.195. 12 EXPLANATION 13 The inclusion of this explanation does not constitute agreement with 14 the explanation’s substance by the members of the general assembly. 15 This bill relates to notice and consent requirements for 16 testing and treatment of Lyme disease. 17 The bill provides that a health care provider who draws 18 the blood of a patient to perform a laboratory test for 19 the presence of Lyme disease or a medical laboratory that 20 performs a laboratory test for the presence of Lyme disease 21 shall provide the written notice prescribed in the bill to 22 the patient at the time the patient’s blood is drawn. The 23 notice must include statements that: current laboratory 24 testing for the presence of Lyme disease can be problematic 25 and standard laboratory tests often result in false negative 26 and false positive results; that if testing is performed too 27 early, the patient may not have produced enough antibodies to 28 be considered positive because the patient’s immune response 29 requires time to develop antibodies; that if the patient is 30 tested for the presence of Lyme disease and the results are 31 negative, this does not necessarily mean the patient does 32 not have Lyme disease; and that if the patient continues 33 to experience unexplained symptoms, the patient should 34 contact the patient’s health care provider and inquire about 35 -3- LSB 5087HV (3) 90 pf/ko 3/ 4

H.F. 2591 the appropriateness of retesting or initial or additional 1 treatment. 2 If at any time the department of health and human services 3 (HHS) finds there are significant differences between the 4 content of the required notice and the most recent medical 5 evidence on Lyme disease testing, HHS may adopt administrative 6 rules to amend the content of the notice to reflect the most 7 recent medical evidence. Additionally, the provision by a 8 health care provider or medical laboratory of the notice 9 required under the bill shall not be the sole basis for a cause 10 of action or licensee discipline. 11 “Health care provider” and “medical laboratory” are defined 12 in the bill. 13 The bill also requires professional licensing boards 14 for health care providers to develop continuing education 15 requirements regarding treatment strategies to assist patients 16 with prolonged symptoms due to Lyme disease in managing and 17 recovering from these prolonged symptoms. 18 The bill also amends a Code provision relating to Lyme 19 disease treatment and exemption from licensee discipline to 20 provide that a health care provider as defined under the bill 21 shall not be subject to licensee discipline under Code chapter 22 147 (general provisions, health-related professions) or the 23 health licensing board’s enabling statute solely on the basis 24 of the provision of the notice required under the bill. 25 -4- LSB 5087HV (3) 90 pf/ko 4/ 4