Blue Cross & Blue Shield of Rhode Island has transformed a bill that would require insurers to pay for treatment of chronic Lyme disease into a prohibition on disciplining physicians for prescribing the treatment. Some doctors say the new law will do little to help patients.

Backed by a hearing room full of Lyme patients with canes and walkers, Joseph Larisa, Governor Lincoln Almond's chief of staff, told a May 30 hearing of the Joint Committee on Environment and Energy that the revised legislation, would "let each doctor treat as they see fit." But Dr. Peter Brassard, who tested a Lyme vaccine on Block Island and served on the Governor's Commission on Lyme Disease and Other Tick-Borne Diseases, disagrees. The problem is not doctors getting disciplined, he says, but chronic Lyme patients being stiffed by their insurance companies.

Bruce McIntyre, acting chief administrative officer of the Board of Medical Licensure and Discipline, agrees, saying the revised bill solves a problem that does not exist.

A combination of joint pain, fatigue, and headaches, Lyme disease was discovered in the mid-'70s in Lyme, Connecticut. Transmitted by ticks, the disease spread to Rhode Island, which now has the second highest per capita number of Lyme disease cases in the United States, according to the legislation. Taking antibiotics for less than a month cures most cases caught early, but others appear to linger. And because a conclusive test hasn't been developed, many doctors question whether patients have chronic Lyme disease, another physical condition, or a psychological problem. Skeptics compare chronic Lyme to other nebulous ailments, like chronic fatigue syndrome and fibromyalgia.

Brassard believes chronic Lyme exists, but he cautions, "I don't think it's as common as some would like to think." Absent a solid diagnosis, however, many doctors will not prescribe long-term intravenous antibiotics because of their side effects. And insurance companies balk at paying for the expensive treatment.

During the hearing, Larisa explained that the insurance mandate was scrapped because Blue Cross agreed to pay to treat some chronic Lyme cases. Negotiations with other insurers will follow, he promised. Insurance lobbyists certainly would have killed the original bill, adds its sponsor, state Senator Susan Sosnowski (D-South Kingstown).

Brian Jordan, Blue Cross' assistant vice president of legislative affairs, insists the company's opposition was "strictly medical," and "had nothing to do with economics." The insurance giant merely wants to protect patients from doctors prescribing drugs with dangerous side effects, he says.

Issue Date: June 21 - 27, 2002