The legislation, which has 36 cosponsors, would require insurance companies to cover antibiotic treatment for Lyme disease as prescribed by a physician. Many companies now limit coverage after a 28-day period, which advocates say prevents those who need more prolonged treatment from getting it.

The measure was the subject of a recent hearing before a legislative committee, which has asked a state financial panel to analyze the costs it would pose to insurers and the state, according to state Representative Theodore C. Speliotis, the Danvers Democrat who is the bill’s chief sponsor.

With the number of reported Lyme disease cases surging in Massachusetts, an area lawmaker’s bill to expand insurance coverage for people with long-term symptoms of the tick-borne disease is gaining fresh attention on Beacon Hill.

Speliotis has been pushing the bill for about a decade, but he said the committee’s decision to seek the cost numbers is “an important step” in advancing the legislation, which is a priority for Lyme disease patient advocacy groups but opposed by the state’s insurance industry.


“It says the Legislature is looking at it very seriously. That’s a good thing,” he said, noting that in the past, lawmakers were reluctant to give much consideration to the bill, siding with the insurance industry’s position.

Supporters say the bill is the logical next step in expanding access to treatment following the adoption of a 2010 law that protects physicians from being professionally sanctioned if they prescribe long-term antibiotic treatment for a patient.

“What the advocates are saying is if you can protect the doctors, you ought to protect the patient. This is a patients’ rights bill,” Speliotis said. “The real intent of the bill is to ensure that people will get longer coverage than 28 days.’’

Speliotis’s bill received a boost when a special state commission on Lyme disease last year recommended that it be adopted. State figures also show that Lyme disease infection is on the rise.

The state Department of Public Health said that 3,342 confirmed and 1,708 probable Lyme disease cases were reported in Massachusetts in 2012, representing a 19 percent increase over 2011.


“Lyme disease is endemic in all of Massachusetts,” the agency said on its website. Areas of highest incidence include much of the eastern half of the state, with portions of Essex and Middlesex counties with particularly high levels. There were 505 confirmed and probable cases in Essex County in 2012, and 774 in Middlesex.

New estimates released by the US Centers for Disease Control and Prevention in August indicated that the incidence of the disease nationally may be 10 times higher than previously thought. While the agency did not provide a breakdown, its figures suggest 40,000 new cases each year in Massachusetts.

Among those pushing Speliotis’s bill is Susan Fairbanks-Pitzer, a Danvers resident who runs a regional support group for Lyme patients.

Both Fairbanks-Pitzer and her 21-year-old daughter, Alexandra Pitzer, have been diagnosed with Lyme disease and treated for it. However, her daughter’s disease progressed and became so bad that she had to be home-schooled for much of her high school years. After years of treatment, she is better, but not totally free of symptoms.

“Lyme is a serious financial problem in Massachusetts both in actual costs and in lost productivity, and in our quality of life,” Fairbanks-Pitzer said. “Some people don’t get better with a short course of antibiotics, and they can be profoundly disabled.

“And there are people who get better with a longer course of antibiotics, whether oral or intravenous,” she added. “We should not be allowing insurance companies to dictate whether we get well enough.”


Most infectious-diseases specialists say a month or less of antibiotics usually rids the body of infection, although up to three months may be needed to treat Lyme arthritis, a later-stage symptom of the disease.

But thousands of patients and some doctors say Lyme can persist in the body even after being treated aggressively with antibiotics. One of the ways this chronic form of Lyme can be managed or cured, many of them say, is for patients to take more antibiotics for longer periods of time — which can cost more than $5,000 a month.

The Massachusetts Association of Health Plans, which advocates for the insurance industry, opposes the Speliotis bill, according to Dr. Neil Minkoff, the group’s medical director.

“The existence of chronic Lyme disease is highly controversial,” Minkoff said, referring to contention over whether the symptoms that some patients report months or years after treatment for Lyme disease are caused by the disease or some other factors.

“We want to follow the lead of clinical experts, and here the clinical experts are saying they are not sure this is a disease and they don’t recommend long-term antibiotics for it,” he said, citing that as the position of the American College of Rheumatology.

Added Minkoff: “There is a lot of public health concern about overuse of antibiotics and all the negative effects from that,” citing a recent report by the CDC that pointed to drug resistance stemming from the overuse of antibiotics as a major public health issue.


He said that in keeping with the position of the national rheumatology organization, the state’s insurers typically cover antibiotic treatment for a 28-day period, though some will extend it on a case-by-case basis.

Fairbanks-Pitzer said her family is fortunate in that their insurance did cover the long-term antibiotic treatment both she and her daughter needed. But she said, “I know a lot of people that are permanently disabled now because they could not get the treatment they needed because their insurance companies denied it and they could not afford the medicine.”

She cited the case of the daughter of a friend who was diagnosed at age 25 with severe neurological issues. The woman’s condition improved with intravenous antibiotics, but her insurer cut off coverage after two months. Her friend successfully sued to restore the treatment, but Fairbanks-Pitzer said the daughter sustained further neurological damage in the six months she did not have it.

“A qualified physician should be able to order any prescription they believe in their experience is going to help their patient,” Fairbanks-Pitzer said.

Speliotis said that he welcomes the financial analysis his bill will be undergoing, noting that having clear figures concerning its costs will be important to securing votes for its passage.

Despite its long history, Speliotis said, the bill is only now getting a serious look by the Legislature, and he is open to any changes that might help move it along. He said the financial analysis will help the process by giving lawmakers clear numbers on the costs.


“My job is to get a bill before the committee and to advocate as strongly as possible [for it]. But we also need to write a bill that is fair to everyone,” he said.

John Laidler can be reached at laidler@globe.com.