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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*sb0969*
SENATE BILL 969
J5 6lr3651
CF HB 1375
By: Senator Mautz
Introduced and read first time: February 13, 2026
Assigned to: Rules
A BILL ENTITLED
AN ACT concerning 1
Health Insurance – Lyme Disease and Related Tick–Borne Illnesses – 2
Long–Term Antibiotic Treatment 3
FOR the purpose of requiring certain insurers, nonprofit health service plans, and health 4
maintenance organizations to provide certain coverag e for the full length of 5
long–term antibiotic treatment of Lyme disease and related tick –borne illnesses 6
under certain circumstances; prohibiting certain insurers, nonprofit health service 7
plans, and health maintenance organizations from placing a quantitative limit on or 8
denying coverage for benefits required under this Act; and generally relating to 9
health insurance coverage for long–term antibiotic treatment for Lyme disease and 10
related tick–borne illnesses. 11
BY adding to 12
Article – Insurance 13
Section 15–864 14
Annotated Code of Maryland 15
(2017 Replacement Volume and 2025 Supplement) 16
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17
That the Laws of Maryland read as follows: 18
Article – Insurance 19
15–864. 20
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE ME ANINGS 21
INDICATED. 22
(2) “CLINICAL DIAGNOSIS” MEANS THE OBSERVATION BY A LICENSED 23
PHYSICIAN OF SIGNS A ND SYMPTOMS COMPATIB LE WITH ACUTE , PERSISTENT, OR 24
2 SENATE BILL 969
CHRONIC INFECTION OR OTHER CHRONIC MANIFESTATIONS OF LYME DISEASE. 1
(3) (I) “LONG–TERM ANTIBIOTIC TREA TMENT” MEANS THE 2
ADMINISTRATION OF OR AL, INTRAMUSCULAR, OR INTRAVENOUS ANTIB IOTIC 3
MEDICATIONS FOR LONGER THAN 4 WEEKS. 4
(II) “LONG–TERM ANTIBIOTIC TREA TMENT” INCLUDES 5
SEPARATE AND COMBINATION ADMINISTRATIONS OF ANTIBIOTIC MEDICATIONS. 6
(4) “LYME DISEASE” INCLUDES ONE OR MORE OF THE FOLLOWING: 7
(I) THE CLINICAL DIAGNOS IS OF A PATIENT BY A LICENSED 8
PHYSICIAN OF THE PRESENCE OF SIGNS OR SYMPTOMS COMPATIBLE WITH AN ACUTE 9
INFECTION WITH BORRELIA BURGDORFERI; 10
(II) LATE–STAGE, PERSISTENT, OR CHRONIC INFECTION WITH 11
BORRELIA BURGDORFERI; 12
(III) COMPLICATIONS RELATE D TO AN INFECTION WI TH 13
BORRELIA BURGDORFERI; 14
(IV) AN INFECTION BY OTHE R STRAINS OF BORRELIA THAT 15
BECOME IDENTIFIED OR RECOGNIZED BY THE CENTERS FOR DISEASE CONTROL 16
AND PREVENTION AS A CAUSE OF LYME DISEASE; 17
(V) AN INFECTION THAT ME ETS THE SURVEILLANCE CRITERIA 18
FOR LYME DISEASE SET FORT H BY THE CENTERS FOR DISEASE CONTROL AND 19
PREVENTION; AND 20
(VI) A CLINICAL DIAGNOSIS OF LYME DISEASE THAT DOE S NOT 21
MEET THE SURVEILLANC E CRITERIA SET FORTH BY THE CENTERS FOR DISEASE 22
CONTROL AND PREVENTION BUT PRESEN TS OTHER ACUTE , PERSISTENT, OR 23
CHRONIC SIGNS OR SYMPTOMS OF LYME DISEASE AS DETERMINED BY A LIC ENSED 24
PHYSICIAN, WHETHER THAT DIAGNOSIS IS BASED ONLY ON KNOWLEDGE OBTAINED 25
THROUGH MEDICAL HIST ORY AND PHYSICAL EXA MINATION OR IN CONJU NCTION 26
WITH TESTING THAT PROVIDES SUPPORTIVE DATA OF THE DIAGNOSIS. 27
(5) “RELATED TICK –BORNE ILLNESS ” MEANS BARTONELLO SIS, 28
BABESIOSIS, EHRLICHIOSIS, ANAPLASMOSIS, PIROPLASMOSIS, OR ANY OTHER 29
TICK–BORNE ILLNESS THAT MAY BE ASSOCIATED WITH LYME DISEASE. 30
(6) “THERAPEUTIC PURPOSE” MEANS THE USE OF ANT IBIOTICS TO 31
CONTROL THE SYMPTOMS OF LYME DISEASE AND OTHE R RELATED 32
SENATE BILL 969 3
TICK–BORNE ILLNESSES. 1
(B) THIS SECTION APPLIES TO: 2
(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 3
PROVIDE HOSPITAL , MEDICAL, SURGICAL, OR PHARMACEUTICAL BE NEFITS TO 4
INDIVIDUALS OR GROUP S ON AN EXPENSE –INCURRED BASIS UNDER A HEALTH 5
INSURANCE POLICY OR CONTRACT ISSUED OR DELIVERED IN THE STATE; AND 6
(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 7
HOSPITAL, MEDICAL, SURGICAL, OR PHARMACEUTICAL BENEFITS TO INDIVIDUALS 8
OR GROUPS UNDER CONTRACTS THAT ARE ISSUED OR DELIVERED IN THE STATE. 9
(C) IF THE LONG–TERM ANTIBIOTIC TREA TMENT OF LYME DISEASE AND 10
RELATED TICK–BORNE ILLNESSES HAS BEEN ORDERED BY A LI CENSED TREATING 11
PHYSICIAN FOR THERAPEUTIC PURPOSES, AN ENTITY SUBJECT TO THIS SECTION: 12
(1) SHALL PROVIDE COVERA GE FOR THE FULL LENG TH OF THE 13
LONG–TERM ANTIBIOTIC TREATM ENT TO BE ADMINISTER ED IN THE MANNER 14
PRESCRIBED BY THE LICENSED TREATING PHYSICIAN; AND 15
(2) MAY NOT IMPOSE A QUA NTITATIVE LIMITATION ON THE 16
LONG–TERM ANTIBIOTIC TREATMENT. 17
(D) AN ENTITY SUBJECT TO THIS SECTION MAY NOT DENY COVERAGE FOR 18
TREATMENT OTHERWISE ELIGIBLE FOR BENEFIT S UNDER THIS SECTION SOLELY 19
BECAUSE THE TREATMENT MAY BE CATEGORIZED AS UNPROVEN, EXPERIMENTAL, 20
OR INVESTIGATIONAL IN NATURE. 21
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 22
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 23
after January 1, 2027. 24
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 25
January 1, 2027. 26