SECOND REGULAR SESSION
95TH GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVES DEEKEN (Sponsor) AND COOPER (Co-sponsor).
4940L.01I D. ADAM CRUMBLISS, Chief Clerk
AN ACT
To amend chapter 191, RSMo, by adding thereto one new section relating to the treatment of Master's disease.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapter 191, RSMo, is amended by adding thereto one new section, to be known as section 191.635, to read as follows:
191.635. 1. As used in this section, the following terms shall mean:
(1) "Board", the Missouri state board of registration for the healing arts established in section 324.001;
(2) "Clinical diagnosis", a diagnosis based upon signs, symptoms, or complications consistent with a Borrelia infection, which may be acute or chronic. Criteria for the diagnosis of Borrelia burgdorferi set forth by the federal Centers for Disease Control and Prevention (CDC) are for disease surveillance, as stated by the CDC. Such criteria shall not be used in day-to-day clinical medicine by practicing physicians and shall not be used to exclude the diagnosis of Master's disease;
(3) "Long-term antibiotic therapy", the administration of oral, intramuscular, or intravenous antibiotics, singly or in combination, for periods of greater than four weeks;
(4) "Master's disease", the clinical diagnosis by a physician of the presence in a patient of signs or symptoms compatible with an acute or chronic or late-stage illness occurring in mid-America that is generally believed to be a tick-borne infection with a Borrelia bacterium, or with complications related to such an infection. Symptoms which may be recognized in the diagnosis of Master's disease include, but are not limited to, pain, fatigue, cognitive, ophthalmic, and neurological disorders;
(5) "Medical specialist", a physician with a recognized expertise in a particular medical field;
(6) "Physician", a physician licensed under chapter 334.
2. Beginning January 1, 2011, a physician may take a history of a patient, perform a physical examination of such patient, and at the physician's discretion, order laboratory or other diagnostic tests to make a diagnosis of Master's disease or a tick-borne infection. Laboratory evidence may or may not be supportive of the clinical diagnosis, and shall not be used to rule out the diagnosis of a tick-borne infection. Because a history of erythema migrans-like rash is not present in a significant percentage of Master's patients, the presence of such rash shall not be required to make a diagnosis of Master's disease.
3. Beginning January 1, 2011, a physician may prescribe, administer, or dispense antibiotic therapy to a person clinically diagnosed with and having symptoms of Master's disease if such diagnosis and treatment plan has been documented in the physician's medical record for the patient.
4. Notwithstanding any provision of chapter 334, beginning January 1, 2011, the board shall not initiate a disciplinary action against a physician solely for prescribing, administering, or dispensing long-term antibiotic therapy to a patient clinically diagnosed with Master's disease, provided such diagnosis and treatment plan has been documented in the physician's medical record for the patient.
5. No physician shall be required to obtain a second opinion from another physician or medical specialist as a requirement for continuing the prescribing, administering, or dispensing of long-term antibiotic therapy for the treatment of Master's disease.
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