BOSTON — Gov. Charlie Baker has settled on an alternative to the Legislature's broad mandate for long-term antibiotic treatment of Lyme disease.

Baker says he favors a more narrowly focused measure that he says mimics the approach taken in Rhode Island. A chief proponent of the legislation said Baker's amendment to the fiscal 2017 budget, handed down on Friday afternoon, would limit access to treatment and force people to incur higher costs associated with visiting specialists.

The tick-borne illness that can cause everything from aches to neurological problems takes a major toll on the Bay State, infecting thousands each year, according to the Department of Public Health.

The Legislature in its annual budget sought to smooth access to Lyme disease treatment, passing a mandate for public and private insurance coverage of long-term antibiotic treatment — a therapeutic method favored by some and opposed by others in the medical field.

The mandate was met with concern from the business and health insurance industry, along with objections from the Massachusetts Infectious Disease Society, which said long-term antibiotic treatment is dangerous. State mandates do not apply to large organizations with the ability to self-insure under federal rules.

Baker's plan scraps language mandating coverage of off-label uses of drugs and limits the mandate to long-term antibiotic treatment ordered by rheumatologists, infectious disease specialists or neurologists.


"While I support comprehensive coverage and access to Lyme disease treatment, long-term antibiotic therapy is not clinically recognized as an appropriate form of treatment," Baker said in a proposed amendment to the budget rider. "Further, requiring coverage of experimental drugs for off-label use sets a concerning precedent."

Baker's amendment also puts off implementation of the mandate to January 2017. The mandate would sunset July 2021, under the budget language.

"This is obviously a big deal and an important issue for a lot of people in Massachusetts," the governor said Friday. He said the administration has received a lot of feedback on the issue, including from people in the medical community arguing the treatment would be "harmful to the people that we're supposed to be trying to support here."

Rep. David Linsky, a Natick Democrat who backed the amendment in the House budget and cheered its incorporation into the final version of the spending bill sent to the governor's desk, said Baker's proposed language would eliminate existing coverage of off-label uses of drugs for long-term treatment of Lyme disease.

"I understand that the literature is split on this," said Linsky, who said he does not know whether critics of long-term antibiotic treatment or the therapy's proponents are correct, but said "the type of treatment that should be authorized should be left to a patient and the patient's physician."

Linsky said the governor's language would force people to receive treatment from more expensive specialists.

"We're very disappointed in the governor's actions because the proposed amendment, if it were in place, would actually raise consumer cost for health care and would actually make it more difficult for patients struggling with Lyme disease to get treatment," Linsky said.