,,ii #aafth ,,congress #b;d ,session ,s4 #debd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,august #ab1 #bjbj,mr4 ,carper introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend titles ,,xix and ,,xxi of the ,social ,security ,act to provide coverage of comprehensive tobacco cessation services under such titles1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,quit ,because of ,,covid-#ai ,act4 #b4 ,coverage of comprehensive tobacco cessation services in ,medicaid 7a7 ,requiring ,medicaid coverage of counseling and pharmacotherapy for cessation of tobacco use and dependence ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7#a7 in subsection 7a77#d7-- 7,a7 by striking and 7,d7 and inserting 7,d72 and 7,b7 by inserting before the semicolon at the end the following3 2 and 7,e7 counseling and pharmacotherapy for cessation of tobacco use and dependence by individuals who are eligible under the ,state plan 7as defined in subsection 7gg77 during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins with the day after the last day of such emergency period2 and 7#b7 by adding at the end the following new subsection3 7gg7 ,counseling and pharmacotherapy for cessation of tobacco use and dependence 7#a7 ,in general ,for purposes of this title1 the term counseling and pharmacotherapy for cessation of tobacco use and dependence means diagnostic1 therapy1 and counseling services and pharmacotherapy 7including the coverage of prescription and nonprescription tobacco cessation agents approved by the ,food and ,drug ,administration7 for the cessation of tobacco use and dependence by individuals who use tobacco products or who are being treated for tobacco use and dependence that are furnished-- 7,a7 by or under the supervision of a physician2 or 7,b7 by any other health care professional who-- 7i7 is legally authorized to furnish such services under ,state law 7or the ,state regulatory mechanism provided by ,state law7 of the ,state in which the services are furnished2 and 7ii7 is authorized to receive payment for other services under this title or is designated by the ,secretary for this purpose4 7#b7 ,limitation ,such term is limited to-- 7,a7 services that are recommended-- 7i7 in the guideline entitled1 ,treating ,tobacco ,use and ,dependence3 #bjjh ,update3 ,a ,clinical ,practice ,guideline published by the ,public ,health ,service in ,may #bjjh 7or any subsequent modification of such guideline72 or 7ii7 for the cessation of tobacco use and dependence by the ,united ,states ,preventive ,services ,task ,force2 or 7,b7 any additional interventions approved by the ,food and ,drug ,administration as safe and effective in the cessation of tobacco use and dependence by individuals who use tobacco products or who are being treated for tobacco use and dependence4 4 7b7 ,no cost sharing 7#a7 ,in general ,subsections 7a77#b7 and 7b77#b7 of section #aiaf of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo7 are each amended-- 7,a7 in subparagraph 7,f71 by striking or at the end2 7,b7 in subparagraph 7,g71 by striking 2 and and inserting 1 or2 and 7,c7 by adding at the end the following new subparagraph3 7,h7 counseling and pharmacotherapy for cessation of tobacco use and dependence 7as defined in section #aije7;gg77 and covered outpatient drugs 7as defined in subsection 7k77#b7 of section #aibg and including nonprescription drugs described in subsection 7d77#b7 of such section7 that are prescribed for purposes of promoting1 and when used to promote1 tobacco cessation in accordance with a guideline1 recommendation1 or approval specified in section #aije7;gg77#b7 7as applicable7 furnished during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins with the day after the last day of such emergency period2 and 4 7#b7 ,application to alternative cost sharing ,section #aiaf;,a7b77#c77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo-#a7;b77#c77;,b77 is amended by adding at the end the following new clause3 7xii7 ,counseling and pharmacotherapy for cessation of tobacco use and dependence 7as defined in section #aije7;gg77 and covered outpatient drugs 7as defined in subsection 7k77#b7 of section #aibg and including nonprescription drugs described in subsection 7d77#b7 of such section7 that are prescribed for purposes of promoting1 and when used to promote1 tobacco cessation in accordance with a guideline1 recommendation1 or approval specified in section #aije7;gg77#b7 7as applicable7 furnished during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins with the day after the last day of such emergency period4 4 7c7 ,exception from optional restriction under ,medicaid prescription drug coverage ,section #aibg7;d77#b77;,f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7;d77#b77;,f77 is amended to read as follows3 7,f7 ,nonprescription drugs1 except1 in the case of pregnant women 7and1 during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins with the day after the last day of such emergency period1 other individuals who use tobacco products or are being treated for tobacco use and dependence71 when recommended in accordance with the guideline specified in section #aije7;bb77#b77;,a7 7or in accordance with a guideline1 recommendation1 or approval specified in section #aije7;gg77#b71 if applicable71 agents approved by the ,food and ,drug ,administration under the over-the-counter monograph process for purposes of promoting1 and when used to promote1 tobacco cessation4 4 7d7 ,state monitoring and promoting of comprehensive tobacco cessation services under ,medicaid ,section #aijb7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is amended-- 7#a7 in paragraph 7#he71 by striking at the end and2 7#b7 in paragraph 7#hf71 by striking the period at the end and inserting 2 and2 and 7#c7 by inserting after paragraph 7#hf7 the following new paragraph3 7#hg7 during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins with the day after the last day of such emergency period1 provide that the ,state will monitor and promote the use of comprehensive tobacco cessation services under the ,state plan 7including by conducting an outreach campaign to increase awareness of the benefits of using such services7 among-- 7,a7 individuals entitled to medical assistance under the ,state plan who use tobacco products2 and 7,b7 clinicians and others who provide services to individuals entitled to medical assistance under the ,state plan4 4 7e7 ,federal reimbursement for coverage of tobacco cessation services and outreach campaign 7#a7 ,coverage of tobacco cessation services ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d71 as amended by subsection 7a71 is amended-- 7,a7 in subsection 7b71 by striking and 7ff7 and inserting 7ff71 and 7gg77#c72 and 7,b7 in subsection 7gg71 as added by subsection 7a71 by adding at the end the following new paragraph3 7#c7 ,increased ,,fmap ,notwithstanding subsection 7b71 the ,federal medical assistance percentage for a ,state1 with respect to amounts expended by such ,state for medical assistance furnished during the emergency period described in section #aace7;g77#a77;,b7 for counseling and pharmacotherapy for cessation of tobacco use and dependence by eligible individuals1 shall be equal to #ajj percent4 4 7#b7 ,outreach campaign ,section #aijc7;a7 of the ,social ,security ,act 7#db ,u4,s4,c #acif;b7a77 is amended-- 7,a7 by striking the period at the end of paragraph 7#g7 and inserting 2 plus2 and 7,b7 by inserting after paragraph 7#g7 the following new paragraph3 7#h7 an amount equal to #ajj percent of the sums expended in a quarter that occurs during the emergency period described in section #aace7;g77#a77;,b7 which are attributable to the development1 implementation1 and evaluation of the outreach campaign required under section #aijb7;a77#hg74 4 7f7 ,no prior authorization for tobacco cessation drugs under ,medicaid ,section #aibg7;d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifr-#h7;d77 is amended-- 7#a7 in paragraph 7#a77;,a71 by striking ,a ,state and inserting ,subject to paragraph 7#h71 a ,state2 and 7#b7 by adding at the end the following new paragraph3 7#h7 ,no prior authorization programs for tobacco cessation drugs ,during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period after the last day of such emergency period1 a ,state plan may not require1 as a condition of coverage or payment for a covered outpatient drug that is an agent to promote smoking cessation 7including agents approved by the ,food and ,drug ,administration7 or tobacco cessation1 the approval of such drug before its dispensing4 4 7g7 ,exclusion of enhanced payments from territorial caps ,notwithstanding any other provision of law1 for purposes of section #aajh of the ,social ,security ,act 7#db ,u4,s4,c4 #acjh71 with respect to any additional amount paid to a territory as a result of the application of paragraph 7#h7 of section #aijc7;a7 or subsection 7gg77#c7 of section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a71 #acif;d7-- 7#a7 the limitation on payments to territories under subsections 7f7 and 7g7 of such section #aajh shall not apply to such additional amounts2 and 7#b7 such additional amounts shall be disregarded in applying such subsections4 #c4 ,coverage of comprehensive tobacco cessation services in ,,chip 7a7 ,requiring ,,chip coverage of counseling and pharmacotherapy for cessation of tobacco use and dependence 7#a7 ,in general ,section #bajc7;c77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7c77#b77 is amended by adding at the end the following new subparagraph3 7,d7 ,counseling and pharmacotherapy for cessation of tobacco use and dependence by individuals who are eligible under the ,state child health plan during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins with the day after the last day of such emergency period4 4 7#b7 ,counseling and pharmacotherapy for cessation of tobacco use and dependence defined ,section #baaj7;c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;jj7c77 is amended by adding at the end the following new paragraph3 7#aj7 ,counseling and pharmacotherapy for cessation of tobacco use and dependence 7,a7 ,in general ,the term counseling and pharmacotherapy for cessation of tobacco use and dependence means diagnostic1 therapy1 and counseling services and pharmacotherapy 7including the coverage of prescription and nonprescription tobacco cessation agents approved by the ,food and ,drug ,administration7 for the cessation of tobacco use and dependence by individuals who use tobacco products or who are being treated for tobacco use and dependence that are furnished-- 7i7 by or under the supervision of a physician2 or 7ii7 by any other health care professional who-- 7,i7 is legally authorized to furnish such services under ,state law 7or the ,state regulatory mechanism provided by ,state law7 of the ,state in which the services are furnished2 and 7,,ii7 is authorized to receive payment for other services under this title or is designated by the ,secretary for this purpose4 7,b7 ,limitation ,such term is limited to-- 7i7 services that are recommended-- 7,i7 in the guideline entitled1 ,treating ,tobacco ,use and ,dependence3 #bjjh ,update3 ,a ,clinical ,practice ,guideline published by the ,public ,health ,service in ,may #bjjh 7or any subsequent modification of such guideline72 or 7,,ii7 for the cessation of tobacco use and dependence by the ,united ,states ,preventive ,services ,task ,force2 or 7ii7 any additional interventions approved by the ,food and ,drug ,administration as safe and effective in the cessation of tobacco use and dependence by individuals who use tobacco products or who are being treated for tobacco use and dependence4 4 7b7 ,no cost sharing ,section #bajc7;e7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7e77 is amended by adding at the end the following new paragraph3 7#e7 ,no cost sharing on benefits for counseling and pharmacotherapy for cessation of tobacco use and dependence ,the ,state child health plan may not impose deductibles1 coinsurance1 or other cost sharing with respect to benefits for counseling and pharmacotherapy for cessation of tobacco use and dependence 7as defined in section #baaj7;c77#aj77 and prescription drugs that are covered under a ,state child health plan that are prescribed for purposes of promoting tobacco cessation in accordance with a guideline1 recommendation1 or approval specified in section #baaj7;c77#aj77;,b7 furnished during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins with the day after the last day of such emergency period4 4 7c7 ,exception from optional restriction under ,,chip prescription drug coverage ,section #bajc of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7 is amended by adding at the end the following new subsection3 7g7 ,exception from optional restriction under ,,chip prescription drug coverage ,the ,state child health plan may exclude or otherwise restrict nonprescription drugs1 except-- 7#a7 in the case of pregnant women1 when recommended in accordance with a guideline1 recommendation1 or approval specified in section #baaj7;c77#aj77;,b71 agents approved by the ,food and ,drug ,administration under the over-the-counter monograph process for purposes of promoting1 and when used to promote1 tobacco cessation2 and 7#b7 in the case of individuals who are eligible under the ,state child health plan1 when recommended in accordance with a guideline1 recommendation1 or approval specified in section #baaj7;c77#aj77;,b7 referred to in section #baaj7;c77#aj77;,b71 agents approved by the ,food and ,drug ,administration under the over-the-counter monograph process for purposes of promoting1 and when used to promote1 tobacco cessation during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins on the day after the last day of such emergency period4 4 7d7 ,state monitoring and promoting of comprehensive tobacco cessation services under ,,chip ,section #bajb of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;bb7 is amended by adding at the end the following new subsection3 7d7 ,state monitoring and promoting of comprehensive tobacco cessation services under ,,chip ,a ,state child health plan shall include a description of the procedures to be used by the ,state during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period after the last day of such emergency period to monitor and promote the use of comprehensive tobacco cessation services under the ,state plan 7including conducting an outreach campaign to increase awareness of the benefits of using such services7 among-- 7#a7 individuals entitled to child health assistance under the ,state child health plan who use tobacco products2 and 7#b7 clinicians and others who provide services to individuals entitled to child health assistance under the ,state child health plan4 4 7e7 ,federal reimbursement for ,,chip coverage and outreach campaign ,section #baje7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;ee7a77 is amended by adding at the end the following new paragraph3 7#e7 ,federal reimbursement for ,,chip coverage of comprehensive tobacco cessation services and outreach campaign ,in addition to the payments made under paragraph 7#a7 7and1 in the case of a payment that may be made both under paragraph 7#a7 and under this paragraph1 instead of a payment under paragraph 7#a771 for the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins on the day after the last day of such emergency period1 the ,secretary shall pay-- 7,a7 an amount equal to #ajj percent of the sums expended during each quarter which are attributable to the cost of furnishing counseling and pharmacotherapy for cessation of tobacco use and dependence by individuals who are eligible under the ,state child health plan2 plus 7,b7 an amount equal to #ajj percent of the sums expended during each quarter which are attributable to the development1 implementation1 and evaluation of an outreach campaign to-- 7i7 increase awareness of comprehensive tobacco cessation services covered in the ,state child health plan among-- 7,i7 individuals who are likely to be eligible for medical assistance under the ,state child health plan2 and 7,,ii7 clinicians and others who provide services to individuals who are likely to be eligible for medical assistance under the ,state child health plan2 and 7ii7 increase awareness of the benefits of using comprehensive tobacco cessation services covered in the ,state child health plan among-- 7,i7 individuals who are likely to be eligible for medical assistance under the ,state child health plan2 and 7,,ii7 clinicians and others who provide services to individuals who are likely to be eligible for medical assistance under the ,state child health plan about the benefits of using comprehensive tobacco cessation services4 4 7f7 ,no prior authorization for tobacco cessation drugs under ,,chip ,section #bajc of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc71 as amended by subsection 7c71 is further amended-- 7#a7 in subsection 7c77#b77;,a71 by inserting 7in accordance with subsection 7h77 after ,coverage of prescription drugs2 and 7#b7 by adding at the end the following new subsection3 7h7 ,no prior authorization programs for tobacco cessation drugs ,during the period beginning on the first day of the emergency period described in section #aace7;g77#a77;,b7 and ending on the last day of the #b-year period that begins with the day after the last day of such emergency period1 a ,state child health plan may not require1 as a condition of coverage or payment for a prescription drug that is an agent to promote smoking cessation 7including agents approved by the ,food and ,drug ,administration7 or tobacco cessation1 the approval of such drug before its dispensing4 4 #d4 ,conforming amendments ,title ,,xix of the ,social ,security ,act 7#db ,u4,s4,c4 #acif et seq47 is amended in each of sections #aije7;a77#d77;,d71 #aije7;bb77#a71 #aije7;bb77#b77;,b71 #aiaf7;a77#b77;,b71 #aiaf7;b77#b77;,b71 and #aiaf;,a7b77#c77;,b77iii7 by striking tobacco use each place it appears and inserting tobacco use and dependence4 #e4 ,rule of construction ,none of the amendments made by this ,act shall be construed to limit coverage of any counseling or pharmacotherapy for individuals under #ah years of age4