,,ii #aaith ,,congress #ast ,session ,s4 #bjfd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,june #ab1 #bjbe,ms4 ,blunt ,rochester introduced the following bill2 which was read twice and referred to the ,committee on ,finance ,a ,,bill ,to amend title ,,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 ,helping ,tobacco ,users ,quit ,act4 #b4 ,coverage of comprehensive tobacco cessation services in ,medicaid 7a7 ,requiring ,medicaid coverage of counseling and pharmacotherapy for cessation of tobacco use and temporary enhanced ,,fmap for coverage of tobacco cessation services ,section #aije of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7 is amended-- 7#a7 by amending subsection 7a77#d77;,d7 to read as follows3 7,d7 counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the ,state plan 7as defined in subsection 7bb7722 7#b7 in subsection 7b71 by inserting 7bb77#b71 after 7aa712 and 7#c7 by striking subsection 7bb7 and inserting the following3 7bb7 ,counseling and pharmacotherapy for cessation of tobacco use 7#a7 ,in general ,for purposes of this title1 the term counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the ,state plan 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 by individuals who use tobacco products or who are being treated for tobacco use that is 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 purpose1 which is recommended 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 guideline7 or is recommended for the cessation of tobacco use by the ,u4,s4 ,preventive ,services ,task ,force or any additional intervention approved by the ,food and ,drug ,administration as safe and effective in helping smokers quit4 7#b7 ,temporary enhanced ,,fmap for coverage of tobacco cessation services ,notwithstanding subsection 7b71 for calendar quarters occurring during the period beginning on the date of the enactment of the ,helping ,tobacco ,users ,quit ,act and ending #e years after such date1 the ,federal medical assistance percentage with respect to amounts expended by a ,state for medical assistance for counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the ,state plan 7as defined in paragraph 7#a77 shall be equal to #ij percent4 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,b71 by striking 1 and counseling and all that follows through section #aije7;bb77#b77;,a72 7,b7 in subparagraph 7,i71 by striking or at the end2 7,c7 in subparagraph 7,j71 by striking 2 and and inserting 2 or2 and 7,d7 by adding at the end the following new subparagraph3 7,k7 counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the ,state plan 7as defined in section #aije7;bb77 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 promoting tobacco cessation in accordance with the guideline specified in section #aije7;bb72 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-- 7,a7 in clause 7iii71 by striking 1 and counseling and pharmacotherapy for cessation of tobacco use by pregnant women 7as defined in section #aije7;bb772 and 7,b7 by adding at the end the following new clause3 7xv7 ,counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the ,state plan 7as defined in section #aije7;bb77 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 promoting tobacco cessation in accordance with the guideline specified in section #aije7;bb74 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 when recommended in accordance with the guideline referred to in section #aije7;bb71 agents approved by the ,food and ,drug ,administration for purposes of promoting 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#hf71 by striking at the end and2 7#b7 in paragraph 7#hg71 by striking the period at the end and inserting 2 and2 and 7#c7 by inserting after paragraph 7#hg7 the following new paragraph3 7#hh7 provide for the ,state 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 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 outreach campaign ,section #aijc7;a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;b7a77 is amended-- 7#a7 in paragraph 7#g71 by striking the period at the end and inserting 2 plus2 and 7#b7 by inserting after paragraph 7#g7 the following new paragraph3 7#h7 with respect to the development1 implementation1 and evaluation of an outreach campaign to-- 7,a7 increase awareness of comprehensive tobacco cessation services covered in the ,state plan among-- 7i7 individuals who are likely to be eligible for medical assistance under the ,state plan2 and 7ii7 clinicians and others who provide services to individuals who are likely to be eligible for medical assistance under the ,state plan2 and 7,b7 increase awareness of the benefits of using comprehensive tobacco cessation services covered in the ,state plan among-- 7i7 individuals who are likely to be eligible for medical assistance under the ,state plan2 and 7ii7 clinicians and others who provide services to individuals who are likely to be eligible for medical assistance under the ,state plan about the benefits of using comprehensive tobacco cessation services1 for calendar quarters occurring during the period beginning on the date of the enactment of this paragraph and ending on #e years after the date of enactment of this paragraph1 an amount equal to #ij percent of the sums expended during each quarter which are attributable to such development1 implementation1 and evaluation1 and for calendar quarters succeeding such period1 an amount equal to ,federal medical assistance percentage determined under section #aije7;b7 of the sums expended during each quarter which are so attributable4 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 ,a ,state plan may not require1 as a condition of coverage or payment for a covered outpatient drug1 the approval of an agent to promote smoking cessation 7including agents approved by the ,food and ,drug ,administration7 or tobacco cessation4 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 section #aije7;bb77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7bb77#b77-- 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 7h7 ,effective date ,the amendments made by this section shall take effect on the first day of the first fiscal year that begins on or after the date of enactment of this ,act4 #c4 ,coverage of comprehensive tobacco cessation services in ,,chip 7a7 ,requiring ,,chip coverage of counseling and pharmacotherapy for cessation of tobacco use 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 by individuals who are eligible under the ,state child health plan4 4 7#b7 ,counseling and pharmacotherapy for cessation of tobacco use 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 ,the term counseling and pharmacotherapy for cessation of tobacco use 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 by individuals who use tobacco products or who are being treated for tobacco use 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 purpose which is recommended 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 guideline7 or is recommended for the cessation of tobacco use by the ,u4,s4 ,preventive ,services ,task ,force or any additional intervention approved by the ,food and ,drug ,administration as safe and effective in helping smokers quit4 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 ,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 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 the guideline specified in section #baaj7;c77#aj77;,b74 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 except1 in the case of-- 7#a7 pregnant women when recommended in accordance with the guideline specified in section #baaj7;c77#aj77;,b71 agents approved by the ,food and ,drug ,administration for purposes of promoting tobacco cessation2 and 7#b7 individuals who are eligible under the ,state child health plan when recommended in accordance with the ,guideline referred to in section #baaj7;c77#aj77;,b71 agents approved by the ,food and ,drug ,administration for purposes of promoting tobacco cessation4 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 7e7 ,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 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 medical assistance under the ,state child health plan who use tobacco products2 and 7#b7 clinicians and others who provide services to individuals entitled to medical assistance under the ,state child health plan4 4 7e7 ,federal reimbursement for ,,chip coverage and outreach campaign 7#a7 ,in general ,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 for calendar quarters occurring during the period beginning on the date of the enactment of this paragraph and ending on #e years after the date of enactment of this paragraph1 the ,secretary shall pay-- 7,a7 an amount equal to #ij percent of the sums expended during each quarter which are attributable to the cost of furnishing counseling and pharmacotherapy for cessation of tobacco use by individuals who are eligible under the ,state child health plan 7net of any payments made to the ,state under paragraph 7#a7 with respect to such counseling and pharmacotherapy72 plus 7,b7 an amount equal to #ij 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 7#b7 ,adjustment of chip allotments ,section #bajd7m7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;dd7m77 is amended-- 7,a7 in paragraph 7#b77;,b71 by striking and 7#ab7 and inserting 7#ab71 and 7#ac72 and 7,b7 by adding at the end the following new paragraph3 7#ac7 ,adjusting allotments to account for ,federal payments for ,,chip coverage of comprehensive tobacco cessation services and outreach campaign ,if a ,state 7including the ,district of ,columbia and each commonwealth and territory7 receives a payment for a fiscal year under section #baje7;a77#e71 the allotment determined for the ,state for such fiscal year shall be increased by the amount of such payment4 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 ,a ,state child health plan may not require1 as a condition of coverage or payment for a prescription drugs1 the approval of an agent to promote smoking cessation 7including agents approved by the ,food and ,drug ,administration7 or tobacco cessation4 4 7g7 ,effective date ,the amendments made by this section shall take effect on the first day of the first fiscal year that begins on or after the date of enactment of this ,act4 #d4 ,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