,,ii  #aai? ,,congress  #a/ ,session    
,s4 #bjfd  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #ab1 #bjbe,ms4   
,blunt ,ro*e/] introduc$ ! foll[+ bill2 
:i* 0 read twice & ref]r$ to !          
,committee on ,f9ance  ,a ,,bill  ,to   
am5d title ,,xix & ,,xxi ( ! ,social    
,security ,act to provide cov]age (     
compreh5sive tobacco cessation s]vices  
"u su* titles1 & = o!r purposes4  #a4   
,%ort title ,?is ,act may be cit$ z !   
,help+ ,tobacco ,us]s ,quit ,act4  #b4  
,cov]age ( compreh5sive tobacco         
cessation s]vices 9 ,m$icaid  7a7       
,requir+ ,m$icaid cov]age ( c\nsel+ &   
ph>maco!rapy = cessation ( tobacco use &
 tempor>y enhanc$ ,,fmap = cov]age (    
tobacco cessation s]vices ,section #aije
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acif;d7 is am5d$-- 7#a7 by   
am5d+ subsection 7a77#d77;,d7 to read z 
foll[s3 7,d7 c\nsel+ & ph>maco!rapy =   
cessation ( tobacco use by individuals  
:o are eligible "u ! ,/ate plan 7z def9$
 9 subsection 7bb7722  7#b7 9 subsection

 7b71 by ins]t+ 7bb77#b71 aft] 7aa712 & 
7#c7 by /rik+ subsection 7bb7 & ins]t+ !
 foll[+3  7bb7 ,c\nsel+ & ph>maco!rapy =
 cessation ( tobacco use  7#a7 ,9 g5]al 
,= purposes ( ?is title1 ! t]m c\nsel+ &
 ph>maco!rapy = cessation ( tobacco use 
by individuals :o are eligible "u !     
,/ate plan means diagno/ic1 !rapy1 &    
c\nsel+ s]vices & ph>maco!rapy 7includ+ 
! cov]age ( prescription &              
nonprescription tobacco cessation ag5ts 
approv$ by ! ,food & ,drug              
,adm9i/ration7 = ! cessation ( tobacco  
use by individuals :o use tobacco       
products or :o are be+ treat$ = tobacco 
use t is furni%$-- 7,a7 by or "u !      
sup]vision ( a physician2 or  7,b7 by   
any o!r heal? c>e pr(essional :o-- 7i7  
is legally au?oriz$ to furni% su*       
s]vices "u ,/ate law 7or ! ,/ate        
regulatory me*anism provid$ by ,/ate    
law7 ( ! ,/ate 9 :i* ! s]vices are      
furni%$2 &  7ii7 is au?oriz$ to receive 
paym5t = o!r s]vices "u ?is title or is 
designat$ by ! ,secret>y = ?is purpose1 

:i* is recomm5d$ 9 ! guidel9e entitl$1  
,treat+ ,tobacco ,use & ,dep5d5ce3 #bjjh
 ,update3 ,a ,cl9ical ,practice         
,guidel9e publi%$ by ! ,public ,heal?   
,s]vice 9 ,may #bjjh 7or any subsequ5t  
modification ( su* guidel9e7 or is      
recomm5d$ = ! cessation ( tobacco use by
 ! ,u4,s4 ,prev5tive ,s]vices ,task ,=ce
 or any additional int]v5tion approv$ by
 ! ,food & ,drug ,adm9i/ration z safe & 
effective 9 help+ smok]s quit4  7#b7    
,tempor>y enhanc$ ,,fmap = cov]age (    
tobacco cessation s]vices ,not)/&+      
subsection 7b71 = cal5d> qu>t]s occurr+ 
dur+ ! p]iod beg9n+ on ! date ( !       
enactm5t ( ! ,help+ ,tobacco ,us]s ,quit
 ,act & end+ #e ye>s aft] su* date1 !   
,f$]al m$ical assi/ance p]c5tage )      
respect to am\nts exp5d$ by a ,/ate =   
m$ical assi/ance = c\nsel+ &            
ph>maco!rapy = cessation ( tobacco use  
by individuals :o are eligible "u !     
,/ate plan 7z def9$ 9 p>agraph 7#a77    
%all be equal to #ij p]c5t4  4  7b7 ,no 
co/ %>+  7#a7 ,9 g5]al ,subsections     

7a77#b7 & 7b77#b7 ( section #aiaf ( !   
,social ,security ,act 7#db ,u4,s4,c4   
#acifo7 are ea* am5d$-- 7,a7 9          
subp>agraph 7,b71 by /rik+ 1 & c\nsel+ &
 all t foll[s ?r\gh section             
#aije7;bb77#b77;,a72  7,b7 9 subp>agraph
 7,i71 by /rik+ or at ! end2  7,c7 9    
subp>agraph 7,j71 by /rik+ 2 & & ins]t+ 
2 or2 &  7,d7 by add+ at ! end ! foll[+ 
new subp>agraph3  7,k7 c\nsel+ &        
ph>maco!rapy = cessation ( tobacco use  
by individuals :o are eligible "u !     
,/ate plan 7z def9$ 9 section           
#aije7;bb77 & cov]$ outpati5t drugs 7z  
def9$ 9 subsection 7k77#b7 ( section    
#aibg & includ+ nonprescription drugs   
describ$ 9 subsection 7d77#b7 ( su*     
section7 t are prescrib$ = purposes (   
promot+ tobacco cessation 9 accordance )
 ! guidel9e specifi$ 9 section          
#aije7;bb72 &  4  7#b7 ,application to  
alt]native co/ %>+ ,section             
#aiaf;,a7b77#c77;,b7 ( ! ,social        
,security ,act 7#db ,u4,s4,c4           
#acifo-#a7;b77#c77;,b77 is am5d$-- 7,a7 

9 clause 7iii71 by /rik+ 1 & c\nsel+ &  
ph>maco!rapy = cessation ( tobacco use  
by pregnant wom5 7z def9$ 9 section     
#aije7;bb772 &  7,b7 by add+ at ! end ! 
foll[+ new clause3  7xv7 ,c\nsel+ &     
ph>maco!rapy = cessation ( tobacco use  
by individuals :o are eligible "u !     
,/ate plan 7z def9$ 9 section           
#aije7;bb77 & cov]$ outpati5t drugs 7z  
def9$ 9 subsection 7k77#b7 ( section    
#aibg & includ+ nonprescription drugs   
describ$ 9 subsection 7d77#b7 ( su*     
section7 t are prescrib$ = purposes (   
promot+ tobacco cessation 9 accordance )
 ! guidel9e specifi$ 9 section          
#aije7;bb74  4  7c7 ,exception f        
optional re/riction "u ,m$icaid         
prescription drug cov]age ,section      
#aibg7;d77#b77;,f7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acifr-#h7;d77#b77;,f77 is am5d$ to read
 z foll[s3  7,f7 ,nonprescription drugs1
 except1 :5 recomm5d$ 9 accordance ) !  
guidel9e ref]r$ to 9 section #aije7;bb71
 ag5ts approv$ by ! ,food & ,drug       

,adm9i/ration = purposes ( promot+      
tobacco cessation4  4  7d7 ,/ate        
monitor+ & promot+ ( compreh5sive       
tobacco cessation s]vices "u ,m$icaid   
,section #aijb7;a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acif;a7 is am5d$--
 7#a7 9 p>agraph 7#hf71 by /rik+ at !   
end &2  7#b7 9 p>agraph 7#hg71 by /rik+ 
! p]iod at ! end & ins]t+ 2 &2 &  7#c7  
by ins]t+ aft] p>agraph 7#hg7 ! foll[+  
new p>agraph3  7#hh7 provide = ! ,/ate  
to monitor & promote ! use (            
compreh5sive tobacco cessation s]vices  
"u ! ,/ate plan 7includ+ conduct+ an    
outrea* campaign to increase aw>5ess ( !
 b5efits ( us+ su* s]vices7 among-- 7,a7
 individuals entitl$ to m$ical assi/ance
 "u ! ,/ate plan :o use tobacco         
products2 &  7,b7 cl9icians & o!rs :o   
provide s]vices to individuals entitl$  
to m$ical assi/ance "u ! ,/ate plan4  4 
7e7 ,f$]al reimbursem5t = outrea*       
campaign ,section #aijc7;a7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acif;b7a77 is am5d$-- 7#a7 9 p>agraph  

7#g71 by /rik+ ! p]iod at ! end & ins]t+
 2 plus2 &  7#b7 by ins]t+ aft] p>agraph
 7#g7 ! foll[+ new p>agraph3  7#h7 )    
respect to ! developm5t1 implem5tation1 
& evaluation ( an outrea* campaign to-- 
7,a7 increase aw>5ess ( compreh5sive    
tobacco cessation s]vices cov]$ 9 !     
,/ate plan among-- 7i7 individuals :o   
are likely to be eligible = m$ical      
assi/ance "u ! ,/ate plan2 &  7ii7      
cl9icians & o!rs :o provide s]vices to  
individuals :o are likely to be eligible
 = m$ical assi/ance "u ! ,/ate plan2 &  
7,b7 increase aw>5ess ( ! b5efits ( us+ 
compreh5sive tobacco cessation s]vices  
cov]$ 9 ! ,/ate plan among-- 7i7        
individuals :o are likely to be eligible
 = m$ical assi/ance "u ! ,/ate plan2 &  
7ii7 cl9icians & o!rs :o provide s]vices
 to individuals :o are likely to be     
eligible = m$ical assi/ance "u ! ,/ate  
plan ab\t ! b5efits ( us+ compreh5sive  
tobacco cessation s]vices1  = cal5d>    
qu>t]s occurr+ dur+ ! p]iod beg9n+ on ! 
date ( ! enactm5t ( ?is p>agraph & end+ 

on #e ye>s aft] ! date ( enactm5t ( ?is 
p>agraph1 an am\nt equal to #ij p]c5t ( 
! sums exp5d$ dur+ ea* qu>t] :i* are    
attributable to su* developm5t1         
implem5tation1 & evaluation1 & = cal5d> 
qu>t]s succe$+ su* p]iod1 an am\nt equal
 to ,f$]al m$ical assi/ance p]c5tage    
det]m9$ "u section #aije7;b7 ( ! sums   
exp5d$ dur+ ea* qu>t] :i* are s         
attributable4  4  7f7 ,no prior         
au?orization = tobacco cessation drugs  
"u ,m$icaid ,section #aibg7;d7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acifr-#h7;d77 is am5d$-- 7#a7 9        
p>agraph 7#a77;,a71 by /rik+ ,a ,/ate & 
ins]t+ ,subject to p>agraph 7#h71 a     
,/ate2 &  7#b7 by add+ at ! end ! foll[+
 new p>agraph3  7#h7 ,no prior          
au?orization programs = tobacco         
cessation drugs ,a ,/ate plan may n     
require1 z a condition ( cov]age or     
paym5t = a cov]$ outpati5t drug1 !      
approval ( an ag5t to promote smok+     
cessation 7includ+ ag5ts approv$ by !   
,food & ,drug ,adm9i/ration7 or tobacco 

cessation4  4  7g7 ,exclusion ( enhanc$ 
paym5ts f t]ritorial caps ,not)/&+ any  
o!r provision ( law1 = purposes (       
section #aajh ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acjh71 ) respect to any
 additional am\nt paid to a t]ritory z a
 result ( ! application ( section       
#aije7;bb77#b7 ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acif;d7bb77#b77--  
7#a7 ! limitation on paym5ts to         
t]ritories "u subsections 7f7 & 7g7 (   
su* section #aajh %all n apply to su*   
additional am\nts2 &  7#b7 su*          
additional am\nts %all be disreg>d$ 9   
apply+ su* subsections4  7h7 ,effective 
date ,! am5dm5ts made by ?is section    
%all take effect on ! fir/ day ( ! fir/ 
fiscal ye> t beg9s on or aft] ! date (  
enactm5t ( ?is ,act4  #c4 ,cov]age (    
compreh5sive tobacco cessation s]vices 9
 ,,*ip  7a7 ,requir+ ,,*ip cov]age (    
c\nsel+ & ph>maco!rapy = cessation (    
tobacco use  7#a7 ,9 g5]al ,section     
#bajc7;c77#b7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acig;cc7c77#b77 is     

am5d$ by add+ at ! end ! foll[+ new     
subp>agraph3  7,d7 ,c\nsel+ &           
ph>maco!rapy = cessation ( tobacco use  
by individuals :o are eligible "u !     
,/ate *ild heal? plan4  4  7#b7 ,c\nsel+
 & ph>maco!rapy = cessation ( tobacco   
use def9$ ,section #baaj7;c7 ( ! ,social
 ,security ,act 7#db ,u4,s4,c4          
#acig;jj7c77 is am5d$ by add+ at ! end !
 foll[+ new p>agraph3  7#aj7 ,c\nsel+ & 
ph>maco!rapy = cessation ( tobacco use  
,! t]m c\nsel+ & ph>maco!rapy =         
cessation ( tobacco use means diagno/ic1
 !rapy1 & c\nsel+ s]vices & ph>maco!rapy
 7includ+ ! cov]age ( prescription &    
nonprescription tobacco cessation ag5ts 
approv$ by ! ,food & ,drug              
,adm9i/ration7 = ! cessation ( tobacco  
use by individuals :o use tobacco       
products or :o are be+ treat$ = tobacco 
use t are furni%$-- 7,a7 by or "u !     
sup]vision ( a physician2 or  7,b7 by   
any o!r heal? c>e pr(essional :o--  7i7 
is legally au?oriz$ to furni% su*       
s]vices "u ,/ate law 7or ! ,/ate        

regulatory me*anism provid$ by ,/ate    
law7 ( ! ,/ate 9 :i* ! s]vices are      
furni%$2 &  7ii7 is au?oriz$ to receive 
paym5t = o!r s]vices "u ?is title or is 
designat$ by ! ,secret>y = ?is purpose  
:i* is recomm5d$ 9 ! guidel9e entitl$1  
,treat+ ,tobacco ,use & ,dep5d5ce3 #bjjh
 ,update3 ,a ,cl9ical ,practice         
,guidel9e publi%$ by ! ,public ,heal?   
,s]vice 9 ,may #bjjh 7or any subsequ5t  
modification ( su* guidel9e7 or is      
recomm5d$ = ! cessation ( tobacco use by
 ! ,u4,s4 ,prev5tive ,s]vices ,task ,=ce
 or any additional int]v5tion approv$ by
 ! ,food & ,drug ,adm9i/ration z safe & 
effective 9 help+ smok]s quit4  4  7b7  
,no co/ %>+ ,section #bajc7;e7 ( !      
,social ,security ,act 7#db ,u4,s4,c4   
#acig;cc7e77 is am5d$ by add+ at ! end !
 foll[+ new p>agraph3  7#e7 ,no co/ %>+ 
on b5efits = c\nsel+ & ph>maco!rapy =   
cessation ( tobacco use ,! ,/ate *ild   
heal? plan may n impose d$uctibles1     
co9surance1 or o!r co/ %>+ ) respect to 
b5efits = c\nsel+ & ph>maco!rapy =      

cessation ( tobacco use 7z def9$ 9      
section #baaj7;c77#aj77 & prescription  
drugs t are cov]$ "u a ,/ate *ild heal? 
plan t are prescrib$ = purposes (       
promot+ tobacco cessation 9 accordance )
 ! guidel9e specifi$ 9 section          
#baaj7;c77#aj77;,b74  4  7c7 ,exception 
f optional re/riction "u ,,*ip          
prescription drug cov]age ,section #bajc
 ( ! ,social ,security ,act 7#db        
,u4,s4,c4 #acig;cc7 is am5d$ by add+ at 
! end ! foll[+ new subsection3  7g7     
,exception f optional re/riction "u     
,,*ip prescription drug cov]age ,! ,/ate
 *ild heal? plan may exclude or o!rwise 
re/rict nonprescription drugs1 except1 9
 ! case (-- 7#a7 pregnant wom5 :5       
recomm5d$ 9 accordance ) ! guidel9e     
specifi$ 9 section #baaj7;c77#aj77;,b71 
ag5ts approv$ by ! ,food & ,drug        
,adm9i/ration = purposes ( promot+      
tobacco cessation2 &  7#b7 individuals  
:o are eligible "u ! ,/ate *ild heal?   
plan :5 recomm5d$ 9 accordance ) !      
,guidel9e ref]r$ to 9 section           

#baaj7;c77#aj77;,b71 ag5ts approv$ by ! 
,food & ,drug ,adm9i/ration = purposes (
 promot+ tobacco cessation4  4  7d7     
,/ate monitor+ & promot+ ( compreh5sive 
tobacco cessation s]vices "u ,,*ip      
,section #bajb ( ! ,social ,security    
,act 7#db ,u4,s4,c4 #acig;bb7 is am5d$  
by add+ at ! end ! foll[+ new           
subsection3  7e7 ,/ate monitor+ &       
promot+ ( compreh5sive tobacco cessation
 s]vices "u ,,*ip ,a ,/ate *ild heal?   
plan %all include a description ( !     
proc$ures to be us$ by ! ,/ate to       
monitor & promote ! use ( compreh5sive  
tobacco cessation s]vices "u ! ,/ate    
plan 7includ+ conduct+ an outrea*       
campaign to increase aw>5ess ( ! b5efits
 ( us+ su* s]vices7 among-- 7#a7        
individuals entitl$ to m$ical assi/ance 
"u ! ,/ate *ild heal? plan :o use       
tobacco products2 &  7#b7 cl9icians &   
o!rs :o provide s]vices to individuals  
entitl$ to m$ical assi/ance "u ! ,/ate  
*ild heal? plan4  4  7e7 ,f$]al         
reimbursem5t = ,,*ip cov]age & outrea*  

campaign  7#a7 ,9 g5]al ,section        
#baje7;a7 ( ! ,social ,security ,act    
7#db ,u4,s4,c4 #acig;ee7a77 is am5d$ by 
add+ at ! end ! foll[+ new p>agraph3    
7#e7 ,f$]al reimbursem5t = ,,*ip cov]age
 ( compreh5sive tobacco cessation       
s]vices & outrea* campaign ,9 addition  
to ! paym5ts made "u p>agraph 7#a7 =    
cal5d> qu>t]s occurr+ dur+ ! p]iod      
beg9n+ on ! date ( ! enactm5t ( ?is     
p>agraph & end+ on #e ye>s aft] ! date (
 enactm5t ( ?is p>agraph1 ! ,secret>y   
%all pay-- 7,a7 an am\nt equal to #ij   
p]c5t ( ! sums exp5d$ dur+ ea* qu>t] :i*
 are attributable to ! co/ ( furni%+    
c\nsel+ & ph>maco!rapy = cessation (    
tobacco use by individuals :o are       
eligible "u ! ,/ate *ild heal? plan 7net
 ( any paym5ts made to ! ,/ate "u       
p>agraph 7#a7 ) respect to su* c\nsel+ &
 ph>maco!rapy72 plus  7,b7 an am\nt     
equal to #ij p]c5t ( ! sums exp5d$ dur+ 
ea* qu>t] :i* are attributable to !     
developm5t1 implem5tation1 & evaluation 
( an outrea* campaign to-- 7i7 increase 

aw>5ess ( compreh5sive tobacco cessation
 s]vices cov]$ 9 ! ,/ate *ild heal? plan
 among-- 7,i7 individuals :o are likely 
to be eligible = m$ical assi/ance "u !  
,/ate *ild heal? plan2 &  7,,ii7        
cl9icians & o!rs :o provide s]vices to  
individuals :o are likely to be eligible
 = m$ical assi/ance "u ! ,/ate *ild     
heal? plan2 &  7ii7 increase aw>5ess ( !
 b5efits ( us+ compreh5sive tobacco     
cessation s]vices cov]$ 9 ! ,/ate *ild  
heal? plan among-- 7,i7 individuals :o  
are likely to be eligible = m$ical      
assi/ance "u ! ,/ate *ild heal? plan2 & 
7,,ii7 cl9icians & o!rs :o provide      
s]vices to individuals :o are likely to 
be eligible = m$ical assi/ance "u !     
,/ate *ild heal? plan ab\t ! b5efits (  
us+ compreh5sive tobacco cessation      
s]vices4  4  7#b7 ,adju/m5t ( *ip       
allotm5ts ,section #bajd7m7 ( ! ,social 
,security ,act 7#db ,u4,s4,c4           
#acig;dd7m77 is am5d$-- 7,a7 9 p>agraph 
7#b77;,b71 by /rik+ & 7#ab7 & ins]t+    
7#ab71 & 7#ac72 &  7,b7 by add+ at ! end

 ! foll[+ new p>agraph3  7#ac7 ,adju/+  
allotm5ts to acc\nt = ,f$]al paym5ts =  
,,*ip cov]age ( compreh5sive tobacco    
cessation s]vices & outrea* campaign ,if
 a ,/ate 7includ+ ! ,di/rict ( ,columbia
 & ea* commonweal? & t]ritory7 receives 
a paym5t = a fiscal ye> "u section      
#baje7;a77#e71 ! allotm5t det]m9$ = !   
,/ate = su* fiscal ye> %all be increas$ 
by ! am\nt ( su* paym5t4  4  7f7 ,no    
prior au?orization = tobacco cessation  
drugs "u ,,*ip ,section #bajc ( !       
,social ,security ,act 7#db ,u4,s4,c4   
#acig;cc71 z am5d$ by subsection 7c71 is
 fur!r am5d$-- 7#a7 9 subsection        
7c77#b77;,a71 by ins]t+ 79 accordance ) 
subsection 7h77 aft] ,cov]age (         
prescription drugs2 &  7#b7 by add+ at !
 end ! foll[+ new subsection3  7h7 ,no  
prior au?orization programs = tobacco   
cessation drugs ,a ,/ate *ild heal? plan
 may n require1 z a condition ( cov]age 
or paym5t = a prescription drugs1 !     
approval ( an ag5t to promote smok+     
cessation 7includ+ ag5ts approv$ by !   

,food & ,drug ,adm9i/ration7 or tobacco 
cessation4  4  7g7 ,effective date ,!   
am5dm5ts made by ?is section %all take  
effect on ! fir/ day ( ! fir/ fiscal ye>
 t beg9s on or aft] ! date ( enactm5t ( 
?is ,act4  #d4 ,rule ( con/ruction ,none
 ( ! am5dm5ts made by ?is ,act %all be  
con/ru$ to limit cov]age ( any c\nsel+  
or ph>maco!rapy = individuals "u #ah    
ye>s ( age4