I 111th CONGRESS 1st Session H. R. 1850 IN THE HOUSE OF REPRESENTATIVES April 1, 2009 Ms. DeGette (for herself and Mr. Platts) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL To amend titles V, XVIII, and XIX of the Social Security Act to promote tobacco use cessation under the Medicare Program, the Medicaid Program, and the maternal and child health program.

1.

Short title

This Act may be cited as the Quit Smoking for Life Act of 2009.

2.

Coverage of counseling for cessation of tobacco use under the Medicare program

(a)

Coverage

Section 1861(s)(2) of the Social Security Act (42 U.S.C. 1395x(s)(2)) is amended— (1)in subparagraph (DD), by striking and at the end; (2)in subparagraph (EE), by adding and at the end; and (3)by adding at the end the following new subparagraph: (FF)counseling for cessation of tobacco use (as defined in section 1861(hhh)); . (b)

Services described

Section 1861 of such Act (42 U.S.C. 1395x) is further amended by adding at the end the following new subsection: (hhh)

Counseling for cessation of tobacco use

(1)Subject to paragraph (2), the term counseling for cessation of tobacco use means diagnostic, therapy, and counseling services for cessation of tobacco use, for individuals who use tobacco products or are being treated for tobacco use, furnished— (A)by or under the supervision of a physician; or (B)by any other health care professional who— (i)is legally authorized to furnish such services under State law (or the State regulatory mechanism provided by State law) of the State in which the services are furnished; and (ii)is authorized to receive payment for other services under this title or is designated by the Secretary for this purpose. (2)Such term is limited to— (A)services that are included in the most current clinical practice guidelines on treating tobacco use and dependence issued by the Public Health Service; and (B)such other services that the Secretary recognizes to be effective. . (c)

Payment; elimination of deductible

(1)

Payment

Section 1833(a)(1) of such Act (42 U.S.C. 1395l(a)(1)) is amended— (A)by striking and before (W); and (B)by inserting before the semicolon at the end the following: , and (X) with respect to counseling for cessation of tobacco use (as defined in section 1861(hhh)), the amount paid shall be 80 percent of the lesser of the actual charge for the service or the amount determined by a fee schedule established by the Secretary for purposes of this clause. (2)

Elimination of deductible

The first sentence of section 1833(b) of such Act (42 U.S.C. 1395l(b)) is amended— (A)by striking and before (9); and (B)by inserting before the period the following: , and (10) such deductible shall not apply with respect to counseling for cessation of tobacco use (as defined in section 1861(hhh)). (d)

Effective Date

The amendments made by this section shall apply to services furnished on or after January 1 of the first calendar year that begins at least 6 months after the date of the enactment of this Act.

3.

Coverage of tobacco cessation pharmacotherapy under the Medicare program

(a)

Inclusion of tobacco cessation agents as covered drugs

Section 1860D–2(e)(1) of the Social Security Act (42 U.S.C. 1395w–102(e)(1)) is amended— (1)in subparagraph (A), by striking or after the semicolon at the end; (2)in subparagraph (B), by striking the comma at the end and inserting ; or; and (3)by inserting after subparagraph (B) the following new subparagraph: (C)any agent approved by the Food and Drug Administration for purposes of promoting, and when used to promote, tobacco use cessation that may be dispensed without a prescription (commonly referred to as an over-the-counter drug), but only if such an agent is prescribed by a physician (or other person authorized to prescribe under State law), . (b)

Establishment of categories and classes consisting of tobacco cessation agents

Section 1860D–4(b)(3)(C) of the Social Security Act (42 U.S.C. 1395w–104(b)(3)(C)) is amended by adding at the end the following new clause: (iv)

Categories and classes of tobacco cessation agents

There shall be a therapeutic category or class of covered part D drugs consisting of agents approved by the Food and Drug Administration for cessation of tobacco use. Such category or class shall include tobacco cessation agents described in subparagraphs (A) and (C) of section 1860D–2(e)(1). .

4.

Coverage of counseling and medication for cessation of tobacco use under the Medicaid program

(a)

Dropping exception from medicaid prescription drug coverage for tobacco use cessation medications

(1)

In general

Section 1927(d)(2) of the Social Security Act (42 U.S.C. 1396r–8(d)(2)) is amended— (A)by striking subparagraph (E); (B)by redesignating subparagraph (F) through (K) as subparagraphs (E) through (J), respectively; and (C)in subparagraph (F), as so redesignated, by inserting before the period at the end the following: , other than agents approved by the Food and Drug Administration for purposes of promoting, and when used to promote, tobacco use cessation (regardless, for purposes of this title only, of whether such agents may be dispensed only upon prescription or may be dispensed without a prescription (commonly referred to as an over-the-counter drug), but only if such an agent is prescribed by a physician (or other person authorized to prescribe under State law)). (2)

Conforming amendment

Section 1860D–2(e)(2)(A) of the Social Security Act (42 U.S.C. 1395w–102(e)(2)(A)) is amended by striking , other than subparagraph (E) of such section (relating to smoking cessation agents),. (b)

Requiring coverage of tobacco use cessation counseling

Section 1905(a)(4) of such Act (42 U.S.C. 1396d(a)(4)) is amended— (1)by striking and before (C); and (2)by adding at the end the following: , and (D) counseling for cessation of tobacco use (as defined in section 1861(hhh));. (c)

Treatment of tobacco cessation services and medications as services related to pregnancy

Section 1905 of such Act is amended by adding at the end the following new subsection: (y)Services described in subsection (a)(4)(D) shall be treated as services related to pregnancy with respect to women during pregnancy (and during the 60-day period beginning on the last day of the pregnancy). . (d)

Effective date

The amendments made by this section shall apply to items and services furnished on or after January 1 of the first calendar year that begins at least 6 months after the date of the enactment of this Act.

5.

Promoting cessation of tobacco use under the maternal and child health program

(a)

Quality Maternal and Child Health Services includes tobacco use cessation counseling and medications

Section 501 of the Social Security Act (42 U.S.C. 701) is amended by adding at the end the following new subsection: (d)For purposes of this title, counseling for cessation of tobacco use (as defined in section 1861(hhh)), drugs and biologicals used to promote tobacco use cessation (regardless of whether such drugs or biologicals may be dispensed only upon prescription or may be dispensed without a prescription (commonly referred to as an over-the-counter drug), but only if such a drug or biological is prescribed by a physician (or other person authorized to prescribe under State law)), and the inclusion of antitobacco messages in health promotion counseling shall be considered to be part of quality maternal and child health services. . (b)

Effective date

The amendment made by subsection (a) shall take effect on the date of the enactment of this Act.