1.This Act may be cited as the
Medicare, Medicaid, and MCH Tobacco
Cessation Promotion Act of 2009
.
2.Medicare
coverage of counseling for cessation of tobacco use
(a)Section
1861(s)(2) of the Social Security Act
(42 U.S.C. 1395x(s)(2)), as amended by section 152(b) of the Medicare
Improvements for Patients and Providers Act of 2008 (Public Law 110–275), is
amended—
(1)in subparagraph
(DD), by striking and
at the end;
(2)in subparagraph
(EE), by inserting 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 subsection
(hhh));
.
(b)Section 1861 of the Social Security Act (42 U.S.C. 1395x), as so
amended, is amended by adding at the end the following new subsection:
(hhh)Counseling
for Cessation of Tobacco Use(1)(A)Subject to subparagraph
(B), 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 who are being treated for tobacco use
which are furnished—
(i)by or under the supervision of a
physician;
(ii)by a practitioner described in clause
(i), (iii), (iv), (v), or (vi) of section 1842(b)(18)(C); or
(iii)by a licensed tobacco cessation
counselor (as defined in paragraph (2)).
(B)Such term is limited to—
(i)services recommended in
Treating Tobacco Use and Dependence: A Clinical Practice
Guideline
, published by the Public Health Service in May 2008, or any
subsequent modification of such Guideline; and
(ii)such other services that the
Secretary recognizes to be effective.
(2)In this subsection, the term
licensed tobacco cessation counselor means a tobacco cessation
counselor who—
(A)is licensed as such by the State (or
in a State which does not license tobacco cessation counselors as such, is
legally authorized to perform the services of a tobacco cessation counselor in
the jurisdiction in which the counselor performs such services); and
(B)meets uniform minimum standards
relating to basic knowledge, qualification training, continuing education, and
documentation that are established by the Secretary for purposes of this
subsection.
.
(c)Payment and
Elimination of Cost-Sharing for Counseling for Cessation of Tobacco
Use
(1)Payment and
elimination of coinsuranceSection 1833(a)(1) of the
Social Security 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 100 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 subparagraph
.
(2)Elimination of
coinsurance in outpatient hospital settings
(A)Exclusion from
opd fee scheduleSection 1833(t)(1)(B)(iv) of the
Social Security Act (42 U.S.C.
1395l(t)(1)(B)(iv)) is amended by striking and diagnostic
mammography
and inserting , diagnostic mammography, or
counseling for cessation of tobacco use (as defined in section
1861(hhh))
.
(B)Section 1833(a)(2) of the
Social Security Act (42 U.S.C.
1395l(a)(2)) is amended—
(i)in
subparagraph (F), by striking and
after the semicolon at the
end;
(ii)in
subparagraph (G)(ii), by striking the comma at the end and inserting ;
and
; and
(iii)by inserting
after subparagraph (G)(ii) the following new subparagraph:
(H)with respect to
counseling for cessation of tobacco use (as defined in section 1861(hhh))
furnished by an outpatient department of a hospital, the amount determined
under paragraph
(1)(X),
.
(3)Elimination of
deductibleThe first sentence of section 1833(b) of the
Social Security 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)Application of
Limits on BillingSection 1842(b)(18)(C) of the
Social Security Act (42 U.S.C.
1395u(b)(18)(C)) is amended by adding at the end the following new
clause:
(vii)A licensed tobacco cessation
counselor (as defined in section
1861(hhh)(2)).
.
(e)Inclusion as
Part of Initial Preventive Physical ExaminationSection
1861(ww)(2) of the Social Security Act
(42 U.S.C. 1395x(ww)(2)) is amended by adding at the end the following new
subparagraph:
(O)Counseling for cessation of tobacco
use (as defined in subsection
(hhh)).
.
(f)The amendments made by this section shall apply to services
furnished on or after the date that is 1 year after the date of enactment of
this Act.
3.Medicare
coverage of tobacco cessation pharmacotherapy
(a)Inclusion of
Tobacco Cessation Agents as Covered DrugsSection 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 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
AgentsSection 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 agentsThere 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).
.
(c)Section 1860D–2(e)(2)(A) of the
Social Security Act (42 U.S.C.
1395w–102(e)(2)(A)), as amended by section 175 of the Medicare Improvements for
Patients and Providers Act of 2008 (Public Law 110–275), is amended by striking
, other than subparagraph (E) of such section (relating to smoking
cessation agents),
.
4.Promoting
cessation of tobacco use under the Medicaid program
(a)Coverage of
Tobacco Cessation Counseling Services
(1)Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is
amended—
(A)in paragraph
(27), by striking and
after the semicolon at the end;
(B)in paragraph
(28), by striking the comma at the end and inserting ; and
;
and
(C)by inserting
after paragraph (28) the following new paragraph:
(29)at the option of
the State, counseling for cessation of tobacco use (as defined in section
1861(hhh)),
.
(2)Section 1902(a)(10)(C)(iv) of the
Social Security Act (42 U.S.C.
1396a(a)(10)(C)(iv)) is amended by inserting or (29)
after
(24)
.
(b)Elimination of
Optional Exclusion From Medicaid Prescription Drug Coverage for Tobacco
Cessation MedicationsSection 1927(d)(2) of the
Social Security Act (42 U.S.C.
1396r–8(d)(2)) is amended—
(1)by striking
subparagraph (E);
(2)by redesignating
subparagraphs (F) through (K) as subparagraphs (E) through (J), respectively;
and
(3)in subparagraph
(F) (as redesignated by paragraph (2)), 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
cessation
.
(c)Removal of
Cost-Sharing for Tobacco Cessation Counseling Services and
MedicationsSubsections (a)(2) and (b)(2) of section 1916 of the
Social Security Act (42 U.S.C. 1396o)
are each amended—
(1)in subparagraph
(D), by striking or
after the comma at the end;
(2)in subparagraph
(E), by striking ; and
and inserting , or
;
and
(3)by adding at the
end the following new subparagraph:
(F)(i)counseling for
cessation of tobacco use described in section 1905(a)(29); or
(ii)covered outpatient drugs (as
defined in paragraph (2) of section 1927(k), and including nonprescription
drugs described in paragraph (4) of such section) that are prescribed for
purposes of promoting, and when used to promote, tobacco cessation;
and
.
(d)Increased FMAP
for Tobacco Cessation Counseling Services and MedicationsThe
first sentence of section 1905(b) of the Social
Security Act (42 U.S.C. 1396d(b)) is amended—
(1)by striking
and
before (4)
; and
(2)by inserting
before the period the following: , and (5) for purposes of this title,
the Federal medical assistance percentage shall be 80 percent with respect to
amounts expended as medical assistance for counseling for cessation of tobacco
use described in subsection (a)(29) and for covered outpatient drugs (as
defined in paragraph (2) of section 1927(k), and including nonprescription
drugs described in paragraph (4) of such section) that are prescribed for
purposes of promoting, and when used to promote, tobacco
cessation
.
(e)The amendments made by this section shall apply to services
furnished on or after the date that is 1 year after the date of enactment of
this Act.
5.Promoting
cessation of tobacco use under the maternal and child health services block
grant program
(a)Quality
Maternal and Child Health Services Includes Tobacco Cessation Counseling and
MedicationsSection 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, quality maternal and child health services include the
following:
(1)Counseling for
cessation of tobacco use (as defined in section 1861(hhh)).
(2)The encouragement
of the prescribing and use of agents approved by the Food and Drug
Administration for purposes of tobacco cessation.
(3)The inclusion of
messages that discourage tobacco use in health promotion
counseling.
.
(b)The amendment made by subsection (a) shall take effect on
the date that is 1 year after the date of enactment of this Act.