[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4775 Introduced in House (IH)]

<DOC>






118th CONGRESS
  1st Session
                                H. R. 4775

   To amend title XIX and XXI of the Social Security Act to provide 
coverage of comprehensive tobacco cessation services under such titles, 
                        and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 20, 2023

 Ms. Blunt Rochester (for herself and Mr. Fitzpatrick) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend title XIX and XXI of the Social Security Act to provide 
coverage of comprehensive tobacco cessation services under such titles, 
                        and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Helping Tobacco Users Quit Act''.

SEC. 2. COVERAGE OF COMPREHENSIVE TOBACCO CESSATION SERVICES IN 
              MEDICAID.

    (a) Requiring Medicaid Coverage of Counseling and Pharmacotherapy 
for Cessation of Tobacco Use and Temporary Enhanced FMAP for Coverage 
of Tobacco Cessation Services.--Section 1905 of the Social Security Act 
(42 U.S.C. 1396d) is amended--
            (1) by amending subsection (a)(4)(D) to read as follows: 
        ``(D) counseling and pharmacotherapy for cessation of tobacco 
        use by individuals who are eligible under the State plan (as 
        defined in subsection (bb));'';
            (2) in subsection (b), by inserting ``(bb)(2),'' after 
        ``(aa),''; and
            (3) by striking subsection (bb) and inserting the 
        following:
    ``(bb) Counseling and Pharmacotherapy for Cessation of Tobacco 
Use.--
            ``(1) In general.--For purposes of this title, the term 
        `counseling and pharmacotherapy for cessation of tobacco use by 
        individuals who are eligible under the State plan' means 
        diagnostic, therapy, and counseling services and 
        pharmacotherapy (including the coverage of prescription and 
        nonprescription tobacco cessation agents approved by the Food 
        and Drug Administration) for the cessation of tobacco use by 
        individuals who use tobacco products or who are being treated 
        for tobacco use that is 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,
                 which is recommended in the guideline entitled, 
                `Treating Tobacco Use and Dependence: 2008 Update: A 
                Clinical Practice Guideline' published by the Public 
                Health Service in May 2008 (or any subsequent 
                modification of such guideline) or is recommended for 
                the cessation of tobacco use by the U.S. Preventive 
                Services Task Force or any additional intervention 
                approved by the Food and Drug Administration as safe 
                and effective in helping smokers quit.
            ``(2) Temporary enhanced fmap for coverage of tobacco 
        cessation services.--Notwithstanding subsection (b), for 
        calendar quarters occurring during the period beginning on the 
        date of the enactment of this paragraph and ending 5 years 
        after the date of enactment of this paragraph, 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 (as defined in paragraph (1)) 
        shall be equal to 90 percent.''.
    (b) No Cost Sharing.--
            (1) In general.--Subsections (a)(2) and (b)(2) of section 
        1916 of the Social Security Act (42 U.S.C. 1396o) are each 
        amended--
                    (A) in subparagraph (B), by striking ``, and 
                counseling'' and all that follows through ``section 
                1905(bb)(2)(A)'';
                    (B) by adjusting the left margins of subparagraphs 
                (H) and (I) so as to align with the left margin of 
                subparagraph (G);
                    (C) in subparagraph (H), by striking ``or'' at the 
                end;
                    (D) in subparagraph (I), by striking ``; and'' and 
                inserting ``; or''; and
                    (E) by adding at the end the following new 
                subparagraph:
                    ``(J) counseling and pharmacotherapy for cessation 
                of tobacco use by individuals who are eligible under 
                the State plan (as defined in section 1905(bb)) and 
                covered outpatient drugs (as defined in subsection 
                (k)(2) of section 1927 and including nonprescription 
                drugs described in subsection (d)(2) of such section) 
                that are prescribed for purposes of promoting tobacco 
                cessation in accordance with the guideline specified in 
                section 1905(bb); and''.
            (2) Application to alternative cost sharing.--Section 
        1916A(b)(3)(B) of the Social Security Act (42 U.S.C. 1396o-
        1(b)(3)(B)) is amended--
                    (A) in clause (iii), by striking ``, and counseling 
                and pharmacotherapy for cessation of tobacco use by 
                pregnant women (as defined in section 1905(bb))'';
                    (B) by adjusting the left margins of clauses (xii) 
                and (xiii) so as to align with the left margin of 
                clause (xi); and
                    (C) by adding at the end the following new clause:
                            ``(xiv) Counseling and pharmacotherapy for 
                        cessation of tobacco use by individuals who are 
                        eligible under the State plan (as defined in 
                        section 1905(bb)) and covered outpatient drugs 
                        (as defined in subsection (k)(2) of section 
                        1927 and including nonprescription drugs 
                        described in subsection (d)(2) of such section) 
                        that are prescribed for purposes of promoting 
                        tobacco cessation in accordance with the 
                        guideline specified in section 1905(bb).''.
    (c) Exception From Optional Restriction Under Medicaid Prescription 
Drug Coverage.--Section 1927(d)(2)(F) of the Social Security Act (42 
U.S.C. 1396r-8(d)(2)(F)) is amended to read as follows:
                    ``(F) Nonprescription drugs, except, when 
                recommended in accordance with the guideline referred 
                to in section 1905(bb), agents approved by the Food and 
                Drug Administration for purposes of promoting tobacco 
                cessation.''.
    (d) State Monitoring and Promoting of Comprehensive Tobacco 
Cessation Services Under Medicaid.--Section 1902(a) of the Social 
Security Act (42 U.S.C. 1396a) is amended--
            (1) in paragraph (86), by striking at the end ``and'';
            (2) in paragraph (87), by striking the period at the end 
        and inserting ``; and''; and
            (3) by inserting after paragraph (87) the following new 
        paragraph:
            ``(88) provide for the State to monitor and promote the use 
        of comprehensive tobacco cessation services under the State 
        plan (including conducting an outreach campaign to increase 
        awareness of the benefits of using such services) among--
                    ``(A) individuals entitled to medical assistance 
                under the State plan who use tobacco products; and
                    ``(B) clinicians and others who provide services to 
                individuals entitled to medical assistance under the 
                State plan.''.
    (e) Federal Reimbursement for Outreach Campaign.--Section 1903(a) 
of the Social Security Act (42 U.S.C. 1396b(a)) is amended--
            (1) in paragraph (7), by striking the period at the end and 
        inserting ``; plus''; and
            (2) by inserting after paragraph (7) the following new 
        paragraph:
            ``(8) with respect to the development, implementation, and 
        evaluation of an outreach campaign to--
                    ``(A) increase awareness of comprehensive tobacco 
                cessation services covered in the State plan among--
                            ``(i) individuals who are likely to be 
                        eligible for medical assistance under the State 
                        plan; and
                            ``(ii) clinicians and others who provide 
                        services to individuals who are likely to be 
                        eligible for medical assistance under the State 
                        plan; and
                    ``(B) increase awareness of the benefits of using 
                comprehensive tobacco cessation services covered in the 
                State plan among--
                            ``(i) individuals who are likely to be 
                        eligible for medical assistance under the State 
                        plan; and
                            ``(ii) 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 services,
                for calendar quarters occurring during the period 
                beginning on the date of the enactment of this 
                paragraph and ending on 5 years after the date of 
                enactment of this paragraph, an amount equal to 90 
                percent of the sums expended during each quarter which 
                are attributable to such development, implementation, 
                and evaluation, and for calendar quarters succeeding 
                such period, an amount equal to Federal medical 
                assistance percentage determined under section 1905(b) 
                of the sums expended during each quarter which are so 
                attributable.''.
    (f) No Prior Authorization for Tobacco Cessation Drugs Under 
Medicaid.--Section 1927(d) of the Social Security Act (42 U.S.C. 1396r-
8(d)) is amended--
            (1) in paragraph (1)(A), by striking ``A State'' and 
        inserting ``Subject to paragraph (8), a State''; and
            (2) by adding at the end the following new paragraph:
            ``(8) No prior authorization programs for tobacco cessation 
        drugs.--A State plan may not require, as a condition of 
        coverage or payment for a covered outpatient drug, the approval 
        of an agent to promote smoking cessation (including agents 
        approved by the Food and Drug Administration) or tobacco 
        cessation.''.
    (g) Exclusion of Enhanced Payments From Territorial Caps.--
Notwithstanding any other provision of law, for purposes of section 
1108 of the Social Security Act (42 U.S.C. 1308), with respect to any 
additional amount paid to a territory as a result of the application of 
section 1905(bb)(2) of the Social Security Act (42 U.S.C. 
1396d(bb)(2))--
            (1) the limitation on payments to territories under 
        subsections (f) and (g) of such section 1108 shall not apply to 
        such additional amounts; and
            (2) such additional amounts shall be disregarded in 
        applying such subsections.
    (h) 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 Act.

SEC. 3. COVERAGE OF COMPREHENSIVE TOBACCO CESSATION SERVICES IN CHIP.

    (a) Requiring CHIP Coverage of Counseling and Pharmacotherapy for 
Cessation of Tobacco Use.--
            (1) In general.--Section 2103(c)(2) of the Social Security 
        Act (42 U.S.C. 1397cc(c)(2)) is amended by adding at the end 
        the following new subparagraph:
                    ``(D) Counseling and pharmacotherapy for cessation 
                of tobacco use by individuals who are eligible under 
                the State child health plan.''.
            (2) Counseling and pharmacotherapy for cessation of tobacco 
        use defined.--Section 2110(c) of the Social Security Act (42 
        U.S.C. 1397jj(c)) is amended by adding at the end the following 
        new paragraph:
            ``(10) Counseling and pharmacotherapy for cessation of 
        tobacco use.--The term `counseling and pharmacotherapy for 
        cessation of tobacco use' means diagnostic, therapy, and 
        counseling services and pharmacotherapy (including the coverage 
        of prescription and nonprescription tobacco cessation agents 
        approved by the Food and Drug Administration) for the cessation 
        of tobacco use by individuals who use tobacco products or who 
        are being treated for tobacco use that are 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
                 which is recommended in the guideline entitled, 
                `Treating Tobacco Use and Dependence: 2008 Update: A 
                Clinical Practice Guideline' published by the Public 
                Health Service in May 2008 (or any subsequent 
                modification of such guideline) or is recommended for 
                the cessation of tobacco use by the U.S. Preventive 
                Services Task Force or any additional intervention 
                approved by the Food and Drug Administration as safe 
                and effective in helping smokers quit.''.
    (b) No Cost Sharing.--Section 2103(e) of the Social Security Act 
(42 U.S.C. 1397cc(e)) is amended by adding at the end the following new 
paragraph:
            ``(5) No cost sharing on benefits for counseling and 
        pharmacotherapy for cessation of tobacco use.--The State child 
        health plan may not impose deductibles, coinsurance, or other 
        cost sharing with respect to benefits for counseling and 
        pharmacotherapy for cessation of tobacco use (as defined in 
        section 2110(c)(10)) 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 2110(c)(10)(B).''.
    (c) Exception From Optional Restriction Under CHIP Prescription 
Drug Coverage.--Section 2103 of the Social Security Act (42 U.S.C. 
1397cc) is amended by adding at the end the following new subsection:
    ``(g) Exception From Optional Restriction Under CHIP Prescription 
Drug Coverage.--The State child health plan may exclude or otherwise 
restrict nonprescription drugs, except, in the case of--
            ``(1) pregnant women when recommended in accordance with 
        the guideline specified in section 2110(c)(10)(B), agents 
        approved by the Food and Drug Administration for purposes of 
        promoting tobacco cessation; and
            ``(2) individuals who are eligible under the State child 
        health plan when recommended in accordance with the Guideline 
        referred to in section 2110(c)(10)(B), agents approved by the 
        Food and Drug Administration for purposes of promoting tobacco 
        cessation.''.
    (d) State Monitoring and Promoting of Comprehensive Tobacco 
Cessation Services Under CHIP.--Section 2102 of the Social Security Act 
(42 U.S.C. 1397bb) is amended by adding at the end the following new 
subsection:
    ``(d) 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 (including conducting an outreach campaign to increase 
awareness of the benefits of using such services) among--
            ``(1) individuals entitled to medical assistance under the 
        State child health plan who use tobacco products; and
            ``(2) clinicians and others who provide services to 
        individuals entitled to medical assistance under the State 
        child health plan.''.
    (e) Federal Reimbursement for CHIP Coverage and Outreach 
Campaign.--
            (1) In general.--Section 2105(a) of the Social Security Act 
        (42 U.S.C. 1397ee(a)) is amended by adding at the end the 
        following new paragraph:
            ``(5) Federal reimbursement for chip coverage of 
        comprehensive tobacco cessation services and outreach 
        campaign.--In addition to the payments made under paragraph (1) 
        for calendar quarters occurring during the period beginning on 
        the date of the enactment of this paragraph and ending on 5 
        years after the date of enactment of this paragraph, the 
        Secretary shall pay--
                    ``(A) an amount equal to 90 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 (net of any 
                payments made to the State under paragraph (1) with 
                respect to such counseling and pharmacotherapy); plus
                    ``(B) an amount equal to 90 percent of the sums 
                expended during each quarter which are attributable to 
                the development, implementation, and evaluation of an 
                outreach campaign to--
                            ``(i) increase awareness of comprehensive 
                        tobacco cessation services covered in the State 
                        child health plan among--
                                    ``(I) individuals who are likely to 
                                be eligible for medical assistance 
                                under the State child health plan; and
                                    ``(II) clinicians and others who 
                                provide services to individuals who are 
                                likely to be eligible for medical 
                                assistance under the State child health 
                                plan; and
                            ``(ii) increase awareness of the benefits 
                        of using comprehensive tobacco cessation 
                        services covered in the State child health plan 
                        among--
                                    ``(I) individuals who are likely to 
                                be eligible for medical assistance 
                                under the State child health plan; and
                                    ``(II) 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 
                                services.''.
            (2) Adjustment of chip allotments.--Section 2104(m) of the 
        Social Security Act (42 U.S.C. 1397dd(m)) is amended--
                    (A) in paragraph (2)(B), by striking ``and (12)'' 
                and inserting ``(12), and (13)''; and
                    (B) by adding at the end the following new 
                paragraph:
            ``(13) Adjusting allotments to account for federal payments 
        for chip coverage of comprehensive tobacco cessation services 
        and outreach campaign.--If a State (including the District of 
        Columbia and each commonwealth and territory) receives a 
        payment for a fiscal year under section 2105(a)(5), the 
        allotment determined for the State for such fiscal year shall 
        be increased by the amount of such payment.''.
    (f) No Prior Authorization for Tobacco Cessation Drugs Under 
CHIP.--Section 2103 of the Social Security Act (42 U.S.C. 1397cc), as 
amended by subsection (c), is further amended--
            (1) in subsection (c)(2)(A), by inserting ``(in accordance 
        with subsection (h)'' after ``Coverage of prescription drugs''; 
        and
            (2) by adding at the end the following new subsection:
    ``(h) No Prior Authorization Programs for Tobacco Cessation 
Drugs.--A State child health plan may not require, as a condition of 
coverage or payment for a prescription drugs, the approval of an agent 
to promote smoking cessation (including agents approved by the Food and 
Drug Administration) or tobacco cessation.''.
    (g) 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 Act.

SEC. 4. 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 18 
years of age.
                                 <all>