Quit Because of COVID-19 Act
This bill provides for Medicaid and Children's Health Insurance Program (CHIP) coverage of certain tobacco cessation services during the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019), as well as for two years after the emergency period ends.
Specifically, the bill provides for coverage of diagnostic, therapy, and counseling services and pharmacotherapy, including prescription and nonprescription tobacco cessation agents, that are provided under medical supervision and in accordance with specified guidelines. The bill excludes such items and services from cost-sharing and applies an enhanced Federal Medical Assistance Percentage (i.e., federal matching rate).
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7286 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 7286
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
June 22, 2020
Ms. Blunt Rochester (for herself, Ms. DeGette, Mr. Soto, Mr. Engel, and
Ms. Barragan) 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 ``Quit Because of COVID-19 Act''.
SEC. 2. COVERAGE OF COMPREHENSIVE TOBACCO CESSATION SERVICES IN
MEDICAID.
(a) Requiring Medicaid Coverage of Counseling and Pharmacotherapy
for Cessation of Tobacco Use.--Section 1905 of the Social Security Act
(42 U.S.C. 1396d) is amended--
(1) in subsection (a)(4)--
(A) in subparagraph (D), by striking ``and''; and
(B) by inserting before the semicolon the
following: ``; and (E) counseling and pharmacotherapy
for cessation of tobacco use by individuals who are
eligible under the State plan (as defined in subsection
(gg)) during the period beginning on the first day of
the emergency period described in section 1135(g)(1)(B)
and ending on the last day of the 2-year period after
the last day of such emergency period'';
(2) by adding at the end the following new subsection:
``(gg) For purposes of this title, 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--
``(1) by or under the supervision of a physician; or
``(2) by any other health care professional who--
``(A) 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
``(B) 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.--
(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 (F), by striking ``or'' at the
end;
(B) in subparagraph (G), by striking ``; and'' and
inserting ``, or'' ; and
(C) by adding at the end the following new
subparagraph:
``(H) counseling and pharmacotherapy for cessation
of tobacco use (as defined in section 1905(gg)) 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(gg)(2)(A) furnished during the period
beginning on the first day of the emergency period
described in section 1135(g)(1)(B) and ending on the
last day of the 2-year period after the last day of
such emergency period; 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 by adding at the end the following new
clause:
``(xii) Counseling and pharmacotherapy for
cessation of tobacco use (as defined in section
1905(gg)) 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(gg)(2)(A) furnished
during the period beginning on the first day of
the emergency period described in section
1135(g)(1)(B) and ending on the last day of the
2-year period after the last day of such
emergency period.''.
(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, in the case
of--
``(i) pregnant women when recommended in
accordance with the guideline specified in
section 1905(bb)(2)(A), agents approved by the
Food and Drug Administration under the over-
the-counter monograph process for purposes of
promoting tobacco cessation; and
``(ii) individuals who are eligible under
the State plan when recommended in accordance
with the Guideline referred to in section
1905(gg)(2)(A), agents approved by the Food and
Drug Administration under the over-the-counter
monograph process for purposes of promoting
tobacco cessation (as defined in subsection
(bb) during the period beginning on the first
day of the emergency period described in
section 1135(g)(1)(B) and ending on the last
day of the 2-year period after the last day of
such emergency period.''.
(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 (85), by striking at the end ``and'';
(2) in paragraph (86), by striking the period at the end
and inserting ``; and''; and
(3) by inserting after paragraph (86) the following new
paragraph:
``(87) during the period beginning on the first day of the
emergency period described in section 1135(g)(1)(B) and ending
on the last day of the 2-year period after the last day of such
emergency period, 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 Medicaid Coverage and 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
paragraphs:
``(8) during the period beginning on the first day of the
emergency period described in section 1135(g)(1)(B) and ending
on the last day of the 2-year period after the last day of such
emergency period, an amount equal to 100 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
plan as described in section 1905(a)(4)(E); plus
``(9) during the period described in paragraph (8), an
amount equal to 100 percent of the sums expended during each
quarter which are attributable 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.''.
(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.--During the period beginning on the first day of the
emergency period described in section 1135(g)(1)(B) and ending
on the last day of the 2-year period after the last day of such
emergency period, 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.''.
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 during the period beginning
on the first day of the emergency period described in
section 1135(g)(1)(B) and ending on the last day of the
2-year period after the last day of such emergency
period.''.
(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) furnished during
the period beginning on the first day of the emergency period
described in section 1135(g)(1)(B) and ending on the last day
of the 2-year period after the last day of such emergency
period.''.
(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 under the over-
the-counter monograph process 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 under the over-the-counter
monograph process for purposes of promoting tobacco cessation
during the period beginning on the first day of the emergency
period described in section 1135(g)(1)(B) and ending on the
last day of the 2-year period after the last day of such
emergency period.''.
(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 during the
period beginning on the first day of the emergency period described in
section 1135(g)(1)(B) and ending on the last day of the 2-year period
after the last day of such emergency period 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.--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), during the period beginning on the first day of the
emergency period described in section 1135(g)(1)(B) and ending
on the last day of the 2-year period after the last day of such
emergency period, the Secretary shall pay--
``(A) an amount equal to 100 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; plus
``(B) an amount equal to 100 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.''.
(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.--During the period beginning on the first day of the emergency
period described in section 1135(g)(1)(B) and ending on the last day of
the 2-year period after the last day of such emergency period, 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.''.
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>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
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