Quit Because of COVID–19 Act

I 117TH CONGRESS 1ST SESSION H. R. 2125 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 MARCH 23, 2021 Ms. BLUNT ROCHESTER (for herself, Mr. FITZPATRICK, Ms. DEGETTE, Ms. BARRAGA´N, Ms. WASSERMAN SCHULTZ, Ms. UNDERWOOD, Ms. BASS, Ms. DEAN, Ms. WILD, Mr. TONKO, Mr. VARGAS, Mr. SUOZZI, and Ms. SCANLON) introduced the following bill; which was referred to the Com- mittee 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 Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Quit Because of 4 COVID–19 Act’’. 5 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 2125 IH SEC. 2. COVERAGE OF COMPREHENSIVE TOBACCO CES- 1 SATION SERVICES IN MEDICAID. 2 (a) REQUIRING MEDICAID COVERAGE OF COUN- 3 SELING AND PHARMACOTHERAPY FOR CESSATION OF TO- 4 BACCO USE.—Section 1905 of the Social Security Act (42 5 U.S.C. 1396d) is amended— 6 (1) by amending subsection (a)(4)(D) to read 7 as follows: ‘‘(D) counseling and pharmacotherapy for 8 cessation of tobacco use by individuals who are eligi- 9 ble under the State plan (as defined in subsection 10 (hh))’’; 11 (2) by adding at the end the following new sub- 12 section: 13 ‘‘(hh) For purposes of this title, the term ‘counseling 14 and pharmacotherapy for cessation of tobacco use’ means 15 diagnostic, therapy, and counseling services and 16 pharmacotherapy (including the coverage of prescription 17 and nonprescription tobacco cessation agents approved by 18 the Food and Drug Administration) for the cessation of 19 tobacco use by individuals who use tobacco products or 20 who are being treated for tobacco use that are furnished— 21 ‘‘(1) by or under the supervision of a physician; 22 or 23 ‘‘(2) by any other health care professional 24 who— 25 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 2125 IH ‘‘(A) is legally authorized to furnish such 1 services under State law (or the State regu- 2 latory mechanism provided by State law) of the 3 State in which the services are furnished; and 4 ‘‘(B) is authorized to receive payment for 5 other services under this title or is designated 6 by the Secretary for this purpose; 7 which is recommended in the guideline entitled, 8 ‘Treating Tobacco Use and Dependence: 2008 Up- 9 date: A Clinical Practice Guideline’ published by the 10 Public Health Service in May 2008 (or any subse- 11 quent modification of such guideline) or is rec- 12 ommended for the cessation of tobacco use by the 13 U.S. Preventive Services Task Force or any addi- 14 tional intervention approved by the Food and Drug 15 Administration as safe and effective in helping 16 smokers quit.’’. 17 (b) NO COST SHARING.— 18 (1) IN GENERAL.—Subsections (a)(2) and 19 (b)(2) of section 1916 of the Social Security Act (42 20 U.S.C. 1396o) are each amended— 21 (A) by repealing subparagraph (B); 22 (B) in subparagraph (F), by striking ‘‘or’’ 23 at the end; 24 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 2125 IH (C) in subparagraph (G), by striking ‘‘; 1 and’’ and inserting ‘‘, or’’ ; and 2 (D) by adding at the end the following new 3 subparagraph: 4 ‘‘(H) counseling and pharmacotherapy for 5 cessation of tobacco use (as defined in section 6 1905(hh)) and covered outpatient drugs (as de- 7 fined in subsection (k)(2) of section 1927 and 8 including nonprescription drugs described in 9 subsection (d)(2) of such section) that are pre- 10 scribed for purposes of promoting tobacco ces- 11 sation in accordance with the guideline specified 12 in section 1905(hh); and’’. 13 (2) APPLICATION TO ALTERNATIVE COST SHAR- 14 ING.—Section 1916A(b)(3)(B) of the Social Security 15 Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended— 16 (A) by repealing clause (iii); and 17 (B) by adding at the end the following new 18 clause: 19 ‘‘(xii) Counseling and 20 pharmacotherapy for cessation of tobacco 21 use (as defined in section 1905(hh)) and 22 covered outpatient drugs (as defined in 23 subsection (k)(2) of section 1927 and in- 24 cluding nonprescription drugs described in 25 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 2125 IH subsection (d)(2) of such section) that are 1 prescribed for purposes of promoting to- 2 bacco cessation in accordance with the 3 guideline specified in section 1905(hh).’’. 4 (c) EXCEPTION FROM OPTIONAL RESTRICTION 5 UNDER MEDICAID PRESCRIPTION DRUG COVERAGE.— 6 Section 1927(d)(2)(F) of the Social Security Act (42 7 U.S.C. 1396r–8(d)(2)(F)) is amended to read as follows: 8 ‘‘(F) Nonprescription drugs, except, in the 9 case of individuals who are eligible under the 10 State plan when recommended in accordance 11 with the Guideline referred to in section 12 1905(hh), agents approved by the Food and 13 Drug Administration under the over-the-counter 14 monograph process for purposes of promoting 15 tobacco cessation (as defined in subsection 16 (hh)).’’. 17 (d) STATE MONITORING AND PROMOTING OF COM- 18 PREHENSIVE TOBACCO CESSATION SERVICES UNDER 19 MEDICAID.—Section 1902(a) of the Social Security Act 20 (42 U.S.C. 1396a) is amended— 21 (1) in paragraph (85), by striking at the end 22 ‘‘and’’; 23 (2) in paragraph (86), by striking the period at 24 the end and inserting ‘‘; and’’; and 25 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 2125 IH (3) by inserting after paragraph (86) the fol- 1 lowing new paragraph: 2 ‘‘(87) provide for the State to monitor and pro- 3 mote the use of comprehensive tobacco cessation 4 services under the State plan (including conducting 5 an outreach campaign to increase awareness of the 6 benefits of using such services) among— 7 ‘‘(A) individuals entitled to medical assist- 8 ance under the State plan who use tobacco 9 products; and 10 ‘‘(B) clinicians and others who provide 11 services to individuals entitled to medical assist- 12 ance under the State plan.’’. 13 (e) FEDERAL REIMBURSEMENT FOR MEDICAID COV- 14 ERAGE AND OUTREACH CAMPAIGN.—Section 1903(a) of 15 the Social Security Act (42 U.S.C. 1396b(a)) is amend- 16 ed— 17 (1) in paragraph (7), by striking the period at 18 the end and inserting ‘‘; plus’’; and 19 (2) by inserting after paragraph (7) the fol- 20 lowing new paragraphs: 21 ‘‘(8) with respect to counseling and 22 pharmacotherapy for cessation of tobacco use by in- 23 dividuals who are eligible under the State plan— 24 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 2125 IH ‘‘(A) for calendar quarters occurring dur- 1 ing the period beginning on the date of the en- 2 actment of this paragraph and ending 2 years 3 after the last day of the emergency period de- 4 scribed in section 1135(g)(1)(B), an amount 5 equal to 100 percent of the sums expended dur- 6 ing each quarter which are attributable to the 7 cost of furnishing such counseling and 8 pharmacotherapy; and 9 ‘‘(B) for calendar quarters occurring after 10 the period described in subparagraph (A), an 11 amount equal to Federal medical assistance 12 percentage determined under section 1905(b) of 13 the sums expended during each quarter which 14 are so attributable; plus 15 ‘‘(9) with respect to the development, imple- 16 mentation, and evaluation of an outreach campaign 17 to— 18 ‘‘(A) increase awareness of comprehensive 19 tobacco cessation services covered in the State 20 plan among— 21 ‘‘(i) individuals who are likely to be el- 22 igible for medical assistance under the 23 State plan; and 24 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 2125 IH ‘‘(ii) clinicians and others who provide 1 services to individuals who are likely to be 2 eligible for medical assistance under the 3 State plan; and 4 ‘‘(B) increase awareness of the benefits of 5 using comprehensive tobacco cessation services 6 covered in the State plan among— 7 ‘‘(i) individuals who are likely to be el- 8 igible for medical assistance under the 9 State plan; and 10 ‘‘(ii) clinicians and others who provide 11 services to individuals who are likely to be 12 eligible for medical assistance under the 13 State plan about the benefits of using com- 14 prehensive tobacco cessation services; 15 for calendar quarters occurring during the pe- 16 riod beginning on the date of the enactment of 17 this paragraph and ending on 2 years after the 18 last day of the emergency period described in 19 section 1135(g)(1)(B), an amount equal to 100 20 percent of the sums expended during each quar- 21 ter which are attributable to such development, 22 implementation, and evaluation, and for cal- 23 endar quarters succeeding such period, an 24 amount equal to Federal medical assistance 25 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 2125 IH percentage determined under section 1905(b) of 1 the sums expended during each quarter which 2 are so attributable.’’. 3 (f) NO PRIOR AUTHORIZATION FOR TOBACCO CES- 4 SATION DRUGS UNDER MEDICAID.—Section 1927(d) of 5 the Social Security Act (42 U.S.C. 1396r–8(d)) is amend- 6 ed— 7 (1) in paragraph (1)(A), by striking ‘‘A State’’ 8 and inserting ‘‘Subject to paragraph (8), a State’’; 9 and 10 (2) by adding at the end the following new 11 paragraph: 12 ‘‘(8) NO PRIOR AUTHORIZATION PROGRAMS FOR 13 TOBACCO CESSATION DRUGS.—A State plan may not 14 require, as a condition of coverage or payment for 15 a covered outpatient drug, the approval of an agent 16 to promote smoking cessation (including agents ap- 17 proved by the Food and Drug Administration) or to- 18 bacco cessation.’’. 19 SEC. 3. COVERAGE OF COMPREHENSIVE TOBACCO CES- 20 SATION SERVICES IN CHIP. 21 (a) REQUIRING CHIP COVERAGE OF COUNSELING 22 AND PHARMACOTHERAPY FOR CESSATION OF TOBACCO 23 USE.— 24 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 2125 IH (1) IN GENERAL.—Section 2103(c)(2) of the 1 Social Security Act (42 U.S.C. 1397cc(c)(2)) is 2 amended by adding at the end the following new 3 subparagraph: 4 ‘‘(D) Counseling and pharmacotherapy for 5 cessation of tobacco use by individuals who are 6 eligible under the State child health plan.’’. 7 (2) COUNSELING AND PHARMACOTHERAPY FOR 8 CESSATION OF TOBACCO USE DEFINED.—Section 9 2110(c) of the Social Security Act (42 U.S.C. 10 1397jj(c)) is amended by adding at the end the fol- 11 lowing new paragraph: 12 ‘‘(10) COUNSELING AND PHARMACOTHERAPY 13 FOR CESSATION OF TOBACCO USE.—The term ‘coun- 14 seling and pharmacotherapy for cessation of tobacco 15 use’ means diagnostic, therapy, and counseling serv- 16 ices and pharmacotherapy (including the coverage of 17 prescription and nonprescription tobacco cessation 18 agents approved by the Food and Drug Administra- 19 tion) for the cessation of tobacco use by individuals 20 who use tobacco products or who are being treated 21 for tobacco use that are furnished— 22 ‘‘(A) by or under the supervision of a phy- 23 sician; or 24 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 2125 IH ‘‘(B) by any other health care professional 1 who— 2 ‘‘(i) is legally authorized to furnish 3 such services under State law (or the State 4 regulatory mechanism provided by State 5 law) of the State in which the services are 6 furnished; and 7 ‘‘(ii) is authorized to receive payment 8 for other services under this title or is des- 9 ignated by the Secretary for this purpose; 10 which is recommended in the guideline entitled, 11 ‘Treating Tobacco Use and Dependence: 2008 12 Update: A Clinical Practice Guideline’ pub- 13 lished by the Public Health Service in May 14 2008 (or any subsequent modification of such 15 guideline) or is recommended for the cessation 16 of tobacco use by the U.S. Preventive Services 17 Task Force or any additional intervention ap- 18 proved by the Food and Drug Administration 19 as safe and effective in helping smokers quit.’’. 20 (b) NO COST SHARING.—Section 2103(e) of the So- 21 cial Security Act (42 U.S.C. 1397cc(e)) is amended by 22 adding at the end the following new paragraph: 23 ‘‘(5) NO COST SHARING ON BENEFITS FOR 24 COUNSELING AND PHARMACOTHERAPY FOR CES- 25 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 2125 IH SATION OF TOBACCO USE.—The State child health 1 plan may not impose deductibles, coinsurance, or 2 other cost sharing with respect to benefits for coun- 3 seling and pharmacotherapy for cessation of tobacco 4 use (as defined in section 2110(c)(10)) and prescrip- 5 tion drugs that are covered under a State child 6 health plan that are prescribed for purposes of pro- 7 moting tobacco cessation in accordance with the 8 guideline specified in section 2110(c)(10)(B).’’. 9 (c) EXCEPTION FROM OPTIONAL RESTRICTION 10 UNDER CHIP PRESCRIPTION DRUG COVERAGE.—Section 11 2103 of the Social Security Act (42 U.S.C. 1397cc) is 12 amended by adding at the end the following new sub- 13 section: 14 ‘‘(g) EXCEPTION FROM OPTIONAL RESTRICTION 15 UNDER CHIP PRESCRIPTION DRUG COVERAGE.—The 16 State child health plan may exclude or otherwise restrict 17 nonprescription drugs, except, in the case of— 18 ‘‘(1) pregnant women when recommended in ac- 19 cordance with the guideline specified in section 20 2110(c)(10)(B), agents approved by the Food and 21 Drug Administration under the over-the-counter 22 monograph process for purposes of promoting to- 23 bacco cessation; and 24 VerDate Sep 11 2014 23:48 May 19, 2021 Jkt 019200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H2125.IH H2125 kjohnson on DSK79L0C42PROD with BILLS 13 •HR 2125 IH ‘‘(2) individuals [Text truncated for display. 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