Quit Because of COVID-19 Act

I 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. BARRAGA´N) 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 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 SEC. 2. COVERAGE OF COMPREHENSIVE TOBACCO CES- 6 SATION SERVICES IN MEDICAID. 7 (a) REQUIRING MEDICAID COVERAGE OF COUN- 8 SELING AND PHARMACOTHERAPY FOR CESSATION OF TO- 9 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 2 •HR 7286 IH BACCO USE.—Section 1905 of the Social Security Act (42 1 U.S.C. 1396d) is amended— 2 (1) in subsection (a)(4)— 3 (A) in subparagraph (D), by striking 4 ‘‘and’’; and 5 (B) by inserting before the semicolon the 6 following: ‘‘; and (E) counseling and 7 pharmacotherapy for cessation of tobacco use 8 by individuals who are eligible under the State 9 plan (as defined in subsection (gg)) during the 10 period beginning on the first day of the emer- 11 gency period described in section 1135(g)(1)(B) 12 and ending on the last day of the 2-year period 13 after the last day of such emergency period’’; 14 (2) by adding at the end the following new sub- 15 section: 16 ‘‘(gg) For purposes of this title, the term ‘counseling 17 and pharmacotherapy for cessation of tobacco use’ means 18 diagnostic, therapy, and counseling services and 19 pharmacotherapy (including the coverage of prescription 20 and nonprescription tobacco cessation agents approved by 21 the Food and Drug Administration) for the cessation of 22 tobacco use by individuals who use tobacco products or 23 who are being treated for tobacco use that are furnished— 24 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 3 •HR 7286 IH ‘‘(1) by or under the supervision of a physician; 1 or 2 ‘‘(2) by any other health care professional 3 who— 4 ‘‘(A) is legally authorized to furnish such 5 services under State law (or the State regu- 6 latory mechanism provided by State law) of the 7 State in which the services are furnished; and 8 ‘‘(B) is authorized to receive payment for 9 other services under this title or is designated 10 by the Secretary for this purpose; 11 which is recommended in the guideline entitled, 12 ‘Treating Tobacco Use and Dependence: 2008 Up- 13 date: A Clinical Practice Guideline’ published by the 14 Public Health Service in May 2008 (or any subse- 15 quent modification of such guideline) or is rec- 16 ommended for the cessation of tobacco use by the 17 U.S. Preventive Services Task Force or any addi- 18 tional intervention approved by the Food and Drug 19 Administration as safe and effective in helping 20 smokers quit.’’. 21 (b) NO COST SHARING.— 22 (1) IN GENERAL.—Subsections (a)(2) and 23 (b)(2) of section 1916 of the Social Security Act (42 24 U.S.C. 1396o) are each amended— 25 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 4 •HR 7286 IH (A) in subparagraph (F), by striking ‘‘or’’ 1 at the end; 2 (B) in subparagraph (G), by striking ‘‘; 3 and’’ and inserting ‘‘, or’’ ; and 4 (C) by adding at the end the following new 5 subparagraph: 6 ‘‘(H) counseling and pharmacotherapy for 7 cessation of tobacco use (as defined in section 8 1905(gg)) and covered outpatient drugs (as de- 9 fined in subsection (k)(2) of section 1927 and 10 including nonprescription drugs described in 11 subsection (d)(2) of such section) that are pre- 12 scribed for purposes of promoting tobacco ces- 13 sation in accordance with the guideline specified 14 in section 1905(gg)(2)(A) furnished during the 15 period beginning on the first day of the emer- 16 gency period described in section 1135(g)(1)(B) 17 and ending on the last day of the 2-year period 18 after the last day of such emergency period; 19 and’’. 20 (2) APPLICATION TO ALTERNATIVE COST SHAR- 21 ING.—Section 1916A(b)(3)(B) of the Social Security 22 Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended by 23 adding at the end the following new clause: 24 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 5 •HR 7286 IH ‘‘(xii) Counseling and 1 pharmacotherapy for cessation of tobacco 2 use (as defined in section 1905(gg)) and 3 covered outpatient drugs (as defined in 4 subsection (k)(2) of section 1927 and in- 5 cluding nonprescription drugs described in 6 subsection (d)(2) of such section) that are 7 prescribed for purposes of promoting to- 8 bacco cessation in accordance with the 9 guideline specified in section 10 1905(gg)(2)(A) furnished during the pe- 11 riod beginning on the first day of the 12 emergency period described in section 13 1135(g)(1)(B) and ending on the last day 14 of the 2-year period after the last day of 15 such emergency period.’’. 16 (c) EXCEPTION FROM OPTIONAL RESTRICTION 17 UNDER MEDICAID PRESCRIPTION DRUG COVERAGE.— 18 Section 1927(d)(2)(F) of the Social Security Act (42 19 U.S.C. 1396r–8(d)(2)(F)) is amended to read as follows: 20 ‘‘(F) Nonprescription drugs, except, in the 21 case of— 22 ‘‘(i) pregnant women when rec- 23 ommended in accordance with the guide- 24 line specified in section 1905(bb)(2)(A), 25 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 6 •HR 7286 IH agents approved by the Food and Drug 1 Administration under the over-the-counter 2 monograph process for purposes of pro- 3 moting tobacco cessation; and 4 ‘‘(ii) individuals who are eligible under 5 the State plan when recommended in ac- 6 cordance with the Guideline referred to in 7 section 1905(gg)(2)(A), agents approved 8 by the Food and Drug Administration 9 under the over-the-counter monograph 10 process for purposes of promoting tobacco 11 cessation (as defined in subsection (bb) 12 during the period beginning on the first 13 day of the emergency period described in 14 section 1135(g)(1)(B) and ending on the 15 last day of the 2-year period after the last 16 day of such emergency period.’’. 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 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 7 •HR 7286 IH (3) by inserting after paragraph (86) the fol- 1 lowing new paragraph: 2 ‘‘(87) during the period beginning on the first 3 day of the emergency period described in section 4 1135(g)(1)(B) and ending on the last day of the 2- 5 year period after the last day of such emergency pe- 6 riod, provide for the State to monitor and promote 7 the use of comprehensive tobacco cessation services 8 under the State plan (including conducting an out- 9 reach campaign to increase awareness of the benefits 10 of using such services) among— 11 ‘‘(A) individuals entitled to medical assist- 12 ance under the State plan who use tobacco 13 products; and 14 ‘‘(B) clinicians and others who provide 15 services to individuals entitled to medical assist- 16 ance under the State plan.’’. 17 (e) FEDERAL REIMBURSEMENT FOR MEDICAID COV- 18 ERAGE AND OUTREACH CAMPAIGN.—Section 1903(a) of 19 the Social Security Act (42 U.S.C. 1396b(a)) is amend- 20 ed— 21 (1) in paragraph (7), by striking the period at 22 the end and inserting ‘‘; plus’’; and 23 (2) by inserting after paragraph (7) the fol- 24 lowing new paragraphs: 25 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 8 •HR 7286 IH ‘‘(8) during the period beginning on the first 1 day of the emergency period described in section 2 1135(g)(1)(B) and ending on the last day of the 2- 3 year period after the last day of such emergency pe- 4 riod, an amount equal to 100 percent of the sums 5 expended during each quarter which are attributable 6 to the cost of furnishing counseling and 7 pharmacotherapy for cessation of tobacco use by in- 8 dividuals who are eligible under the State plan as 9 described in section 1905(a)(4)(E); plus 10 ‘‘(9) during the period described in paragraph 11 (8), an amount equal to 100 percent of the sums ex- 12 pended during each quarter which are attributable 13 to the development, implementation, and evaluation 14 of an outreach campaign to— 15 ‘‘(A) increase awareness of comprehensive 16 tobacco cessation services covered in the State 17 plan among— 18 ‘‘(i) individuals who are likely to be el- 19 igible for medical assistance under the 20 State plan; and 21 ‘‘(ii) clinicians and others who provide 22 services to individuals who are likely to be 23 eligible for medical assistance under the 24 State plan; and 25 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 9 •HR 7286 IH ‘‘(B) increase awareness of the benefits of 1 using comprehensive tobacco cessation services 2 covered in the State plan among— 3 ‘‘(i) individuals who are likely to be el- 4 igible for medical assistance under the 5 State plan; and 6 ‘‘(ii) clinicians and others who provide 7 services to individuals who are likely to be 8 eligible for medical assistance under the 9 State plan about the benefits of using com- 10 prehensive tobacco cessation services.’’. 11 (f) NO PRIOR AUTHORIZATION FOR TOBACCO CES- 12 SATION DRUGS UNDER MEDICAID.—Section 1927(d) of 13 the Social Security Act (42 U.S.C. 1396r–8(d)) is amend- 14 ed— 15 (1) in paragraph (1)(A), by striking ‘‘A State’’ 16 and inserting ‘‘Subject to paragraph (8), a State’’; 17 and 18 (2) by adding at the end the following new 19 paragraph: 20 ‘‘(8) NO PRIOR AUTHORIZATION PROGRAMS FOR 21 TOBACCO CESSATION DRUGS.—During the period be- 22 ginning on the first day of the emergency period de- 23 scribed in section 1135(g)(1)(B) and ending on the 24 last day of the 2-year period after the last day of 25 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 10 •HR 7286 IH such emergency period, a State plan may not re- 1 quire, as a condition of coverage or payment for a 2 covered outpatient drug, the approval of an agent to 3 promote smoking cessation (including agents ap- 4 proved by the Food and Drug Administration) or to- 5 bacco cessation.’’. 6 SEC. 3. COVERAGE OF COMPREHENSIVE TOBACCO CES- 7 SATION SERVICES IN CHIP. 8 (a) REQUIRING CHIP COVERAGE OF COUNSELING 9 AND PHARMACOTHERAPY FOR CESSATION OF TOBACCO 10 USE.— 11 (1) IN GENERAL.—Section 2103(c)(2) of the 12 Social Security Act (42 U.S.C. 1397cc(c)(2)) is 13 amended by adding at the end the following new 14 subparagraph: 15 ‘‘(D) Counseling and pharmacotherapy for 16 cessation of tobacco use by individuals who are 17 eligible under the State child health plan during 18 the period beginning on the first day of the 19 emergency period described in section 20 1135(g)(1)(B) and ending on the last day of 21 the 2-year period after the last day of such 22 emergency period.’’. 23 (2) COUNSELING AND PHARMACOTHERAPY FOR 24 CESSATION OF TOBACCO USE DEFINED.—Section 25 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 11 •HR 7286 IH 2110(c) of the Social Security Act (42 U.S.C. 1 1397jj(c)) is amended by adding at the end the fol- 2 lowing new paragraph: 3 ‘‘(10) COUNSELING AND PHARMACOTHERAPY 4 FOR CESSATION OF TOBACCO USE.—The term ‘coun- 5 seling and pharmacotherapy for cessation of tobacco 6 use’ means diagnostic, therapy, and counseling serv- 7 ices and pharmacotherapy (including the coverage of 8 prescription and nonprescription tobacco cessation 9 agents approved by the Food and Drug Administra- 10 tion) for the cessation of tobacco use by individuals 11 who use tobacco products or who are being treated 12 for tobacco use that are furnished— 13 ‘‘(A) by or under the supervision of a phy- 14 sician; or 15 ‘‘(B) by any other health care professional 16 who— 17 ‘‘(i) is legally authorized to furnish 18 such services under State law (or the State 19 regulatory mechanism provided by State 20 law) of the State in which the services are 21 furnished; and 22 ‘‘(ii) is authorized to receive payment 23 for other services under this title or is des- 24 ignated by the Secretary for this purpose; 25 VerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286 pbinns on DSKJLVW7X2PROD with BILLS 12 •HR 7286 IH which is recommended in the guideline entitled, 1 ‘Treating Tobacco Use and Dependence: 2008 2 Update: A Clinical Practice Guideline’ pub- 3 lished by the Public Health Service in May 4 2008 (or any subsequent modification of such 5 guideline) or is recommended for the cessation 6 of tobacco use by the U.S. Preventive Services 7 Task Force or any additional intervention ap- 8 proved by the Food and Drug Administration 9 as safe and effective in helping smokers quit.’’. 10 (b) NO COST SHARING.—Section 2103(e) of the So- 11 cial Security Act (42 U.S.C. 1397cc(e)) is amended by 12 adding at the end the following new paragraph: 13 ‘‘(5) NO COST SHARING ON BENEFITS FOR 14 COUNSELING AND PHARMACOTHERAPY FOR CES- 15 SATION OF TOBACCO USE.—The State child health 16 plan may not impose deductibles, coinsurance, or 17 other cost sharing with respect to benefits for coun- 18 seling and pharmacotherapy for cessation of tobacco 19 use (as defined in section 2110(c)(10)) and prescrip- 20 tion drugs that are covered under a State child 21 health plan that are prescribed for purposes of pro- 22 moting tobacco cessation in accordance with the 23 guideline specified [Text truncated for display. 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