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: (e) 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.