[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2064 Introduced in Senate (IS)]
<DOC>
119th CONGRESS
1st Session
S. 2064
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 SENATE OF THE UNITED STATES
June 12, 2025
Ms. Blunt Rochester introduced the following bill; which was read twice
and referred to the Committee on Finance
_______________________________________________________________________
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 the Helping Tobacco Users Quit Act and
ending 5 years after such date, 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) in subparagraph (I), by striking ``or'' at the
end;
(C) in subparagraph (J), by striking ``; and'' and
inserting ``; or''; and
(D) by adding at the end the following new
subparagraph:
``(K) 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))''; and
(B) by adding at the end the following new clause:
``(xv) 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:
``(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.
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.
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