I

106TH CONGRESS

2D SESSION H. R. 5208

To amend titles V, XVIII, and XIX of the Social Security Act to promote

smoking cessation under the medicare program, the medicaid program,

and the maternal and child health program.

IN THE HOUSE OF REPRESENTATIVES

SEPTEMBER 19, 2000

Ms. DEGETTE (for herself, Mrs. MORELLA, Mrs. TAUSCHER, Mr. MEEHAN,

Mr. WAXMAN, Mr. WEYGAND, Mr. STARK, Mr. LAFALCE, Mr. SANDERS,

Mr. DOGGETT, Mr. LEVIN, Mrs. LOWEY, and Mr. FILNER) introduced

the following bill; which was referred to the Committee on Commerce,

and in addition to the Committee on Ways and Means, for a period to

be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee

concerned

A BILL

To amend titles V, XVIII, and XIX of the Social Security

Act to promote smoking cessation under the medicare

program, the medicaid program, and the maternal and

child health program.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Medicare, Medicaid,

5 and MCH Smoking Cessation Promotion Act of 2000’’.
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1 SEC. 2. COVERAGE OF COUNSELING FOR CESSATION OF

2 TOBACCO USE UNDER THE MEDICARE PRO3 GRAM.

4 (a) COVERAGE.—Section 1861(s)(2) of the Social Se5 curity Act (42 U.S.C. 1395x(s)(2)) is amended—

6 (1) in subparagraph (S), by striking ‘‘and’’ at

7 the end;

8 (2) in subparagraph (T), by adding ‘‘and’’ at

9 the end; and

10 (3) by adding at the end the following new sub11 paragraph:

12 ‘‘(U) counseling for cessation of tobacco use (as

13 defined in section 1861(uu));’’.

14 (b) COUNSELING DESCRIBED.—Section 1861 of such

15 Act (42 U.S.C. 1395x) is further amended by adding at

16 the end the following new subsection:

17 ‘‘Counseling for Cessation of Tobacco Use

18 ‘‘(uu)(1) Except as provided in paragraph (2), the

19 term ‘counseling for cessation of tobacco use’ may include

20 diagnostic, therapy, and counseling services for cessation

21 of tobacco use but only for individuals who have a history

22 of tobacco use and only if the services are furnished—

23 ‘‘(A) by or under the supervision of a physician;

24 or

25 ‘‘(B) by any other health care professional who

26 (i) is legally authorized to furnish such services
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1 under State law (or the State regulatory mechanism

2 provided by State law) of the State in which the

3 services are furnished and (ii) is authorized to re4 ceive payment for other services under this title or

5 is designated by the Secretary for this purpose.

6 ‘‘(2) Such term does not include counseling services

7 that have not been shown (or recognized by the Secretary)

8 to be effective.’’.

9 (c) ELIMINATION OF COST-SHARING.—

10 (1) ELIMINATION OF COINSURANCE.—Section

11 1833(a)(1) of such Act (42 U.S.C. 1395l(a)(1)) is

12 amended—

13 (A) by striking ‘‘and’’ before ‘‘(S)’’; and

14 (B) by inserting before the semicolon at

15 the end the following: ‘‘, and (T) with respect

16 to counseling for cessation of tobacco use (as

17 defined in section 1861(uu), the amount paid

18 shall be 100 percent of the lesser of the actual

19 charge for the services or the amount deter20 mined by a fee schedule established by the Sec21 retary for purposes of this clause’’.

22 (2) ELIMINATION OF DEDUCTIBLE.—The first

23 sentence of section 1833(b)(1) of such Act (42

24 U.S.C. 1395l(b)(1)) is amended—

25 (A) by striking ‘‘and’’ before ‘‘(6)’’; and
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1 (B) by inserting before the period the fol2 lowing: ‘‘, and (7) such deductible shall not

3 apply with respect to counseling for cessation of

4 tobacco use (as defined in section 1861(uu)’’.

5 (d) EFFECTIVE DATE.—The amendments made by

6 this section apply to services furnished on or after Janu7 ary 1, 2002.

8 SEC. 3. MEDICAID PROGRAM.

9 (a) DROPPING EXCEPTION FROM MEDICAID PRE10 SCRIPTION DRUG COVERAGE FOR SMOKING CESSATION

11 MEDICATIONS.—Section 1927(d)(2) of the Social Security

12 Act (42 U.S.C. 1396r–8(d)(2)) is amended—

13 (1) by striking subparagraph (E); and

14 (2) in subparagraph (F), by inserting before the

15 period at the end the following: ‘‘except agents ap16 proved by the Food and Drug Administration for

17 purposes of promoting, and when used to promote,

18 smoking cessation’’.

19 (b) REQUIRING COVERAGE OF SMOKING CESSATION

20 COUNSELING IN SERVICES FOR PREGNANT WOMEN.—

21 Section 1902(a)(10)(C)(ii)(II) of such Act (42 U.S.C.

22 1396a(a)(10)(C)(ii)(II)) is amended by inserting ‘‘and

23 counseling for cessation of tobacco use (as defined in sec24 tion 1861(uu))’’ after ‘‘prenatal care and delivery serv25 ices’’.
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1 (c) REMOVAL OF COST-SHARING FOR SMOKING CES2 SATION COUNSELING SERVICES FOR PREGNANT

3 WOMEN.—Section 1916 of such Act (42 U.S.C. 1396o)

4 is amended, in each of subsections (a)(2)(B) and

5 (b)(2)(B), by inserting ‘‘counseling for cessation of to6 bacco use (as defined in section 1861(uu)) furnished to

7 pregnant women and other’’ after ‘‘(B)’’.

8 (d) EFFECTIVE DATE.—The amendments made by

9 this section apply to services furnished on or after Janu10 ary 1, 2002.

11 SEC. 4. MATERNAL AND CHILD HEALTH PROGRAM.

12 (a) QUALITY MATERNAL AND CHILD HEALTH SERV13 ICES INCLUDES SMOKING CESSATION COUNSELING AND

14 MEDICATIONS.—Section 501 of the Social Security Act

15 (42 U.S.C. 701) is amended by adding at the end the fol16 lowing new subsection:

17 ‘‘(c) For purposes of this title, counseling for ces18 sation of tobacco use (as defined in section 1861(uu)),

19 medications used to promote smoking cessation, and the

20 inclusion of anti-tobacco messages in health promotion

21 counseling shall be considered to be part of quality mater22 nal and child health services.’’.
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1 (b) EFFECTIVE DATE.—The amendment made by

2 subsection (a) takes effect on the date of the enactment

3 of this Act.

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