I 

111TH CONGRESS 

1ST SESSION H. R. 1850 

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

tobacco use cessation under the Medicare Program, the Medicaid Program, and the maternal and child health program. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 1, 2009 

Ms. DEGETTE (for herself and Mr. PLATTS) introduced the following bill; 

which was referred to the Committee on Energy and 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 tobacco use 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 ‘‘Quit Smoking for Life 

5 Act of 2009’’. 


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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 (DD), by striking ‘‘and’’ at 

7 the end; 

8 (2) in subparagraph (EE), by adding ‘‘and’’ at 

9 the end; and 

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

12 ‘‘(FF) counseling for cessation of tobacco use 

13 (as defined in section 1861(hhh));’’. 

14 (b) SERVICES 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 ‘‘(hhh) COUNSELING FOR CESSATION OF TOBACCO

18 USE.—(1) Subject to paragraph (2), the term ‘counseling 

19 for cessation of tobacco use’ means diagnostic, therapy, 

20 and counseling services for cessation of tobacco use, for 

21 individuals who use tobacco products or are being treated 

22 for tobacco use, furnished— 

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

24 or 

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

26 who— 


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1 ‘‘(i) is legally authorized to furnish such 

2 services under State law (or the State regu3 latory mechanism provided by State law) of the 

4 State in which the services are furnished; and 

5 ‘‘(ii) is authorized to receive payment for 

6 other services under this title or is designated 

7 by the Secretary for this purpose. 

8 ‘‘(2) Such term is limited to— 

9 ‘‘(A) services that are included in the most cur10 rent clinical practice guidelines on treating tobacco 

11 use and dependence issued by the Public Health 

12 Service; and 

13 ‘‘(B) such other services that the Secretary rec14 ognizes to be effective.’’. 

15 (c) PAYMENT; ELIMINATION OF DEDUCTIBLE.— 

16 (1) PAYMENT.—Section 1833(a)(1) of such Act 

17 (42 U.S.C. 1395l(a)(1)) is amended— 

18 (A) by striking ‘‘and’’ before ‘‘(W)’’; and 

19 (B) by inserting before the semicolon at 

20 the end the following: ‘‘, and (X) with respect 

21 to counseling for cessation of tobacco use (as 

22 defined in section 1861(hhh)), the amount paid 

23 shall be 80 percent of the lesser of the actual 

24 charge for the service or the amount determined 


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1 by a fee schedule established by the Secretary 

2 for purposes of this clause’’. 

3 (2) ELIMINATION OF DEDUCTIBLE.—The first 

4 sentence of section 1833(b) of such Act (42 U.S.C. 

5 1395l(b)) is amended— 

6 (A) by striking ‘‘and’’ before ‘‘(9)’’; and 

7 (B) by inserting before the period the fol8 lowing: ‘‘, and (10) such deductible shall not 

9 apply with respect to counseling for cessation of 

10 tobacco use (as defined in section 1861(hhh))’’. 

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

12 this section shall apply to services furnished on or after 

13 January 1 of the first calendar year that begins at least 

14 6 months after the date of the enactment of this Act. 

15 SEC. 3. COVERAGE OF TOBACCO CESSATION 

16 PHARMACOTHERAPY UNDER THE MEDICARE 

17 PROGRAM. 

18 (a) INCLUSION OF TOBACCO CESSATION AGENTS AS

19 COVERED DRUGS.—Section 1860D–2(e)(1) of the Social 

20 Security Act (42 U.S.C. 1395w–102(e)(1)) is amended— 

21 (1) in subparagraph (A), by striking ‘‘or’’ after 

22 the semicolon at the end; 

23 (2) in subparagraph (B), by striking the comma 

24 at the end and inserting ‘‘; or’’; and 


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1 (3) by inserting after subparagraph (B) the fol2 lowing new subparagraph: 

3 ‘‘(C) any agent approved by the Food and 

4 Drug Administration for purposes of promoting, 

5 and when used to promote, tobacco use ces6 sation that may be dispensed without a pre7 scription (commonly referred to as an ‘over-the8 counter’ drug), but only if such an agent is pre9 scribed by a physician (or other person author10 ized to prescribe under State law),’’. 

11 (b) ESTABLISHMENT OF CATEGORIES AND CLASSES

12 CONSISTING OF TOBACCO CESSATION AGENTS.—Section 

13 1860D–4(b)(3)(C) of the Social Security Act (42 U.S.C. 

14 1395w–104(b)(3)(C)) is amended by adding at the end the 

15 following new clause: 

16 ‘‘(iv) CATEGORIES AND CLASSES OF

17 TOBACCO CESSATION AGENTS.—There 

18 shall be a therapeutic category or class of 

19 covered part D drugs consisting of agents 

20 approved by the Food and Drug Adminis21 tration for cessation of tobacco use. Such 

22 category or class shall include tobacco ces23 sation agents described in subparagraphs 

24 (A) and (C) of section 1860D–2(e)(1).’’. 


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1 SEC. 4. COVERAGE OF COUNSELING AND MEDICATION FOR 

2 CESSATION OF TOBACCO USE UNDER THE 

3 MEDICAID PROGRAM. 

4 (a) DROPPING EXCEPTION FROM MEDICAID PRE5 SCRIPTION DRUG COVERAGE FOR TOBACCO USE CES6 SATION MEDICATIONS.— 

7 (1) IN GENERAL.—Section 1927(d)(2) of the 

8 Social Security Act (42 U.S.C. 1396r–8(d)(2)) is 

9 amended— 

10 (A) by striking subparagraph (E); 

11 (B) by redesignating subparagraph (F) 

12 through (K) as subparagraphs (E) through (J), 

13 respectively; and 

14 (C) in subparagraph (F), as so redesig15 nated, by inserting before the period at the end 

16 the following: ‘‘, other than agents approved by 

17 the Food and Drug Administration for purposes 

18 of promoting, and when used to promote, to19 bacco use cessation (regardless, for purposes of 

20 this title only, of whether such agents may be 

21 dispensed only upon prescription or may be dis22 pensed without a prescription (commonly re23 ferred to as an ‘over-the-counter’ drug), but 

24 only if such an agent is prescribed by a physi25 cian (or other person authorized to prescribe 

26 under State law))’’. 


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1 (2) CONFORMING AMENDMENT.—Section 

2 1860D–2(e)(2)(A) of the Social Security Act (42 

3 U.S.C. 1395w–102(e)(2)(A)) is amended by striking 

4 ‘‘, other than subparagraph (E) of such section (re5 lating to smoking cessation agents),’’. 

6 (b) REQUIRING COVERAGE OF TOBACCO USE CES7 SATION COUNSELING.—Section 1905(a)(4) of such Act 

8 (42 U.S.C. 1396d(a)(4)) is amended— 

9 (1) by striking ‘‘and’’ before ‘‘(C)’’; and 

10 (2) by adding at the end the following: ‘‘, and 

11 (D) counseling for cessation of tobacco use (as de12 fined in section 1861(hhh));’’. 

13 (c) TREATMENT OF TOBACCO CESSATION SERVICES

14 AND MEDICATIONS AS SERVICES RELATED TO PREG15 NANCY.—Section 1905 of such Act is amended by adding 

16 at the end the following new subsection: 

17 ‘‘(y) Services described in subsection (a)(4)(D) shall 

18 be treated as services related to pregnancy with respect 

19 to women during pregnancy (and during the 60-day period 

20 beginning on the last day of the pregnancy).’’. 

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

22 this section shall apply to items and services furnished on 

23 or after January 1 of the first calendar year that begins 

24 at least 6 months after the date of the enactment of this 

25 Act. 


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1 SEC. 5. PROMOTING CESSATION OF TOBACCO USE UNDER 

2 THE MATERNAL AND CHILD HEALTH PRO3 GRAM. 

4 (a) QUALITY MATERNAL AND CHILD HEALTH SERV5 ICES INCLUDES TOBACCO USE CESSATION COUNSELING

6 AND MEDICATIONS.—Section 501 of the Social Security 

7 Act (42 U.S.C. 701) is amended by adding at the end the 

8 following new subsection: 

9 ‘‘(d) For purposes of this title, counseling for ces10 sation of tobacco use (as defined in section 1861(hhh)), 

11 drugs and biologicals used to promote tobacco use ces12 sation (regardless of whether such drugs or biologicals 

13 may be dispensed only upon prescription or may be dis14 pensed without a prescription (commonly referred to as 

15 an ‘over-the-counter’ drug), but only if such a drug or bio16 logical is prescribed by a physician (or other person au17 thorized to prescribe under State law)), and the inclusion 

18 of antitobacco messages in health promotion counseling 

19 shall be considered to be part of quality maternal and child 

20 health services.’’. 

21 (b) EFFECTIVE DATE.—The amendment made by 

22 subsection (a) shall take effect on the date of the enact23 ment of this Act. 

Æ 


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