I 

117TH CONGRESS 

1ST SESSION H. R. 2185 

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 

MARCH 26, 2021 

Ms. BLUNT ROCHESTER (for herself, Ms. LEE of California, Ms. KELLY of 

Illinois, Ms. WILLIAMS of Georgia, and Mrs. HAYES) 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. 

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 Because of 

5 COVID–19 Act’’. 


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1 SEC. 2. COVERAGE OF COMPREHENSIVE TOBACCO CES2 SATION SERVICES IN MEDICAID. 

3 (a) REQUIRING MEDICAID COVERAGE OF COUN4 SELING AND PHARMACOTHERAPY FOR CESSATION OF TO5 BACCO USE.—Section 1905 of the Social Security Act (42 

6 U.S.C. 1396d) is amended— 

7 (1) by amending subsection (a)(4)(D) to read 

8 as follows: ‘‘(D) counseling and pharmacotherapy for 

9 cessation of tobacco use by individuals who are eligi10 ble under the State plan (as defined in subsection 

11 (hh))’’; and 

12 (2) by adding at the end the following new sub13 section: 

14 ‘‘(hh) For purposes of this title, the term ‘counseling 

15 and pharmacotherapy for cessation of tobacco use’ means 

16 diagnostic, therapy, and counseling services and 

17 pharmacotherapy (including the coverage of prescription 

18 and nonprescription tobacco cessation agents approved by 

19 the Food and Drug Administration) for the cessation of 

20 tobacco use by individuals who use tobacco products or 

21 who are being treated for tobacco use that are furnished— 

22 ‘‘(1) by or under the supervision of a physician; 

23 or 

24 ‘‘(2) by any other health care professional 

25 who— 


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1 ‘‘(A) 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 ‘‘(B) is authorized to receive payment for 

6 other services under this title or is designated 

7 by the Secretary for this purpose; 

8 which is recommended in the guideline entitled, 

9 ‘Treating Tobacco Use and Dependence: 2008 Up10 date: A Clinical Practice Guideline’ published by the 

11 Public Health Service in May 2008 (or any subse12 quent modification of such guideline) or is rec13 ommended for the cessation of tobacco use by the 

14 U.S. Preventive Services Task Force or any addi15 tional intervention approved by the Food and Drug 

16 Administration as safe and effective in helping 

17 smokers quit.’’. 

18 (b) NO COST SHARING.— 

19 (1) IN GENERAL.—Subsections (a)(2) and 

20 (b)(2) of section 1916 of the Social Security Act (42 

21 U.S.C. 1396o) are each amended— 

22 (A) by repealing subparagraph (B); 

23 (B) in subparagraph (F), by striking ‘‘or’’ 

24 at the end; 


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1 (C) in subparagraph (G), by striking ‘‘; 

2 and’’ and inserting ‘‘, or’’; and 

3 (D) by adding at the end the following new 

4 subparagraph: 

5 ‘‘(H) counseling and pharmacotherapy for 

6 cessation of tobacco use (as defined in section 

7 1905(hh)) and covered outpatient drugs (as de8 fined in subsection (k)(2) of section 1927 and 

9 including nonprescription drugs described in 

10 subsection (d)(2) of such section) that are pre11 scribed for purposes of promoting tobacco ces12 sation in accordance with the guideline specified 

13 in section 1905(hh); and’’. 

14 (2) APPLICATION TO ALTERNATIVE COST SHAR15 ING.—Section 1916A(b)(3)(B) of the Social Security 

16 Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended— 

17 (A) by repealing clause (iii); and 

18 (B) by adding at the end the following new 

19 clause: 

20 ‘‘(xii) Counseling and 

21 pharmacotherapy for cessation of tobacco 

22 use (as defined in section 1905(hh)) and 

23 covered outpatient drugs (as defined in 

24 subsection (k)(2) of section 1927 and in25 cluding nonprescription drugs described in 


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1 subsection (d)(2) of such section) that are 

2 prescribed for purposes of promoting to3 bacco cessation in accordance with the 

4 guideline specified in section 1905(hh).’’. 

5 (c) EXCEPTION FROM OPTIONAL RESTRICTION

6 UNDER MEDICAID PRESCRIPTION DRUG COVERAGE.— 

7 Section 1927(d)(2)(F) of the Social Security Act (42 

8 U.S.C. 1396r–8(d)(2)(F)) is amended to read as follows: 

9 ‘‘(F) Nonprescription drugs, except, in the 

10 case of individuals who are eligible under the 

11 State plan when recommended in accordance 

12 with the Guideline referred to in section 

13 1905(hh), agents approved by the Food and 

14 Drug Administration under the over-the-counter 

15 monograph process for purposes of promoting 

16 tobacco cessation (as defined in subsection 

17 (hh)).’’. 

18 (d) STATE MONITORING AND PROMOTING OF COM19 PREHENSIVE TOBACCO CESSATION SERVICES UNDER

20 MEDICAID.—Section 1902(a) of the Social Security Act 

21 (42 U.S.C. 1396a) is amended— 

22 (1) in paragraph (85), by striking at the end 

23 ‘‘and’’; 

24 (2) in paragraph (86), by striking the period at 

25 the end and inserting ‘‘; and’’; and 


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1 (3) by inserting after paragraph (86) the fol2 lowing new paragraph: 

3 ‘‘(87) provide for the State to monitor and pro4 mote the use of comprehensive tobacco cessation 

5 services under the State plan (including conducting 

6 an outreach campaign to increase awareness of the 

7 benefits of using such services) among— 

8 ‘‘(A) individuals entitled to medical assist9 ance under the State plan who use tobacco 

10 products; and 

11 ‘‘(B) clinicians and others who provide 

12 services to individuals entitled to medical assist13 ance under the State plan.’’. 

14 (e) FEDERAL REIMBURSEMENT FOR MEDICAID COV15 ERAGE AND OUTREACH CAMPAIGN.—Section 1903(a) of 

16 the Social Security Act (42 U.S.C. 1396b(a)) is amend17 ed— 

18 (1) in paragraph (7), by striking the period at 

19 the end and inserting ‘‘; plus’’; and 

20 (2) by inserting after paragraph (7) the fol21 lowing new paragraphs: 

22 ‘‘(8) with respect to counseling and 

23 pharmacotherapy for cessation of tobacco use by in24 dividuals who are eligible under the State plan— 


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1 ‘‘(A) for calendar quarters occurring dur2 ing the period beginning on the date of the en3 actment of this paragraph and ending 2 years 

4 after the last day of the emergency period de5 scribed in section 1135(g)(1)(B), an amount 

6 equal to 100 percent of the sums expended dur7 ing each quarter which are attributable to the 

8 cost of furnishing such counseling and 

9 pharmacotherapy; and 

10 ‘‘(B) for calendar quarters occurring after 

11 the period described in subparagraph (A), an 

12 amount equal to Federal medical assistance 

13 percentage determined under section 1905(b) of 

14 the sums expended during each quarter which 

15 are so attributable; plus 

16 ‘‘(9) with respect to the development, imple17 mentation, and evaluation of an outreach campaign 

18 to— 

19 ‘‘(A) increase awareness of comprehensive 

20 tobacco cessation services covered in the State 

21 plan among— 

22 ‘‘(i) individuals who are likely to be el23 igible for medical assistance under the 

24 State plan; and 


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1 ‘‘(ii) clinicians and others who provide 

2 services to individuals who are likely to be 

3 eligible for medical assistance under the 

4 State plan; and 

5 ‘‘(B) increase awareness of the benefits of 

6 using comprehensive tobacco cessation services 

7 covered in the State plan among— 

8 ‘‘(i) individuals who are likely to be el9 igible for medical assistance under the 

10 State plan; and 

11 ‘‘(ii) clinicians and others who provide 

12 services to individuals who are likely to be 

13 eligible for medical assistance under the 

14 State plan about the benefits of using com15 prehensive tobacco cessation services; 

16 for calendar quarters occurring during the pe17 riod beginning on the date of the enactment of 

18 this paragraph and ending on 2 years after the 

19 last day of the emergency period described in 

20 section 1135(g)(1)(B), an amount equal to 100 

21 percent of the sums expended during each quar22 ter which are attributable to such development, 

23 implementation, and evaluation, and for cal24 endar quarters succeeding such period, an 

25 amount equal to Federal medical assistance 


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1 percentage determined under section 1905(b) of 

2 the sums expended during each quarter which 

3 are so attributable.’’. 

4 (f) NO PRIOR AUTHORIZATION FOR TOBACCO CES5 SATION DRUGS UNDER MEDICAID.—Section 1927(d) of 

6 the Social Security Act (42 U.S.C. 1396r–8(d)) is amend7 ed— 

8 (1) in paragraph (1)(A), by striking ‘‘A State’’ 

9 and inserting ‘‘Subject to paragraph (8), a State’’; 

10 and 

11 (2) by adding at the end the following new 

12 paragraph: 

13 ‘‘(8) NO PRIOR AUTHORIZATION PROGRAMS FOR

14 TOBACCO CESSATION DRUGS.—A State plan may not 

15 require, as a condition of coverage or payment for 

16 a covered outpatient drug, the approval of an agent 

17 to promote smoking cessation (including agents ap18 proved by the Food and Drug Administration) or to19 bacco cessation.’’. 

20 SEC. 3. COVERAGE OF COMPREHENSIVE TOBACCO CES21 SATION SERVICES IN CHIP. 

22 (a) REQUIRING CHIP COVERAGE OF COUNSELING

23 AND PHARMACOTHERAPY FOR CESSATION OF TOBACCO

24 USE.— 


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1 (1) IN GENERAL.—Section 2103(c)(2) of the 

2 Social Security Act (42 U.S.C. 1397cc(c)(2)) is 

3 amended by adding at the end the following new 

4 subparagraph: 

5 ‘‘(D) Counseling and pharmacotherapy for 

6 cessation of tobacco use by individuals who are 

7 eligible under the State child health plan.’’. 

8 (2) COUNSELING AND PHARMACOTHERAPY FOR

9 CESSATION OF TOBACCO USE DEFINED.—Section 

10 2110(c) of the Social Security Act (42 U.S.C. 

11 1397jj(c)) is amended by adding at the end the fol12 lowing new paragraph: 

13 ‘‘(10) COUNSELING AND PHARMACOTHERAPY

14 FOR CESSATION OF TOBACCO USE.—The term ‘coun15 seling and pharmacotherapy for cessation of tobacco 

16 use’ means diagnostic, therapy, and counseling serv17 ices and pharmacotherapy (including the coverage of 

18 prescription and nonprescription tobacco cessation 

19 agents approved by the Food and Drug Administra20 tion) for the cessation of tobacco use by individuals 

21 who use tobacco products or who are being treated 

22 for tobacco use that are furnished— 

23 ‘‘(A) by or under the supervision of a phy24 sician; or 


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

2 who— 

3 ‘‘(i) is legally authorized to furnish 

4 such services under State law (or the State 

5 regulatory mechanism provided by State 

6 law) of the State in which the services are 

7 furnished; and 

8 ‘‘(ii) is authorized to receive payment 

9 for other services under this title or is des10 ignated by the Secretary for this purpose; 

11 which is recommended in the guideline entitled, 

12 ‘Treating Tobacco Use and Dependence: 2008 

13 Update: A Clinical Practice Guideline’ pub14 lished by the Public Health Service in May 

15 2008 (or any subsequent modification of such 

16 guideline) or is recommended for the cessation 

17 of tobacco use by the U.S. Preventive Services 

18 Task Force or any additional intervention ap19 proved by the Food and Drug Administration 

20 as safe and effective in helping smokers quit.’’. 

21 (b) NO COST SHARING.—Section 2103(e) of the So22 cial Security Act (42 U.S.C. 1397cc(e)) is amended by 

23 adding at the end the following new paragraph: 

24 ‘‘(5) NO COST SHARING ON BENEFITS FOR

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1 SATION OF TOBACCO USE.—The State child health 

2 plan may not impose deductibles, coinsurance, or 

3 other cost sharing with respect to benefits for coun4 seling and pharmacotherapy for cessation of tobacco 

5 use (as defined in section 2110(c)(10)) and prescrip6 tion drugs that are covered under a State child 

7 health plan that are prescribed for purposes of pro8 moting tobacco cessation in accordance with the 

9 guideline specified in section 2110(c)(10)(B).’’. 

10 (c) EXCEPTION FROM OPTIONAL RESTRICTION

11 UNDER CHIP PRESCRIPTION DRUG COVERAGE.—Section 

12 2103 of the Social Security Act (42 U.S.C. 1397cc) is 

13 amended by adding at the end the following new sub14 section: 

15 ‘‘(g) EXCEPTION FROM OPTIONAL RESTRICTION

16 UNDER CHIP PRESCRIPTION DRUG COVERAGE.—The 

17 State child health plan may exclude or otherwise restrict 

18 nonprescription drugs, except, in the case of— 

19 ‘‘(1) pregnant women when recommended in ac20 cordance with the guideline specified in section 

21 2110(c)(10)(B), agents approved by the Food and 

22 Drug Administration under the over-the-counter 

23 monograph process for purposes of promoting to24 bacco cessation; and 


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1 ‘‘(2) individuals who are eligible under the 

2 State child health plan when recommended in ac3 cordance with the Guideline referred to in section 

4 2110(c)(10)(B), agents approved by the Food and 

5 Drug Administration under the over-the-counter 

6 monograph process for purposes of promoting to7 bacco cessation.’’. 

8 (d) STATE MONITORING AND PROMOTING OF COM9 PREHENSIVE TOBACCO CESSATION SERVICES UNDER

10 CHIP.—Section 2102 of the Social Security Act (42 

11 U.S.C. 1397bb) is amended by adding at the end the fol12 lowing new subsection: 

13 ‘‘(d) STATE MONITORING AND PROMOTING OF COM14 PREHENSIVE TOBACCO CESSATION SERVICES UNDER

15 CHIP.—A State child health plan shall include a descrip16 tion of the procedures to be used by the State to monitor 

17 and promote the use of comprehensive tobacco cessation 

18 services under the State plan (including conducting an 

19 outreach campaign to increase awareness of the benefits 

20 of using such services) among— 

21 ‘‘(1) individuals entitled to medical assistance 

22 under the State child health plan who use tobacco 

23 products; and 


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1 ‘‘(2) clinicians and others who provide services 

2 to individuals entitled to medical assistance under 

3 the State child health plan.’’. 

4 (e) FEDERAL REIMBURSEMENT FOR CHIP COV5 ERAGE AND OUTREACH CAMPAIGN.—Section 2105(a) of 

6 the Social Security Act (42 U.S.C. 1397ee(a)) is amended 

7 by adding at the end the following new paragraph: 

8 ‘‘(5) FEDERAL REIMBURSEMENT FOR CHIP

9 COVERAGE OF COMPREHENSIVE TOBACCO CES10 SATION SERVICES AND OUTREACH CAMPAIGN.—In 

11 addition to the payments made under paragraph (1) 

12 for calendar quarters occurring during the period be13 ginning on the date of the enactment of this para14 graph and ending on 2 years after the last day of 

15 the emergency period described in section 

16 1135(g)(1)(B), the Secretary shall pay— 

17 ‘‘(A) an amount equal to 100 percent of 

18 the sums expended during each quarter which 

19 are attributable to the cost of furnishing coun20 seling and pharmacotherapy for cessation of to21 bacco use by individuals who are eligible under 

22 the State child health plan; plus 

23 ‘‘(B) an amount equal to 100 percent of 

24 the sums expended during each quarter which 

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1 tation, and evaluation of an outreach campaign 

2 to— 

3 ‘‘(i) increase awareness of comprehen4 sive tobacco cessation services covered in 

5 the State child health plan among— 

6 ‘‘(I) individuals who are likely to 

7 be eligible for medical assistance 

8 under the State child health plan; and 

9 ‘‘(II) clinicians and others who 

10 provide services to individuals who are 

11 likely to be eligible for medical assist12 ance under the State child health 

13 plan; and 

14 ‘‘(ii) increase awareness of the bene15 fits of using comprehensive tobacco ces16 sation services covered in the State child 

17 health plan among— 

18 ‘‘(I) individuals who are likely to 

19 be eligible for medical assistance 

20 under the State child health plan; and 

21 ‘‘(II) clinicians and others who 

22 provide services to individuals who are 

23 likely to be eligible for medical assist24 ance under the State child health plan 

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1 prehensive tobacco cessation serv2 ices.’’. 

3 (f) NO PRIOR AUTHORIZATION FOR TOBACCO CES4 SATION DRUGS UNDER CHIP.—Section 2103 of the So5 cial Security Act (42 U.S.C. 1397cc), as amended by sub6 section (c), is further amended— 

7 (1) in subsection (c)(2)(A), by inserting ‘‘(in ac8 cordance with subsection (h)’’ after ‘‘Coverage of 

9 prescription drugs’’; and 

10 (2) by adding at the end the following new sub11 section: 

12 ‘‘(h) NO PRIOR AUTHORIZATION PROGRAMS FOR TO13 BACCO CESSATION DRUGS.—A State child health plan 

14 may not require, as a condition of coverage or payment 

15 for a prescription drug, the approval of an agent to pro16 mote smoking cessation (including agents approved by the 

17 Food and Drug Administration) or tobacco cessation.’’. 

18 SEC. 4. EXCLUSION OF ENHANCED PAYMENTS FROM TER19 RITORIAL CAPS. 

20 Notwithstanding any other provision of law, for pur21 poses of section 1108 of the Social Security Act (42 

22 U.S.C. 1308), with respect to any additional amount paid 

23 to a territory as a result of the application of paragraph 

24 (8) of section 1903(a) or subsection (gg)(3) of section 


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1 1905 of the Social Security Act (42 U.S.C. 1396b(a), 

2 1396d)— 

3 (1) the limitation on payments to territories 

4 under subsections (f) and (g) of such section 1108 

5 shall not apply to such additional amounts; and 

6 (2) such additional amounts shall be dis7 regarded in applying such subsections. 

8 SEC. 5. RULE OF CONSTRUCTION. 

9 None of the amendments made by this Act shall be 

10 construed to limit coverage of any counseling or 

11 pharmacotherapy for individuals under 18 years of age. 

Æ 


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