I 

116TH CONGRESS 

2D SESSION H. R. 7286 

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 

JUNE 22, 2020 

Ms. BLUNT ROCHESTER (for herself, Ms. DEGETTE, Mr. SOTO, Mr. ENGEL, 

and Ms. BARRAGA ́N) 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’’. 

6 SEC. 2. COVERAGE OF COMPREHENSIVE TOBACCO CES7 SATION SERVICES IN MEDICAID. 

8 (a) REQUIRING MEDICAID COVERAGE OF COUN9 SELING AND PHARMACOTHERAPY FOR CESSATION OF TOVerDate Sep 11 2014 23:09 Jul 11, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H7286.IH H7286

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1 BACCO USE.—Section 1905 of the Social Security Act (42 

2 U.S.C. 1396d) is amended— 

3 (1) in subsection (a)(4)— 

4 (A) in subparagraph (D), by striking 

5 ‘‘and’’; and 

6 (B) by inserting before the semicolon the 

7 following: ‘‘; and (E) counseling and 

8 pharmacotherapy for cessation of tobacco use 

9 by individuals who are eligible under the State 

10 plan (as defined in subsection (gg)) during the 

11 period beginning on the first day of the emer12 gency period described in section 1135(g)(1)(B) 

13 and ending on the last day of the 2-year period 

14 after the last day of such emergency period’’; 

15 (2) by adding at the end the following new sub16 section: 

17 ‘‘(gg) For purposes of this title, the term ‘counseling 

18 and pharmacotherapy for cessation of tobacco use’ means 

19 diagnostic, therapy, and counseling services and 

20 pharmacotherapy (including the coverage of prescription 

21 and nonprescription tobacco cessation agents approved by 

22 the Food and Drug Administration) for the cessation of 

23 tobacco use by individuals who use tobacco products or 

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


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

2 or 

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

4 who— 

5 ‘‘(A) is legally authorized to furnish such 

6 services under State law (or the State regu7 latory mechanism provided by State law) of the 

8 State in which the services are furnished; and 

9 ‘‘(B) is authorized to receive payment for 

10 other services under this title or is designated 

11 by the Secretary for this purpose; 

12 which is recommended in the guideline entitled, 

13 ‘Treating Tobacco Use and Dependence: 2008 Up14 date: A Clinical Practice Guideline’ published by the 

15 Public Health Service in May 2008 (or any subse16 quent modification of such guideline) or is rec17 ommended for the cessation of tobacco use by the 

18 U.S. Preventive Services Task Force or any addi19 tional intervention approved by the Food and Drug 

20 Administration as safe and effective in helping 

21 smokers quit.’’. 

22 (b) NO COST SHARING.— 

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

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

25 U.S.C. 1396o) are each amended— 


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

2 at the end; 

3 (B) in subparagraph (G), by striking ‘‘; 

4 and’’ and inserting ‘‘, or’’ ; and 

5 (C) by adding at the end the following new 

6 subparagraph: 

7 ‘‘(H) counseling and pharmacotherapy for 

8 cessation of tobacco use (as defined in section 

9 1905(gg)) and covered outpatient drugs (as de10 fined in subsection (k)(2) of section 1927 and 

11 including nonprescription drugs described in 

12 subsection (d)(2) of such section) that are pre13 scribed for purposes of promoting tobacco ces14 sation in accordance with the guideline specified 

15 in section 1905(gg)(2)(A) furnished during the 

16 period beginning on the first day of the emer17 gency period described in section 1135(g)(1)(B) 

18 and ending on the last day of the 2-year period 

19 after the last day of such emergency period; 

20 and’’. 

21 (2) APPLICATION TO ALTERNATIVE COST SHAR22 ING.—Section 1916A(b)(3)(B) of the Social Security 

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

24 adding at the end the following new clause: 


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1 ‘‘(xii) Counseling and 

2 pharmacotherapy for cessation of tobacco 

3 use (as defined in section 1905(gg)) and 

4 covered outpatient drugs (as defined in 

5 subsection (k)(2) of section 1927 and in6 cluding nonprescription drugs described in 

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

8 prescribed for purposes of promoting to9 bacco cessation in accordance with the 

10 guideline specified in section 

11 1905(gg)(2)(A) furnished during the pe12 riod beginning on the first day of the 

13 emergency period described in section 

14 1135(g)(1)(B) and ending on the last day 

15 of the 2-year period after the last day of 

16 such emergency period.’’. 

17 (c) EXCEPTION FROM OPTIONAL RESTRICTION

18 UNDER MEDICAID PRESCRIPTION DRUG COVERAGE.— 

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

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

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

22 case of— 

23 ‘‘(i) pregnant women when rec24 ommended in accordance with the guide25 line specified in section 1905(bb)(2)(A), 


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1 agents approved by the Food and Drug 

2 Administration under the over-the-counter 

3 monograph process for purposes of pro4 moting tobacco cessation; and 

5 ‘‘(ii) individuals who are eligible under 

6 the State plan when recommended in ac7 cordance with the Guideline referred to in 

8 section 1905(gg)(2)(A), agents approved 

9 by the Food and Drug Administration 

10 under the over-the-counter monograph 

11 process for purposes of promoting tobacco 

12 cessation (as defined in subsection (bb) 

13 during the period beginning on the first 

14 day of the emergency period described in 

15 section 1135(g)(1)(B) and ending on the 

16 last day of the 2-year period after the last 

17 day of such emergency period.’’. 

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) during the period beginning on the first 

4 day of the emergency period described in section 

5 1135(g)(1)(B) and ending on the last day of the 2- 

6 year period after the last day of such emergency pe7 riod, provide for the State to monitor and promote 

8 the use of comprehensive tobacco cessation services 

9 under the State plan (including conducting an out10 reach campaign to increase awareness of the benefits 

11 of using such services) among— 

12 ‘‘(A) individuals entitled to medical assist13 ance under the State plan who use tobacco 

14 products; and 

15 ‘‘(B) clinicians and others who provide 

16 services to individuals entitled to medical assist17 ance under the State plan.’’. 

18 (e) FEDERAL REIMBURSEMENT FOR MEDICAID COV19 ERAGE AND OUTREACH CAMPAIGN.—Section 1903(a) of 

20 the Social Security Act (42 U.S.C. 1396b(a)) is amend21 ed— 

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

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

24 (2) by inserting after paragraph (7) the fol25 lowing new paragraphs: 


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1 ‘‘(8) during the period beginning on the first 

2 day of the emergency period described in section 

3 1135(g)(1)(B) and ending on the last day of the 2- 

4 year period after the last day of such emergency pe5 riod, an amount equal to 100 percent of the sums 

6 expended during each quarter which are attributable 

7 to the cost of furnishing counseling and 

8 pharmacotherapy for cessation of tobacco use by in9 dividuals who are eligible under the State plan as 

10 described in section 1905(a)(4)(E); plus 

11 ‘‘(9) during the period described in paragraph 

12 (8), an amount equal to 100 percent of the sums ex13 pended during each quarter which are attributable 

14 to the development, implementation, and evaluation 

15 of an outreach campaign to— 

16 ‘‘(A) increase awareness of comprehensive 

17 tobacco cessation services covered in the State 

18 plan among— 

19 ‘‘(i) individuals who are likely to be el20 igible for medical assistance under the 

21 State plan; and 

22 ‘‘(ii) clinicians and others who provide 

23 services to individuals who are likely to be 

24 eligible for medical assistance under the 

25 State plan; and 


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

2 using comprehensive tobacco cessation services 

3 covered in the State plan among— 

4 ‘‘(i) individuals who are likely to be el5 igible for medical assistance under the 

6 State plan; and 

7 ‘‘(ii) clinicians and others who provide 

8 services to individuals who are likely to be 

9 eligible for medical assistance under the 

10 State plan about the benefits of using com11 prehensive tobacco cessation services.’’. 

12 (f) NO PRIOR AUTHORIZATION FOR TOBACCO CES13 SATION DRUGS UNDER MEDICAID.—Section 1927(d) of 

14 the Social Security Act (42 U.S.C. 1396r–8(d)) is amend15 ed— 

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

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

18 and 

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

20 paragraph: 

21 ‘‘(8) NO PRIOR AUTHORIZATION PROGRAMS FOR

22 TOBACCO CESSATION DRUGS.—During the period be23 ginning on the first day of the emergency period de24 scribed in section 1135(g)(1)(B) and ending on the 

25 last day of the 2-year period after the last day of 


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1 such emergency period, a State plan may not re2 quire, as a condition of coverage or payment for a 

3 covered outpatient drug, the approval of an agent to 

4 promote smoking cessation (including agents ap5 proved by the Food and Drug Administration) or to6 bacco cessation.’’. 

7 SEC. 3. COVERAGE OF COMPREHENSIVE TOBACCO CES8 SATION SERVICES IN CHIP. 

9 (a) REQUIRING CHIP COVERAGE OF COUNSELING

10 AND PHARMACOTHERAPY FOR CESSATION OF TOBACCO

11 USE.— 

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

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

14 amended by adding at the end the following new 

15 subparagraph: 

16 ‘‘(D) Counseling and pharmacotherapy for 

17 cessation of tobacco use by individuals who are 

18 eligible under the State child health plan during 

19 the period beginning on the first day of the 

20 emergency period described in section 

21 1135(g)(1)(B) and ending on the last day of 

22 the 2-year period after the last day of such 

23 emergency period.’’. 

24 (2) COUNSELING AND PHARMACOTHERAPY FOR

25 CESSATION OF TOBACCO USE DEFINED.—Section 


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1 2110(c) of the Social Security Act (42 U.S.C. 

2 1397jj(c)) is amended by adding at the end the fol3 lowing new paragraph: 

4 ‘‘(10) COUNSELING AND PHARMACOTHERAPY

5 FOR CESSATION OF TOBACCO USE.—The term ‘coun6 seling and pharmacotherapy for cessation of tobacco 

7 use’ means diagnostic, therapy, and counseling serv8 ices and pharmacotherapy (including the coverage of 

9 prescription and nonprescription tobacco cessation 

10 agents approved by the Food and Drug Administra11 tion) for the cessation of tobacco use by individuals 

12 who use tobacco products or who are being treated 

13 for tobacco use that are furnished— 

14 ‘‘(A) by or under the supervision of a phy15 sician; or 

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

17 who— 

18 ‘‘(i) is legally authorized to furnish 

19 such services under State law (or the State 

20 regulatory mechanism provided by State 

21 law) of the State in which the services are 

22 furnished; and 

23 ‘‘(ii) is authorized to receive payment 

24 for other services under this title or is des25 ignated by the Secretary for this purpose; 


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1 which is recommended in the guideline entitled, 

2 ‘Treating Tobacco Use and Dependence: 2008 

3 Update: A Clinical Practice Guideline’ pub4 lished by the Public Health Service in May 

5 2008 (or any subsequent modification of such 

6 guideline) or is recommended for the cessation 

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

8 Task Force or any additional intervention ap9 proved by the Food and Drug Administration 

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

11 (b) NO COST SHARING.—Section 2103(e) of the So12 cial Security Act (42 U.S.C. 1397cc(e)) is amended by 

13 adding at the end the following new paragraph: 

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

15 COUNSELING AND PHARMACOTHERAPY FOR CES16 SATION OF TOBACCO USE.—The State child health 

17 plan may not impose deductibles, coinsurance, or 

18 other cost sharing with respect to benefits for coun19 seling and pharmacotherapy for cessation of tobacco 

20 use (as defined in section 2110(c)(10)) and prescrip21 tion drugs that are covered under a State child 

22 health plan that are prescribed for purposes of pro23 moting tobacco cessation in accordance with the 

24 guideline specified in section 2110(c)(10)(B) fur25 nished during the period beginning on the first day 


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1 of the emergency period described in section 

2 1135(g)(1)(B) and ending on the last day of the 2- 

3 year period after the last day of such emergency pe4 riod.’’. 

5 (c) EXCEPTION FROM OPTIONAL RESTRICTION

6 UNDER CHIP PRESCRIPTION DRUG COVERAGE.—Section 

7 2103 of the Social Security Act (42 U.S.C. 1397cc) is 

8 amended by adding at the end the following new sub9 section: 

10 ‘‘(g) EXCEPTION FROM OPTIONAL RESTRICTION

11 UNDER CHIP PRESCRIPTION DRUG COVERAGE.—The 

12 State child health plan may exclude or otherwise restrict 

13 nonprescription drugs, except, in the case of— 

14 ‘‘(1) pregnant women when recommended in ac15 cordance with the guideline specified in section 

16 2110(c)(10)(B), agents approved by the Food and 

17 Drug Administration under the over-the-counter 

18 monograph process for purposes of promoting to19 bacco cessation; and 

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

21 State child health plan when recommended in ac22 cordance with the Guideline referred to in section 

23 2110(c)(10)(B), agents approved by the Food and 

24 Drug Administration under the over-the-counter 

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1 bacco cessation during the period beginning on the 

2 first day of the emergency period described in sec3 tion 1135(g)(1)(B) and ending on the last day of the 

4 2-year period after the last day of such emergency 

5 period.’’. 

6 (d) STATE MONITORING AND PROMOTING OF COM7 PREHENSIVE TOBACCO CESSATION SERVICES UNDER

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

9 U.S.C. 1397bb) is amended by adding at the end the fol10 lowing new subsection: 

11 ‘‘(d) STATE MONITORING AND PROMOTING OF COM12 PREHENSIVE TOBACCO CESSATION SERVICES UNDER

13 CHIP.—A State child health plan shall include a descrip14 tion of the procedures to be used by the State during the 

15 period beginning on the first day of the emergency period 

16 described in section 1135(g)(1)(B) and ending on the last 

17 day of the 2-year period after the last day of such emer18 gency period to monitor and promote the use of com19 prehensive tobacco cessation services under the State plan 

20 (including conducting an outreach campaign to increase 

21 awareness of the benefits of using such services) among— 

22 ‘‘(1) individuals entitled to medical assistance 

23 under the State child health plan who use tobacco 

24 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 during the period beginning on the first day of the 

13 emergency period described in section 1135(g)(1)(B) 

14 and ending on the last day of the 2-year period after 

15 the last day of such emergency period, the Secretary 

16 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.—During the period beginning 

14 on the first day of the emergency period described in sec15 tion 1135(g)(1)(B) and ending on the last day of the 2- 

16 year period after the last day of such emergency period, 

17 a State child health plan may not require, as a condition 

18 of coverage or payment for a prescription drugs, the ap19 proval of an agent to promote smoking cessation (includ20 ing agents approved by the Food and Drug Administra21 tion) or tobacco cessation.’’. 


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1 SEC. 4. RULE OF CONSTRUCTION. 

2 None of the amendments made by this Act shall be 

3 construed to limit coverage of any counseling or 

4 pharmacotherapy for individuals under 18 years of age. 

Æ 


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