II

106TH CONGRESS

2D SESSION S. 3073

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 SENATE OF THE UNITED STATES

SEPTEMBER 19, 2000

Mr. DURBIN (for himself and Mr. BROWNBACK) introduced the following bill;

which was read twice and referred to the Committee on Finance

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:

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

12 defined in section 1861(uu));’’.

13 (b) COUNSELING DESCRIBED.—Section 1861 of the

14 Social Security Act Act (42 U.S.C. 1395x) is amended by

15 adding at the end the following:

16 ‘‘Counseling for Cessation of Tobacco Use

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

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

19 diagnostic, therapy, and counseling services for cessation

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

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

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

23 or

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

25 is legally authorized to furnish such services under

26 State law (or the State regulatory mechanism pro-
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1 vided by State law) of the State in which the serv2 ices are furnished.

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

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

5 to be effective.’’.

6 (c) ELIMINATION OF COST-SHARING.—

7 (1) ELIMINATION OF COINSURANCE.—Section

8 1833(a)(1) of the Social Security Act (42 U.S.C.

9 1395l(a)(1)) is amended—

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

11 (B) by inserting before the semicolon at

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

13 to counseling for cessation of tobacco use (as

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

15 shall be 100 percent of the lesser of the actual

16 charge for the services or the amount deter17 mined by a fee schedule established by the Sec18 retary for purposes of this clause’’.

19 (2) ELIMINATION OF DEDUCTIBLE.—The first

20 sentence of section 1833(b)(1) of the Social Security

21 Act (42 U.S.C. 1395l(b)(1)) is amended—

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

23 (B) by inserting before the period the fol24 lowing: ‘‘, and (7) such deductible shall not
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1 apply with respect to counseling for cessation of

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

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

4 this section apply to services furnished on or after Janu5 ary 1, 2002.

6 SEC. 3. MEDICAID PROGRAM.

7 (a) DROPPING EXCEPTION FROM MEDICAID PRE8 SCRIPTION DRUG COVERAGE FOR SMOKING CESSATION

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

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

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

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

13 period at the end the following: ‘‘except agents ap14 proved by the Food and Drug Administration for

15 purposes of promoting, and when used to promote,

16 smoking cessation’’.

17 (b) REQUIRING COVERAGE OF SMOKING CESSATION

18 COUNSELING IN SERVICES FOR PREGNANT WOMEN.—

19 Section 1902(a)(10)(C)(iii)(II) of the Social Security Act

20 (42 U.S.C. 1396a(a)(10)(C)(iii)(II)) is amended by insert21 ing ‘‘and counseling for cessation of tobacco use (as de22 fined in section 1861(uu))’’ after ‘‘prenatal care and deliv23 ery services’’.

24 (c) REMOVAL OF COST-SHARING FOR SMOKING CES25 SATION COUNSELING SERVICES FOR PREGNANT
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1 WOMEN.—Section 1916 of the Social Security Act (42

2 U.S.C. 1396o) is amended, in each of subsections

3 (a)(2)(B) and (b)(2)(B), by inserting ‘‘counseling for ces4 sation of tobacco use (as defined in section 1861(uu)) fur5 nished to pregnant women and other’’ after the subpara6 graph designation.

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

8 this section apply to services furnished on or after Janu9 ary 1, 2002.

10 SEC. 4. MATERNAL AND CHILD HEALTH PROGRAM.

11 (a) QUALITY MATERNAL AND CHILD HEALTH SERV12 ICES INCLUDES SMOKING CESSATION COUNSELING AND

13 MEDICATIONS.—Section 501 of the Social Security Act

14 (42 U.S.C. 701) is amended by adding at the end the fol15 lowing new subsection:

16 ‘‘(c) For purposes of this title, counseling for ces17 sation of tobacco use (as defined in section 1861(uu)),

18 medications used to promote smoking cessation, and the

19 inclusion of anti-tobacco messages in health promotion

20 counseling shall be considered to be part of quality mater21 nal and child health services.’’.

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

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

24 of this Act.

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