II 

117TH CONGRESS 

1ST SESSION S. 2622 

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 SENATE OF THE UNITED STATES 

AUGUST 5, 2021 

Mr. CARPER (for himself and Ms. COLLINS) introduced the following bill; 

which was read twice and referred to the Committee on Finance 

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 15:55 Aug 06, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S2622.IS S2622

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1 BACCO USE AND TEMPORARY ENHANCED FMAP FOR

2 COVERAGE OF TOBACCO CESSATION SERVICES.—Section 

3 1905 of the Social Security Act (42 U.S.C. 1396d) is 

4 amended— 

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

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

7 cessation of tobacco use by individuals who are eligi8 ble under the State plan (as defined in subsection 

9 (bb));’’; 

10 (2) in subsection (b), by inserting ‘‘(bb)(2),’’ 

11 after ‘‘(aa),’’; and 

12 (3) by striking subsection (bb) and inserting 

13 the following: 

14 ‘‘(bb) COUNSELING AND PHARMACOTHERAPY FOR

15 CESSATION OF TOBACCO USE.— 

16 ‘‘(1) IN GENERAL.—For purposes of this title, 

17 the term ‘counseling and pharmacotherapy for ces18 sation of tobacco use by individuals who are eligible 

19 under the State plan’ means diagnostic, therapy, 

20 and counseling services and pharmacotherapy (in21 cluding the coverage of prescription and nonprescrip22 tion tobacco cessation agents approved by the Food 

23 and Drug Administration) for the cessation of to24 bacco use by individuals who use tobacco products or 


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1 who are being treated for tobacco use that is fur2 nished— 

3 ‘‘(A) by or under the supervision of a phy4 sician; or 

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

6 who— 

7 ‘‘(i) is legally authorized to furnish 

8 such services under State law (or the State 

9 regulatory mechanism provided by State 

10 law) of the State in which the services are 

11 furnished; and 

12 ‘‘(ii) is authorized to receive payment 

13 for other services under this title or is des14 ignated by the Secretary for this purpose; 

15 which is recommended in the guideline entitled, 

16 ‘Treating Tobacco Use and Dependence: 2008 

17 Update: A Clinical Practice Guideline’ pub18 lished by the Public Health Service in May 

19 2008 (or any subsequent modification of such 

20 guideline) or is recommended for the cessation 

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

22 Task Force or any additional intervention ap23 proved by the Food and Drug Administration 

24 as safe and effective in helping smokers quit. 


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1 ‘‘(2) TEMPORARY ENHANCED FMAP FOR COV2 ERAGE OF TOBACCO CESSATION SERVICES.—Not3 withstanding subsection (b), for calendar quarters 

4 occurring during the period beginning on the date of 

5 the enactment of this paragraph and ending 2 years 

6 after the last day of the emergency period described 

7 in section 1135(g)(1)(B), the Federal medical assist8 ance percentage with respect to amounts expended 

9 by a State for medical assistance for counseling and 

10 pharmacotherapy for cessation of tobacco use by in11 dividuals who are eligible under the State plan (as 

12 defined in paragraph (1)) shall be equal to 100 per13 cent.’’. 

14 (b) NO COST SHARING.— 

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

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

17 U.S.C. 1396o) are each amended— 

18 (A) in subparagraph (B), by striking ‘‘, 

19 and counseling’’ and all that follows through 

20 ‘‘section 1905(bb)(2)(A)’’; 

21 (B) by adjusting the left margins of sub22 paragraphs (H) and (I) so as to align with the 

23 left margin of subparagraph (G); 

24 (C) in subparagraph (H), by striking ‘‘or’’ 

25 at the end; 


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1 (D) in subparagraph (I), by striking ‘‘; 

2 and’’ and inserting ‘‘; or’’; and 

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

4 subparagraph: 

5 ‘‘(J) counseling and pharmacotherapy for 

6 cessation of tobacco use by individuals who are 

7 eligible under the State plan (as defined in sec8 tion 1905(bb)) and covered outpatient drugs (as 

9 defined in subsection (k)(2) of section 1927 and 

10 including nonprescription drugs described in 

11 subsection (d)(2) of such section) that are pre12 scribed for purposes of promoting tobacco ces13 sation in accordance with the guideline specified 

14 in section 1905(bb); and’’. 

15 (2) APPLICATION TO ALTERNATIVE COST SHAR16 ING.—Section 1916A(b)(3)(B) of the Social Security 

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

18 (A) in clause (iii), by striking ‘‘, and coun19 seling and pharmacotherapy for cessation of to20 bacco use by pregnant women (as defined in 

21 section 1905(bb))’’; 

22 (B) by adjusting the left margins of 

23 clauses (xii) and (xiii) so as to align with the 

24 left margin of clause (xi); and 


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

2 clause: 

3 ‘‘(xiv) Counseling and 

4 pharmacotherapy for cessation of tobacco 

5 use by individuals who are eligible under 

6 the State plan (as defined in section 

7 1905(bb)) and covered outpatient drugs 

8 (as defined in subsection (k)(2) of section 

9 1927 and including nonprescription drugs 

10 described in subsection (d)(2) of such sec11 tion) that are prescribed for purposes of 

12 promoting tobacco cessation in accordance 

13 with the guideline specified in section 

14 1905(bb).’’. 

15 (c) EXCEPTION FROM OPTIONAL RESTRICTION

16 UNDER MEDICAID PRESCRIPTION DRUG COVERAGE.— 

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

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

19 ‘‘(F) Nonprescription drugs, except, when 

20 recommended in accordance with the guideline 

21 referred to in section 1905(bb), agents ap22 proved by the Food and Drug Administration 

23 under the over-the-counter monograph process 

24 for purposes of promoting tobacco cessation.’’. 


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1 (d) STATE MONITORING AND PROMOTING OF COM2 PREHENSIVE TOBACCO CESSATION SERVICES UNDER

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

4 (42 U.S.C. 1396a) is amended— 

5 (1) in paragraph (86), by striking at the end 

6 ‘‘and’’; 

7 (2) in paragraph (87), by striking the period at 

8 the end and inserting ‘‘; and’’; and 

9 (3) by inserting after paragraph (87) the fol10 lowing new paragraph: 

11 ‘‘(88) provide for the State to monitor and pro12 mote the use of comprehensive tobacco cessation 

13 services under the State plan (including conducting 

14 an outreach campaign to increase awareness of the 

15 benefits of using such services) among— 

16 ‘‘(A) individuals entitled to medical assist17 ance under the State plan who use tobacco 

18 products; and 

19 ‘‘(B) clinicians and others who provide 

20 services to individuals entitled to medical assist21 ance under the State plan.’’. 

22 (e) FEDERAL REIMBURSEMENT FOR OUTREACH

23 CAMPAIGN.—Section 1903(a) of the Social Security Act 

24 (42 U.S.C. 1396b(a)) is amended— 


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

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

3 (2) by inserting after paragraph (7) the fol4 lowing new paragraph: 

5 ‘‘(8) with respect to the development, imple6 mentation, and evaluation of an outreach campaign 

7 to— 

8 ‘‘(A) increase awareness of comprehensive 

9 tobacco cessation services covered in the State 

10 plan among— 

11 ‘‘(i) individuals who are likely to be el12 igible for medical assistance under the 

13 State plan; and 

14 ‘‘(ii) clinicians and others who provide 

15 services to individuals who are likely to be 

16 eligible for medical assistance under the 

17 State plan; and 

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

19 using comprehensive tobacco cessation services 

20 covered in the State plan among— 

21 ‘‘(i) individuals who are likely to be el22 igible for medical assistance under the 

23 State plan; and 

24 ‘‘(ii) clinicians and others who provide 

25 services to individuals who are likely to be 


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1 eligible for medical assistance under the 

2 State plan about the benefits of using com3 prehensive tobacco cessation services; 

4 for calendar quarters occurring during the pe5 riod beginning on the date of the enactment of 

6 this paragraph and ending on 2 years after the 

7 last day of the emergency period described in 

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

9 percent of the sums expended during each quar10 ter which are attributable to such development, 

11 implementation, and evaluation, and for cal12 endar quarters succeeding such period, an 

13 amount equal to Federal medical assistance 

14 percentage determined under section 1905(b) of 

15 the sums expended during each quarter which 

16 are so attributable.’’. 

17 (f) NO PRIOR AUTHORIZATION FOR TOBACCO CES18 SATION DRUGS UNDER MEDICAID.—Section 1927(d) of 

19 the Social Security Act (42 U.S.C. 1396r–8(d)) is amend20 ed— 

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

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

23 and 

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

25 paragraph: 


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1 ‘‘(8) NO PRIOR AUTHORIZATION PROGRAMS FOR

2 TOBACCO CESSATION DRUGS.—A State plan may not 

3 require, as a condition of coverage or payment for 

4 a covered outpatient drug, the approval of an agent 

5 to promote smoking cessation (including agents ap6 proved by the Food and Drug Administration) or to7 bacco cessation.’’. 

8 (g) EXCLUSION OF ENHANCED PAYMENTS FROM

9 TERRITORIAL CAPS.—Notwithstanding any other provi10 sion of law, for purposes of section 1108 of the Social Se11 curity Act (42 U.S.C. 1308), with respect to any addi12 tional amount paid to a territory as a result of the applica13 tion of section 1905(bb)(2) of the Social Security Act (42 

14 U.S.C. 1396d(bb)(2))— 

15 (1) the limitation on payments to territories 

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

17 shall not apply to such additional amounts; and 

18 (2) such additional amounts shall be dis19 regarded in applying such subsections. 

20 (h) EFFECTIVE DATE.—The amendments made by 

21 this section shall take effect on the first day of the first 

22 fiscal year that begins on or after the date of enactment 

23 of this Act. 


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1 SEC. 3. COVERAGE OF COMPREHENSIVE TOBACCO CES2 SATION SERVICES IN CHIP. 

3 (a) REQUIRING CHIP COVERAGE OF COUNSELING

4 AND PHARMACOTHERAPY FOR CESSATION OF TOBACCO

5 USE.— 

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

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

8 amended by adding at the end the following new 

9 subparagraph: 

10 ‘‘(D) Counseling and pharmacotherapy for 

11 cessation of tobacco use by individuals who are 

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

13 (2) COUNSELING AND PHARMACOTHERAPY FOR

14 CESSATION OF TOBACCO USE DEFINED.—Section 

15 2110(c) of the Social Security Act (42 U.S.C. 

16 1397jj(c)) is amended by adding at the end the fol17 lowing new paragraph: 

18 ‘‘(10) COUNSELING AND PHARMACOTHERAPY

19 FOR CESSATION OF TOBACCO USE.—The term ‘coun20 seling and pharmacotherapy for cessation of tobacco 

21 use’ means diagnostic, therapy, and counseling serv22 ices and pharmacotherapy (including the coverage of 

23 prescription and nonprescription tobacco cessation 

24 agents approved by the Food and Drug Administra25 tion) for the cessation of tobacco use by individuals 


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1 who use tobacco products or who are being treated 

2 for tobacco use that are furnished— 

3 ‘‘(A) by or under the supervision of a phy4 sician; or 

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

6 who— 

7 ‘‘(i) is legally authorized to furnish 

8 such services under State law (or the State 

9 regulatory mechanism provided by State 

10 law) of the State in which the services are 

11 furnished; and 

12 ‘‘(ii) is authorized to receive payment 

13 for other services under this title or is des14 ignated by the Secretary for this purpose; 

15 which is recommended in the guideline entitled, 

16 ‘Treating Tobacco Use and Dependence: 2008 

17 Update: A Clinical Practice Guideline’ pub18 lished by the Public Health Service in May 

19 2008 (or any subsequent modification of such 

20 guideline) or is recommended for the cessation 

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

22 Task Force or any additional intervention ap23 proved by the Food and Drug Administration 

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


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1 (b) NO COST SHARING.—Section 2103(e) of the So2 cial Security Act (42 U.S.C. 1397cc(e)) is amended by 

3 adding at the end the following new paragraph: 

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

5 COUNSELING AND PHARMACOTHERAPY FOR CES6 SATION OF TOBACCO USE.—The State child health 

7 plan may not impose deductibles, coinsurance, or 

8 other cost sharing with respect to benefits for coun9 seling and pharmacotherapy for cessation of tobacco 

10 use (as defined in section 2110(c)(10)) and prescrip11 tion drugs that are covered under a State child 

12 health plan that are prescribed for purposes of pro13 moting tobacco cessation in accordance with the 

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

15 (c) EXCEPTION FROM OPTIONAL RESTRICTION

16 UNDER CHIP PRESCRIPTION DRUG COVERAGE.—Section 

17 2103 of the Social Security Act (42 U.S.C. 1397cc) is 

18 amended by adding at the end the following new sub19 section: 

20 ‘‘(g) EXCEPTION FROM OPTIONAL RESTRICTION

21 UNDER CHIP PRESCRIPTION DRUG COVERAGE.—The 

22 State child health plan may exclude or otherwise restrict 

23 nonprescription drugs, except, in the case of— 

24 ‘‘(1) pregnant women when recommended in ac25 cordance with the guideline specified in section 


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1 2110(c)(10)(B), agents approved by the Food and 

2 Drug Administration under the over-the-counter 

3 monograph process for purposes of promoting to4 bacco cessation; and 

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

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

8 2110(c)(10)(B), agents approved by the Food and 

9 Drug Administration under the over-the-counter 

10 monograph process for purposes of promoting to11 bacco cessation.’’. 

12 (d) STATE MONITORING AND PROMOTING OF COM13 PREHENSIVE TOBACCO CESSATION SERVICES UNDER

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

15 U.S.C. 1397bb) is amended by adding at the end the fol16 lowing new subsection: 

17 ‘‘(d) STATE MONITORING AND PROMOTING OF COM18 PREHENSIVE TOBACCO CESSATION SERVICES UNDER

19 CHIP.—A State child health plan shall include a descrip20 tion of the procedures to be used by the State to monitor 

21 and promote the use of comprehensive tobacco cessation 

22 services under the State plan (including conducting an 

23 outreach campaign to increase awareness of the benefits 

24 of using such services) among— 


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1 ‘‘(1) individuals entitled to medical assistance 

2 under the State child health plan who use tobacco 

3 products; and 

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

5 to individuals entitled to medical assistance under 

6 the State child health plan.’’. 

7 (e) FEDERAL REIMBURSEMENT FOR CHIP COV8 ERAGE AND OUTREACH CAMPAIGN.— 

9 (1) IN GENERAL.—Section 2105(a) of the So10 cial Security Act (42 U.S.C. 1397ee(a)) is amended 

11 by adding at the end the following new paragraph: 

12 ‘‘(5) FEDERAL REIMBURSEMENT FOR CHIP

13 COVERAGE OF COMPREHENSIVE TOBACCO CES14 SATION SERVICES AND OUTREACH CAMPAIGN.—In 

15 addition to the payments made under paragraph (1) 

16 for calendar quarters occurring during the period be17 ginning on the date of the enactment of this para18 graph and ending on 2 years after the last day of 

19 the emergency period described in section 

20 1135(g)(1)(B), the Secretary shall pay— 

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

22 the sums expended during each quarter which 

23 are attributable to the cost of furnishing coun24 seling and pharmacotherapy for cessation of to25 bacco use by individuals who are eligible under 


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1 the State child health plan (net of any pay2 ments made to the State under paragraph (1) 

3 with respect to such counseling and 

4 pharmacotherapy); plus 

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

6 the sums expended during each quarter which 

7 are attributable to the development, implemen8 tation, and evaluation of an outreach campaign 

9 to— 

10 ‘‘(i) increase awareness of comprehen11 sive tobacco cessation services covered in 

12 the State child health plan among— 

13 ‘‘(I) individuals who are likely to 

14 be eligible for medical assistance 

15 under the State child health plan; and 

16 ‘‘(II) clinicians and others who 

17 provide services to individuals who are 

18 likely to be eligible for medical assist19 ance under the State child health 

20 plan; and 

21 ‘‘(ii) increase awareness of the bene22 fits of using comprehensive tobacco ces23 sation services covered in the State child 

24 health plan among— 


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1 ‘‘(I) individuals who are likely to 

2 be eligible for medical assistance 

3 under the State child health plan; and 

4 ‘‘(II) clinicians and others who 

5 provide services to individuals who are 

6 likely to be eligible for medical assist7 ance under the State child health plan 

8 about the benefits of using com9 prehensive tobacco cessation serv10 ices.’’. 

11 (2) ADJUSTMENT OF CHIP ALLOTMENTS.—Sec12 tion 2104(m) of the Social Security Act (42 U.S.C. 

13 1397dd(m)) is amended— 

14 (A) in paragraph (2)(B), by striking ‘‘ and 

15 (12)’’ and inserting ‘‘(12), and (13)’’; and 

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

17 paragraph: 

18 ‘‘(13) ADJUSTING ALLOTMENTS TO ACCOUNT

19 FOR FEDERAL PAYMENTS FOR CHIP COVERAGE OF

20 COMPREHENSIVE TOBACCO CESSATION SERVICES

21 AND OUTREACH CAMPAIGN.—If a State (including 

22 the District of Columbia and each commonwealth 

23 and territory) receives a payment for a fiscal year 

24 under section 2105(a)(5), the allotment determined 


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1 for the State for such fiscal year shall be increased 

2 by the amount of such payment.’’. 

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 drugs, the approval of an agent to pro16 mote smoking cessation (including agents approved by the 

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

18 (g) EFFECTIVE DATE.—The amendments made by 

19 this section shall take effect on the first day of the first 

20 fiscal year that begins on or after the date of enactment 

21 of this Act. 


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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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