144 
‘‘(A) by or under the supervision of a physician; 
or 
‘‘(B) by any other health care professional 
who— 
‘‘(i) is legally authorized to furnish such 
services under State law (or the State regu-
latory mechanism provided by State law) of the 
State in which the services are furnished; and 
‘‘(ii) is authorized to receive payment for 
other services under this title or is designated 
by the Secretary for this purpose. 
‘‘(2) Such term is limited to— 
‘‘(A) services recommended in ‘Treating To-
bacco Use and Dependence: A Clinical Practice 
Guideline’, published by the Public Health Service in 
June 2000, or any subsequent modification of such 
Guideline; and 
‘‘(B) such other services that the Secretary rec-
ognizes to be effective. 
‘‘(3) Each individual who is described in paragraph 
(1) and enrolled under part B shall be eligible for the serv-
ices described in this subsection for up to 3 attempts to 
cease the use of tobacco.’’. 
(3) PAYMENT
AND
ELIMINATION
OF
COST- 
SHARING.— 
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145 
(A) PAYMENT AND ELIMINATION OF COIN-
SURANCE.—Section 1833(a)(1) of the Social 
Security Act (42 U.S.C. 1395l(a)(1)), as 
amended by section 502(c)(1), is amended— 
(i) in subparagraph (N) by striking 
‘‘or screenings for clinical depression, anx-
iety, and impaired cognitive functioning (as 
defined in section 1861(ccc))’’ and insert-
ing ‘‘, screenings for clinical depression, 
anxiety, and impaired cognitive functioning 
(as defined in section 1861(ccc)), or coun-
seling and pharmacotherapy for cessation 
of tobacco use (as defined in section 
1861(ddd))’’; and 
(ii) in subparagraph (W), by striking 
‘‘and screenings for clinical depression, 
anxiety, and impaired cognitive functioning 
(as defined in section 1861(ccc))’’ and in-
serting ‘‘screenings for clinical depression, 
anxiety, and impaired cognitive functioning 
(as defined in section 1861(ccc)), and 
counseling and pharmacotherapy for ces-
sation of tobacco use (as defined in section 
1861(ddd))’’. 
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146 
(B) PAYMENT
UNDER
PHYSICIAN
FEE 
SCHEDULE.—Section 1848(j)(3) of the Social 
Security Act (42 U.S.C. 1395w–4(j)(3)), as 
amended by section 502(c)(2), is amended by 
inserting ‘‘(2)(CC) (with separate payment 
amounts for pharmacotherapy, including pre-
scription and nonprescription tobacco cessation 
agents approved by the Food and Drug Admin-
istration),’’ after ‘‘(2)(BB),’’. 
(C) ELIMINATION
OF
COINSURANCE
IN 
OUTPATIENT HOSPITAL SETTINGS.— 
(i) 
EXCLUSION
FROM
OPD
FEE 
SCHEDULE.—Section 1833(t)(1)(B)(iv) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395l(t)(1)(B)(iv)), as amended by section 
502(c)(3)(A), is amended by striking ‘‘or 
screenings for clinical depression, anxiety, 
and impaired cognitive functioning (as de-
fined in section 1861(ccc))’’ and inserting 
‘‘screenings for clinical depression, anxiety, 
and impaired cognitive functioning (as de-
fined in section 1861(ccc)), or counseling 
and pharmacotherapy for cessation of to-
bacco 
use 
(as 
defined 
in 
section 
1861(ddd))’’. 
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147 
(ii) CONFORMING AMENDMENT.—Sec-
tion 1833(a)(2)(H) of the Social Security 
Act (42 U.S.C. 1395l(a)(2)(H)), as added 
by section 502(c)(3)(B), is amended by 
striking ‘‘and screenings for clinical de-
pression, anxiety, and impaired cognitive 
functioning 
(as 
defined 
in 
section 
1861(ccc))’’ and inserting ‘‘screenings for 
clinical depression, anxiety, and impaired 
cognitive functioning (as defined in section 
1861(ccc)), 
and 
counseling 
and 
pharmacotherapy for cessation of tobacco 
use (as defined in section 1861(ddd))’’. 
(D) ELIMINATION OF DEDUCTIBLE.—Sec-
tion 1833(b)(7) of the Social Security Act (42 
U.S.C. 1395l(b)(7)), as added by section 
502(c)(4), 
is 
amended 
by 
striking 
‘‘or 
screenings for clinical depression, anxiety, and 
impaired cognitive functioning (as defined in 
section 1861(ccc))’’ and inserting ‘‘screenings 
for clinical depression, anxiety, and impaired 
cognitive functioning (as defined in section 
1861(ccc)), or counseling and pharmacotherapy 
for cessation of tobacco use (as defined in sec-
tion 1861(ddd))’’. 
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148 
(4) APPLICATION OF LIMITS ON BILLING.—Sec-
tion 1842(b)(18)(C) of the Social Security Act (42 
U.S.C. 1395u(b)(18)(C)), as amended by section 
502(d), is amended by adding at the end the fol-
lowing new clause: 
‘‘(ix) Any individual designated by the Sec-
retary under section 1861(ddd)(1)(B)(ii).’’. 
(5) FREQUENCY.—Section 1862(a)(1) of the 
Social Security Act (42 U.S.C. 1395y(a)(1)), as 
amended by section 502(e), is amended— 
(A) in subparagraph (M), by striking 
‘‘and’’ after the comma at the end; 
(B) in subparagraph (N), by striking the 
semicolon at the end and inserting ‘‘, and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(O) 
in 
the 
case 
of 
counseling 
and 
pharmacotherapy for cessation of tobacco use (as de-
fined in section 1861(ddd)), which is performed with 
respect to more attempts to cease tobacco use than 
is covered under such section;’’. 
(b) PROMOTING
CESSATION
OF
TOBACCO
USE 
UNDER THE MEDICAID PROGRAM.— 
(1) DROPPING
EXCEPTION
FROM
MEDICAID 
PRESCRIPTION DRUG COVERAGE FOR TOBACCO CES-
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149 
SATION
MEDICATIONS.—Section 1927(d)(2) of the 
Social Security Act (42 U.S.C. 1396r–8(d)(2)) is 
amended— 
(A) by striking subparagraph (E); 
(B) by redesignating subparagraphs (F) 
through (J) as subparagraphs (E) through (I), 
respectively; and 
(C) in subparagraph (F) (as redesignated 
by paragraph (2)), by inserting before the pe-
riod at the end the following: ‘‘, except agents 
approved by the Food and Drug Administration 
for purposes of promoting, and when used to 
promote, tobacco cessation’’. 
(2) REQUIRING COVERAGE OF TOBACCO CES-
SATION
COUNSELING
AND
PHARMACOTHERAPY 
SERVICES
FOR
PREGNANT
WOMEN.—Section 
1905(a)(4) of the Social Security Act (42 U.S.C. 
1396d(a)(4)) is amended— 
(A) by striking ‘‘and’’ before ‘‘(C)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘; and (D) counseling 
and pharmacotherapy for cessation of tobacco 
use (as defined in section 1861(ddd)) for preg-
nant women’’. 
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