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 fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce 
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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Quit Because of 
COVID–19 Act’’. 
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SEC. 2. COVERAGE OF COMPREHENSIVE TOBACCO CES-
SATION SERVICES IN MEDICAID. 
(a) REQUIRING MEDICAID COVERAGE
OF COUN-
SELING AND PHARMACOTHERAPY FOR CESSATION OF TO-
BACCO USE.—Section 1905 of the Social Security Act (42 
U.S.C. 1396d) is amended— 
(1) by amending subsection (a)(4)(D) to read 
as follows: ‘‘(D) counseling and pharmacotherapy for 
cessation of tobacco use by individuals who are eligi-
ble under the State plan (as defined in subsection 
(hh))’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(hh) For purposes of this title, the term ‘counseling 
and pharmacotherapy for cessation of tobacco use’ means 
diagnostic, 
therapy, 
and 
counseling 
services 
and 
pharmacotherapy (including the coverage of prescription 
and nonprescription tobacco cessation agents approved by 
the Food and Drug Administration) for the cessation of 
tobacco use by individuals who use tobacco products or 
who are being treated for tobacco use that are furnished— 
‘‘(1) by or under the supervision of a physician; 
or 
‘‘(2) by any other health care professional 
who— 
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‘‘(A) 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 
‘‘(B) is authorized to receive payment for 
other services under this title or is designated 
by the Secretary for this purpose; 
which is recommended in the guideline entitled, 
‘Treating Tobacco Use and Dependence: 2008 Up-
date: A Clinical Practice Guideline’ published by the 
Public Health Service in May 2008 (or any subse-
quent modification of such guideline) or is rec-
ommended for the cessation of tobacco use by the 
U.S. Preventive Services Task Force or any addi-
tional intervention approved by the Food and Drug 
Administration as safe and effective in helping 
smokers quit.’’. 
(b) NO COST SHARING.— 
(1) IN
GENERAL.—Subsections (a)(2) and 
(b)(2) of section 1916 of the Social Security Act (42 
U.S.C. 1396o) are each amended— 
(A) by repealing subparagraph (B); 
(B) in subparagraph (F), by striking ‘‘or’’ 
at the end; 
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(C) in subparagraph (G), by striking ‘‘; 
and’’ and inserting ‘‘, or’’; and 
(D) by adding at the end the following new 
subparagraph: 
‘‘(H) counseling and pharmacotherapy for 
cessation of tobacco use (as defined in section 
1905(hh)) and covered outpatient drugs (as de-
fined in subsection (k)(2) of section 1927 and 
including nonprescription drugs described in 
subsection (d)(2) of such section) that are pre-
scribed for purposes of promoting tobacco ces-
sation in accordance with the guideline specified 
in section 1905(hh); and’’. 
(2) APPLICATION TO ALTERNATIVE COST SHAR-
ING.—Section 1916A(b)(3)(B) of the Social Security 
Act (42 U.S.C. 1396o–1(b)(3)(B)) is amended— 
(A) by repealing clause (iii); and 
(B) by adding at the end the following new 
clause: 
‘‘(xii) 
Counseling 
and 
pharmacotherapy for cessation of tobacco 
use (as defined in section 1905(hh)) and 
covered outpatient drugs (as defined in 
subsection (k)(2) of section 1927 and in-
cluding nonprescription drugs described in 
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subsection (d)(2) of such section) that are 
prescribed for purposes of promoting to-
bacco cessation in accordance with the 
guideline specified in section 1905(hh).’’. 
(c) EXCEPTION
FROM
OPTIONAL
RESTRICTION 
UNDER MEDICAID PRESCRIPTION DRUG COVERAGE.— 
Section 1927(d)(2)(F) of the Social Security Act (42 
U.S.C. 1396r–8(d)(2)(F)) is amended to read as follows: 
‘‘(F) Nonprescription drugs, except, in the 
case of individuals who are eligible under the 
State plan when recommended in accordance 
with the Guideline referred to in section 
1905(hh), agents approved by the Food and 
Drug Administration under the over-the-counter 
monograph process for purposes of promoting 
tobacco cessation (as defined in subsection 
(hh)).’’. 
(d) STATE MONITORING AND PROMOTING OF COM-
PREHENSIVE TOBACCO CESSATION SERVICES UNDER 
MEDICAID.—Section 1902(a) of the Social Security Act 
(42 U.S.C. 1396a) is amended— 
(1) in paragraph (85), by striking at the end 
‘‘and’’; 
(2) in paragraph (86), by striking the period at 
the end and inserting ‘‘; and’’; and 
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(3) by inserting after paragraph (86) the fol-
lowing new paragraph: 
‘‘(87) provide for the State to monitor and pro-
mote the use of comprehensive tobacco cessation 
services under the State plan (including conducting 
an outreach campaign to increase awareness of the 
benefits of using such services) among— 
‘‘(A) individuals entitled to medical assist-
ance under the State plan who use tobacco 
products; and 
‘‘(B) clinicians and others who provide 
services to individuals entitled to medical assist-
ance under the State plan.’’. 
(e) FEDERAL REIMBURSEMENT FOR MEDICAID COV-
ERAGE AND OUTREACH CAMPAIGN.—Section 1903(a) of 
the Social Security Act (42 U.S.C. 1396b(a)) is amend-
ed— 
(1) in paragraph (7), by striking the period at 
the end and inserting ‘‘; plus’’; and 
(2) by inserting after paragraph (7) the fol-
lowing new paragraphs: 
‘‘(8) 
with 
respect 
to 
counseling 
and 
pharmacotherapy for cessation of tobacco use by in-
dividuals who are eligible under the State plan— 
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‘‘(A) for calendar quarters occurring dur-
ing the period beginning on the date of the en-
actment of this paragraph and ending 2 years 
after the last day of the emergency period de-
scribed in section 1135(g)(1)(B), an amount 
equal to 100 percent of the sums expended dur-
ing each quarter which are attributable to the 
cost 
of 
furnishing 
such 
counseling 
and 
pharmacotherapy; and 
‘‘(B) for calendar quarters occurring after 
the period described in subparagraph (A), an 
amount equal to Federal medical assistance 
percentage determined under section 1905(b) of 
the sums expended during each quarter which 
are so attributable; plus 
‘‘(9) with respect to the development, imple-
mentation, and evaluation of an outreach campaign 
to— 
‘‘(A) increase awareness of comprehensive 
tobacco cessation services covered in the State 
plan among— 
‘‘(i) individuals who are likely to be el-
igible for medical assistance under the 
State plan; and 
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‘‘(ii) clinicians and others who provide 
services to individuals who are likely to be 
eligible for medical assistance under the 
State plan; and 
‘‘(B) increase awareness of the benefits of 
using comprehensive tobacco cessation services 
covered in the State plan among— 
‘‘(i) individuals who are likely to be el-
igible for medical assistance under the 
State plan; and 
‘‘(ii) clinicians and others who provide 
services to individuals who are likely to be 
eligible for medical assistance under the 
State plan about the benefits of using com-
prehensive tobacco cessation services; 
for calendar quarters occurring during the pe-
riod beginning on the date of the enactment of 
this paragraph and ending on 2 years after the 
last day of the emergency period described in 
section 1135(g)(1)(B), an amount equal to 100 
percent of the sums expended during each quar-
ter which are attributable to such development, 
implementation, and evaluation, and for cal-
endar quarters succeeding such period, an 
amount equal to Federal medical assistance 
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percentage determined under section 1905(b) of 
the sums expended during each quarter which 
are so attributable.’’. 
(f) NO PRIOR AUTHORIZATION FOR TOBACCO CES-
SATION DRUGS UNDER MEDICAID.—Section 1927(d) of 
the Social Security Act (42 U.S.C. 1396r–8(d)) is amend-
ed— 
(1) in paragraph (1)(A), by striking ‘‘A State’’ 
and inserting ‘‘Subject to paragraph (8), a State’’; 
and 
(2) by adding at the end the following new 
paragraph: 
‘‘(8) NO PRIOR AUTHORIZATION PROGRAMS FOR 
TOBACCO CESSATION DRUGS.—A State plan may not 
require, as a condition of coverage or payment for 
a covered outpatient drug, the approval of an agent 
to promote smoking cessation (including agents ap-
proved by the Food and Drug Administration) or to-
bacco cessation.’’. 
SEC. 3. COVERAGE OF COMPREHENSIVE TOBACCO CES-
SATION SERVICES IN CHIP. 
(a) REQUIRING CHIP COVERAGE OF COUNSELING 
AND PHARMACOTHERAPY FOR CESSATION OF TOBACCO 
USE.— 
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(1) IN
GENERAL.—Section 2103(c)(2) of the 
Social Security Act (42 U.S.C. 1397cc(c)(2)) is 
amended by adding at the end the following new 
subparagraph: 
‘‘(D) Counseling and pharmacotherapy for 
cessation of tobacco use by individuals who are 
eligible under the State child health plan.’’. 
(2) COUNSELING AND PHARMACOTHERAPY FOR 
CESSATION
OF
TOBACCO
USE
DEFINED.—Section 
2110(c) of the Social Security Act (42 U.S.C. 
1397jj(c)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(10) COUNSELING
AND
PHARMACOTHERAPY 
FOR CESSATION OF TOBACCO USE.—The term ‘coun-
seling and pharmacotherapy for cessation of tobacco 
use’ means diagnostic, therapy, and counseling serv-
ices and pharmacotherapy (including the coverage of 
prescription and nonprescription tobacco cessation 
agents approved by the Food and Drug Administra-
tion) for the cessation of tobacco use by individuals 
who use tobacco products or who are being treated 
for tobacco use that are furnished— 
‘‘(A) by or under the supervision of a phy-
sician; or 
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‘‘(B) by any other health care professional 
who— 
‘‘(i) is legally authorized to furnish 
such services under State law (or the State 
regulatory 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 des-
ignated by the Secretary for this purpose; 
which is recommended in the guideline entitled, 
‘Treating Tobacco Use and Dependence: 2008 
Update: A Clinical Practice Guideline’ pub-
lished by the Public Health Service in May 
2008 (or any subsequent modification of such 
guideline) or is recommended for the cessation 
of tobacco use by the U.S. Preventive Services 
Task Force or any additional intervention ap-
proved by the Food and Drug Administration 
as safe and effective in helping smokers quit.’’. 
(b) NO COST SHARING.—Section 2103(e) of the So-
cial Security Act (42 U.S.C. 1397cc(e)) is amended by 
adding at the end the following new paragraph: 
‘‘(5) NO
COST
SHARING
ON
BENEFITS
FOR 
COUNSELING
AND
PHARMACOTHERAPY
FOR
CES-
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SATION OF TOBACCO USE.—The State child health 
plan may not impose deductibles, coinsurance, or 
other cost sharing with respect to benefits for coun-
seling and pharmacotherapy for cessation of tobacco 
use (as defined in section 2110(c)(10)) and prescrip-
tion drugs that are covered under a State child 
health plan that are prescribed for purposes of pro-
moting tobacco cessation in accordance with the 
guideline specified in section 2110(c)(10)(B).’’. 
(c) EXCEPTION
FROM
OPTIONAL
RESTRICTION 
UNDER CHIP PRESCRIPTION DRUG COVERAGE.—Section 
2103 of the Social Security Act (42 U.S.C. 1397cc) is 
amended by adding at the end the following new sub-
section: 
‘‘(g) EXCEPTION FROM OPTIONAL RESTRICTION 
UNDER CHIP PRESCRIPTION DRUG COVERAGE.—The 
State child health plan may exclude or otherwise restrict 
nonprescription drugs, except, in the case of— 
‘‘(1) pregnant women when recommended in ac-
cordance with the guideline specified in section 
2110(c)(10)(B), agents approved by the Food and 
Drug Administration under the over-the-counter 
monograph process for purposes of promoting to-
bacco cessation; and 
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‘‘(2) individuals who are eligible under the 
State child health plan when recommended in ac-
cordance with the Guideline referred to in section 
2110(c)(10)(B), agents approved by the Food and 
Drug Administration under the over-the-counter 
monograph process for purposes of promoting to-
bacco cessation.’’. 
(d) STATE MONITORING AND PROMOTING OF COM-
PREHENSIVE TOBACCO CESSATION SERVICES UNDER 
CHIP.—Section 2102 of the Social Security Act (42 
U.S.C. 1397bb) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(d) STATE MONITORING AND PROMOTING OF COM-
PREHENSIVE TOBACCO CESSATION SERVICES UNDER 
CHIP.—A State child health plan shall include a descrip-
tion of the procedures to be used by the State to monitor 
and promote the use of comprehensive tobacco cessation 
services under the State plan (including conducting an 
outreach campaign to increase awareness of the benefits 
of using such services) among— 
‘‘(1) individuals entitled to medical assistance 
under the State child health plan who use tobacco 
products; and 
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‘‘(2) clinicians and others who provide services 
to individuals entitled to medical assistance under 
the State child health plan.’’. 
(e) FEDERAL REIMBURSEMENT
FOR CHIP COV-
ERAGE AND OUTREACH CAMPAIGN.—Section 2105(a) of 
the Social Security Act (42 U.S.C. 1397ee(a)) is amended 
by adding at the end the following new paragraph: 
‘‘(5) FEDERAL
REIMBURSEMENT
FOR
CHIP 
COVERAGE
OF
COMPREHENSIVE
TOBACCO
CES-
SATION
SERVICES
AND
OUTREACH
CAMPAIGN.—In 
addition to the payments made under paragraph (1) 
for calendar quarters occurring during the period be-
ginning on the date of the enactment of this para-
graph and ending on 2 years after the last day of 
the 
emergency 
period 
described 
in 
section 
1135(g)(1)(B), the Secretary shall pay— 
‘‘(A) an amount equal to 100 percent of 
the sums expended during each quarter which 
are attributable to the cost of furnishing coun-
seling and pharmacotherapy for cessation of to-
bacco use by individuals who are eligible under 
the State child health plan; plus 
‘‘(B) an amount equal to 100 percent of 
the sums expended during each quarter which 
are attributable to the development, implemen-
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tation, and evaluation of an outreach campaign 
to— 
‘‘(i) increase awareness of comprehen-
sive tobacco cessation services covered in 
the State child health plan among— 
‘‘(I) individuals who are likely to 
be eligible for medical assistance 
under the State child health plan; and 
‘‘(II) clinicians and others who 
provide services to individuals who are 
likely to be eligible for medical assist-
ance under the State child health 
plan; and 
‘‘(ii) increase awareness of the bene-
fits of using comprehensive tobacco ces-
sation services covered in the State child 
health plan among— 
‘‘(I) individuals who are likely to 
be eligible for medical assistance 
under the State child health plan; and 
‘‘(II) clinicians and others who 
provide services to individuals who are 
likely to be eligible for medical assist-
ance under the State child health plan 
about the benefits of using com-
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prehensive tobacco cessation serv-
ices.’’. 
(f) NO PRIOR AUTHORIZATION FOR TOBACCO CES-
SATION DRUGS UNDER CHIP.—Section 2103 of the So-
cial Security Act (42 U.S.C. 1397cc), as amended by sub-
section (c), is further amended— 
(1) in subsection (c)(2)(A), by inserting ‘‘(in ac-
cordance with subsection (h)’’ after ‘‘Coverage of 
prescription drugs’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(h) NO PRIOR AUTHORIZATION PROGRAMS FOR TO-
BACCO CESSATION DRUGS.—A State child health plan 
may not require, as a condition of coverage or payment 
for a prescription drug, the approval of an agent to pro-
mote smoking cessation (including agents approved by the 
Food and Drug Administration) or tobacco cessation.’’. 
SEC. 4. EXCLUSION OF ENHANCED PAYMENTS FROM TER-
RITORIAL CAPS. 
Notwithstanding any other provision of law, for pur-
poses of section 1108 of the Social Security Act (42 
U.S.C. 1308), with respect to any additional amount paid 
to a territory as a result of the application of paragraph 
(8) of section 1903(a) or subsection (gg)(3) of section 
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1905 of the Social Security Act (42 U.S.C. 1396b(a), 
1396d)— 
(1) the limitation on payments to territories 
under subsections (f) and (g) of such section 1108 
shall not apply to such additional amounts; and 
(2) such additional amounts shall be dis-
regarded in applying such subsections. 
SEC. 5. RULE OF CONSTRUCTION. 
None of the amendments made by this Act shall be 
construed to limit coverage of any counseling or 
pharmacotherapy for individuals under 18 years of age. 
Æ 
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