Title: Quit Because of COVID–19 Act
Policy area: Health

Summary:
Quit Because of COVID-19 Act
This bill provides for Medicaid and Children's Health Insurance Program (CHIP) coverage of certain tobacco cessation services.
Specifically, the bill provides for coverage, without cost-sharing, of diagnostic, therapy, and counseling services and pharmacotherapy, including prescription and nonprescription tobacco cessation agents, that are provided under medical supervision and in accordance with specified guidelines. It also applies a 100% Federal Medical Assistance Percentage (i.e., federal matching rate) for such items and services during the public health emergency relating to COVID-19 and for two years after the emergency period ends.


[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2125 Introduced in House (IH)]

<DOC>






117th CONGRESS
  1st Session
                                H. R. 2125

   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 23, 2021

  Ms. Blunt Rochester (for herself, Mr. Fitzpatrick, Ms. DeGette, Ms. 
Barragan, Ms. Wasserman Schultz, Ms. Underwood, Ms. Bass, Ms. Dean, Ms. 
 Wild, Mr. Tonko, Mr. Vargas, Mr. Suozzi, and Ms. Scanlon) 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.

    Be it enacted by the Senate and House of Representatives 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''.

SEC. 2. COVERAGE OF COMPREHENSIVE TOBACCO CESSATION SERVICES IN 
              MEDICAID.

    (a) Requiring Medicaid Coverage of Counseling and Pharmacotherapy 
for Cessation of Tobacco 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 eligible under the State plan (as 
        defined in subsection (hh))'';
            (2) by adding at the end the following new subsection:
    ``(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--
                    ``(A) 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
                    ``(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 Update: A Clinical Practice 
        Guideline' published 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 
        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;
                    (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 defined in subsection 
                (k)(2) of section 1927 and including nonprescription 
                drugs described in subsection (d)(2) of such section) 
                that are prescribed for purposes of promoting tobacco 
                cessation in accordance with the guideline specified in 
                section 1905(hh); and''.
            (2) Application to alternative cost sharing.--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 including nonprescription drugs described 
                        in subsection (d)(2) of such section) that are 
                        prescribed for purposes of promoting tobacco 
                        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 Comprehensive 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
            (3) by inserting after paragraph (86) the following new 
        paragraph:
            ``(87) provide for 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--
                    ``(A) individuals entitled to medical assistance 
                under the State plan who use tobacco products; and
                    ``(B) clinicians and others who provide services to 
                individuals entitled to medical assistance under the 
                State plan.''.
    (e) Federal Reimbursement for Medicaid Coverage and Outreach 
Campaign.--Section 1903(a) of the Social Security Act (42 U.S.C. 
1396b(a)) is amended--
            (1) in paragraph (7), by striking the period at the end and 
        inserting ``; plus''; and
            (2) by inserting after paragraph (7) the following new 
        paragraphs:
            ``(8) with respect to counseling and pharmacotherapy for 
        cessation of tobacco use by individuals who are eligible under 
        the State plan--
                    ``(A) for calendar quarters occurring during the 
                period beginning on the date of the enactment of this 
                paragraph and ending 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 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, implementation, 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 
                        eligible 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; 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 
                        eligible 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 comprehensive 
                        tobacco cessation services;
                for calendar quarters occurring during the period 
                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 quarter which are 
                attributable to such development, implementation, and 
                evaluation, and for calendar quarters succeeding such 
                period, an amount equal to Federal medical assistance 
                percentage determined under section 1905(b) of the sums 
                expended during each quarter which are so 
                attributable.''.
    (f) No Prior Authorization for Tobacco Cessation Drugs Under 
Medicaid.--Section 1927(d) of the Social Security Act (42 U.S.C. 1396r-
8(d)) is amended--
            (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 
        approved by the Food and Drug Administration) or tobacco 
        cessation.''.

SEC. 3. COVERAGE OF COMPREHENSIVE TOBACCO CESSATION SERVICES IN CHIP.

    (a) Requiring CHIP Coverage of Counseling and Pharmacotherapy for 
Cessation of Tobacco Use.--
            (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 following 
        new paragraph:
            ``(10) Counseling and pharmacotherapy for cessation of 
        tobacco use.--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--
                    ``(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 
                        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 
                        designated by the Secretary for this purpose;
                 which is recommended in the guideline entitled, 
                `Treating Tobacco Use and Dependence: 2008 Update: A 
                Clinical Practice Guideline' published 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 
                approved by the Food and Drug Administration as safe 
                and effective in helping smokers quit.''.
    (b) No Cost Sharing.--Section 2103(e) of the Social 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 cessation of tobacco use.--The State child 
        health plan may not impose deductibles, coinsurance, or other 
        cost sharing with respect to benefits for counseling and 
        pharmacotherapy for cessation of tobacco use (as defined in 
        section 2110(c)(10)) and prescription drugs that are covered 
        under a State child health plan that are prescribed for 
        purposes of promoting 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 subsection:
    ``(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 accordance 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 tobacco 
        cessation; and
            ``(2) individuals who are eligible under the State child 
        health plan when recommended in accordance 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 tobacco 
        cessation.''.
    (d) State Monitoring and Promoting of Comprehensive 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 following new 
subsection:
    ``(d) State Monitoring and Promoting of Comprehensive Tobacco 
Cessation Services Under CHIP.--A State child health plan shall include 
a description 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
            ``(2) clinicians and others who provide services to 
        individuals entitled to medical assistance under the State 
        child health plan.''.
    (e) Federal Reimbursement for CHIP Coverage 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 cessation services and outreach 
        campaign.--In addition to the payments made under paragraph (1) 
        for calendar quarters occurring during the period 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), 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 counseling and pharmacotherapy 
                for cessation of tobacco 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, implementation, and evaluation of an 
                outreach campaign to--
                            ``(i) increase awareness of comprehensive 
                        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 
                                assistance under the State child health 
                                plan; and
                            ``(ii) increase awareness of the benefits 
                        of using comprehensive 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 
                                assistance under the State child health 
                                plan about the benefits of using 
                                comprehensive tobacco cessation 
                                services.''.
    (f) No Prior Authorization for Tobacco Cessation Drugs Under 
CHIP.--Section 2103 of the Social Security Act (42 U.S.C. 1397cc), as 
amended by subsection (c), is further amended--
            (1) in subsection (c)(2)(A), by inserting ``(in accordance 
        with subsection (h)'' after ``Coverage of prescription drugs''; 
        and
            (2) by adding at the end the following new subsection:
    ``(h) No Prior Authorization Programs for Tobacco Cessation 
Drugs.--A State child health plan may not require, as a condition of 
coverage or payment for a prescription drugs, the approval of an agent 
to promote smoking cessation (including agents approved by the Food and 
Drug Administration) or tobacco cessation.''.

SEC. 4. EXCLUSION OF ENHANCED PAYMENTS FROM TERRITORIAL CAPS.

    Notwithstanding any other provision of law, for purposes 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 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 disregarded 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.
                                 <all>