An Act To Reduce Tobacco-related Illness and Lower Health Care Costs in MaineCare
Maine Legislature, Session 126, LD 0386
Committee: Health and Human Services
Sponsors: SANBORN, LANGLEY, DILL, FARNSWORTH, MORIARTY, PRINGLE, RANKIN, ROTUNDO, TREAT
Amends: 22 MRSA §3174-W

Legislative Document 
No. 386 
H.P. 261 
House of Representatives, February 12, 2013 
An Act To Reduce Tobacco-related Illness and Lower Health Care 
Costs in MaineCare 
(EMERGENCY) 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
MILLICENT M. MacFARLAND 
Clerk 
Presented by Representative SANBORN of Gorham. 
Cosponsored by Senator LANGLEY of Hancock and 
Representatives: DILL of Old Town, FARNSWORTH of Portland, MacDONALD of 
Boothbay, MORIARTY of Cumberland, PRINGLE of Windham, RANKIN of Hiram, 
ROTUNDO of Lewiston, TREAT of Hallowell. 
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, tobacco use is the leading cause of preventable death in the United States 
and in Maine; and 
Whereas, in the United States, an estimated 443,000 deaths occur annually that are 
attributable to smoking, including nearly 161,000 deaths from cancer, 128,000 from 
cardiovascular diseases and 103,000 from respiratory diseases; and 
Whereas, smoking costs Maine approximately $602,000,000 each year in direct 
medical costs and $534,000,000 from productivity losses due to premature death, 
including 10.6% of MaineCare expenditures, which is equivalent to $216,000,000, 
attributed to tobacco use; and 
Whereas, MaineCare members are almost 2 1/2 times more likely to smoke than the 
non-MaineCare adult population, yet are more likely to have a desire to quit tobacco use; 
and 
Whereas, tobacco cessation is one of the most effective clinical preventive services, 
with clinical evidence that shows that smoking cessation interventions, including brief 
behavioral counseling sessions and pharmacotherapy delivered in primary care settings, 
are effective in increasing the proportion of smokers who successfully quit and remain 
abstinent for one year and that the combination of counseling and medication is more 
effective for smoking cessation than either medication or counseling alone. The United 
States Preventive Services Task Force found convincing evidence that smoking cessation 
decreases the risk for heart disease, stroke and lung disease. Tobacco cessation at any 
point during pregnancy yields substantial health benefits for the expectant mother and 
baby; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  22 MRSA §3174-WW is enacted to read: 
§3174-WW.  Tobacco cessation 
1.  Coverage.  The department shall provide coverage for comprehensive tobacco 
cessation treatment to a MaineCare member who is 18 years of age or older or who is 
pregnant.  Coverage must include, at a minimum: 
A.  Coverage for all pharmacotherapy that is approved by the federal Food and Drug 
Administration for tobacco dependence treatment or is recommended as effective in 
the United States Public Health Service clinical practice guideline on treating tobacco 
use and dependence; and 
B.  Coverage for tobacco cessation counseling, to be available in individual and 
group forms. 
2.  Conditions of coverage.  Coverage under this section must be provided with no 
copayments or other out-of-pocket cost sharing, including deductibles.  The department 
may not impose annual or lifetime dollar limits or annual or lifetime limits on attempts to 
quit and may not require a MaineCare member to participate in counseling to receive 
medications. 
3.  Federal reimbursement.  The department shall pursue all opportunities to 
maximize available federal reimbursement, including available administrative Medicaid 
match rates for telephonic counseling services, federal pharmacology purchasing 
agreements or other opportunities to maximize state resources for tobacco cessation 
medications and services. 
Emergency clause.  In view of the emergency cited in the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This bill requires the provision of tobacco cessation treatment for MaineCare 
members who are 18 years of age or older or are pregnant.  It provides for comprehensive 
evidence-based coverage in accordance with the United States Preventive Services Task 
Force and the United States Public Health Service clinical practice guideline on treating 
tobacco use and dependence.  The bill requires coverage without copayments or other 
cost sharing and directs the Department of Health and Human Services to pursue 
opportunities for federal reimbursement of the cost of coverage.