Transcript Abbott - 2003 National Conference on Tobacco or Health

Legislative and
Executive Branch
Activity on Cessation
- What’s Going On
and What’s Next?
Matt Barry
Senior Policy Analyst
Campaign for Tobacco
Free Kids
December 11, 2003
Overview
• Medicaid
• Medicare
• 108th Congress
• Other Federal
Activities
• Taking Action/Next
Steps
Current CMS Policy On Cessation: Medicaid
General Policy •
Smoking cessation benefits, such as counseling and drug
therapy, are optional benefits under Medicaid (except for kids
covered under EPSDT).
•
Smoking cessation drugs are specifically classified as those
drugs that may be excluded from coverage under Medicaid.
•
Smoking cessation counseling services may be provided under
a variety of Medicaid benefit categories.
Pregnant Women - There are no mandatory smoking cessation
benefits for pregnant women under Medicaid. A state may elect
to provide smoking cessation services in a State plan.
Current CMS Policy On Cessation: Medicare
•
Medicare does not currently provide coverage for tobacco
cessation services under Part B.
•
Congress passed H.R. 1, The Medicare Prescription Drug,
Improvement, and Modernization Act of 2003 that includes
coverage of prescription smoking cessation drugs (nicotine
nasal spray, nicotine inhaler, bupropion SR - question over
coverage of prescription OTC NRTs). Coverage begins 2006.
•
Medicare does provide coverage for tobacco cessation, where
medically necessary, in the context of Part A inpatient hospital
services.
•
There is an ongoing Medicare Stop Smoking Program tobacco
cessation demonstration project in 7 States (Alabama, Florida,
Missouri, Ohio, Oklahoma, Nebraska, and Wyoming).
What’s Going On In Congress??
Cessation bills in 108th Congress
• H.R. 2876 - Quit Smoking Incentive and Opportunity Act
of 2003 (LaTourette, Platts, Meehan, Jones) - Provides for refundable tax
credit for “qualified” cessation expenses, including drugs and counseling, up to
$400 annually.
• H. R. 2383 - To amend the Internal Revenue Code of 1986
to clarify the tax treatment of smoking cessation costs
(Ramstad) - Adds cessation drugs to list of medicines/drugs eligible for limitations
on tax liability.
• H.R.3293 - Prevent Prematurity and Improve Child Health
Act of 2003 (DeGette) - Deletes exception of cessation drug coverage under
SSA, requires coverage of counseling for pregnant women, evaluates
performance measures on MCH grant for cessation, and adds language noting
cessation is part of a quality MCH program..
• S.1734 - Prevent Prematurity and Improve Child Health
Act of 2003 (Lincoln, Lugar, Bingaman, Murray, Miller) - Same as H.R. 3293.
Cessation bills in 108th Congress
•
S.1238 - Improving Women's Health Act of 2003 (Lincoln,
Murray, Landrieu, Cantwell, Bingaman) - Deletes exception of cessation drug
coverage under SSA, requires coverage of counseling for pregnant women,
adds language noting cessation is part of a quality MCH program.
•
H.R.1860 - Medicare Wellness Act of 2003 (Levin, Foley) Provides for therapy and counseling services for cessation to all beneficiaries
(does not include drugs).
•
S.1101 - National Cancer Act of 2003 (Feinstein, Smith,
Daschle, Jeffords, Kennedy, Collins, Landrieu, Hutchison, Johnson, Corzine,
Lincoln, Cantwell, Clinton, Lautenberg, Murray, Dodd, Boxer, Stabenow,
Nelson, Schumer, Hollings, Reed, Kerry, Mikulkski, Leahy) - Requires
coverage by most health plans of therapy and counseling services for
cessation (drugs limited to those already available under plan for cessation).
•
H.R.2741- National Cancer Act of 2003 (Capps, Miller,
Maloney, Frost, Towns) - Same as S. 1101.
For latest information on legislation - http://thomas.loc.gov/
Other Activity At Federal Level
Final report of the Cessation Subcommittee was sent to Secretary Tommy
Thompson March 2003, no further action to report (for more
information see http://www.cdc.gov/tobacco/ICSH/subcommittee.htm).
Federal Employees Health Benefit Plan - In August 7, 2003 memo to Rep.
Meehan, OPM Director Kay Cole James stated:
“I continue to encourage FEHBP plans to provide benefits for
programs aimed at health promotion and disease prevention, including
smoking cessation programs … While we urge plans to cover special
benefits and programs, we do not mandate that they do so …”
For more information on FEHBP, see
http://www.opm.gov/insure/health/index.asp.
Turning Dreams
Into Reality:
How Do We Make
Access to
Cessation Services
a Reality?
Need to be clear and unambiguous about goals
“Damn the torpedoes, full speed ahead!”
Avoid inconsistency ...
Avoid confusion …
Abbott: Who's on first, What's on second, I Don't
Know's on third Costello: You know the fellows' names?
Abbott: Certainly!
Costello: Well then who's on first?
Abbott: Yes!
Costello: I mean the fellow's name!
Abbott: Who!
Costello: The guy on first!
Abbott: Who!
Costello: The first baseman!
Abbott: Who!
Costello: The guy playing first!
Abbott: Who is on first!
Costello: Now whaddya askin' me for?
Abbott: I'm telling you Who is on first.
Costello: Well, I'm asking YOU who's on first!
Abbott: That's the man's name.
Credibility
Persistence
Stop Wasting Money
Save Money
Safe
Effective
This isn’t a mystery ...
CESSATION WORKS!!!