119-s2064

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[S. 2064 Introduced in Senate

    (IS) ]

<DOC>

119th CONGRESS
 1st Session
 S. 2064

 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 SENATE OF THE UNITED STATES

 June 12, 2025

Ms. Blunt Rochester introduced the following bill; which was read twice 
 and referred to the Committee on Finance

_______________________________________________________________________

 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 ``Helping Tobacco Users Quit Act''.

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

    (a) Requiring Medicaid Coverage of Counseling and Pharmacotherapy 
for Cessation of Tobacco Use and Temporary Enhanced FMAP for Coverage 
of Tobacco Cessation Services.--

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

    (bb) );'';

    (2) in subsection

    (b) , by inserting ``

    (bb)

    (2) ,'' after 
 ``

    (aa) ,''; and

    (3) by striking subsection

    (bb) and inserting the 
 following:
 ``

    (bb) Counseling and Pharmacotherapy for Cessation of Tobacco 
Use.--
 ``

    (1) In general.--For purposes of this title, the term 
 `counseling and pharmacotherapy for cessation of tobacco use by 
 individuals who are eligible under the State plan' 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 is 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.
 ``

    (2) Temporary enhanced fmap for coverage of tobacco 
 cessation services.--Notwithstanding subsection

    (b) , for 
 calendar quarters occurring during the period beginning on the 
 date of the enactment of the Helping Tobacco Users Quit Act and 
 ending 5 years after such date, the Federal medical assistance 
 percentage with respect to amounts expended by a State for 
 medical assistance for counseling and pharmacotherapy for 
 cessation of tobacco use by individuals who are eligible under 
 the State plan (as defined in paragraph

    (1) ) shall be equal to 
 90 percent.''.

    (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) in subparagraph
        (B) , by striking ``, and 
 counseling'' and all that follows through ``

section 1905

    (bb)

    (2)
        (A) '';
        (B) in subparagraph
            (I) , by striking ``or'' at the 
 end;
            (C) in subparagraph
        (J) , by striking ``; and'' and 
 inserting ``; or''; and
            (D) by adding at the end the following new 
 subparagraph:
 ``
        (K) counseling and pharmacotherapy for cessation 
 of tobacco use by individuals who are eligible under 
 the State plan (as defined in 

section 1905

    (bb) ) 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

    (bb) ; 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) in clause
            (iii) , by striking ``, and counseling 
 and pharmacotherapy for cessation of tobacco use by 
 pregnant women (as defined in 

section 1905

    (bb) )''; and
        (B) by adding at the end the following new clause:
 ``
            (xv) Counseling and pharmacotherapy for 
 cessation of tobacco use by individuals who are 
 eligible under the State plan (as defined in 
 

section 1905

    (bb) ) 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

    (bb) .''.
            (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, when 
 recommended in accordance with the guideline referred 
 to in 

section 1905

    (bb) , agents approved by the Food and 
 Drug Administration for purposes of promoting tobacco 
 cessation.''.
            (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

    (86) , by striking at the end ``and'';

    (2) in paragraph

    (87) , by striking the period at the end 
 and inserting ``; and''; and

    (3) by inserting after paragraph

    (87) the following new 
 paragraph:
 ``

    (88) 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 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 
 paragraph:
 ``

    (8) 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 5 years after the date of 
 enactment of this paragraph, an amount equal to 90 
 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.''.

    (g) 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 

section 1905

    (bb)

    (2) of the Social Security Act (42 U.S.C. 
1396d

    (bb)

    (2) )--

    (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.

    (h) Effective Date.--The amendments made by this section shall take 
effect on the first day of the first fiscal year that begins on or 
after the date of enactment of this Act.

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 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 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:
 ``

    (e) 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.--

    (1) In general.--

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 5 
 years after the date of enactment of this paragraph, the 
 Secretary shall pay--
 ``
        (A) an amount equal to 90 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 (net of any 
 payments made to the State under paragraph

    (1) with 
 respect to such counseling and pharmacotherapy); plus
 ``
        (B) an amount equal to 90 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.''.

    (2) Adjustment of chip allotments.--

Section 2104
            (m) of the 
 Social Security Act (42 U.S.C. 1397dd
            (m) ) is amended--
        (A) in paragraph

    (2)
        (B) , by striking ``and

    (12) '' 
 and inserting ``

    (12) , and

    (13) ''; and
        (B) by adding at the end the following new 
 paragraph:
 ``

    (13) Adjusting allotments to account for federal payments 
 for chip coverage of comprehensive tobacco cessation services 
 and outreach campaign.--If a State (including the District of 
 Columbia and each commonwealth and territory) receives a 
 payment for a fiscal year under 

section 2105

    (a)

    (5) , the 
 allotment determined for the State for such fiscal year shall 
 be increased by the amount of such payment.''.

    (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.''.

    (g) Effective Date.--The amendments made by this section shall take 
effect on the first day of the first fiscal year that begins on or 
after the date of enactment of this Act.

SEC. 4. 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>