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AB-1162 Medi-Cal: tobacco cessation.(2015-2016)

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Enrolled  September 14, 2015
Passed  IN  Senate  September 09, 2015
Passed  IN  Assembly  September 10, 2015
Amended  IN  Senate  September 04, 2015
Amended  IN  Senate  August 31, 2015
Amended  IN  Senate  July 14, 2015
Amended  IN  Assembly  June 01, 2015
Amended  IN  Assembly  April 23, 2015

CALIFORNIA LEGISLATURE— 2015–2016 REGULAR SESSION

Assembly Bill
No. 1162


Introduced by Assembly Member Holden
(Coauthor: Assembly Member Levine)

February 27, 2015


An act to add Section 14134.25 to the Welfare and Institutions Code, relating to Medi-Cal.


LEGISLATIVE COUNSEL'S DIGEST


AB 1162, Holden. Medi-Cal: tobacco cessation.
Existing law provides for the Medi-Cal program, administered by the State Department of Health Care Services, under which basic health care services are provided to qualified low-income persons. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program. Existing law requires that preventive services assigned a grade of A or B by the United States Preventive Services Task Force be provided to Medi-Cal beneficiaries without any cost sharing by the beneficiary in order for the state to receive increased federal contributions for those services, as specified.
This bill would provide that, only to the extent that federal financial participation is available and not otherwise jeopardized, and any necessary federal approvals have been obtained, tobacco cessation services are covered benefits, subject to utilization controls, under the Medi-Cal program, and would require those services to include all intervention recommendations, as periodically updated, assigned a grade A or B by the United States Preventive Services Task Force, and, at a minimum, 4 quit attempts per year. The bill would also require, only to the extent consistent with the recommendations of the United States Preventive Services Task Force, tobacco cessation services to include at least 4 counseling sessions per quit attempt and a 12-week treatment regimen of any medication approved by the federal Food and Drug Administration for tobacco cessation. The bill would require the department to seek any federal approvals necessary to implement those provisions.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   Local Program: NO  

The people of the State of California do enact as follows:


SECTION 1.

 Section 14134.25 is added to the Welfare and Institutions Code, to read:

14134.25.
 (a) Tobacco cessation services are covered benefits under the Medi-Cal program, subject to utilization controls. Tobacco cessation services shall include all intervention recommendations, as periodically updated, assigned a grade A or B by the United States Preventive Services Task Force. In addition, tobacco cessation services shall include a minimum of four quit attempts per year, with no required break between attempts, for all beneficiaries 18 years of age and older who use tobacco. For beneficiaries under 18 years of age, tobacco cessation services shall be provided in accordance with the American Academy of Pediatrics guidelines and the intervention recommendations, as periodically updated, assigned a grade A or B by the United States Preventive Services Task Force.
(b) For purposes of this section, in addition to the services described in subdivision (a) and only to the extent consistent with the intervention recommendations, as periodically updated, assigned a grade A or B by the United States Preventive Services Task Force, tobacco cessation services shall include:
(1) At least four tobacco cessation counseling sessions per quit attempt, which may be conducted in person or by telephone and individually or as part of a group, at the beneficiary’s option.
(2) (A) A 12-week treatment regimen of any medication approved by the federal Food and Drug Administration for tobacco cessation, including prescription and over-the-counter medications.
(B) At least one prescription medication and all over-the-counter medications shall be available without prior authorization.
(C) A prescription from a provider with authority to prescribe and proof of Medi-Cal coverage shall be sufficient documentation to fill a prescription for over-the-counter tobacco cessation medications.
(c) Beneficiaries who are covered under this section shall not be required to receive a particular form of tobacco cessation service as a condition of receiving any other form of tobacco cessation service.
(d) Effective January 1, 2016, the department shall seek any federal approvals necessary to implement this section that the department determines are necessary to implement this section.
(e) This section shall be implemented only to the extent that federal financial participation is available and not otherwise jeopardized, and any necessary federal approvals have been obtained.