California Assembly Bill AB1162 Amended / Bill

 BILL NUMBER: AB 1162AMENDED BILL TEXT AMENDED IN SENATE AUGUST 31, 2015 AMENDED IN SENATE JULY 14, 2015 AMENDED IN ASSEMBLY JUNE 1, 2015 AMENDED IN ASSEMBLY APRIL 23, 2015 INTRODUCED BY Assembly Member Holden 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, as amended, 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   that, only to the extent that federal financial participation is available and any necessary federal approvals have been obtained,  tobacco cessation services are covered  benefits   benefits, subject to utilization controls,  under the Medi-Cal program,  and  would require  that  those services  include,   to include all intervention recommendations, as periodically updated, assigned a grade A or B by the United States Preventive Services Task   Force, a   nd,  at a minimum, 4 quit attempts per  year, and would   year. The bill would  also  require   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  90-day   12-week  treatment regimen of any medication approved by the federal Food and Drug Administration for tobacco  cessation that is covered under the Medi-Cal program as of January 1, 2015.   cessation. The bill would require the department to seek any federal approvals necessary to implement those provisions.  Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated 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 and shall, at a minimum, include   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  of any age   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  90-day   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.  (D) Except as provided in subparagraph (B), coverage described in this paragraph shall not be subject to any barriers, requirements, or restrictions.   (E) This paragraph shall apply to medications approved by the federal Food and Drug Administration and that are covered under the Medi-Cal program as of January 1, 2015.  (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 any necessary federal approvals have been obtained.