Amended in Assembly April 23, 2015

California Legislature—2015–16 Regular Session

Assembly BillNo. 1162


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 tobacco cessation services are covered benefits under the Medi-Cal program and would require that those services include, at a minimum, unlimited quit attempts, which would be defined to include at least 4 counseling sessions and a 90-day treatment regimen of any medication approved by the federal Food and Drug Administration for tobacco cessation.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

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

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SECTION 1.  

Section 14134.25 is added to the Welfare and
2Institutions Code
, to read:

3

14134.25.  

(a) Tobacco cessation services are covered benefits
4under the Medi-Cal program and shall, at a minimum, include
5unlimited quit attempts, with no required break between attempts,
6for beneficiaries of any age who use tobacco.

7(b) For purposes of this section, a “quit attempt” shall be defined
8to consist of the following:

9(1) At least four tobacco cessation counseling sessions, which
10may be conducted in person or by telephone and individually or
11as part of a group, at the beneficiary’s option.

12(2) A 90-day treatment regimen of any medication approved by
13the federal Food and Drug Administration for tobacco cessation,
14 including prescription and over-the-counter medications. A
15prescription from a provider with authority to prescribe and proof
16of Medi-Cal coverage shall be sufficient documentation to fill a
17prescription for over-the-counter tobacco cessation medications.
18The coverage described in this paragraph shall not be subject to
19any barriers, requirements, or restrictions, including, but not limited
20to, prior authorization.

21(c) begin deleteThe receipt of covered services end deletebegin insertBeneficiaries who are
22covered end insert
under this section shall not bebegin delete a precondition for the use
23of one form of treatment in order to receive any other form of
24treatment.end delete
begin insert required to receive a particular form of tobacco
25cessation service as a condition of receiving any other form of
26tobacco cessation service.end insert



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