Amended in Assembly June 1, 2015

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 quitbegin delete attempts, which would be defined to includeend deletebegin insert attempts, and would also require tobacco cessation services to includeend insert at least 4 counseling sessionsbegin insert per quit attemptend insert and a 90-day treatment regimen of any medication approved by the federal Food and Drug Administration for tobaccobegin delete cessation.end deletebegin insert cessation that is covered under the Medi-Cal program as of January 1, 2015.end insert

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,begin delete a “quit attempt”end deletebegin insert tobacco
8cessation servicesend insert
shallbegin delete be defined to consist of the following:end delete
9begin insert include:end insert

10(1) At least four tobacco cessation counselingbegin delete sessions,end deletebegin insert sessions
11per quit attempt,end insert
which may be conducted in person or by telephone
12and individually or as part of a group, at the beneficiary’s option.

13(2) A 90-day treatment regimen of any medication approved by
14the federal Food and Drug Administration for tobacco cessation,
15 including prescription and over-the-counter medications. A
16prescription from a provider with authority to prescribe and proof
17of Medi-Cal coverage shall be sufficient documentation to fill a
18prescription for over-the-counter tobacco cessation medications.
19The coverage described in this paragraph shall not be subject to
20any barriers, requirements, or restrictions, including, but not limited
21to, prior authorization.begin insert This paragraph shall apply to medications
22approved by the federal Food and Drug Administration and that
23are covered under the Medi-Cal program as of January 1, 2015.end insert

24(c) Beneficiaries who are covered under this section shall not
25be required to receive a particular form of tobacco cessation service
26as a condition of receiving any other form of tobacco cessation
27service.



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