Smoking cessation programs get expanded Medicare coverage

The health reform law stipulates that approved preventive care services will be available for free to anyone who needs them.

By Chris Silva — Posted Sept. 10, 2010

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The Dept. of Health and Human Services has implemented a provision of the health system reform law that expands Medicare coverage of smoking cessation counseling to include any smoker in the program.

Previously, Medicare had covered counseling only for beneficiaries diagnosed with a recognized tobacco-related disease or showed signs or symptoms of such a disease. But the reform law stipulates that, starting Jan. 1, the program will cover any approved preventive care services for anyone who needs them, at no cost to beneficiaries. That includes tobacco counseling and other services, such as certain colorectal cancer screenings and mammograms.

The new law gives enrolled individuals access to free annual physical examinations so they can partner with physicians to develop and update personal prevention plans, which, according to HHS, will be based on risk factors and current needs.

The smoking cessation decision applies to services under Parts A and B and does not change the existing policies for Part D -- the prescription drug benefit -- or any state-level policies for Medicaid or the Children's Health Insurance Program, HHS said in its Aug. 25 announcement. The new benefit will cover two individual tobacco cessation counseling attempts a year. Each attempt may include up to four sessions, with a total annual benefit covering up to eight sessions per patient.

"Today's decision builds on existing preventive services that are available to Medicare beneficiaries," said CMS Administrator Donald Berwick, MD. "Giving older Americans and persons with disabilities who rely on Medicare the coverage they need for counseling treatments that can aid them in quitting will have a positive impact on their quality of life. As a result, all Medicare beneficiaries now have more help to avoid the painful -- and often deadly -- consequences of tobacco use."

The American Medical Association applauded the policy change.

"We have long supported this expansion of coverage to all Medicare patients who smoke so all seniors can benefit from counseling that can help prevent life-threatening diseases associated with tobacco use," said AMA President Cecil B. Wilson, MD. "More than 400,000 Americans die needlessly every year as a direct result of tobacco use. This expansion of coverage takes an important step toward helping Medicare patients lead healthier, tobacco-free lives."

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