BILL NUMBER: AB 1162	AMENDED
	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.