BILL NUMBER: AB 1162	AMENDED
	BILL TEXT

	AMENDED IN SENATE  SEPTEMBER 4, 2015
	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
    (   Coauthor:   Assembly Member  
Levine   ) 

                        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, only to the extent that federal
financial participation is available  and not  
otherwise jeopardized,  and any necessary federal approvals have
been obtained, tobacco cessation services are covered benefits,
subject to utilization controls, under the Medi-Cal program, and
would require those services to include all intervention
recommendations, as periodically updated, assigned a grade A or B by
the United States Preventive Services Task Force, and, at a minimum,
4 quit attempts per year. The bill would also 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 12-week
treatment regimen of any medication approved by the federal Food and
Drug Administration for tobacco 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, 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 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 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.
   (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,  
available and not otherwise jeopardized,  and any necessary
federal approvals have been obtained.