BILL NUMBER: AB 1696	ENROLLED
	BILL TEXT

	PASSED THE SENATE  AUGUST 16, 2016
	PASSED THE ASSEMBLY  AUGUST 23, 2016
	AMENDED IN SENATE  AUGUST 15, 2016
	AMENDED IN SENATE  JUNE 27, 2016
	AMENDED IN ASSEMBLY  MAY 31, 2016
	AMENDED IN ASSEMBLY  MARCH 28, 2016
	AMENDED IN ASSEMBLY  MARCH 7, 2016

INTRODUCED BY   Assembly Member Holden
   (Coauthor: Assembly Member Wood)

                        JANUARY 21, 2016

   An act to add Section 14134.25 to the Welfare and Institutions
Code, relating to Medi-Cal.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1696, Holden. Medi-Cal: tobacco cessation services.
   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 include quit attempts based upon medical
necessity, as specified. The bill also would 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 treatment
regimen of any medication approved by the federal Food and Drug
Administration and that is a covered Medi-Cal benefit for tobacco
cessation.
   The bill would require the department to seek any federal
approvals necessary to implement its provisions.


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. Tobacco cessation services shall
include quit attempts based on medical necessity, as defined in
Section 14059.5, and consistent with United States Preventive
Services Task Force grade A and B recommendations, 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 both
the American Academy of Pediatrics Bright Futures periodicity
schedule and anticipatory guidance as periodically updated, as well
as services 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 for beneficiaries 18 years of age and
older shall include:
   (1) At least four tobacco cessation counseling sessions per quit
attempt that may be conducted in person or by telephone and
individually or as part of a group, at the beneficiary's option.
   (2) (A) A tobacco cessation treatment regimen of any medication
approved by the federal Food and Drug Administration, and that is a
covered Medi-Cal benefit, for tobacco cessation, including
prescription and over-the-counter medications, in accordance with
United States Preventive Services Task Force grade A and B
recommendations.
   (B) 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, 2017, 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 not otherwise
jeopardized, and any necessary federal approvals have been obtained.