Medicare Expands Coverage of Counseling for Senior
Citizens Who Want to Stop Smoking
Medicare had covered tobacco counseling only for
those diagnosed with a tobacco-related disease or showed signs of such a
disease
Aug. 25, 2010 – More help for senior citizens who
want to stop smoking will soon be available through a change being made
at Medicare. The Department of Health and Human Services today expanded
Medicare coverage of evidence-based tobacco cessation counseling,
removing a barrier to treatment for all tobacco users covered by
Medicare, which includes about 4.5 million seniors.
Before today’s decision, Medicare had covered
tobacco counseling only for individuals diagnosed with a recognized
tobacco-related disease or showed signs or symptoms of such a disease.
Under the new coverage, any smoker covered by Medicare will be able to
receive tobacco cessation counseling from a qualified physician or other
Medicare-recognized practitioner who can work with them to help them
stop using tobacco.
All Medicare beneficiaries will continue to have
access to smoking-cessation prescription medication through the Medicare
Prescription Drug Program (Part D).
“For too long, many tobacco users with Medicare
coverage were denied access to evidence-based tobacco cessation
counseling,” said HHS Secretary Kathleen Sebelius. “
Most Medicare beneficiaries want to quit their
tobacco use. Now, older adults and other Medicare beneficiaries can get
the help they need to successfully overcome tobacco dependence.”
“Today’s decision builds on the existing
preventive services that are available to Medicare beneficiaries,” said
CMS Administrator Don Berwick, M.D.
“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 health and quality of life. As a result, all Medicare
beneficiaries now have more help to avoid the painful—and often
deadly—consequences of tobacco use.”
Tobacco use remains the leading cause of
preventable illness and death in the United States and is a major
contributor to the nation’s increasing medical costs.
The Centers for Disease Control and Prevention
estimates that tobacco use causes about one of five deaths in the United
States each year and that, on average, adults who use tobacco die 14
years earlier than non-users.
It is estimated that between 1995 and 2015,
tobacco-related diseases will cost Medicare about $800 billion.
Despite the expansive list of adverse effects
caused by tobacco use, and smoking in particular, about 46 million
Americans continue to smoke. Of these, an estimated 4.5 million are
Medicare beneficiaries 65 or older and less than 1 million are younger
than 65 and are covered by Medicare due to a disability.
For smokers who successfully quit, the health
benefits will begin immediately and continue for the rest of their
lives. These benefits include reducing their risk of death from
coronary heart disease, chronic obstructive lung disease, and lung and
other cancers.
The new benefit will cover two individual tobacco
cessation counseling attempts per year. Each attempt may include up to
four sessions, with a total annual benefit thus covering up to eight
sessions per Medicare patient who uses tobacco.
Today’s final coverage decision will apply to
services under Parts A and B of Medicare and does not change the
existing policies for Part D, or any state-level policies for Medicaid
or the Children’s Health Insurance Program. HHS will issue guidance in
the coming months about a new benefit for pregnant women to receive
Medicaid-covered tobacco cessation counseling. This new benefit, a
provision of the Affordable Care Act, requires states to make coverage
available to pregnant Medicaid beneficiaries by October 1, 2010.
“We know that older adults and other Medicare
beneficiaries can be successful in their struggles to stop using
tobacco, as long as they have the right resources available to them,”
said Assistant Secretary of Health Howard Koh, M.D., M.P.H. “Today’s
decision will assure that beneficiaries can access that help from
qualified physicians and other Medicare-recognized practitioners.”
Under the Affordable Care Act, effective Jan. 1,
2011, Medicare will cover preventive care services, including the
tobacco cessation counseling services provided under today’s decision,
and other services such as certain colorectal cancer screening and
mammograms at no cost to beneficiaries. The Affordable Care Act also
gives beneficiaries access to a no-cost annual physical exam so they can
partner with their doctors to develop and update personal prevention
plans, which will be based on their current health needs and risk
factors.
Aug. 25, 2010 – More help for senior citizens who
want to stop smoking will soon be available through a change being made
at Medicare. The Department of Health and Human Services today expanded
Medicare coverage of evidence-based tobacco cessation counseling,
removing a barrier to treatment for all tobacco users covered by
Medicare, which includes about 4.5 million seniors.
As inflation went negative, retail drug prices
jumped 8.3%; similar climb in manufacturer prices
