Bill Text: IA SF490 | 2019-2020 | 88th General Assembly | Introduced

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Bill Title: A bill for an act relating to tobacco cessation services under the Medicaid program. (Formerly SSB 1189.)

Spectrum: Committee Bill

Status: (Introduced - Dead) 2020-01-16 - Subcommittee: Greene, Quirmbach, and Segebart. S.J. 109. [SF490 Detail]

Download: Iowa-2019-SF490-Introduced.html

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Senate File 490 - Introduced
SENATE FILE 490
BY COMMITTEE ON HUMAN
RESOURCES
(SUCCESSOR TO SSB 1189)
A BILL FOR
An Act relating to tobacco cessation services under the
Medicaid program.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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S.F. 490
Section 1. TOBACCO CESSATION SERVICES —— NICOTINE
REPLACEMENT THERAPY —— MEDICAID PROGRAM.
1. Beginning July 1, 2019, the department of human
services shall, contractually and by administrative rules
adopted pursuant to chapter 17A, require under Medicaid
fee-for-service and Medicaid managed care administration that
a Medicaid member, who contacts the member’s Medicaid managed
care organization’s tobacco cessation program or Quitline
Iowa seeking tobacco cessation services utilizing nicotine
replacement therapy, shall be eligible to receive nicotine
replacement therapy without prior authorization, unless
otherwise provided under subsection 2. However, after two
failed attempts by the Medicaid member within a consecutive
eighteen-month period, any subsequent request for nicotine
replacement therapy by the Medicaid member shall be subject to
prior authorization.
2. If a Medicaid member is under eighteen years of age,
age-appropriate federal food and drug administration guidelines
shall be applicable and prior authorization shall be required
for approval of nicotine replacement therapy.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
This bill requires the department of human services (DHS) to
contractually and by administrative rules adopted pursuant to
Code chapter 17A require, under Medicaid fee-for-service and
Medicaid managed care administration, that a Medicaid member,
who contacts the member’s Medicaid managed care organization’s
tobacco cessation program or Quitline Iowa seeking tobacco
cessation services utilizing nicotine replacement therapy,
shall be eligible to receive nicotine replacement therapy
without prior authorization, with some limitations, including
if the Medicaid member has had two failed attempts using the
nicotine replacement therapy or if the member is under 18 years
of age.
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