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 1 Medicaid program. 2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 3 TLSB 2670SV (4) 88 pf/rh

S.F. 490 Section 1. TOBACCO CESSATION SERVICES —— NICOTINE 1 REPLACEMENT THERAPY —— MEDICAID PROGRAM. 2 1. Beginning July 1, 2019, the department of human 3 services shall, contractually and by administrative rules 4 adopted pursuant to chapter 17A, require under Medicaid 5 fee-for-service and Medicaid managed care administration that 6 a Medicaid member, who contacts the member’s Medicaid managed 7 care organization’s tobacco cessation program or Quitline 8 Iowa seeking tobacco cessation services utilizing nicotine 9 replacement therapy, shall be eligible to receive nicotine 10 replacement therapy without prior authorization, unless 11 otherwise provided under subsection 2. However, after two 12 failed attempts by the Medicaid member within a consecutive 13 eighteen-month period, any subsequent request for nicotine 14 replacement therapy by the Medicaid member shall be subject to 15 prior authorization. 16 2. If a Medicaid member is under eighteen years of age, 17 age-appropriate federal food and drug administration guidelines 18 shall be applicable and prior authorization shall be required 19 for approval of nicotine replacement therapy. 20 EXPLANATION 21 The inclusion of this explanation does not constitute agreement with 22 the explanation’s substance by the members of the general assembly. 23 This bill requires the department of human services (DHS) to 24 contractually and by administrative rules adopted pursuant to 25 Code chapter 17A require, under Medicaid fee-for-service and 26 Medicaid managed care administration, that a Medicaid member, 27 who contacts the member’s Medicaid managed care organization’s 28 tobacco cessation program or Quitline Iowa seeking tobacco 29 cessation services utilizing nicotine replacement therapy, 30 shall be eligible to receive nicotine replacement therapy 31 without prior authorization, with some limitations, including 32 if the Medicaid member has had two failed attempts using the 33 nicotine replacement therapy or if the member is under 18 years 34 of age. 35 -1- LSB 2670SV (4) 88 pf/rh 1/ 1