Medicaid Takes on Smoking


State Medicaid officials say they are trying to help clients stop smoking by changing the program's coverage policy and starting a pilot program to see if counseling helps.

In December, the agency exempted smoking cessation medications from the three-prescription limit for adults covered by Medicaid through fee-for-service or Primary Care Case Management (PCCM). Medicaid now pays for smoking cessation medications in addition to the three prescriptions. The U.S. Public Health Service reports that over-the-counter treatments of nicotine dependence are known to double long-term quit rates, officials say.

The counseling pilot program targets Medicaid patients in the San Antonio area and will determine if counseling helps them stop smoking while reducing the state's costs. Senate Bill 10 -- which TMA helped pass -- in the 2007 legislative session authorized the program.

Pilot participants will be asked to set a date to stop smoking. They will be placed in one of three treatment groups, including a group that will get face-to-face counseling and another that will be counseled by telephone. Participants in those groups will work with a counselor to develop an individualized plan to help them stop smoking. The third group, the control group, will use the anti-smoking help already available through Medicaid, including over-the-counter and prescription medications.

Pilot participants will be surveyed four times over a year to track their progress and determine the success rate for each group. The state says it expects to complete an analysis of the pilot by spring 2010.


Action , March 16, 2009

Last Updated On

May 13, 2016

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