Health Plans

On May 2, 2014, the Departments of Health and Human Services, Labor, and the Treasury jointly issued guidance on cessation coverage for insurers. This guidance, which is based on the 2008 guideline,1 stated that insurers would be in compliance if they covered, without cost sharing or prior authorization, two quit attempts per year, including individual, group, and telephone counseling and all medications approved by the Food and Drug Administration (FDA) for tobacco cessation

Improved coverage of cessation treatments increases attempts to quit, treatment use, and rates of successful quitting. In particular, coverage that reimburses cessation interventions may increase the chances that physicians will intervene with smokers.

Methods that rapidly and easily connect smokers with cessation-treatment resources also increase treatment utilization and cessation rates.

Comprehensive, barrier-free, widely promoted tobacco-cessation coverage makes it easier for smokers to quit and for physicians to help them do so. By covering and publicizing the availability of proven cessation treatments, insurers can reduce smoking rates, smoking-related disease, and health care costs. Over time, such coverage could accelerate the end of the epidemic of tobacco-related disease. If the ACA’s tobacco-cessation provisions are fully implemented, they could turn out to be one of its greatest legacies.

Promotion was essential to the impressive outcomes of the 2006 Massachusetts Medicaid tobacco-cessation benefit.

Return On Investment (ROI) Fact Sheet

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