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Government News
Medicare to Cover Some Efforts To Stop Smoking
Psychiatric News
Volume 40 Number 3 page 6-6

Medicare may expand benefits to offer coverage for smoking cessation treatments under a proposed rule issued last month.

The coverage would extend to beneficiaries who smoke and have been diagnosed with a smoking-related disease or are taking certain drugs whose metabolism is affected by tobacco use. These include insulin and medicines for high blood pressure, seizures, blood clots, and depression, according to the Department of Health and Human Services.

Minimal counseling is already covered at each evaluation and management visit. Beyond that, Medicare proposes to cover two cessation attempts a year. Each attempt may include a maximum of four intermediate or intensive sessions, with the total annual benefit covering up to eight sessions. Practitioners and patients may choose between intermediate or intensive cessation strategies for each attempt.

The Centers for Disease Control and Prevention estimated in 2002 that 57 percent of smokers age 65 and over reported a desire to quit.

"The evidence available fully supports the hope that seniors at risk of the diseases caused by smoking can quit, given the right assistance," said Mark McClellan, M.D., Ph.D., administrator of the federal Centers for Medicare and Medicaid Services. "Millions of our beneficiaries have smoked for many years and are now experiencing the heart problems, lung problems, and many other often-fatal diseases that smoking can cause."

A final decision on instituting the expanded coverage is expected by March. The proposed coverage policy and background information are posted online at<www.cms.hhs.gov/mcd/viewdraftdecisionmemo.asp?id=130>.

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