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
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
A final decision on instituting the expanded coverage is expected by
March. The proposed coverage policy and background information are posted