text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Medicare, Medicaid, and MCH Tobacco 
  Cessation Promotion Act of 2004''.
  
  SEC. 2. MEDICARE COVERAGE OF COUNSELING FOR CESSATION OF TOBACCO USE.
  
      (a) Coverage.--Section 1861(s)(2) of the Social Security Act (42 
  U.S.C. 1395x(s)(2)) is amended--
              (1) in subparagraph (Y), by striking ``and'' at the end;
              (2) in subparagraph (Z), by inserting ``and'' at the end; 
          and
              (3) by adding at the end the following new subparagraph:
              ``(AA) counseling for cessation of tobacco use (as defined 
          in subsection (bbb));''.
      (b) Services Described.--Section 1861 of the Social Security Act 
  (42 U.S.C. 1395x) is amended by adding at the end the following new 
  subsection:
  
                 ``Counseling for Cessation of Tobacco Use
  
      ``(bbb)(1)(A) Subject to subparagraph (B), the term `counseling for 
  cessation of tobacco use' means diagnostic, therapy, and counseling 
  services for cessation of tobacco use for individuals who use tobacco 
  products or who are being treated for tobacco use which are furnished--
              ``(i) by or under the supervision of a physician;
              ``(ii) by a practitioner described in clause (i), (iii), 
          (iv), (v) or (vi) of section 1842(b)(18)(C); or
              ``(iii) by a licensed tobacco cessation counselor (as 
          defined in paragraph (2)).
      ``(B) Such term is limited to--
              ``(i) services recommended in `Treating Tobacco Use and 
          Dependence: A Clinical Practice Guideline', published by the 
          Public Health Service in June 2000, or any subsequent 
          modification of such Guideline; and
              ``(ii) such other services that the Secretary recognizes to 
          be effective.
      ``(2) In this subsection, the term `licensed tobacco cessation 
  counselor' means a tobacco cessation counselor who--
              ``(A) is licensed as such by the State (or in a State which 
          does not license tobacco cessation counselors as such, is 
          legally authorized to perform the services of a tobacco 
          cessation counselor in the jurisdiction in which the counselor 
          performs such services); and
              ``(B) meets uniform minimum standards relating to basic 
          knowledge, qualification training, continuing education, and 
          documentation that are established by the Secretary for 
          purposes of this subsection.''.
      (c) Payment and Elimination of Cost-Sharing for Counseling for 
  Cessation of Tobacco Use.--
              (1) Payment and elimination of coinsurance.--Section 
          1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) 
          is amended--
                      (A) by striking ``and'' before ``(V)''; and
                      (B) by inserting before the semicolon at the end 
                  the following: ``, and (W) with respect to counseling 
                  for cessation of tobacco use (as defined in section 
                  1861(ww)), the amount paid shall be 100 percent of the 
                  lesser of the actual charge for the service or the 
                  amount determined by a fee schedule established by the 
                  Secretary for purposes of this subparagraph''.
              (2) Elimination of coinsurance in outpatient hospital 
          settings.--
                      (A) Exclusion from opd fee schedule.--Section 
                  1833(t)(1)(B)(iv) of the Social Security Act (42 U.S.C. 
                  1395l(t)(1)(B)(iv)) is amended by striking ``and 
                  diagnostic mammography'' and inserting ``, diagnostic 
                  mammography, or counseling for cessation of tobacco use 
                  (as defined in section 1861(bbb))''.
                      (B) Conforming amendments.--Section 1833(a)(2) of 
                  the Social Security Act (42 U.S.C. 1395l(a)(2)) is 
                  amended--
                              (i) in subparagraph (F), by striking 
                          ``and'' after the semicolon at the end;
                              (ii) in subparagraph (G)(ii), by striking 
                          the comma at the end and inserting ``; and''; 
                          and
                              (iii) by inserting after subparagraph 
                          (G)(ii) the following new subparagraph:
                      ``(H) with respect to counseling for cessation of 
                  tobacco use (as defined in section 1861(bbb)) furnished 
                  by an outpatient department of a hospital, the amount 
                  determined under paragraph (1)(W),''.
              (3) Elimination of deductible.--The first sentence of 
          section 1833(b) of the Social Security Act (42 U.S.C. 1395l(b)) 
          is amended--
                      (A) by striking ``and'' before ``(6)''; and
                      (B) by inserting before the period the following: 
                  ``, and (7) such deductible shall not apply with 
                  respect to counseling for cessation of tobacco use (as 
                  defined in section 1861(bbb))''.
      (d) Application of Limits on Billing.--Section 1842(b)(18)(C) of 
  the Social Security Act (42 U.S.C. 1395u(b)(18)(C)) is amended by 
  adding at the end the following new clause:
              ``(vii) A licensed tobacco cessation counselor (as defined 
          in section 1861(bbb)(2)).''.
      (e) Inclusion as Part of Initial Preventive Physical Examination.--
  Section 1861(ww)(2) of the Social Security Act (42 U.S.C. 1395x(ww)(2)) 
  is amended by adding at the end the following new subparagraph:
              ``(L) Counseling for cessation of tobacco use (as defined 
          in subsection (bbb)).''.
      (f) Effective Date.--The amendments made by this section shall 
  apply to services furnished on or after the date that is 1 year after 
  the date of enactment of this Act.
  
  SEC. 3. MEDICARE COVERAGE OF TOBACCO CESSATION PHARMACOTHERAPY.
  
      (a) Inclusion of Tobacco Cessation Agents as Covered Drugs.--
  Section 1860D-2(e)(1) of the Social Security Act (42 U.S.C. 1395w-
  102(e)(1)) is amended--
              (1) in subparagraph (A), by striking ``or'' after the 
          semicolon at the end;
              (2) in subparagraph (B), by striking the comma at the end 
          and inserting ``; or''; and
              (3) by inserting after subparagraph (B) the following new 
          subparagraph:
                      ``(C) any agent approved by the Food and Drug 
                  Administration for purposes of promoting, and when used 
                  to promote, tobacco cessation that may be dispensed 
                  without a prescription (commonly referred to as an 
                  `over-the-counter' drug), but only if such an agent is 
                  prescribed by a physician (or other person authorized 
                  to prescribe under State law),''.
      (b) Establishment of Categories and Classes Consisting of Tobacco 
  Cessation Agents.--Section 1860D-4(b)(3)(C) of the Social Security Act 
  (42 U.S.C. 1395w-104(b)(3)(C)) is amended by adding at the end the 
  following new clause:
                              ``(iv) Categories and classes of tobacco 
                          cessation agents.--There shall be a therapeutic 
                          category or class of covered part D drugs 
                          consisting of agents approved by the Food and 
                          Drug Administration for cessation of tobacco 
                          use. Such category or class shall include 
                          tobacco cessation agents described in 
                          subparagraphs (A) and (C) of section 1860D-
                          2(e)(1).''.
      (c) Conforming Amendment.--Section 1860D-2(e)(2)(A) of the Social 
  Security Act (42 U.S.C. 1395w-102(e)(2)(A)) is amended by striking ``, 
  other than subparagraph (E) of such section (relating to smoking 
  cessation agents),''.
  
  SEC. 4. PROMOTING CESSATION OF TOBACCO USE UNDER THE MEDICAID PROGRAM.
  
      (a) Coverage of Tobacco Cessation Counseling Services.--
              (1) In general.--Section 1905(a) of the Social Security Act 
          (42 U.S.C. 1396d(a)) is amended--
                      (A) in paragraph (26), by striking ``and'' after 
                  the semicolon at the end;
                      (B) by redesignating paragraph (27) as paragraph 
                  (28); and
                      (C) by inserting after paragraph (26) the following 
                  new paragraph:
              ``(27) at the option of the State, counseling for cessation 
          of tobacco use (as defined in section 1861(bbb)); and''.
              (2) Conforming amendment.--Section 1902(a)(10)(C)(iv) of 
          the Social Security Act (42 U.S.C. 1396a(a)(10)(C)(iv)) is 
          amended by inserting ``or (27)'' after ``(24)''.
      (b) Elimination of Optional Exclusion From Medicaid Prescription 
  Drug Coverage for Tobacco Cessation Medications.--Section 1927(d)(2) of 
  the Social Security Act (42 U.S.C. 1396r-8(d)(2)) is amended--
              (1) by striking subparagraph (E);
              (2) by redesignating subparagraphs (F) through (J) as 
          subparagraphs (E) through (I), respectively; and
              (3) in subparagraph (F) (as redesignated by paragraph (2)), 
          by inserting before the period at the end the following: ``, 
          other than agents approved by the Food and Drug Administration 
          for purposes of promoting, and when used to promote, tobacco 
          cessation''.
      (c) Removal of Cost-Sharing for Tobacco Cessation Counseling 
  Services and Medications.--Subsections (a)(2) and (b)(2) of section 
  1916 of the Social Security Act (42 U.S.C. 1396o) are each amended--
              (1) in subparagraph (D), by striking ``or'' after the comma 
          at the end;
              (2) in subparagraph (E), by striking ``; and'' and 
          inserting ``, or''; and
              (3) by adding at the end the following new subparagraph:
                      ``(F)(i) counseling for cessation of tobacco use 
                  described in section 1905(a)(27); or
                      ``(ii) covered outpatient drugs (as defined in 
                  paragraph (2) of section 1927(k), and including 
                  nonprescription drugs described in paragraph (4) of 
                  such section) that are prescribed for purposes of 
                  promoting, and when used to promote, tobacco cessation; 
                  and''.
      (d) Increased FMAP for Tobacco Cessation Counseling Services and 
  Medications.--The first sentence of section 1905(b) of the Social 
  Security Act (42 U.S.C. 1396d(b)) is amended--
              (1) by striking ``and'' before ``(4)''; and
              (2) by inserting before the period the following: ``, and 
          (5) for purposes of this title, the Federal medical assistance 
          percentage shall be 80 percent with respect to amounts expended 
          as medical assistance for counseling for cessation of tobacco 
          use described in subsection (a)(27) and for covered outpatient 
          drugs (as defined in paragraph (2) of section 1927(k), and 
          including nonprescription drugs described in paragraph (4) of 
          such section) that are prescribed for purposes of promoting, 
          and when used to promote, tobacco cessation''.
      (e) Effective Date.--The amendments made by this section shall 
  apply to services furnished on or after the date that is 1 year after 
  the date of enactment of this Act.
  
  SEC. 5. PROMOTING CESSATION OF TOBACCO USE UNDER THE MATERNAL AND CHILD 
                HEALTH SERVICES BLOCK GRANT PROGRAM.
  
      (a) Quality Maternal and Child Health Services Includes Tobacco 
  Cessation Counseling and Medications.--Section 501 of the Social 
  Security Act (42 U.S.C. 701) is amended by adding at the end the 
  following new subsection:
      ``(c) For purposes of this title, quality maternal and child health 
  services include the following:
              ``(1) Counseling for cessation of tobacco use (as defined 
          in section 1861(bbb)).
              ``(2) The encouragement of the prescribing and use of 
          agents approved by the Food and Drug Administration for 
          purposes of tobacco cessation.
              ``(3) The inclusion of messages that discourage tobacco use 
          in health promotion counseling.''.
      (b) Effective Date.--The amendment made by subsection (a) shall 
  take effect on the date that is 1 year after the date of enactment of 
  this Act.
target: Medicare, Medicaid, and MCH Tobacco Cessation Promotion Act of 2004 - Amends title XVIII (Medicare) of the Social Security Act to provide for Medicare coverage of: (1) counseling for cessation of tobacco use; and (2) tobacco cessation pharmacotherapy.
  
  Provides for similar benefits under SSA titles V (Maternal and Child Health Services) and XIX (Medicaid).
feat_title: A bill to amend title V, XVIII, and XIX of the Social Security Act to promote cessation of tobacco use under the medicare program, the medicaid program, and the maternal and child health services block grant program.