National Working Group for ACTTION

July 27, 2010

Dear Partners,

Partnership for Prevention and ActionToQuit were very pleased with the announcement in mid-July of new regulations under the Affordable Health Care Act requiring private health plans to cover evidence-based preventive services and to eliminate cost-sharing for preventive care.  Among the services to be covered are tobacco cessation interventions to for tobacco users.

In remarks accompanying the announcement, Health and Human Services Secretary Kathleen Sebelius cited a Partnership for Prevention study which showed that 100,000 lives could be saved by increased utilization of 5 clinical preventive services, including cessation.  The study considered increasing to 90% the number of smokers who are advised by health professionals to quit and offered medication or other assistance.

ActionToQuit has focused on the need to increase access to comprehensive cessation treatments and provide coverage without barriers for tobacco users.  We are pleased that the new regulations require coverage for the U.S. Preventive Services Task Force Recommendations that clinicians ask all adults, including pregnant women, about tobacco use and provide tobacco cessation interventions for those who use tobacco products.  The USPSTF recommendation says that combination therapy with counseling—such as the 5 A’s of ask, advise, assess, assist and arrange—and medications are more effective than either component alone.

These regulations are good news for those who want to increase access to cessation services, but it is essential that these new regulations  make it crystal clear that copayments and deductibles are not allowed for the drug portion of comprehensive cessation services.  The drugs associated with cessation should be treated as preventive services and exempt from cost sharing.

We encourage our partners to comment on these regulations, both congratulating the Health and Human Services Department for taking this important step and urging them to assure that no cost sharing is required for the recommended pharmacotherapy under this benefit.  In commenting, please refer to file code OCIIO-9992-IFC. Comments can be submitted electronically at http://www.regulations.gov.  Enter the file code in the search box on the homepage then select the title under HHS.  The deadline to submit comments is September 17, 2010 at 11:59pm ET.  By regular mail, send written comments to:

Office of Consumer Information and Insurance Oversight
Department of Health and Human Services,
Attention: OCIIO-9992-IFC,
P.O. Box 8016,
Baltimore, MD 21244-1850

Regards,

Diane Canova, JD
Vice President, Policy & Programs
Partnership for Prevention