July 1, 2010

Oregon Health Insurance Plans Must Cover Cessation

A new Oregon law requires health insurers to include reimbursement of at least $500 for enrolled members who enter physician-recommended tobacco cessation programs that follow U.S. Public Health Service guidelines. The mandate impacts people covered by private insurance, not those with short-term coverage, a handful of “nontraditional” plans, Medicare or Medicaid.

In early May, a collaboration called Helping Benefit Oregon Smokers held the first in a series of three meetings to strategize how to draw attention to the mandate.  The sponsors of the collaboration are the Oregon Coalition of Healthcare Purchasers, the American Lung Association of Oregon and Oregon Health & Science University.  They want to educate chambers of commerce and business associations about the new benefit and assure them there will be a return on the investment.

Smoking is believed to cost the state $2.2 billion annually, according to data gathered by the collaborative. Direct medical costs account for about half of that figure, while the remaining costs come from lost productivity resulting from premature deaths. By contrast, once a smoker quits, it only takes about two years to see healthcare savings. 

The $500 minimum benefit (some plans already provide more coverage than that minimum) covers at least one tobacco cessation benefit during their enrollment. This new benefit began on Jan. 1, 2010. Oregon Medicaid recipients have had these same benefits dating back to 1998. Some health plans aren’t changing their coverage as a result of the law because they already offer smoking cessation benefits. At Kaiser Permanente, for example, tobacco users can see a physician as often as they want to help them quit smoking, and smoking cessation medications are covered under patients’ pharmaceutical benefits. They have to be enrolled in a behavioral program to receive the medication.

More Michigan Smokers Calling Quit Line

Michigan’s new law banning smoking in restaurants, bars and some other public places is boosting the number of people seeking help to quit smoking.

The Michigan Department of Community Health reports a 20 percent increase in calls to its Michigan Tobacco Quit Line, since April 26. The line provides free information and referrals. Counseling and other services are available to Medicaid, Medicare, county health plan and uninsured callers.

Some individuals also may qualify for free nicotine replacement therapy. A Michigan Smoker’s Quit Kit is available at www.michigan.gov/tobac.

Iowa to End Free Nicotine Replacement Products

The Iowa Department of Public Health has announced that as of June 30, it would stop giving out free samples of the nicotine patches and gum to people who called the Quitline Iowa program. The change is a result of state budget cuts.

The Quitline Iowa budget is being cut by nearly half. About 27,450 people have received the free nicotine patches and gum since the offer was first made in 2008. Quitline Iowa still will offer counseling services for smokers trying to quit.

Overall spending on Iowa anti-smoking efforts is climbing, from $11.4 million to $12.7 million. But health department officials say more than a third of the money comes from federal sources, which specify how the money is used.

Kentucky Medicaid Cessation Program Gets $1.5 Million

The Kentucky Medicaid cessation benefit will receive $1.5 million a year for the next two fiscal years that, combined with additional federal matching money, will provide about $11 million for the program.  The statewide cessation benefit was authorized in 2007 but never funded.  The law calls for the state to provide a combination of medication and counseling to help people stop smoking.

Passport Health Plan, a Medicaid managed care system serving about 165,000 people in Jefferson and 15 surrounding counties, voluntarily began offering smoking cessation services to its members three years ago without extra payment under its contract with the state. But beyond Passport, smokers on Medicaid have had little other assistance except for the state’s toll-free help line, which offers advice and counseling. Local health departments offer some stop-smoking assistance but services and funding are limited.

The Passport smoking-cessation program called “Yes, You Can!”, uses a combination of counseling as well as medications including nicotine replacement therapy, such as patches, and prescription medications that ease the craving for nicotine.  Passport offers a model they can share with the state program.

N.J. Advocates Seek to Keep Anti-tobacco Programs in Budget

The New Jersey governor’s proposed budget would eliminate the state’s $7.5 million anti-tobacco programs.  If the Legislature doesn’t restore the money for the budget year that begins July 1, “New Jersey will be the worst state in the country when it comes to the support of tobacco-control programs,’’ said Fred Jacobs, a former state health commissioner and the current chairman of anti-smoking organization NJ BREATHES.
More than 10,000 people last year used the state’s hotline, online counseling services and clinics to stop smoking, according to NJ BREATHES. The money also supports 170 high school and 119 middle school anti-tobacco groups and has helped cut teen smoking rates in half.

New Jersey once dedicated $30 million a year to anti-tobacco efforts, but budget cuts over the years eroded funding to $7.5 million this year. The proposed budget, if approved by the Legislature, eliminates the funding entirely.

Cigarette Makers and Retailers Sue to Block New York City Rule Requiring Antismoking Posters

Last December the New York City Department of Health started requiring tobacco retailers to post warning signs about tobacco use including graphic images of diseased brains, lungs and teeth, as well as information for smokers interested in quitting. Small signs must be placed within three inches of each cash register. In June the three big tobacco companies and the New York State Association of Convenience Stores and retailers filed a federal lawsuit against the city in an effort to remove required signs from about 11,500 establishments.

The suit contends that the placard rule infringes on the federal government’s authority to regulate cigarette advertising and warnings and violates the First Amendment rights of store owners who disagree with their message, and that the placards are so disgusting that they hurt business by discouraging people from buying not only cigarettes but also more-wholesome merchandise like milk and sandwiches.

In a statement, the city’s health department said that putting warnings where cigarettes were sold was one of the most effective ways to deter people from smoking and to discourage a new generation of smokers. “By trying to suppress this educational campaign,” the statement said, “the tobacco industry is signaling its desire to keep kids in the dark.”  The signs are based on research that shows pictures are much more effective at conveying the hazards of smoking than written text, according to the health department.