BILL REQ. #:  S-0299.2 

Read first time 01/11/11.   Referred to Committee on Health & Long-Term Care.

     AN ACT Relating to insurance coverage of tobacco cessation treatment in the preventative benefit required under the federal law; adding new sections to chapter 48.43 RCW; creating a new section; and providing a contingent expiration date.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

NEW SECTION.  Sec. 1   A new section is added to chapter 48.43 RCW to read as follows:
     To the extent required by federal law, a group or individual plan contract that is issued, amended, renewed, or delivered on or after September 23, 2010, must comply with the requirements of section 2713 of the federal public health service act (42 U.S.C. Sec. 200 gg-13), as added by section 1001 of the federal patient protection and affordable care act (P.L. 111-148), and any subsequent rules or regulations issued pursuant to that section, to provide coverage for certain preventive health services without imposing cost sharing.

NEW SECTION.  Sec. 2   A new section is added to chapter 48.43 RCW to read as follows:
     (1) Group and individual plan contracts issued, amended, renewed, or delivered on or after January 1, 2012, must cover a minimum of two courses of treatment in a twelve-month period for all tobacco cessation treatments rated "A" or "B" by the United States preventive services task force, which must include counseling and over-the-counter medication and prescription pharmacotherapy approved by the federal food and drug administration.
     (2) The coverage provided pursuant to this section is only available upon the order of an authorized provider. Nothing in this section precludes a health plan from allowing enrollees to access tobacco cessation services on a self-referral basis.
     (3) As used in this section, "course of treatment" means:
     (a) As applied to counseling, at least four sessions of counseling, which may be telephone, group, or individual counseling with each session lasting at least ten minutes; or
     (b) As applied to a prescription or over-the-counter medication, the duration of treatment approved by the federal food and drug administration for that medication.
     (4) Enrollees may not be required to enter counseling in order to receive tobacco cessation medications after the patient's first course of treatment.
     (5) A health plan may not impose prior authorization or stepped-care requirements on tobacco cessation treatments.

NEW SECTION.  Sec. 3   Section 2 of this act expires on the date that the office of the insurance commissioner determines that the requirements of section 2 of this act will result in the state assuming additional costs pursuant to U.S.C. Sec. 1311 of the federal patient protection and affordable care act (P.L. 111-148), as amended by subsection (e) of Sec. 10104 of Title X of that federal act, as that federal act existed on the effective date of this section.

NEW SECTION.  Sec. 4   The office of the insurance commissioner must provide notice of the expiration date of section 2 of this act to affected parties, the chief clerk of the house of representatives, the secretary of the senate, the office of the code reviser, and others as deemed appropriate by the office of the insurance commissioner.