205.618 Coverage for tobacco cessation medications and services.
264 words·~1 min read·
/ky/chapter-205/205-618A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)Notwithstanding any provision of law to the contrary, the Department for
Medicaid Services or a managed care organization contracted to provide
Medicaid services shall, at a minimum, provide coverage for all United States
Food and Drug Administration-approved tobacco cessation medications, all
forms of tobacco cessation services recommended by the United States
Preventive Services Task Force, including but not limited to individual, group,
and telephone counseling, and any combination thereof.
(2)The following conditions shall not be imposed on any tobacco cessation
services provided pursuant to this section:
(a)Counseling requirements for medication;
(b)Limits on the duration of services, including but not limited to annual or
lifetime limits on the number of covered attempts to quit; or
(c)Copayments or other out-of-pocket cost sharing, including deductibles.
(3)Utilization management requirements, including prior authorization and
step therapy, shall not be imposed on any tobacco cessation services provided
pursuant to this section, except in the following circumstances where prior
authorization may be required:
(a)For a treatment that exceeds the duration recommended by the most
recently published United States Public Health Service clinical practice
guidelines on treating tobacco use and dependence; or
(b)For services associated with more than two
(2)attempts to quit within a
twelve
(12)month period.
(4)Nothing in this section shall be construed to prohibit the Department for
Medicaid Services or a managed care organization contracted to provide
Medicaid services from providing coverage for tobacco cessation services in
addition to those recommended or to deny coverage for services that are not
recommended by the United States Preventive Services Task Force.