Issue: December 2009
December 01, 2009
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Most state Medicaid programs offer limited access to tobacco-dependence treatment

Only two states offered unrestricted access to tobacco-cessation treatments.

Issue: December 2009
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Medicaid coverage for various smoking cessation treatments is limited in most states, according to a report published in Morbidity and Mortality Weekly.

Although smoking rates in the United States have been reduced by half since the 1960s, smoking rates among low-income adults are higher than in the general population (33% vs. 20%). According to the report, 43 of 51 (84%) state Medicaid programs offer some form of tobacco-dependence treatment in a traditional fee-for-service manner.

Twenty Medicaid programs have added coverage during the last decade and four Medicaid programs have added coverage since 2006. Of the 43 programs that offered tobacco-dependence therapies, 41 placed some form of limitation on the coverage in the form of copayments (32 states), limiting duration of treatment (25 states), requiring prior authorization (21 states) and requiring enrollment in behavioral modification programs as a precondition for receiving pharmacotherapy (13 states). Only New Jersey and New Mexico offered access to tobacco-dependence treatments with no limitations or restrictions on coverage.

“Research demonstrates that providing access to comprehensive tobacco-dependence treatments increases quit rates,” the authors wrote in the report. “Providing Medicaid coverage for these treatments would ensure that all enrollees can access and benefit from these treatments.”

McMenamin SB. MMWR. 2009;58:1199-1204.