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Medicaid Toolbox

Medicaid and Quitlines: A Toolbox for Expanding Medicaid
Benefits and Gaining Reimbursement for Quitlines


Medicaid is the nation’s health insurance program for low-income people, functioning as a safety-net for about 60 million Americans. Those covered include pregnant women, children and parents, people with disabilities, and some seniors. They are among the sickest and most vulnerable people in the nation.

The prevalence of smoking remains higher in the Medicaid population compared to the rest of the U.S. population (MMWR, 2009). Medicaid expenditures attributable to smoking total about $22 billion annually, representing 11% of all Medicaid expenditures (MMWR, 2009). Tobacco control professionals have long been concerned with assuring that effective smoking cessation services are covered by Medicaid and available to its members.

Although progress has been made in gaining comprehensive state coverage for cessation benefits and for Medicaid payment for services provided by traditional medical professionals, significant barriers still need to be addressed to assure: adequate coverage for cessation services in all states; and Medicaid payment for services delivered by traditional medical providers, quitlines, and other qualified counselors. State quitline data shows that Medicaid members comprise about 20% of all callers to the quitlines (NAQC, 2009). An even higher number of Medicaid members could be served if the Center for Medicare and Medicaid Services (CMS) would allow payment to quitlines for their services to Medicaid members.

Call for Action

Recently enacted health care reform provides opportunities to expand tobacco control services for Medicaid members. NAQC calls on its members and partners to take action by:
  1. Working with state Medicaid programs to expand coverage for tobacco cessation services to include counseling and medications as recommended by the Public Health Services Clinical Guidelines on Tobacco Use and Dependence. IN, MA, MN, NV, OR, and PA are leading the way on this.
  2. In partnership with the Medicaid program, promoting Medicaid benefits and the availability of quitline services to Medicaid members. Many states are working on this with great results!
  3. Working with CMS at state and national levels to allow Medicaid reimbursement for quitline services; UT and OR are leading the way at a state level. NAQC is working with other tobacco control organizations on this at a national level.
NAQC has compiled resources to support action on these goals. We encourage collaboration between quitlines and Medicaid programs that will make high quality and effective quitline services available to the many Medicaid members who smoke or use other forms of tobacco. The resources include:

A Primer on Medicaid for Cessation Professionals
A Primer on Quitlines for Medicaid Professionals
Medicaid and Tobacco: Prevalence Rates and Expenditures
Quitline Services to Medicaid Members
Health Care Reform: State Rankings on Cessation Coverage and Action Steps
Quitlines and Medicaid Partnership – Projects, Tools, and Lessons Learned
Tools for Making the Business Case
Barriers to Medicaid Payment for Quitline Services – Status and Solutions
Resource List


This Web resource was produced with funding from the Robert Wood Johnson Foundation (Grant #66689). The contents of this resource are under the editorial control of NAQC and do not necessarily represent the official views of the funding organization.




A Primer on Medicaid for Cessation Professionals

Medicaid is a complex health insurance program for about 60 million of the most vulnerable Americans, including pregnant women, children and parents, people with disabilities and some seniors. The materials provided below give an overview of the Medicaid program for tobacco control professionals, and are essential background reading. Before approaching your Medicaid program about partnership activities, learn how many members receive health care through Medicaid, who they are, the cost of the program and other critical facts.

Resources

Kaiser Commission on Medicaid and the Uninsured. Medicaid Facts. The Henry J. Kaiser Family Foundation. June 2010. view document

Kaiser Commission on Medicaid and the Uninsured. Medicaid: A Primer 2010. The Henry J. Kaiser Family Foundation. June 2010. visit web page

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A Primer on Quitlines for Medicaid Professionals

Quitlines are telephonic counseling services that provide high quality and effective treatment for smokers who want to quit. They are available in every state and are recommended by the U.S. Public Health Services Clinical Guideline for Treating Tobacco Use and Dependence (2008 update). The materials below provide an overview of quitlines for Medicaid professionals, and are essential background reading. Before meeting with your state quitline about partnership activities, learn about the effective services provided by quitlines, the populations they serve, their budget and the unique characteristics of the quitline in your state.

Resources

All Quitline Facts. NAQC. July 2010. Frequently asked questions and answers on quitlines, including data from NAQC’s annual survey of quitlines – 2009. view document

Quitline Services in Your State. NAQC. July 2010. Click on your state to learn about the specific services available through the quitline. visit web page

Tobacco Cessation Quitlines: A Good Investment to Save Lives, Decrease Direct Medical Costs and Increase Productivity (2009). Phoenix, AZ: North American Quitline Consortium. view document

Quitline Reports. NAQC. July 2010. These reports display quitline information in tabular form for all quitlines in North America. visit web page

Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Fiore MC, Jaen CR, Baker TB, et al. Rockville, MD: US Department of Health and Human Services, Public Health Service; 2008. This guideline shows that quitlines are effective treatment services for tobacco cessation. visit web page

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Medicaid and Tobacco: Prevalence Rates and Expenditures

The prevalence of smoking remains higher in the Medicaid population compared to the rest of the U.S. population (MMWR, 2009). In 2007, 33% of adult Medicaid enrollees smoked cigarettes, which is substantially higher than the general population prevalence of 19.8%. These data are based on the 2007 National Health Interview Survey (reference below).

On an annual basis, the Medicaid program spends over $200 billion on medical care. Medicaid expenditures attributable to smoking total about $22 billion annually, representing 11% of all Medicaid expenditures (MMWR, 2009). To better understand the cost of tobacco use for the Medicaid program and its members, see the articles below.

Resources

MMWR: State Medicaid Coverage for Tobacco-Dependence Treatments—United States, 2007. November 06, 2009 / Vol. 58 / No. 43. visit web page

Miller LS, Zhang X, Novotny T; et al. State estimates of Medicaid expenditures attributable to cigarette smoking, fiscal year 1993. Public Health Rep. 1998; 113(2):140-151. (link not available)

Petersen, R, et al. Medicaid reimbursement for prenatal smoking intervention influences quitting and cessation. Tob Control 2006; 15(1):30-4. visit web page

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Quitline Services to Medicaid Members

Quitlines serve a wide range of tobacco users including those disproportionately impacted by tobacco use such as Medicaid and other low socioeconomic status (SES) smokers. NAQC estimates that nearly 50% of smokers who call quitlines are low SES and about 20% are Medicaid members. We will have national estimates available in the spring of 2011, when the 2010 NAQC annual survey data are available.

Resources

NAQC. (2009). Tobacco Cessation Quitlines: A Good Investment to Save Lives, Decrease Direct Medical Costs and Increase Productivity. Phoenix, AZ: North American Quitline Consortium. view document

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Health Care Reform: State Rankings on Cessation Coverage and Action Steps


Current Medicaid Coverage for Tobacco Cessation

Tobacco-dependence treatments are highly cost-effective; however, Medicaid coverage for tobacco-dependence treatments differs widely from state to state. Although a growing number of state Medicaid programs are improving their coverage for tobacco cessation services as recommended by the Public Health Services Clinical Guideline on Tobacco Use and Dependence, only six cover all recommended counseling and medications: MN, IN, MA, NV, OR and PA. Most states place significant barriers on the availability of treatments through co-payments, stepped-care requirements, required enrollment in counseling in order to obtain medication, pre-authorization for medications, limitations on number of treatment courses, and by not covering combined treatments (MMWR).

As shown by the Liu article below, cessation coverage has a significant influence on quitting. The excellent article by Land, Warner et. al. describes the MA experience, which resulted in significantly reduced smoking prevalence when the Medicaid benefit included medications and counseling, reduced barriers to treatment, and broad promotion of the benefit. It is noteworthy that most state Medicaid programs do not reimburse quitlines for their services to Medicaid members (see section on Barriers to Medicaid Payment).

The Impact of Health Care Reform
The recently enacted health care reform legislation (i.e., the Patient Protection and Affordable Care Act – PPACA) expands the number of Medicaid members who are eligible for care, expands cessation treatment for pregnant women, eliminates cost-sharing for tobacco cessation, and presents opportunities in all states for expanding coverage for tobacco cessation treatment. However, it will take state-level actions such as collaboration between cessation professionals and Medicaid programs to expand coverage for tobacco cessation.

According to the Kaiser Family Foundation, PPACA expands Medicaid to nearly all individuals under age 65 with incomes up to 133% of the federal poverty line. As a result of PPACA:
  • Medicaid expansions will significantly increase coverage and reduce the number of uninsured;
  • The federal government will pay a very high share of new Medicaid costs in all states; and
  • Increases in state spending will be small compared to increases in coverage and federal revenues and relative to what states would have spent if reform had not been enacted.
The Trust for America’s Health analyzed selected prevention and public health provisions of the PPACA and found that:
  • Section 2713 stipulates that coverage shall be provided, with no cost sharing, for all preventive health services that have a rating of ‘A’ or ‘B’ in the current US Preventive Services Task Force. [Note: Tobacco cessation has an ‘A’ rating]; and
  • Section 4107 requires states to provide Medicaid coverage for counseling and pharmacotherapy for tobacco cessation by pregnant women. Cost sharing is prohibited.
At the time this information was posted, PPACA reform is underway at the federal, state and local levels. NAQC and its national partners agree that there are many opportunities to influence new cessation coverage policies. One of these opportunities is in Medicaid as each state’s Medicaid program will be required to cover comprehensive cessation benefits for pregnant women by October 1, 2010. However, individual states, rather than PPACA, will determine whether to cover comprehensive cessation benefits for all other (e.g., non-pregnant) Medicaid patients. As discussed above, most states currently do not cover a comprehensive cessation benefit for Medicaid members. This gap in health care coverage leaves millions of Medicaid members who use tobacco without access to all the help they need to quit.

We encourage NAQC members and partners to work with Medicaid programs to enhance cessation coverage for all Medicaid members.

The resources below show state-by-state coverage for counseling and medications and provide background on PPACA. Learn how your state Medicaid coverage ranks and take action to expand coverage!

Resources

Partnership for Prevention. Save Lives and Money: Health People on Medicaid Quit Tobacco. Action to Quit, Partnership for Prevention, American Lung Association. July 2010. view document

Land T, Warner D, Paskowsky M et. al. Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. PLoS ONE. March 2010: 5(3) e9770. view document

MMWR: State Medicaid Coverage for Tobacco-Dependence Treatments—United States, 2007. November 06, 2009 / Vol. 58 / No. 43. visit web page

State Tobacco Cessation Coverage Database. The database contains information on Medicaid coverage, state employee health plan coverage, insurance mandates for cessation, quitlines, and ALA programs for each state. These data include details of coverage, like barriers to accessing treatment, as well as the sources for each data point. visit web page

Trust for America’s Health. Review of Selected PPACA Prevention, Public Health and Workforce Provisions. Spring 2010. view document

Kaiser Family Foundation. Health Reform web page. Accessed July 23, 2010. visit web page

Liu, F. Effect of Medicaid Coverage of Tobacco-Dependence Treatments on Smoking Cessation. Int J Env Res Pub Hlth 2009 (6) 3143-3155; doi:10.3390/ijjerph6123143. visit web page

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Quitlines and Medicaid Partnership – Projects, Tools, and Lessons Learned

In the past 10 years, tobacco control and cessation professionals have partnered with Medicaid programs to advance three issues:
  • Expanding coverage (and decreasing barriers) for tobacco cessation services to Medicaid members;
  • Promoting existing cessation coverage and the availability of free quitline services to Medicaid members; and
  • Gaining some level of funding and/or reimbursement for delivery of quitline services to Medicaid members.
To date, only three states IA, OR, UT- have succeeded in gaining some level of funding and/or reimbursement from Medicaid for delivery of quitline services to its members. Examples of projects and tools are listed below.

Partnerships to Expand Coverage for Tobacco Cessation Services
Between 2005 and 2007, the Iowa Department of Public Health, Quitline Iowa and Medicaid officials worked together to design and implement an enhanced benefit for cessation services. This work is described in the NAQC resource below.
Since 2008, the New York Tobacco Control Program has been working with Medicaid to enhance cessation benefits for Medicaid members. This work began with the benefit for pregnant women, expanded to the postpartum period, and now is focused on all members. See TCLN reference for details.

In 1999 and again in 2003, the Oklahoma Medicaid program enhanced its cessation benefit first to pregnant women and then to all Medicaid members. The state tobacco program and the Oklahoma Tobacco Settlement Endowment Trust were partners in these efforts. Please see the TCLN resource for details.

In 1998, Oregon Medicaid program, with the expertise of the state tobacco program and statewide coalition, developed a new comprehensive tobacco cessation benefit that was widely promoted along with the state quitline to members and health care providers. For details, see TCLN resource below.

Partnerships to Promote Existing Coverage and the Availability of Quitline Services
In 2006, when additional funding was proposed for the Kentucky quitline, the tobacco program manager, quitline staff and Medicaid staff partnered to promote quitline services to pregnant Medicaid members. Their efforts are described in the NAQC resource below.

After working with Medicaid to enhance its cessation benefit, the New York Tobacco Control Program involved its Cessation Centers in helping to clarify and promote the Medicaid benefit to health care organizations and providers. For more details, see the TCLN resource below.

In 2006 and 2007, the Oklahoma Medicaid program, tobacco program and tobacco trust partnered to promote the state’s Medicaid benefit and to encourage members to call the quitline for help in quitting. Over 3,000 calls resulted from the promotion. In 2009, the partners promoted the benefit to health care providers and also educated them about the quitline services. See TCLN resource below for details.

In 1998, Oregon Medicaid program, with the expertise of the state tobacco program and statewide coalition, approved a new comprehensive tobacco cessation benefit that was widely promoted along with the state quitline to members and health care providers. In 2004 and 2008 promotional mailings were sent to all members. For details, see TCLN resource below.

In 2006, Wisconsin Medicaid program and UW-CTRI (which manages the quitline) partnered to make Medicaid members more aware of their cessation benefit and of the quitline in a media campaign called "You Can Afford to Quit.” The campaign served to increase awareness and dispel myths among health care providers and professional health organizations as well as increasing consumer demand and utilization of services. See TCLN resource for details.

Partnerships to Gain Funding and/or Reimbursement for Quitline from Medicaid
In Oregon, Medicaid pays the state quitline for counseling services to fee-for-service members, which comprise about 20% of the state Medicaid members. Recently, the state submitted a waiver to CMS that will enable Medicaid members to receive their medications through the quitline as well, thereby eliminating the need for them to visit their primary care providers for medication. See TCLN resource for details.

In Utah, the Medicaid program has a contract with the tobacco program that funds services for all Medicaid recipients through the state quitline and helps support a portion of the cost of the tobacco control program’s marketing campaigns for the quitline, based on the proportion of the Medicaid population reached by the campaigns. For details, see TCLN resource below.
In Iowa, Medicaid has an agreement to reimburse the Iowa Department of Public Health 50 percent of actual cost of Quitline Iowa’s  services (i.e. providing ongoing counseling, processing fax referrals, and administrative costs) for Medicaid members.  The Medicaid  program requires a fax referral by the physician to Quitline Iowa and enrollment in ongoing counseling  by the patient in order to receive the medication benefit (paid for by Medicaid).  Nearly 80 percent of the total fax referrals received by Quitline Iowa from 2006-2010 have been for Medicaid members.  For details, contact Aaron Swanson at aaron.swanson@idph.iowa.gov.    

Resources

NAQC. Working with Medicaid: What Quitlines Have Learned (2007). A summary of NAQC’s seminar held in 2007, "Establishing Best Practices for Quitline Operations: Back to Basics”. view document

TCLN. Guide for Improving Use of Cessation Services Through Tobacco Control and Medicaid Partnerships. Medicaid Partnership Project. Tobacco Cessation Leadership Network. July 2009. view document

Tools

Benefit Charts and Fact Sheets

New York fact sheet, Medicaid Coverage For Stop Smoking Medications – Health Provider. view document

New York fact sheet, Medicaid Coverage For Stop Smoking Medications – Recipient. view document

New York NYS Medicaid Smoking Cessation Coverage Highlights. visit web page

Utah Benefit Matrix: Tobacco Cessation Benefits for Medicaid and Primary Care Network Patients matrix. view document

Wisconsin Medicaid Fact Sheet: Tobacco Cessation Products and Services Covered Under BadgerCare Plus and Wisconsin Medicaid. view document

Wisconsin. Medicaid Fact Sheet: Wisconsin Medicaid, BadgerCare & SeniorCare Cover Treatments to Quit Tobacco. view document

Wisconsin. UW-CTRI’s Web page, Medicaid Covers Quit-Smoking Treatment, contains fact sheets and other materials to promote Medicaid coverage for tobacco treatments and to assist Wisconsin providers help qualifying beneficiaries to quit. visit web page

Medicaid Promotion

Oklahoma "Help is Here” campaign. A promotional brochure for patients. view document

Oregon "Help is Here” campaign. A promotional brochure for patients. Brochures are available in English, Spanish, Russian and Vietnamese. view document

Utah "Do you Want to Quit” 2009 quitline promotional mailer in English and Spanish. view document

Wisconsin "You Can Afford to Quit Smoking” campaign. Promotional brochure for patients. view document

Wisconsin "You Can Afford to Quit Smoking” campaign presentation for TCLN Roundtable conference call. view document

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Tools for Making the Business Case

America’s Health Insurance Plans (AHIP) and the Center for Health Research, Kaiser Permanente Northwest (CHR) have developed a business case for smoking cessation by estimating the incremental return on investment (ROI) of evidence-based cessation interventions. Businesses use ROI analysis to allocate resources by comparing the implementation costs and future revenues (or savings) of alternative investments. To make the business case for smoking cessation, interventions must demonstrate a positive ROI in 3-5 years compared to existing practice.

After extensive research, AHIP and CHR created a user-friendly, Web-based ROI calculator that estimates the impact of smoking cessation interventions for 1-5 years. The business case for smoking cessation involves demonstrating the short-term financial value of evidence-based interventions to health insurance plans, payers, employers, and other tobacco control stakeholders. These organizations want evidence that interventions can reduce medical care expenditures and productivity costs for quitters in the short-run. This calculator is a tool for producing such evidence!

More information on the business case and the ROI calculator are available at:

http://www.businesscaseroi.org/roi/apps/execsum.aspx
http://www.businesscaseroi.org/roi/default.aspx

Resources

The Business Case for Tobacco Cessation Programs: A Case Study of Group Health Cooperative in Seattle. visit web page

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Barriers to Medicaid Payment for Quitline Services - Status and Solutions

Although a number of state Medicaid offices have expressed an interest in paying quitlines for services to Medicaid members, only two states -- OR and UT -- have succeeded (see TCLN resource for details). Even in these states, the payment arrangements may not be as efficient as they could be if CMS headquarters provided consistent rules for reimbursement. Many state Medicaid agencies have been obstructed by one or more of the challenges listed below:
  1. Quitlines are not viewed as qualified providers for payment by Medicaid. Most state Medicaid agencies agree that quitlines may not be reimbursed because they are not on the Plan B Provider List. A number of states have identified ways to overcome this challenge, most often for quitline service providers that are located within the state or that are located within an institution that has a relationship with Medicaid. NAQC has asked CMS to comment on ways in which this challenge may be overcome.
  2. Medicaid does not reimburse for telephonic counseling. Medicaid officials have voiced concern that if they reimburse quitlines for telephonic counseling, other providers will want to be reimbursed for advice over the phone. There may be an opportunity to overcome this challenge; Medicaid does reimburse for telemedicine and video-conferencing (when the health care provider is visible). NAQC has asked CMS to explore whether it may restrict reimbursement for telephonic counseling to interventions with documented effectiveness such as quitlines. State Medicaid officials have suggested that in developing parameters for payment of telephonic counseling, they should be restrictive, well-defined and easy to implement by state agencies.
  3. Medicaid requires a prescription for over-the-counter and prescription medications, and the medications may not be sent by mail order. In some states, such rules have been set aside if an agency analysis shows that it would be cost-saving to allow payment without a prescription and to distribute by mail order. NAQC has raised this issue with CMS. It would facilitate quitline services to Medicaid members to have a national solution to this challenge.
  4. Although a few state Medicaid agencies believe they are authorized to use administrative funds to pay for quitline services, we do not know of states that agree direct service funds may be used. There is inconsistency across the federal regions in whether administrative funds may be used to pay for quitline services. NAQC has raised this issue for CMS. It would facilitate quitline services to Medicaid members to have consistency across the regions.
  5. Medicaid agencies have been reluctant to pay for a service that may be available free-of-charge to other tobacco users in the state. This is a challenge in some state Medicaid agencies and not in others. As state budgets have been cut during the recession and as health care reform pushes payers to treat tobacco cessation as a regular part of health care, more and more quitlines have approached private and public health care payers to discuss reimbursement of quitline services to their members. In at least two of the states NAQC talked to, health plans had agreed to bear some or all of the costs for quitline services to their members. State Medicaid officials viewed these paying arrangements as an incentive for them to find a way to reimburse the quitline for Medicaid members.
  6. In at least one state, tobacco cessation services are billed to Medicaid using substance abuse codes rather than tobacco cessation codes (which are available, but not open). For this state, there are additional restrictions on who can provide the service, certification requirements, and supervision requirements. It may be helpful to have consistency across the regions on codes that should be used for billing tobacco cessation services.
NAQC looks forward to discussing these issues with CMS and finding a solution that will result in more high quality cessation services for Medicaid members who smoke.

Resources

NAQC. Letter to CMS regarding quitline services to Medicaid members. Linda Bailey. July 2010. view document

On June 14, 2010, NAQC joined with 35 other public health groups to submit a letter to CMS expressing strong support for permitting states to obtain federal Medicaid matching funds for the cost of tobacco cessation services provided by quitlines. Gaining matching funds is a key strategy for making quitlines more sustainable. NAQC plans to follow-up with CMS on this issue and will keep members apprised of progress. view document

NAQC letter to CMS in January 2005 about Medicare coverage (NOTE: This letter is about Medicare coverage rather than Medicaid, but many of the issues are similar). view document

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Resource List


Articles

Halpin HA, Bellows NM and McMenamin SB. Update State Report: Medicaid Coverage of Tobacco Dependence Treatments. Health Affairs, March/April 2006; 25(2):550-556.

Land T, Warner D, Paskowsky M et. al. Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. PLoS ONE. March 2010: 5(3) e9770. view document

Liu, F. Effect of Medicaid Coverage of Tobacco-Dependence Treatments on Smoking Cessation. Int J Env Res Pub Hlth 2009 (6) 3143-3155; doi:10.3390/ijjerph6123143. visit web page

Maciosek MV, Coffield AB, Edwards NM, Flottemesch TJ, Goodman MJ, Solberg LI. Priorities among effective clinical preventive services: results of a systematic review and analysis. Am J Prev Med. 2006; 31(1):52-61.

Miller LS, Zhang X, Novotny T; et al. State estimates of Medicaid expenditures attributable to cigarette smoking, fiscal year 1993. Public Health Rep. 1998; 113(2):140-151.

MMWR: State Medicaid Coverage for Tobacco-Dependence Treatments—United States, 2007. November 06, 2009 / Vol. 58 / No. 43. visit web page

Petersen, R, et al. Medicaid reimbursement for prenatal smoking intervention influences quitting and cessation. Tob Control 2006; 15(1):30-4. visit web page

Pleis JR, Lucas JW. Summary health statistics for U.S. adults: National Health Interview Survey, 2007. Vital Health Stat 2009;10(240).



Guides and Tools on Medicaid

Kaiser Commission on Medicaid and the Uninsured. Medicaid Facts. The Henry J. Kaiser Family Foundation. June 2010. view document

Kaiser Commission on Medicaid and the Uninsured. Medicaid: A Primer 2010. The Henry J. Kaiser Family Foundation. June 2010. visit web page



Guides and Tools on Quitlines

NAQC’s 2006 Medicaid Information Survey (March 2007). The NAQC 2006 Medicaid Information Survey was fielded in September of 2006, to document the scope of efforts undertaken by U.S. quitline administrators with state Medicaid agencies. view document

Working with Medicaid: What Quitlines Have Learned (2007). A summary of NAQC’s seminar held in 2007, "Establishing Best Practices for Quitline Operations: Back to Basics." view document

Tobacco Cessation Quitlines: A Good Investment to Save Lives, Decrease Direct Medical Costs and Increase Productivity (2009). Phoenix, AZ: North American Quitline Consortium. view document

All Quitline Facts. NAQC. July 2010. Frequently asked questions and answers on quitlines, including data from NAQC’s annual survey of quitlines – 2009. view document

Quitline Services in Your State. NAQC. July 2010. Click on your state to learn about the specific services available through the quitline. visit web page

Quitline Reports. NAQC. July 2010. These reports display quitline information in tabular form for all quitlines in North America. visit web page



Guides and Tools on Tobacco Cessation

Treating Tobacco Use and Dependence: 2008 Update. Clinical practice guideline. Fiore MC, Jaen CR, Baker TB, et al. Rockville, MD: US Department of Health and Human Services, Public Health Service; 2008. visit web page

Save Lives and Money: Help People on Medicaid Quit Tobacco. Action to Quit, Partnership for Prevention, American Lung Association. July 2010. This report compares the level of coverage for tobacco cessation treatment by state Medicaid programs. view document

State Tobacco Cessation Coverage Database. The database contains information on Medicaid coverage, state employee health plan coverage, insurance mandates for cessation, quitlines, and ALA programs for each state. These data include details of coverage, like barriers to accessing treatment, as well as the sources for each data point. visit web page

Review of Selected PPACA Prevention, Public Health and Workforce Provisions. Trust for America’s Health Spring 2010. view document

Guide to Community Preventive Services: Tobacco Use Prevention and Control. Contains the U.S. Preventive Services Task Force (USPSTF) recommendations on the use of screening, counseling, and other preventive services that are typically delivered in primary care settings. The USPSTF, an independent panel of experts supported by the Agency for Healthcare Research and Quality (AHRQ), makes recommendations based on systematic reviews of evidence related to the benefits and potential harms of clinical preventive services. visit web page

Guide for Improving Use of Cessation Services Through Tobacco Control and Medicaid Partnerships. Medicaid Partnership Project. Tobacco Cessation Leadership Network. July 2009. view document

Helping Smokers Quit: State Cessation Coverage (2008). A State Policy Trend Report from the American Lung Association. view document

State Medicaid Coverage of Tobacco Cessation Services for Pregnant Women Fact sheet (March 20, 2008). A fact sheet from the Campaign for Tobacco-Free Kids. view document

Saving Lives, Saving Money II: Tobacco-Free Sates Spend Less on Medicaid (2007). A report from the American Legacy Foundation shows the positive impact effective smoking cessation programs can have on state Medicaid expenditures. view document

Toolkit: Invest in a Healthy State: Covering Tobacco Cessation Services Under Medicaid. The Center for Tobacco Cessation, in partnership with the National Partnership to Help Pregnant Smokers Quit, has developed a Medicaid and smoking cessation information packet. view document



Business Case Tools

Making the Case for Smoking Cessation Programs. Executive Summary. AHIP. http://www.businesscaseroi.org/roi/apps/execsum.aspx. Accessed July 26, 2010.

Return-On-Investment (ROI) Calculator. AHIP. http://www.businesscaseroi.org/roi/default.aspx. Accessed July 26, 2010.

The Business Case for Tobacco Cessation Programs: A Case Study of Group Health Cooperative in Seattle. visit web page



State Specific Tools

Benefit Charts and Fact Sheets

New York fact sheet, "Medicaid Coverage For Stop Smoking Medications – Health Provider”. view document

New York fact sheet, "Medicaid Coverage For Stop Smoking Medications – Recipient." view document

New York NYS Medicaid Smoking Cessation Coverage Highlights. visit web page

Utah Benefit Matrix: "Tobacco Cessation Benefits for Medicaid and Primary Care Network Patients” matrix. view document

Wisconsin Medicaid Fact Sheet: "Tobacco Cessation Products and Services Covered Under BadgerCare Plus and Wisconsin Medicaid.” view document

Wisconsin Medicaid Fact Sheet: "Wisconsin Medicaid, BadgerCare & SeniorCare Cover Treatments to Quit Tobacco." view document

Wisconsin UW-CTRI’s Web page, Medicaid Covers Quit-Smoking Treatment, contains fact sheets and other materials to promote Medicaid coverage for tobacco treatments and to assist Wisconsin providers when qualifying beneficiaries to quit. visit web page

Medicaid Promotion

Oklahoma "Help is Here” campaign. A promotional brochure for patients. view document

Oregon "Help is Here” campaign. A promotional brochure for patients. Brochures are available in English, Spanish, Russian and Vietnamese. view document

Utah "Do you Want to Quit” 2009 quitline promotional mailer in English and Spanish. view document

Wisconsin "You Can Afford to Quit Smoking” campaign. Promotional brochure for patients. view document

Wisconsin "You Can Afford to Quit Smoking” campaign presentation for TCLN Roundtable conference call. view document



Letters to CMS

Letter to CMS regarding payment for quitline services to Medicaid members. NAQC. July 2010. view document

Letter to CMS expressing support for Medicaid payment for tobacco cessation. National Public Health Groups. June 2010. NAQC joined with 35 other public health groups to submit a letter to CMS expressing strong support for permitting states to obtain federal Medicaid matching funds for the cost of tobacco cessation services provided by quitlines. Gaining matching funds is a key strategy for making quitlines more sustainable. NAQC plans to follow-up with CMS on this issue and will keep members apprised of progress. view document

Letter to CMS about Medicare coverage (NOTE: This letter is about Medicare coverage rather than Medicaid, but many of the issues are similar). January 2005. view document

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