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Medicare to Cover Quit-Smoking Counseling


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Medicare to Cover Quit-Smoking Counseling

New Benefit for Those with Smoking-Related Diseases

Article date: 2004/12/30

Medicare will soon begin paying for counseling to help people quit smoking, the US Department of Health and Human Services announced.

The new benefit should be available early in 2005. It will be offered to Medicare members who have smoking-related illnesses like lung or heart disease, weak bones, blood clots, or cataracts. Members who take medication that is affected by smoking -- such as insulin, or drugs to control high blood pressure, depression, seizures, or blood clots -- will also be eligible.

"Millions of our beneficiaries have smoked for many years and are now experiencing the heart problems, lung problems, and many other often-fatal diseases that smoking can cause," said Mark McClellan, MD, PhD, administrator of the Centers for Medicare & Medicaid Services (CMS). "It's really hard to quit, but we are going to do everything we can to help."

The proposal for coverage can be found on the CMS Web site. It will be open for public comment until Jan. 21, 2005. After that, the agency has 60 days to review the comments and issue a final policy.

Up to 8 Counseling Sessions Covered

Under the current proposal, the new benefit will pay for as many as 4 counseling sessions twice a year, for a total of 8 sessions in a 12-month period. Members may choose either intensive sessions (lasting longer than 10 minutes) or intermediate sessions (lasting 3-10 minutes). The counseling must be provided by someone trained to help people quit smoking.

"Quitting is hard, but counseling is a proven means of helping smokers succeed," said John Seffrin, PhD, chief executive officer of the American Cancer Society. "It's cost-effective and can double the chances of success."

Seffrin called the new coverage "a step in the right direction" and urged the government to expand it to all Medicare beneficiaries who smoke, not just those with smoking-related illnesses.

In 2006, Medicare will begin paying for prescription medicines that help people quit smoking as part of its new prescription drug coverage.

Quitting Saves Lives and Money

The US Centers for Disease Control and Prevention (CDC) estimates that 9.3% of Americans 65 and older smoke. About 300,000 people in this age group die from smoking-related causes every year. Yet 57% of people in this group say they want to quit, according to the CDC.

"People who quit smoking, regardless of age, live longer than those who continue smoking," Seffrin noted.

In its proposal for the new benefit, Medicare said smoking cost the agency about $14.2 billion in 1993, or about 10% of the program's budget. The new benefit could save Medicare $75 million over the next decade, and save consumers and other state and private health programs as much as $62 million.

The idea to have Medicare pay for quit-smoking counseling came from the Partnership for Prevention, a non-profit group. The group sent Medicare a letter in April, 2004, requesting the new benefit.

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