Medicare To Begin Covering Smoking-Cessation Counseling for Some Beneficiaries

Main Category: Medicare / Medicaid / SCHIP
Article Date: 24 Mar 2005 - 15:00 PDT

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Medicare will cover the cost of smoking-cessation counseling for beneficiaries with diseases caused or complicated by tobacco use,... CMS officials announced on Tuesday, the AP/Long Island Newsday reports (Freking, AP/Long Island Newsday, 3/22). According to CDC, 9.3% of U.S. residents ages 65 and older smoke cigarettes, and 300,000 seniors die of smoking-related diseases annually. CMS estimates that smoking-related health problems accounted for about 10% of total Medicare costs in 1997, or $20.5 billion. Under the decision announced on Tuesday, Medicare will cover counseling for beneficiaries with diseases caused by tobacco use, such as cardiovascular disease, lung disease, weak bones, blood clots and cataracts. CMS said that treatments for those diseases account for the largest share of Medicare costs. In addition, Medicare will cover smoking-cessation counseling for beneficiaries who take medications for diabetes, hypertension, blood clots and depression because tobacco use can reduce the efficacy of such treatments. Medicare will begin to cover smoking-cessation products, such as nicotine patches and gum, when the new prescription drug benefit begins in 2006, provided that the products are prescribed by a physician (Corbett Dooren, Wall Street Journal, 3/23). CMS officials said they did not have a cost estimate for the coverage of smoking-cessation counseling. However, Ronald Sturm, a senior economist at the RAND Institute, said that because Medicare will only cover two smoking-cessation attempts annually -- each with as many as four counseling sessions -- the cost likely will remain limited. In a seven-state pilot program conducted between November 2002 and December 2004, Medicare paid $32 per smoking-cessation counseling session.

Reaction
The decision announced on Tuesday "has great potential to save lives and improve lives for millions of seniors," CMS Administrator Mark McClellan said. Officials for the American Medical Association praised the decision. Ronald Davis, an AMA trustee, said, "Studies have shown that seniors who try to quit smoking are 50% more likely to succeed than all other age groups, and seniors who quit can reduce their risk of death from heart disease to that of nonsmokers within two to three years after quitting." However, Sturm said that most beneficiaries likely will not quit smoking "in their last few years" (AP/Long Island Newsday, 3/22).

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