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Legislature lifts limits on tobacco cessation treatments for KanCare members

The FY 2019 budget recently signed into law by Governor Colyer includes authority for expenditures up to $350,000 for expansion of the tobacco cessation benefits in KanCare. Individuals covered by KanCare are now eligible to re-ceive up to four rounds of nicotine replacement therapy (NRT) each year with no lifetime caps as well as ongoing ces-sation counseling services. The budget proviso replaces the previous limitation of one quit attempt per year and the limitation on counseling which had been reserved only for pregnant women.
This means that all individuals who are covered by KanCare and want help in quitting tobacco now have access to both NRT and counseling services, which together are considered a best practice for increasing the chances of long-term recovery from tobacco use. The budget language prohibits the state Medicaid agency or any MCO from impos-ing any prior authorization requirements for any of the covered tobacco cessation treatments.

The budget strategy for changing the availability of cessation treatment became necessary when legislation intro-duced early in the session was stalled by Senate leaders who would not bring the bill to the floor since it could have become a vehicle for advancing the debate on Medicaid expansion.
Senator Barbara Bollier first introduced the legislation which had the unanimous support of the Senate Public Health & Welfare Committee chaired by Senator Vicki Schmidt. The Committee heard from Dr. Kimber Richter whose family experiences and research work at KUMed informed her compelling testimony. Also providing oral testimony was Rick Cagan with NAMI Kansas and Dr. Tami Gurley-Calvez, also with KUMed. Dr. Gurley-Calvez reviewed an econom-ic study which she co-authored, and which had been commissioned by NAMI Kansas with support of the Kansas Health Foundation. See The Economics of Proactive Smoking Cessation Treatment for Individuals with Serious Men-tal Illness and/or Substance Use Disorder in the Medicaid Population at the link provided.

The line-up of organizations submitting written testimony in support of the bill included the Tobacco Free Kansas Co-alition along with the American Cancer Society Cancer Action Network, American Heart Association, Kansas Health Foundation, Ed Ellerbeck, MD (KUMed), Healthy Communities Wyandotte, Kansas Academy of Family Physicians, March of Dimes, Oral Health Kansas, Roy Jensen, MD (University of Kansas Cancer Center), Shawnee Mission Health and others.

When no action had been taken by the full Senate by the legislative turnaround, Sen. Schmidt re-introduced the bill in the Ways and Means Committee to keep the issue in play; however, the Senate maintained its position of not bringing this bill or any others forward which might risk a debate on the broader issue of Medicaid expansion.

The continuing legislative stalemate presented Senators Bollier and Schmidt with the opportunity of developing a budget proviso as described above. Thanks are due to Budget Conference Committee members, including Senators McGinn, Billlinger and Kelly and Representatives Waymaster, Proehl, and Wolfe-Moore for inserting and accepting the budget language providing for the expanded cessation program.

The Kansas Department of Health & Environment is now moving forward to make this change in policy effective on July 1st. Assurances have been offered by KDHE that these changes to cessation services will become a permanent part of the KanCare program. Partner organizations are moving ahead with plans to develop educational materials and a marketing campaign designed to drive utilization of these new benefits. For more information about getting involved with efforts to promote the new program, contact Rick Cagan, rcagan@namikansas.org.

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