New Bulletin on Coverage for Tobacco Cessation Products Without Cost-Sharing

On December 30, 2019, the Division of Insurance published Bulletin 2019-10, relating to state and federal requirements that carriers cover certain tobacco cessation products without consumer cost-sharing. According to the bulletin, on November 27, 2019, changes were made to Massachusetts law to enhance tobacco cessation benefits. Specifically, the new laws require carriers to provide members with coverage for tobacco cessation counseling and all generic US FDA-approved tobacco cessation products.

In addition, under federal law and as recommended by the US Preventive Services Task Force (USPSTF), preventive services must be provided without cost-sharing. Among the preventive services recommended by USPSTF is screening for all adults for tobacco use and providing tobacco cessation interventions for those who use tobacco. Therefore, when prescribed by a health care provider, carriers may not require any member cost-sharing for either tobacco cessation counseling or any of the generic FDA-approved tobacco cessation products. Those include nicotine gum, nicotine patch, nicotine lozenges, nicotine oral or nasal spray, nicotine inhaler, bupropion, and varenicline.

Employers with fully insured plans in Massachusetts should review the bulletin, although it contains no new employer compliance obligations.

Bulletin 2019-10 »