Massachusetts Medicaid Regulations Formally ‘Deny’ Smoking Cessation Treatment Coverage
In a move that "seems to undercut" the state's $46 million-a-year antismoking program, Massachusetts Medicaid officials are implementing regulations that will "deny" smoking cessation drugs to beneficiaries, the Boston Globe reports. The Division of Medical Assistance previously had an "informal policy" of not covering smoking cessation drugs, saying there was "no proof" of their effectiveness. This month, however, the division issued the "more formal regulation" after physicians began prescribing Zyban for smoking cessation, even thought the state had approved the drug only as an antidepressant. The division had attempted to halt coverage for the treatments four years ago, but the regulations were blocked by former Gov. Paul Cellucci (R). Now, however, acting Gov. Jane Swift (R) is supporting the regulations to free up more funding to provide Medicaid coverage for uninsured women with breast or cervical cancer. Richard McGreal, a spokesperson for the Division of Medical Assistance, said that the decision was based on the program's "limited budget," adding that other coverage, such as of drugs for HIV patients, has been expanded.
Advocates Astounded
Noting that smoking-related illnesses cost the state Medicaid program $250 million each year, advocates were "shock[ed]" by the decision. Nancy Kaufman, a vice president at the Robert Wood Johnson Foundation, said, "It is particularly amazing considering how progressive Massachusetts has been with its tobacco control programs." She noted that other states' Medicaid programs cover a variety of smoking cessation treatments, including Zyban, and that private insurers are "increasingly covering" the therapies. She added, "Smoking is a phenomenon and an addiction that particularly afflicts the lower social classes and low-income populations. How a program that is geared to provide medical services to that population cannot make such a service available is quite surprising" (Phillips, Boston Globe, 5/31).
