The Centers for Medicare & Medicaid Services (CMS) has initiated a national coverage analysis (NCA) for counseling to prevent tobacco use and tobacco-related disease for Medicare beneficiaries who currently use tobacco products but have no diagnosed tobacco-related disease.
Over the past 25 years, Congress has added coverage of specific preventive and screening services—including Pap smear and screening pelvic exams, screening mammograms, colorectal cancer screening tests, and diabetes screening tests—to the Medicare Part B program. Effective January 1, 2009, CMS is allowed to add coverage of “additional preventive services” if certain statutory requirements are met. Specifically, this regulation allows CMS to cover additional preventive services if it determines through the national coverage determination (NCD) process that the service is recommended with a grade A (strongly recommends) or grade B (recommends) rating by the U.S. Preventive Services Task Force (USPSTF) and meets certain other requirements.
Following a review of various preventive services given a grade A or grade B recommendation by the USPSTF, CMS has initiated this new NCA. At present, Medicare Part B covers smoking and tobacco use cessation counseling for individuals who use tobacco and have been diagnosed with a recognized tobacco-related disease or who exhibit symptoms consistent with tobacco disease. The new NCA will evaluate the available evidence regarding counseling to prevent tobacco use and tobacco-caused disease in asymptomatic Medicare beneficiaries, i.e., those without recognized signs or symptoms of tobacco-related disease, and will determine if a new NCD is warranted.
The public is invited to submit comments on this topic for the 30-day period between November 30, 2009 and December 30, 2009. CMS considers all public comments, and is particularly interested in clinical studies and other scientific information related to counseling to prevent tobacco use and tobacco-caused disease under review for individuals who do not yet have signs or symptoms of tobacco-related disease. Comments can be posted at: http://www.cms.hhs.gov/mcd/viewtrackingsheet.asp?id=242.