DHCS issued an All Plan Letter providing instructions on what tobacco prevention and cessation services should be covered by managed care plans. DHCS points to the US Preventive Services Task Force in setting coverage requirements for both pregnant and non-pregnant beneficiaries, including:
- Assessments of tobacco use for all adolescent and adult beneficiaries
- FDA-approved medications for non-pregnant adults, at least one of which must be available without prior authorization requirements
- Counseling services for tobacco user beneficiaries of any age
- Tailored counseling services for pregnant tobacco users
- Prevention of tobacco use for children and adolescents
- Training of managed care-contracted providers
- Systems to identify tobacco users for assessment and reporting purposes
- Systems to track utilization of tobacco cessation treatment
APL 16-014 (November 30, 2016).