Medicaid & Third Party Payer

The ATCA Medicaid & Third Party Payer work group was founded in December 2007. The goal of this group is to reduce barriers to quitting tobacco by increasing the number of private and public health insurance plans that include coverage for tobacco cessation treatment.

Medicaid Coverage

After two years of anticipation, State of Alaska Medicaid issued a letter dated April 29, 2011 announcing changes in tobacco cessation coverage.

  • Removes the prior authorization requirement for treatment with medication
  • Maintains coverage for over-the-counter and prescription tobacco cessation aides, while changing the quantity limit for these medications to a 6 month time period
  • Removes the ‘patch failure’ requirement
  • Allows outpatient pharmacists to charge for counseling services (with a number of stipulations, including a physician script request for medication and counseling, pharmacist completes 1.5 hr training, pharmacist counsels between 3-10 minutes, and counseling documentation).

Medicaid For Providers13-01 Medicaid Tobacco Treatment Coverage, Pharmacists' GuideFind out more:

Providers

Medicaid Recipients

 

 

 

Private Health Plan Coverage

The Gold Standard in Tobacco Treatment BenefitThis work group created the Gold Standard, Tobacco Cessation Coverage document describing the best tobacco cessation insurance coverage.  In the Fall 2012, national health care reform will require tobacco cessation insurance coverage by many private health insurance plans. It is unknown what the requirements will be, but likely The Gold Standard document will be useful.

Return on Investment Calculator for the economic feasibility of adding tobacco cessation coverage

Provider training for tobacco cessation

AK Quit line CME Brief Intervention Provider page (On this page, you will have to log-in as a guest in order to access the training.)

Alaska’ s Tobacco Quit Line information for health care providers