Original Effective Date:
08/01/1994
Current Effective Date:
03/21/2018
HMSA’s Plan for QUEST Integration members provides a comprehensive smoking cessation treatment program for all members who smoke. Services are available statewide and include counseling and U.S. Food and Drug Administration (FDA)-approved tobacco cessation medications, preferably using a combined counseling and medication approach. Smoking cessation services are provided in accordance with the Treating Tobacco Use and Dependence practice guidelines issued by the Agency for Healthcare Research and Quality (AHRQ).
Smoking cessation services are covered based on medical necessity. No prior authorization or step therapy is required. No out-of-pocket cost or copayments shall be required for smoking cessation counseling or medications.
Services include:
Counseling
At least four counseling sessions of at least 10 minutes each per quit attempt. Counseling may be provided individually, in a group, or by phone.
Counseling emphasizes two effective components:
- Practical counseling, including problem-solving and skills training
- Social support delivered as part of treatment
Smoking cessation counseling services may be provided by the following providers who are trained in smoking cessation and functioning within their scope of practice:
- Physician
- Dentist
- Psychologist
- Clinical social worker in behavioral health
- Advanced practice registered nurse (APRN)
- Mental health counselor
- Certified Tobacco Treatment Specialist under the supervision of a licensed provider
Medications
HMSA QUEST covers all tobacco cessation medications approved by the FDA as effective treatments for smoking cessation, including nicotine and non-nicotine agents. Effective medication combinations are also covered.
For More Information
Members interested in smoking cessation services may call QUEST Integration Member Services at 808-948-6486 or toll-free at 1-800-440-0640. Members may also call HMSA Well-Being Connection at 1-855-329-5461. TTY users may call 1-877-447-5990 toll-free.