PORTLAND, OR – Effective Jan. 1, 2010, Oregon insurers will be forced to cover $500 for members toward medications or quit-smoking courses.

Oregon joins a handful of states that have payer mandates, while others are expanding existing laws. Rhode Island’s bill requires insurers to cover all FDA-approved cessation medications and increased counseling.

Charles Bentz, MD, medical director of the Legacy Tobacco Cessation and Prevention Program and a Portland, Ore.-based physician, has been working on the issue for two decades. While not an advocate of mandates, he said, in this case it’s needed.

“You need to decrease barriers for patients,” he said. “Low co-pays for meds enables easy access.”

Regence Blue Cross Blue Shield of Oregon supported Senate Bill 734 “simply because we thought it was the right thing to do,” said Michael Becker, director of legislative and regulatory affairs. “As a company, we are very focused on wellness and encouraging members to adopt healthy lifestyles, an important component of which is smoking cessation.”

Although Regence hasn’t quantified savings associated with its smoking-cessation programs, it realized an average of $1.59 ROI for every dollar invested after only two years of its wellness program for employees, which includes smoking cessation assistance, said wellness manager Jim Shaub.

Blue Cross & Blue Shield of Rhode Island supports the new bill for expanded coverage. The payer currently allows office visit co-pays to be applied to counseling and pharmacy co-pays to drugs for addiction treatment, said Peter Hollmann, MD, associate CMO of provider relations.

Among its other efforts in the area, the Blues plan is helping primary care practices transition to medical homes, which will enable care managers to provide patient education on self-care goals such as tobacco cessation.

“Those practices will likely have a measure of performance that includes the percent of smokers that were advised to quit,” Hollman said.

America’s Health Insurance Plans doesn’t support benefits package mandates, said senior manager Robert Zirkelbach. Instead, AHIP supports programs driven by medical evidence and demand from employers and consumers, he said.

“When health plans offer it, it’s because they work,” he said.