The Centers for Medicare and Medicaid Services (CMS) issued guidelines on June 24 on Medicaid coverage of services and administrative activities to help individuals quit smoking. The CMS issuance covers section 4107 of the Affordable Care Act (ACA) which requires states to offer coverage of comprehensive tobacco cessation services for pregnant women, including both counseling and pharmacotherapy consistent with evidence-based practices identified in 2008 by the U.S. Public Health Service. It also provides new guidance and clarification on tobacco cessation services for children under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) benefit, services that can be covered under other Medicaid benefit categories, and “tobacco telephone quitline” activities for which Medicaid Federal financial participation (FFP) is available on qualifying administrative expenditures. CMS cites extensive research showing that timely, effective tobacco dependence interventions can reduce risks of pregnancy complications as well as cancer, heart disease, stroke, and pulmonary disease, which together cost $96 billion a year in medical expenses and $97 billion a year in lost productivity resulting from tobacco. The Centers for Disease Control and Prevention (CDC) estimates that smoking causes 443,000 deaths in the United States each year.