II 

115TH CONGRESS 

1ST SESSION S. 1148 

To amend title XIX of the Social Security Act to provide States with the 

option of providing medical assistance at a residential pediatric recovery 

center to infants under 1 year of age with neonatal abstinence syndrome 

and their families. 

IN THE SENATE OF THE UNITED STATES 

MAY 17, 2017 

Mr. BROWN (for himself, Mrs. CAPITO, Mr. KING, and Mr. PORTMAN) introduced the following bill; which was read twice and referred to the Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to provide 

States with the option of providing medical assistance 

at a residential pediatric recovery center to infants under 

1 year of age with neonatal abstinence syndrome and 

their families. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Caring Recovery for 

5 Infants and Babies Act’’ or the ‘‘CRIB Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds as follows: 

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•S 1148 IS

1 (1) Neonatal abstinence syndrome (referred to 

2 in this section as ‘‘NAS’’) is a group of conditions 

3 a newborn can have if the newborn was exposed to 

4 drugs, including opioids while in the womb before 

5 birth. 

6 (2) According to a report of the Government 

7 Accountability Office (referred to in this section as 

8 the ‘‘GAO report’’) symptoms of NAS include irrita9 bility, loud crying, stiffness, sweating, vomiting, di10 arrhea, poor feeding, seizures, and respiratory dis11 tress. 

12 (3) According to the GAO report, it is rec13 ommended that newborns with NAS receive a thor14 ough evaluation and specialized and innovative treat15 ment, when warranted. 

16 (4) According to the GAO report, there is a 

17 program gap of available treatment programs for 

18 both pregnant women and newborns with NAS. 

19 (5) According to the GAO report, newborns 

20 with NAS stayed in the hospital on average 16 days 

21 with an average hospital bill of $53,000. 

22 (6) According to GAO reports, NAS has more 

23 than quadrupled in the past decade, increasing from 

24 1.2 per 1,000 hospital births per year in 2000 to 5.8 

25 per 1,000 hospital births per year in 2012; and some 

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1 regional studies have reported much higher inci2 dences. 

3 (7) Addressing the treatment of infants diag4 nosed with NAS will take innovative, specialized, 

5 and collaborative efforts. 

6 (8) In July 2016, Congress passed, and the 

7 President signed into law, the Comprehensive Addic8 tion and Recovery Act of 2016 (Public Law 114– 

9 198), which includes provisions that call for exam10 ining how infants with NAS are cared for (including 

11 available options through State Medicaid programs), 

12 assessing the different medical care models and set13 tings to treat NAS, and prioritizing finding best 

14 practices for treating infants with NAS. 

15 SEC. 3. MEDICAID STATE PLAN OPTION TO ENTER INTO 

16 PROVIDER AGREEMENTS WITH RESIDENTIAL 

17 PEDIATRIC RECOVERY CENTERS. 

18 (a) STATE PLAN AMENDMENT.—Section 1902(a) of 

19 the Social Security Act (42 U.S.C. 1396a(a)) is amend20 ed— 

21 (1) in paragraph (82), by striking ‘‘and’’ after 

22 the semicolon; 

23 (2) in paragraph (83), by striking the period at 

24 the end and inserting ‘‘; and’’; and 

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1 (3) by inserting after paragraph (83), the fol2 lowing new paragraph: 

3 ‘‘(84) provide, at the option of the State, for 

4 making medical assistance available on an inpatient 

5 or outpatient basis at a residential pediatric recovery 

6 center (as defined in subsection (nn)) for infants 

7 who are under 1 year of age with neonatal absti8 nence syndrome and their families.’’. 

9 (b) RESIDENTIAL PEDIATRIC RECOVERY CENTER

10 DEFINED.—Section 1902 of such Act (42 U.S.C. 1396a) 

11 is amended by adding at the end the following new sub12 section: 

13 ‘‘(nn) RESIDENTIAL PEDIATRIC RECOVERY CENTER

14 DEFINED.—For purposes of section 1902(a)(84), the 

15 term ‘residential pediatric recovery center’ means a center 

16 or facility that furnishes items and services for which med17 ical assistance is available under the State plan to infants 

18 who are under 1 year of age with the diagnosis of neonatal 

19 abstinence syndrome without any other significant medical 

20 risk factors and to the families of such infants.’’. 

21 (c) EFFECTIVE DATE.—The amendments made by 

22 this section take effect on October 1, 2017, and shall apply 

23 to medical assistance furnished on or after that date with24 out regard to whether or not final regulations to carry out 

25 such amendments have been promulgated by such date. 

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1 SEC. 4. SENSE OF CONGRESS. 

2 It is the sense of Congress that residential pediatric 

3 recovery centers (as defined in section 1902(nn) of the So4 cial Security Act, as added by section 3(b)) should offer 

5 counseling and other services to mothers (and other appro6 priate family members and caretakers) of infants receiving 

7 treatment at such centers. Such services may include the 

8 following: 

9 (1) Counseling or referrals for services. 

10 (2) Activities to encourage mother-infant bond11 ing. 

12 (3) Training on caring for such infants. 

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