I 

118TH CONGRESS 

2D SESSION H. R. 8839 

To require the Secretary of Health and Human Services to issue guidance 

to States on best practices for screening and treatment of congenital 

syphilis under Medicaid and the Children’s Health Insurance Program. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 26, 2024 

Ms. CARAVEO (for herself, Mr. CISCOMANI, Ms. NORTON, Ms. CLARKE of New 

York, Mr. CARSON, and Mr. COHEN) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To require the Secretary of Health and Human Services 

to issue guidance to States on best practices for screening and treatment of congenital syphilis under Medicaid 

and the Children’s Health Insurance Program. 

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 ‘‘Maternal and Infant 

5 Syphilis Prevention Act’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) In 2022, there were 207,255 total syphilis 

2 cases in the United States, representing an 80 per3 cent increase since 2018 and continuing a decades4 long upward trend. 

5 (2) Untreated, syphilis can seriously damage 

6 the heart and brain and can cause blindness, deaf7 ness, and paralysis. 

8 (3) The increased rise in syphilis cases is caus9 ing the rise in congenital syphilis with more than 

10 3,700 cases documented among newborns in 2022, 

11 more than 10 times the number diagnosed in 2012. 

12 (4) When transmitted during pregnancy, con13 genital syphilis can cause miscarriage, lifelong med14 ical issues, and infant death. Congenital syphilis can 

15 present health issues for babies at birth, including 

16 neonatal death, meningitis, anemia, and problems 

17 with the spleen and liver. If not treated, congenital 

18 syphilis can cause bone and joint problems, vision 

19 and hearing problems, issues with the nervous sys20 tem, and developmental delays. 

21 (5) High incidence rates of congenital syphilis 

22 are often due to lack of timely testing or inadequate 

23 treatment during pregnancy. Timely syphilis testing 

24 and treatment during pregnancy might be able to 


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1 prevent almost 90 percent of congenital syphilis 

2 cases. 

3 (6) Requirements for syphilis screening among 

4 pregnant women varies by State. The majority of 

5 States require syphilis screening in the first visit, 

6 significantly less States require syphilis screenings 

7 during the third trimester or at delivery. 

8 (7) Screening during the third trimester and at 

9 delivery can lead to earlier detection of congenital 

10 syphilis and prevent adverse health outcomes for 

11 mothers and newborn infants. 

12 (8) Increased awareness and education are crit13 ical in reducing syphilis among pregnant women to 

14 prevent congenital syphilis. 

15 SEC. 3. GUIDANCE TO STATES AND TECHNICAL ASSIST16 ANCE UNDER MEDICAID AND CHIP. 

17 (a) IN GENERAL.—Not later than 12 months after 

18 the date of enactment of this section, the Secretary shall 

19 issue guidance to State Medicaid agencies on best prac20 tices with respect to actions that States may take, includ21 ing by using waivers under section 1115 of the Social Se22 curity Act (42 U.S.C. 1315) and authorities under title 

23 XIX of such Act (42 U.S.C. 1396 et seq.) and title XXI 

24 of such Act (42 U.S.C. 1397aa et seq.), for the following 

25 purposes: 


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1 (1) Improving access to expand syphilis screen2 ing for pregnant women and babies. 

3 (2) Best practices for educating medical profes4 sionals and pregnant women with respect to syphilis. 

5 (3) Strategies for integrating telehealth services 

6 and training for providers and patients on the use 

7 of telehealth, including working with interpreters to 

8 furnish health services and providing resources with 

9 respect to congenital syphilis in multiple languages. 

10 (4) Best practices for increasing testing for 

11 syphilis in the third trimester and at delivery. 

12 (5) Improving treatment for syphilis and con13 genital syphilis. 

14 (b) DEFINITIONS.—In this section: 

15 (1) MEDICAID.—The term ‘‘Medicaid’’ means 

16 the program established under title XIX of the So17 cial Security Act (42 U.S.C. 1396 et seq.). 

18 (2) SECRETARY.—The term ‘‘Secretary’’ means 

19 the Secretary of Health and Human Services. 

20 (3) STATE.—The term ‘‘State’’ has the mean21 ing given such term in section 1101(a)(1) of the So22 cial Security Act (42 U.S.C. 1301(a)(1)) for pur23 poses of titles XIX and XXI of such Act. 

24 (c) REPORT TO CONGRESS.—Not later than 2 years 

25 after the date of the enactment of this Act, the Secretary 


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1 shall submit to the Committee on Energy and Commerce 

2 of the House of Representatives and the Committee on 

3 Health, Education, Labor and Pensions of the Senate, and 

4 shall make publicly available, a report analyzing the imple5 mentation by States of the best practices described in sub6 section (a). 

Æ 


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