IIB 

114TH CONGRESS 

2D SESSION H. R. 4978 

IN THE SENATE OF THE UNITED STATES 

MAY 12, 2016 

Received; read twice and referred to the Committee on Finance 

AN ACT 

To require the Government Accountability Office to submit 

to Congress a report on neonatal abstinence syndrome 

(NAS) in the United States and its treatment under 

Medicaid, and for other purposes. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Nurturing And Sup3 porting Healthy Babies Act’’ or as the ‘‘NAS Healthy Ba4 bies Act’’. 

5 SEC. 2. GAO REPORT ON NEONATAL ABSTINENCE SYN6 DROME (NAS). 

7 (a) IN GENERAL.—Not later than 1 year after the 

8 date of the enactment of this Act, the Comptroller General 

9 of the United States shall submit to the Committee on 

10 Energy and Commerce of the House of Representatives 

11 and the Committee on Finance and the Committee on 

12 Health, Education, Labor and Pensions of the Senate a 

13 report on neonatal abstinence syndrome (in this section 

14 referred to as ‘‘NAS’’) in the United States. 

15 (b) INFORMATION TO BE INCLUDED IN REPORT.— 

16 Such report shall include information on the following: 

17 (1) The prevalence of NAS in the United 

18 States, including the proportion of children born in 

19 the United States with NAS who are eligible for 

20 medical assistance under State Medicaid programs 

21 under title XIX of the Social Security Act at birth 

22 and the costs associated with NAS through such 

23 programs. 

24 (2) The services for which coverage is available 

25 under State Medicaid programs for treatment of in26 fants with NAS. 


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1 (3) The settings (including inpatient, out2 patient, hospital-based, and other settings) for the 

3 treatment of infants with NAS and the reimburse4 ment methodologies and costs associated with such 

5 treatment in such settings. 

6 (4) The prevalence of utilization of various care 

7 settings under State Medicaid programs for treat8 ment of infants with NAS and any Federal barriers 

9 to treating such infants under such programs, par10 ticularly in non-hospital-based settings. 

11 (5) What is known about best practices for 

12 treating infants with NAS. 

13 (c) RECOMMENDATIONS.—Such report also shall in14 clude such recommendations as the Comptroller General 

15 determines appropriate for improvements that will ensure 

16 access to treatment for infants with NAS under State 

17 Medicaid programs. 

18 SEC. 3. EXCLUDING ABUSE-DETERRENT FORMULATIONS 

19 OF PRESCRIPTION DRUGS FROM THE MED20 ICAID ADDITIONAL REBATE REQUIREMENT 

21 FOR NEW FORMULATIONS OF PRESCRIPTION 

22 DRUGS. 

23 (a) IN GENERAL.—The last sentence of section 

24 1927(c)(2)(C) of the Social Security Act (42 U.S.C. 

25 1396r–8(c)(2)(C)) is amended by inserting before the peVerDate Sep 11 2014 01:59 May 13, 2016 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4978.RFS H4978

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1 riod at the end the following: ‘‘, but does not include an 

2 abuse-deterrent formulation of the drug (as determined by 

3 the Secretary), regardless of whether such abuse-deterrent 

4 formulation is an extended release formulation’’. 

5 (b) EFFECTIVE DATE.—The amendment made by 

6 subsection (a) shall apply to drugs that are paid for by 

7 a State in calendar quarters beginning on or after the date 

8 of the enactment of this Act. 

9 SEC. 4. LIMITING DISCLOSURE OF PREDICTIVE MODELING 

10 AND OTHER ANALYTICS TECHNOLOGIES TO 

11 IDENTIFY AND PREVENT WASTE, FRAUD, AND 

12 ABUSE. 

13 (a) IN GENERAL.—Title XI of the Social Security Act 

14 is amended by inserting after section 1128J (42 U.S.C. 

15 1320a–7k) the following new section: 

16 ‘‘SEC. 1128K. DISCLOSURE OF PREDICTIVE MODELING AND 

17 OTHER ANALYTICS TECHNOLOGIES TO IDEN18 TIFY AND PREVENT WASTE, FRAUD, AND 

19 ABUSE. 

20 ‘‘(a) REFERENCE TO PREDICTIVE MODELING TECH21 NOLOGIES REQUIREMENTS.—For provisions relating to 

22 the use of predictive modeling and other analytics tech23 nologies to identify and prevent waste, fraud, and abuse 

24 with respect to the Medicare program under title XVIII, 

25 the Medicaid program under title XIX, and the Children’s 


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1 Health Insurance Program under title XXI, see section 

2 4241 of the Small Business Jobs Act of 2010 (42 U.S.C. 

3 1320a–7m). 

4 ‘‘(b) LIMITING DISCLOSURE OF PREDICTIVE MOD5 ELING TECHNOLOGIES.—In implementing such provisions 

6 under such section 4241 with respect to covered algo7 rithms (as defined in subsection (c)), the following shall 

8 apply: 

9 ‘‘(1) NONAPPLICATION OF FOIA.—The covered 

10 algorithms used or developed for purposes of such 

11 section (including by the Secretary or a State (or an 

12 entity operating under a contract with a State)) 

13 shall be exempt from disclosure under section 

14 552(b)(3) of title 5, United States Code. 

15 ‘‘(2) LIMITATION WITH RESPECT TO USE AND

16 DISCLOSURE OF INFORMATION BY STATE AGEN17 CIES.— 

18 ‘‘(A) IN GENERAL.—A State agency may 

19 not use or disclose covered algorithms used or 

20 developed for purposes of such section except 

21 for purposes of administering the State plan (or 

22 a waiver of the plan) under the Medicaid pro23 gram under title XIX or the State child health 

24 plan (or a waiver of the plan) under the Chil25 dren’s Health Insurance Program under title 


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1 XXI, including by enabling an entity operating 

2 under a contract with a State to assist the 

3 State to identify or prevent waste, fraud, and 

4 abuse with respect to such programs. 

5 ‘‘(B) INFORMATION SECURITY.—A State 

6 agency shall have in effect data security and 

7 control policies that the Secretary finds ade8 quate to ensure the security of covered algo9 rithms used or developed for purposes of such 

10 section 4241 and to ensure that access to such 

11 information is restricted to authorized persons 

12 for purposes of authorized uses and disclosures 

13 described in subparagraph (A). 

14 ‘‘(C) PROCEDURAL REQUIREMENTS.— 

15 State agencies to which information is disclosed 

16 pursuant to such section 4241 shall adhere to 

17 uniform procedures established by the Sec18 retary. 

19 ‘‘(c) COVERED ALGORITHM DEFINED.—In this sec20 tion, the term ‘covered algorithm’— 

21 ‘‘(1) means a predictive modeling or other ana22 lytics technology, as used for purposes of section 

23 4241(a) of the Small Business Jobs Act of 2010 (42 

24 U.S.C. 1320a–7m(a)) to identify and prevent waste, 

25 fraud, and abuse with respect to the Medicare proVerDate Sep 11 2014 01:59 May 13, 2016 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4978.RFS H4978

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1 gram under title XVIII, the Medicaid program 

2 under title XIX, and the Children’s Health Insur3 ance Program under title XXI; and 

4 ‘‘(2) includes the mathematical expressions uti5 lized in the application of such technology and the 

6 means by which such technology is developed.’’. 

7 (b) CONFORMING AMENDMENTS.— 

8 (1) MEDICAID STATE PLAN REQUIREMENT.— 

9 Section 1902(a) of the Social Security Act (42 

10 U.S.C. 1396a(a)) is amended— 

11 (A) in paragraph (80), by striking ‘‘and’’ 

12 at the end; 

13 (B) in paragraph (81), by striking the pe14 riod at the end and inserting ‘‘; and’’; and 

15 (C) by inserting after paragraph (81) the 

16 following new paragraph: 

17 ‘‘(82) provide that the State agency responsible 

18 for administering the State plan under this title pro19 vides assurances to the Secretary that the State 

20 agency is in compliance with subparagraphs (A), 

21 (B), and (C) of section 1128K(b)(2).’’. 

22 (2) STATE CHILD HEALTH PLAN REQUIRE23 MENT.—Section 2102(a)(7) of the Social Security 

24 Act (42 U.S.C. 1397bb(a)(7)) is amended— 


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1 (A) in subparagraph (A), by striking ‘‘, 

2 and’’ at the end and inserting a semicolon; 

3 (B) in subparagraph (B), by striking the 

4 period at the end and inserting ‘‘; and’’; and 

5 (C) by adding at the end the following new 

6 subparagraph: 

7 ‘‘(C) to ensure that the State agency in8 volved is in compliance with subparagraphs (A), 

9 (B), and (C) of section 1128K(b)(2).’’. 

10 SEC. 5. MEDICAID IMPROVEMENT FUND. 

11 Section 1941(b)(1) of the Social Security Act (42 

12 U.S.C. 1396w–1(b)(1)) is amended to read as follows: 

13 ‘‘(1) IN GENERAL.—There shall be available to 

14 the Fund, for expenditures from the Fund for fiscal 

15 year 2021 and thereafter, $5,000,000.’’. 

Passed the House of Representatives May 11, 2016. 

Attest: KAREN L. HAAS, 

Clerk. 


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