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Union Calendar No. 433 

114TH CONGRESS 

2D SESSION H. R. 4978 

[Report No. 114–559] 

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. 

IN THE HOUSE OF REPRESENTATIVES 

APRIL 18, 2016 

Mr. JENKINS of West Virginia (for himself, Mrs. BUSTOS, Mr. COSTELLO of 

Pennsylvania, Ms. KUSTER, Mrs. WAGNER, Mr. POLIQUIN, and Mr. 

WOMACK) introduced the following bill; which was referred to the Committee on Energy and Commerce 

MAY 10, 2016 

Additional sponsors: Mr. ROGERS of Kentucky, Mrs. BLACK, Ms. MCSALLY, 

Mr. RYAN of Ohio, Ms. KAPTUR, Mrs. HARTZLER, Mr. ROKITA, Mr. KILMER, and Mr. TURNER

MAY 10, 2016 

Reported with amendments, committed to the Committee of the Whole House 

on the State of the Union, and ordered to be printed 

[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on April 18, 2016] 


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A BILL 

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. 


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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 ‘‘Nurturing And Sup5 porting Healthy Babies Act’’ or as the ‘‘NAS Healthy Ba6 bies Act’’. 

7 SEC. 2. GAO REPORT ON NEONATAL ABSTINENCE SYN8 DROME (NAS). 

9 (a) IN GENERAL.—Not later than one year after the 

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

11 of the United States shall submit to the Committee on En12 ergy and Commerce of the House of Representatives and 

13 the Committee on Finance and the Committee on Health, 

14 Education, Labor and Pensions of the Senate a report on 

15 neonatal abstinence syndrome (in this section referred to 

16 as ‘‘NAS’’) in the United States. 

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

18 Such report shall include information on the following: 

19 (1) The prevalence of NAS in the United States, 

20 including the proportion of children born in the 

21 United States with NAS who are eligible for medical 

22 assistance under State Medicaid programs under title 

23 XIX of the Social Security Act at birth and the costs 

24 associated with NAS through such programs. 


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1 (2) The services for which coverage is available 

2 under State Medicaid programs for treatment of in3 fants with NAS. 

4 (3) The settings (including inpatient, outpatient, 

5 hospital-based, and other settings) for the treatment of 

6 infants with NAS and the reimbursement methodolo7 gies and costs associated with such treatment in such 

8 settings. 

9 (4) The prevalence of utilization of various care 

10 settings under State Medicaid programs for treatment 

11 of infants with NAS and any Federal barriers to 

12 treating such infants under such programs, particu13 larly in non-hospital-based settings. 

14 (c) RECOMMENDATIONS.—Such report also shall in15 clude such recommendations as the Comptroller General de16 termines appropriate for improvements that will ensure ac17 cess to treatment for infants with NAS under State Med18 icaid programs. 

19 SEC. 3. EXCLUDING ABUSE-DETERRENT FORMULATIONS OF 

20 PRESCRIPTION DRUGS FROM THE MEDICAID 

21 ADDITIONAL REBATE REQUIREMENT FOR 

22 NEW FORMULATIONS OF PRESCRIPTION 

23 DRUGS. 

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

25 1927(c)(2)(C) of the Social Security Act (42 U.S.C. 1396r– 


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1 8(c)(2)(C)) is amended by inserting before the period at the 

2 end the following: ‘‘, but does not include an abuse-deterrent 

3 formulation of the drug (as determined by the Secretary), 

4 regardless of whether such abuse-deterrent formulation is an 

5 extended release formulation’’. 

6 (b) EFFECTIVE DATE.—The amendment made by sub7 section (a) shall apply to drugs that are paid for by a State 

8 in calendar quarters beginning on or after the date of the 

9 enactment of this Act. 

10 SEC. 4. LIMITING DISCLOSURE OF PREDICTIVE MODELING 

11 AND OTHER ANALYTICS TECHNOLOGIES TO 

12 IDENTIFY AND PREVENT WASTE, FRAUD, AND 

13 ABUSE. 

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

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

16 1320a–7k) the following new section: 

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

18 OTHER ANALYTICS TECHNOLOGIES TO IDEN19 TIFY AND PREVENT WASTE, FRAUD, AND 

20 ABUSE. 

21 ‘‘(a) REFERENCE TO PREDICTIVE MODELING TECH22 NOLOGIES REQUIREMENTS.—For provisions relating to the 

23 use of predictive modeling and other analytics technologies 

24 to identify and prevent waste, fraud, and abuse with respect 

25 to the Medicare program under title XVIII, the Medicaid 


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1 program under title XIX, and the Children’s Health Insur2 ance Program under title XXI, see section 4241 of the Small 

3 Business Jobs Act of 2010 (42 U.S.C. 1320a–7m). 

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

6 under such section 4241 with respect to covered algorithms 

7 (as defined in subsection (c)), the following shall apply: 

8 ‘‘(1) NONAPPLICATION OF FOIA.—The covered al9 gorithms used or developed for purposes of such sec10 tion (including by the Secretary or a State (or an en11 tity operating under a contract with a State)) shall 

12 be exempt from disclosure under section 552(b)(3) of 

13 title 5, United States Code. 

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

15 DISCLOSURE OF INFORMATION BY STATE AGENCIES.— 

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

17 not use or disclose covered algorithms used or de18 veloped for purposes of such section except for 

19 purposes of administering the State plan (or a 

20 waiver of the plan) under the Medicaid program 

21 under title XIX or the State child health plan 

22 (or a waiver of the plan) under the Children’s 

23 Health Insurance Program under title XXI, in24 cluding by enabling an entity operating under a 

25 contract with a State to assist the State to idenVerDate Sep 11 2014 01:18 May 11, 2016 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6203 E:\BILLS\H4978.RH H4978

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1 tify or prevent waste, fraud and abuse with re2 spect to such programs. 

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

4 agency shall have in effect data security and 

5 control policies that the Secretary finds adequate 

6 to ensure the security of covered algorithms used 

7 or developed for purposes of such section 4241 

8 and to ensure that access to such information is 

9 restricted to authorized persons for purposes of 

10 authorized uses and disclosures described in sub11 paragraph (A). 

12 ‘‘(C) PROCEDURAL REQUIREMENTS.—State 

13 agencies to which information is disclosed pursu14 ant to such section 4241 shall adhere to uniform 

15 procedures established by the Secretary. 

16 ‘‘(c) COVERED ALGORITHM DEFINED.—In this section, 

17 the term ‘covered algorithm’— 

18 ‘‘(1) means a predictive modeling or other ana19 lytics technology, as used for purposes of section 

20 4241(a) of the Small Business Jobs Act of 2010 (42 

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

22 fraud, and abuse with respect to the Medicare pro23 gram under title XVIII, the Medicaid program under 

24 title XIX, and the Children’s Health Insurance Pro25 gram under title XXI; and 


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1 ‘‘(2) includes the mathematical expressions uti2 lized in the application of such technology and the 

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

4 (b) CONFORMING AMENDMENTS.— 

5 (1) MEDICAID STATE PLAN REQUIREMENT.—Sec6 tion 1902(a) of the Social Security Act (42 U.S.C. 

7 1396a(a)) is amended— 

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

9 at the end; 

10 (B) in paragraph (81), by striking the pe11 riod at the end and inserting ‘‘; and’’; and 

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

13 following new paragraph: 

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

15 for administering the State plan under this title pro16 vides assurances to the Secretary that the State agen17 cy is in compliance with subparagraphs (A), (B), and 

18 (C) of section 1128K(b)(2).’’. 

19 (2) STATE CHILD HEALTH PLAN REQUIRE20 MENT.—Section 2102(a)(7) of the Social Security Act 

21 (42 U.S.C. 1397bb(a)(7)) is amended— 

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

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

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

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


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

2 subparagraph: 

3 ‘‘(C) to ensure that the State agency in4 volved is in compliance with subparagraphs (A), 

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

6 SEC. 5. MEDICAID IMPROVEMENT FUND. 

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

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

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

10 the Fund, for expenditures from the Fund for fiscal 

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

Amend the title so as to read: ‘‘A bill 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.’’. 


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Union Calendar No. 433 

114TH CONGRESS 

2D SESSION H. R. 4978 

[Report No. 114–559] 

A BILL 

To require the Government Accountability Office to 

its treatment under Medicaid. nence syndrome (NAS) in the United States and submit to Congress a report on neonatal abstiMAY 10, 2016 

Reported with amendments, committed to the Committee 

dered to be printed of the Whole House on the State of the Union, and orVerDate Sep 11 2014 01:18 May 11, 2016 Jkt 059200 PO 00000 Frm 00010 Fmt 6651 Sfmt 6651 E:\BILLS\H4978.RH H4978

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