I 

108TH CONGRESS 

1ST SESSION H. R. 78

To amend title XVIII of the Social Security Act to require hospitals reimbursed under the Medicare system to establish and implement security 

procedures to reduce the likelihood of infant patient abduction and baby 

switching, including procedures for identifying all infant patients in the 

hospital in a manner that ensures that it will be evident if infants 

are missing from the hospital. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 7, 2003

Ms. JACKSON-LEE of Texas introduced the following bill; which was referred 

to the Committee on Ways and Means, and in addition to the Committees 

on the Judiciary and Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL

To amend title XVIII of the Social Security Act to require 

hospitals reimbursed under the Medicare system to establish and implement security procedures to reduce the 

likelihood of infant patient abduction and baby switching, 

including procedures for identifying all infant patients 

in the hospital in a manner that ensures that it will 

be evident if infants are missing from the hospital.

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 ‘‘Infant Protection and 

3 Baby Switching Prevention Act of 2003’’. 

4 SEC. 2. MEDICARE AND MEDICAID PAYMENTS TO HOS5 PITALS CONTINGENT ON IMPLEMENTATION 

6 OF SECURITY PROCEDURES REGARDING IN7 FANT PATIENT PROTECTION AND BABY 

8 SWITCHING. 

9 (a) AGREEMENTS WITH HOSPITALS.—Section 

10 1866(a)(1) of the Social Security Act (42 U.S.C. 

11 1395cc(a)(1)) is amended—

12 (1) in subparagraph (R), by striking ‘‘and’’ at 

13 the end; 

14 (2) in subparagraph (S), by striking the period 

15 at the end and inserting ‘‘, and’’, and 

16 (3) by inserting after subparagraph (S) the fol17 lowing new subparagraph: 

18 ‘‘(T) in the case of hospitals and critical access 

19 hospitals that provide neonatal or infant care, to 

20 have in effect security procedures that meet stand21 ards established by the Secretary (in consultation 

22 with appropriate organizations) to reduce the likeli23 hood of infant patient abduction and baby switching, 

24 including standards for identifying all infant pa25 tients in the hospital in a manner that ensures that 
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1 it will be evident if infants are missing from the hos2 pital.’’. 

3 (b) REGULATIONS.—

4 (1) IN GENERAL.—In promulgating regulations 

5 under subparagraph (T) of section 1866(a)(1) of 

6 such Act (42 U.S.C. 1395cc(a)(1)), as added by sub7 section (a), the Secretary of Health and Human 

8 Services shall—

9 (A) consult with various organizations rep10 resenting consumers, appropriate State and 

11 local regulatory agencies, hospitals, and critical 

12 access hospitals, 

13 (B) take into account variations in size 

14 and location of hospitals and critical access hos15 pitals, and the percentage of overall services 

16 furnished by such hospitals and critical access 

17 hospitals that neonatal care and infant care 

18 represent, and 

19 (C) promulgate specific regulations that 

20 address each size and type of hospital covered. 

21 (2) DEADLINE FOR PUBLICATION.—Not later 

22 than 12 months after the date of the enactment of 

23 this Act, the Secretary shall publish the regulations 

24 required under paragraph (1). In order to carry out 

25 this requirement in a timely manner, the Secretary 
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1 may promulgate regulations that take effect on an 

2 interim basis, after notice and pending opportunity 

3 for public comment. 

4 (c) PENALTIES.—

5 (1) AMOUNT OF PENALTY.—A hospital that 

6 participates in the Medicare program under title 

7 XVIII of the Social Security Act under an agree8 ment pursuant to section 1866 of such Act (42 

9 U.S.C. 1395cc) that commits a violation described in 

10 paragraph (2) of this subsection is subject to a civil 

11 money penalty of not more than $50,000 (or not 

12 more than $25,000 in the case of a hospital with 

13 less than 100 beds) for each such violation. 

14 (2) VIOLATION DESCRIBED.—A hospital de15 scribed in paragraph (1) commits a violation for 

16 purposes of this subsection if the hospital fails to 

17 have in effect security procedures that meet stand18 ards established by the Secretary under section 

19 1866(a)(1)(T) of such Act, as added by subsection 

20 (a), to reduce the likelihood of infant patient abduc21 tion and baby switching, including standards for 

22 identifying all infant patients in the hospital in a 

23 manner that ensures that it will be evident if infants 

24 are missing from the hospital. 
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1 (3) ADMINISTRATIVE PROVISIONS.—The provi2 sions of section 1128A of such Act (42 U.S.C. 

3 1320a–7a), other than subsections (a) and (b), shall 

4 apply to a civil money penalty under this subsection 

5 in the same manner as such provisions apply with 

6 respect to a penalty or proceeding under section 

7 1128A(a). 

8 (d) EFFECTIVE DATE.—The amendments made by 

9 this section shall take effect 18 months after the date of 

10 the enactment of this Act and apply to the entry and re11 newal of contracts under section 1866 of such Act (42 

12 U.S.C. 1395cc) on or after such date. 

13 SEC. 3. BABY SWITCHING PROHIBITED. 

14 (a) IN GENERAL.—Chapter 55 of title 18, United 

15 States Code, is amended by adding at the end the fol16 lowing: 

17 ‘‘§ 1205. Baby switching 

18 ‘‘(a) Whoever being in interstate commerce knowingly 

19 alters or destroys an identification record of a newborn 

20 patient with the intention that the newborn patient be 

21 misidentified by any person shall be fined not more than 

22 $250,000 in the case of an individual and not more than 

23 $500,000 in the case of an organization, or imprisoned 

24 not more than ten years, or both. 
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1 ‘‘(b) As used in this section, the term ‘identification 

2 record’ means a record maintained by a hospital to aid 

3 in the identification of newborn patients of the hospital, 

4 including any of the following: 

5 ‘‘(1) The footprint, fingerprint, or photograph 

6 of the newborn patient. 

7 ‘‘(2) A written description of the infant. 

8 ‘‘(3) An identification bracelet or anklet put on 

9 the newborn patient, or the mother of the newborn 

10 patient, by a staff member of the hospital.’’. 

11 (b) CLERICAL AMENDMENT.—The table of sections 

12 at the beginning of chapter 55 of title 18, United States 

13 Code, is amended by adding at the end the following new 

14 item:

‘‘1205. Baby switching.’’.

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