IB 
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 Com-
mittee 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. KIL-
MER, 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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Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Nurturing And Sup-
porting Healthy Babies Act’’ or as the ‘‘NAS Healthy Ba-
bies Act’’. 
SEC. 2. GAO REPORT ON NEONATAL ABSTINENCE SYN-
DROME (NAS). 
(a) IN GENERAL.—Not later than one year after the 
date of the enactment of this Act, the Comptroller General 
of the United States shall submit to the Committee on En-
ergy and Commerce of the House of Representatives and 
the Committee on Finance and the Committee on Health, 
Education, Labor and Pensions of the Senate a report on 
neonatal abstinence syndrome (in this section referred to 
as ‘‘NAS’’) in the United States. 
(b) INFORMATION TO BE INCLUDED IN REPORT.— 
Such report shall include information on the following: 
(1) The prevalence of NAS in the United States, 
including the proportion of children born in the 
United States with NAS who are eligible for medical 
assistance under State Medicaid programs under title 
XIX of the Social Security Act at birth and the costs 
associated with NAS through such programs. 
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(2) The services for which coverage is available 
under State Medicaid programs for treatment of in-
fants with NAS. 
(3) The settings (including inpatient, outpatient, 
hospital-based, and other settings) for the treatment of 
infants with NAS and the reimbursement methodolo-
gies and costs associated with such treatment in such 
settings. 
(4) The prevalence of utilization of various care 
settings under State Medicaid programs for treatment 
of infants with NAS and any Federal barriers to 
treating such infants under such programs, particu-
larly in non-hospital-based settings. 
(c) RECOMMENDATIONS.—Such report also shall in-
clude such recommendations as the Comptroller General de-
termines appropriate for improvements that will ensure ac-
cess to treatment for infants with NAS under State Med-
icaid programs. 
SEC. 3. EXCLUDING ABUSE-DETERRENT FORMULATIONS OF 
PRESCRIPTION DRUGS FROM THE MEDICAID 
ADDITIONAL 
REBATE 
REQUIREMENT 
FOR 
NEW 
FORMULATIONS 
OF 
PRESCRIPTION 
DRUGS. 
(a) IN
GENERAL.—The last sentence of section 
1927(c)(2)(C) of the Social Security Act (42 U.S.C. 1396r– 
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8(c)(2)(C)) is amended by inserting before the period at the 
end the following: ‘‘, but does not include an abuse-deterrent 
formulation of the drug (as determined by the Secretary), 
regardless of whether such abuse-deterrent formulation is an 
extended release formulation’’. 
(b) EFFECTIVE DATE.—The amendment made by sub-
section (a) shall apply to drugs that are paid for by a State 
in calendar quarters beginning on or after the date of the 
enactment of this Act. 
SEC. 4. LIMITING DISCLOSURE OF PREDICTIVE MODELING 
AND OTHER ANALYTICS TECHNOLOGIES TO 
IDENTIFY AND PREVENT WASTE, FRAUD, AND 
ABUSE. 
(a) IN GENERAL.—Title XI of the Social Security Act 
is amended by inserting after section 1128J (42 U.S.C. 
1320a–7k) the following new section: 
‘‘SEC. 1128K. DISCLOSURE OF PREDICTIVE MODELING AND 
OTHER ANALYTICS TECHNOLOGIES TO IDEN-
TIFY AND PREVENT WASTE, FRAUD, AND 
ABUSE. 
‘‘(a) REFERENCE TO PREDICTIVE MODELING TECH-
NOLOGIES REQUIREMENTS.—For provisions relating to the 
use of predictive modeling and other analytics technologies 
to identify and prevent waste, fraud, and abuse with respect 
to the Medicare program under title XVIII, the Medicaid 
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program under title XIX, and the Children’s Health Insur-
ance Program under title XXI, see section 4241 of the Small 
Business Jobs Act of 2010 (42 U.S.C. 1320a–7m). 
‘‘(b) LIMITING DISCLOSURE
OF PREDICTIVE MOD-
ELING TECHNOLOGIES.—In implementing such provisions 
under such section 4241 with respect to covered algorithms 
(as defined in subsection (c)), the following shall apply: 
‘‘(1) NONAPPLICATION OF FOIA.—The covered al-
gorithms used or developed for purposes of such sec-
tion (including by the Secretary or a State (or an en-
tity operating under a contract with a State)) shall 
be exempt from disclosure under section 552(b)(3) of 
title 5, United States Code. 
‘‘(2) LIMITATION WITH RESPECT TO USE AND 
DISCLOSURE OF INFORMATION BY STATE AGENCIES.— 
‘‘(A) IN GENERAL.—A State agency may 
not use or disclose covered algorithms used or de-
veloped for purposes of such section except for 
purposes of administering the State plan (or a 
waiver of the plan) under the Medicaid program 
under title XIX or the State child health plan 
(or a waiver of the plan) under the Children’s 
Health Insurance Program under title XXI, in-
cluding by enabling an entity operating under a 
contract with a State to assist the State to iden-
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tify or prevent waste, fraud and abuse with re-
spect to such programs. 
‘‘(B) INFORMATION
SECURITY.—A State 
agency shall have in effect data security and 
control policies that the Secretary finds adequate 
to ensure the security of covered algorithms used 
or developed for purposes of such section 4241 
and to ensure that access to such information is 
restricted to authorized persons for purposes of 
authorized uses and disclosures described in sub-
paragraph (A). 
‘‘(C) PROCEDURAL REQUIREMENTS.—State 
agencies to which information is disclosed pursu-
ant to such section 4241 shall adhere to uniform 
procedures established by the Secretary. 
‘‘(c) COVERED ALGORITHM DEFINED.—In this section, 
the term ‘covered algorithm’— 
‘‘(1) means a predictive modeling or other ana-
lytics technology, as used for purposes of section 
4241(a) of the Small Business Jobs Act of 2010 (42 
U.S.C. 1320a–7m(a)) to identify and prevent waste, 
fraud, and abuse with respect to the Medicare pro-
gram under title XVIII, the Medicaid program under 
title XIX, and the Children’s Health Insurance Pro-
gram under title XXI; and 
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‘‘(2) includes the mathematical expressions uti-
lized in the application of such technology and the 
means by which such technology is developed.’’. 
(b) CONFORMING AMENDMENTS.— 
(1) MEDICAID STATE PLAN REQUIREMENT.—Sec-
tion 1902(a) of the Social Security Act (42 U.S.C. 
1396a(a)) is amended— 
(A) in paragraph (80), by striking ‘‘and’’ 
at the end; 
(B) in paragraph (81), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by inserting after paragraph (81) the 
following new paragraph: 
‘‘(82) provide that the State agency responsible 
for administering the State plan under this title pro-
vides assurances to the Secretary that the State agen-
cy is in compliance with subparagraphs (A), (B), and 
(C) of section 1128K(b)(2).’’. 
(2) STATE
CHILD
HEALTH
PLAN
REQUIRE-
MENT.—Section 2102(a)(7) of the Social Security Act 
(42 U.S.C. 1397bb(a)(7)) is amended— 
(A) in subparagraph (A), by striking ‘‘, 
and’’ at the end and inserting a semicolon; 
(B) in subparagraph (B), by striking the 
period at the end and inserting ‘‘; and’’; and 
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(C) by adding at the end the following new 
subparagraph: 
‘‘(C) to ensure that the State agency in-
volved is in compliance with subparagraphs (A), 
(B), and (C) of section 1128K(b)(2).’’. 
SEC. 5. MEDICAID IMPROVEMENT FUND. 
Section 1941(b)(1) of the Social Security Act (42 
U.S.C. 1396w–1(b)(1)) is amended to read as follows: 
‘‘(1) IN GENERAL.—There shall be available to 
the Fund, for expenditures from the Fund for fiscal 
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 
submit to Congress a report on neonatal absti-
nence syndrome (NAS) in the United States and 
its treatment under Medicaid. 
MAY 10, 2016 
Reported with amendments, committed to the Committee 
of the Whole House on the State of the Union, and or-
dered to be printed 
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