I
105TH CONGRESS
2D SESSION
H. R. 4680
To amend title XVIII of the Social Security Act to require hospitals reim-
bursed 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
OCTOBER 2, 1998
Ms. JACKSON-LEE of Texas (for herself, Ms. KILPATRICK, Ms. MCKINNEY,
Mr. RUSH, Mrs. CLAYTON, Ms. MILLENDER-MCDONALD, Mr. FORD, Mr.
LAMPSON, Mr. REYES, Mr. HINOJOSA, Mr. RODRIGUEZ, Mr. GREEN, Mr.
PASTOR, and Mr. CLYBURN) introduced the following bill; which was re-
ferred to the Committee on Ways and Means, and in addition to the
Committees on Commerce, and the Judiciary, for a period to be subse-
quently 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 estab-
lish 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.
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 ‘‘Infant Protection and
Baby Switching Prevention Act of 1998’’.
SEC. 2. MEDICARE AND MEDICAID PAYMENTS TO HOS-
PITALS CONTINGENT ON IMPLEMENTATION
OF SECURITY PROCEDURES REGARDING IN-
FANT 
PATIENT 
PROTECTION 
AND 
BABY
SWITCHING.
(a) 
AGREEMENTS
WITH
HOSPITALS.—Section
1866(a)(1) of the Social Security Act (42 U.S.C.
1395cc(a)(1)) is amended—
(1) in subparagraph (S), by striking the period
at the end and inserting ‘‘, or’’, and
(2) by inserting after subparagraph (S) the fol-
lowing new subparagraph:
‘‘(T) in the case of hospitals and critical access
hospitals which provide neonatal or infant care, to
have in effect security procedures that meet stand-
ards established by the Secretary (in consultation
with appropriate organizations) to reduce the likeli-
hood of infant patient abduction and baby switching,
including standards for identifying all infant pa-
tients in the hospital in a manner that ensures that
it will be evident if infants are missing from the hos-
pital.’’.
(b) REGULATIONS.—
(1) IN GENERAL.—In promulgating regulations
under subparagraph (T) of section 1866(a)(1) of
such Act (42 U.S.C. 1395cc(a)(1)), as added by sub-
section (a), the Secretary of Health and Human
Services shall—
(A) consult with various organizations rep-
resenting consumers, appropriate State and
local regulatory agencies, hospitals, and critical
access hospitals,
(B) take into account variations in size
and location of hospitals and critical access hos-
pitals, and the percentage of overall services
furnished by such hospitals and critical access
hospitals that neonatal care and infant care
represent, and
(C) promulgate specific regulations that
address each size and type of hospital covered.
(2) DEADLINE FOR PUBLICATION.—Not later
than 12 months after the date of the enactment of
this Act, the Secretary shall publish such regula-
tions. In order to carry out this requirement in a
timely manner, the Secretary may promulgate regu-
lations that take effect on an interim basis, after no-
tice and pending opportunity for public comment.
(c) PENALTIES.—
(1) AMOUNT
OF
PENALTY.—A hospital that
participates in the Medicare program under title
XVIII of the Social Security Act under an agree-
ment pursuant to section 1866 of such Act (42
U.S.C. 1395cc) that commits a violation described in
paragraph (2) of this subsection is subject to a civil
money penalty of not more than $50,000 (or not
more than $25,000 in the case of a hospital with
less than 100 beds) for each such violation.
(2) VIOLATION
DESCRIBED.—A hospital de-
scribed in paragraph (1) commits a violation for
purposes of this subsection if the hospital fails to
have in effect security procedures that meet stand-
ards established by the Secretary under section
1866(a)(1)(T) 
of 
such 
Act 
(42 
U.S.C.
1395cc(a)(1)(T)) to reduce the likelihood of infant
patient abduction and baby switching, including
standards for identifying all infant patients in the
hospital in a manner that ensures that it will be evi-
dent if infants are missing from the hospital.
(3) ADMINISTRATIVE PROVISIONS.—The provi-
sions of section 1128A of such Act (42 U.S.C.
1320a–7a), other than subsections (a) and (b), shall
apply to a civil money penalty under this subsection
in the same manner as such provisions apply with
respect to a penalty or proceeding under section
1128A(a).
(d) EFFECTIVE DATE.—The amendments made by
this section shall take effect 18 months after the date of
the enactment of this Act and apply to the entry and re-
newal of contracts under section 1866 of such Act (42
U.S.C. 1395cc) on or after such date.
SEC. 2. BABY SWITCHING PROHIBITED.
(a) IN GENERAL.—Chapter 55 of title 18, United
States Code, is amended by adding at the end the follow-
ing:
‘‘§ 1205. Baby switching
‘‘(a) Whoever being in interstate commerce knowingly
alters or destroys an identification record of a newborn
patient with the intention that the newborn patient be
misidentified by any person shall be fined not more than
$250,000 in the case of an individual and not more than
$500,000 in the case of an organization, or imprisoned
not more than ten years, or both.
‘‘(b) As used in this section, the term ‘identification
record’ means a record maintained by a hospital to aid
in the identification of newborn patients of the hospital,
including any of the following:
‘‘(1) The footprint, fingerprint, or photograph
of the newborn patient.
‘‘(2) A written description of the infant.
‘‘(3) An identification bracelet or anklet put on
the newborn patient, or the mother of the newborn
patient, by a staff member of the hospital.’’.
(b) CLERICAL AMENDMENT.—The table of sections
at the beginning of chapter 55 of title 18, United States
Code, is amended by adding at the end the following new
item:
‘‘1205. Baby switching.’’.
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