I 
108TH CONGRESS 
1ST SESSION 
H. R. 78
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 
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 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 2003’’. 
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 (R), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (S), by striking the period 
at the end and inserting ‘‘, and’’, and 
(3) by inserting after subparagraph (S) the fol-
lowing new subparagraph: 
‘‘(T) in the case of hospitals and critical access 
hospitals that 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 the regulations 
required under paragraph (1). In order to carry out 
this requirement in a timely manner, the Secretary
may promulgate regulations that take effect on an 
interim basis, after notice 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, as added by subsection 
(a), to reduce the likelihood of infant patient abduc-
tion and baby switching, including standards 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.
(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. 3. BABY SWITCHING PROHIBITED. 
(a) IN GENERAL.—Chapter 55 of title 18, United 
States Code, is amended by adding at the end the fol-
lowing: 
‘‘§ 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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