I 
119TH CONGRESS 
1ST SESSION H. R. 3866 
To require the Secretary of Health and Human Services to issue guidance 
on best practices for screening and treatment of congenital syphilis 
under Medicaid and the Children’s Health Insurance Program, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 10, 2025 
Mr. CISCOMANI (for himself and Ms. STANSBURY) introduced the following 
bill; which was referred to the Committee on Energy and Commerce, and 
in addition to the Committee on Natural Resources, 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 con-
cerned 
A BILL 
To require the Secretary of Health and Human Services 
to issue guidance on best practices for screening and 
treatment of congenital syphilis under Medicaid and the 
Children’s Health Insurance Program, and for other pur-
poses. 
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 ‘‘Maternal and Infant 
Syphilis Prevention Act’’. 
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SEC. 2. FINDINGS. 
Congress finds the following: 
(1) In 2023, there were 209,253 cases of syphi-
lis in the United States, the highest number since 
1950. This represents an 80 percent increase since 
2018 and continuing a decades-long upward trend. 
(2) Untreated, syphilis can seriously damage 
the heart and brain and can cause blindness, deaf-
ness, and paralysis. 
(3) The increased rise in syphilis cases is caus-
ing the rise in congenital syphilis with more than 
3,882, a 3 percent increase from 2022, resulting in 
252 stillbirths and 27 infant deaths. The cases are 
more than 10 times the number diagnosed in 2012. 
(4) When transmitted during pregnancy, con-
genital syphilis can cause miscarriage, lifelong med-
ical issues, and infant death. Congenital syphilis can 
present health issues for babies at birth, including 
neonatal death, meningitis, anemia, and problems 
with the spleen and liver. If not treated, congenital 
syphilis can cause bone and joint problems, vision 
and hearing problems, issues with the nervous sys-
tem, and developmental delays. 
(5) High incidence rates of congenital syphilis 
are often due to lack of timely testing or inadequate 
treatment during pregnancy. Timely syphilis testing 
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and treatment during pregnancy might be able to 
prevent almost 90 percent of congenital syphilis 
cases. 
(6) Requirements for syphilis screening among 
pregnant women varies by State. The majority of 
States require syphilis screening in the first visit, 
significantly less States require syphilis screenings 
during the third trimester or at delivery. 
(7) Screening during the third trimester and at 
delivery can lead to earlier detection of congenital 
syphilis and prevent adverse health outcomes for 
mothers and newborn infants. 
(8) Increased awareness and education are crit-
ical in reducing syphilis among pregnant women to 
prevent congenital syphilis. 
SEC. 3. GUIDANCE AND TECHNICAL ASSISTANCE UNDER 
STATE MEDICAID PROGRAMS AND STATE 
CHIPS. 
(a) IN GENERAL.—Not later than 12 months after 
the date of enactment of this section, the Secretary shall 
issue guidance to State agencies responsible for admin-
istering State Medicaid programs, State CHIPs, or both 
such programs, the Indian Health Service, Indian Tribes, 
tribal organizations, and Urban Indian organizations, on 
best practices with respect to actions that State Medicaid 
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programs, State CHIPs, Indian health programs, and 
urban Indian health programs operated by an urban In-
dian organization pursuant to a grant or contract with the 
Indian Health Service pursuant to title V of the Indian 
Health Care Improvement Act (25 U.S.C. 1601 et seq.) 
may take, including by using waivers under section 1115 
of the Social Security Act (42 U.S.C. 1315) and authori-
ties under title XIX of such Act (42 U.S.C. 1396 et seq.) 
and title XXI of such Act (42 U.S.C. 1397aa et seq.), 
for the following purposes: 
(1) Improving access to expand syphilis screen-
ing for pregnant women and babies. 
(2) Best practices for educating medical profes-
sionals and pregnant women with respect to syphilis. 
(3) Strategies for integrating telehealth services 
and training for providers and patients on the use 
of telehealth, including working with interpreters to 
furnish health services and providing resources with 
respect to congenital syphilis in multiple languages. 
(4) Best practices for increasing testing for 
syphilis in the third trimester and at delivery. 
(5) Improving treatment for syphilis and con-
genital syphilis. 
(b) DEFINITIONS.—In this section: 
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(1) INDIAN
TRIBE, 
TRIBAL
ORGANIZATION, 
URBAN INDIAN, URBAN INDIAN ORGANIZATION, IN-
DIAN
HEALTH
PROGRAM.—The 
terms 
‘‘Indian 
tribe’’, ‘‘tribal organization’’, ‘‘Urban Indian’’, 
‘‘Urban Indian organization’’, and ‘‘Indian health 
program’’ have the meanings given those terms in 
section 4 of the Indian Health Care Improvement 
Act (25 U.S.C. 1603). 
(2) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(3) STATE.—The term ‘‘State’’ has the mean-
ing given such term in section 1101(a)(1) of the So-
cial Security Act (42 U.S.C. 1301(a)(1)) for pur-
poses of titles XIX and XXI of such Act. 
(4) STATE
CHIP.—The term ‘‘State CHIP’’ 
means a State child health plan for child health as-
sistance under title XXI of the Social Security Act 
(42 U.S.C. 1397aa et seq.), and includes any waiver 
of such a plan. 
(5) STATE
MEDICAID
PROGRAM.—The term 
‘‘State Medicaid program’’ means a State plan for 
medical assistance under title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.), and includes 
any waiver of such a plan. 
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(c) REPORT TO CONGRESS.—Not later than 2 years 
after the date of the enactment of this Act, the Secretary 
shall submit to the Committee on Energy and Commerce 
of the House of Representatives, the Committee on 
Health, Education, Labor and Pensions of the Senate, and 
the Committee on Finance of the Senate, and shall make 
publicly available, a report analyzing the implementation 
of the best practices described in subsection (a). 
Æ 
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