U.S. Sen. Angus King of Maine and a West Virginia Republican have introduced legislation aimed at ensuring Medicaid and insurance companies cover highly specialized care for babies born dependent on heroin or other opiates.

The number of babies born addicted to opiates because of exposure to the drugs while still in the womb – a condition known as neonatal abstinence syndrome, or NAS – increased fivefold nationally between 2000 and 2012, according to data from the National Institutes of Health. In Maine, roughly 1,000 newborns were addicted to or affected by drugs last year, accounting for an estimated 1 in every 12 births, according to state officials.

In response to the growing national heroin and opiate crisis, some hospitals around the country have opened “residential pediatric recovery centers” that offer specialized care to infants as they go through sometimes-severe withdrawal symptoms, as well as support and counseling for family members. But according to King’s office, those new facilities may not be eligible for reimbursement through Medicaid or other insurance programs because of a bureaucratic loophole.

The specialized care that babies born with NAS require can result in longer hospital stays and increased costs, up to more than five times the cost of treating other newborns, according to the Government Accountability Office.

A bill introduced by King, I-Maine, and Sen. Shelley Moore Capito, R-W.Va., would direct the Centers for Medicare and Medicaid Services (CMS) to create new guidelines providing a pathway for residential pediatric recovery centers to gain certification from the U.S. Department of Health and Human Services. The bill, dubbed the Cradle Act, would also stipulate that the Centers for Medicare and Medicaid Services should recognize specialized care facilities located in states that adopt their own licensing process in the absence of a federal certification process.

“When a baby is born with neonatal abstinence syndrome, the focus should be on ensuring that the child receives the highest quality, most effective care available,” King said in a statement Friday. “But too often, federal regulations stand in the way of cutting-edge treatment. By allowing CMS to cover a wider variety of care, our legislation will help ensure that babies experiencing withdrawals will have access to a greater range of treatment options that will more effectively put them on track to a happier, healthier life.”

While there are currently no residential pediatric recovery centers in Maine, King and Capito said they hope the creation of federal guidelines would encourage hospitals to create the specialized facilities. A spokeswoman for Maine Medical Center in Portland said Friday she had no information about whether the facility is considering creating the type of specialized center affected by King and Capito’s bill.

A similar measure is also pending in the U.S. House of Representatives.

During a round table on opioids Friday at Hope House Health and Living Center, a treatment center and shelter in Bangor, King said he’s also going to introduce legislation to update a federal law that limits many treatment and recovery centers to 16 beds.

King said the law was enacted in 1965 to prevent the warehousing of mental health patients who were released as a result of deinstitutionalization. He said that concern is no longer valid, and the bed limit is preventing the delivery of substance abuse treatment and recovery services to more people.


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