Revision: Nov. 28, 2023, 12:29 p.m.
2024 SESSION
24-2852.1
05/06
SENATE BILL [bill number]
AN ACT relative to newborn screening for cytomegalovirus.
SPONSORS: [sponsors]
COMMITTEE: [committee]
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ANALYSIS
This bill requires newborn screening for cytomegalovirus (CMV). The bill also directs the pregnant woman's health care provider to perform an amniocentesis to confirm a congenital CMV infection under certain circumstances.
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Explanation: Matter added to current law appears in bold italics.
Matter removed from current law appears [in brackets and struckthrough.]
Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.
24-2852.1
05/06
STATE OF NEW HAMPSHIRE
In the Year of Our Lord Two Thousand Twenty Four
AN ACT relative to newborn screening for cytomegalovirus.
Be it Enacted by the Senate and House of Representatives in General Court convened:
1 Newborn Screening for Cytomegalovirus. Amend RSA 132:10-a, I and II to read as follows:
I. The physician, hospital, nurse midwife, midwife, or other health care provider attending a newborn child shall test a newborn child for metabolic disorders. Such tests shall include, but not be limited to, phenylketonuria, galactosemia, homocystinuria, maple syrup urine disease, [and] hypothyroidism, and cytomegalovirus (CMV). Additional disorders shall be added to the newborn screening panel based upon, but not limited to, the following considerations:
(a) The disorder is well-defined with a known incidence.
(b) The disorder is associated with significant morbidity and/or mortality.
(c) The disorder can be detected with a screening test that is ethical, safe, accurate, and cost-effective.
(d) Effective treatment exists for the disorder, and that early treatment, meaning before the onset of symptoms, is more effective in improving health outcomes than later treatment.
I-a. If one or more of the following signs are identified during an ultrasound, an amniocentesis shall be done to confirm a congenital CMV infection:
(a) Placental thickening.
(b) Organomegaly - abnormal enlargement of organs.
(c) Hepatomegaly – abnormal enlargement of the liver.
(d) Splenomegaly – abnormal enlargement of the spleen.
(e) Pyelectasis - dilation of the renal pelvis, the funnel-like dilated proximal part of the ureter (muscular tubes that propel urine from the kidneys to the urinary bladder) in the kidney (also a marker for Down Syndrome).
(f) Megaloureter – abnormal dilation of the ureter.
(g) Ascites - gastroenterological term for an accumulation of fluid in the peritoneal cavity (is a potential space between the parietal peritoneum and visceral peritoneum; that is, the two membranes that separate the organs in the abdominal cavity from the abdominal wall).
(h) Fetal hydrops - accumulation of fluid in the fetal compartments.
(i) Abnormality of amniotic fluid.
(j) Microcephaly – small head circumference, more than two standard deviations smaller than average.
(k) Cerebral ventriculomegaly – dilation of the lateral ventricles of the brain.
(l) Intracranial calcifications - the build-up of calcium salts in the soft tissue of the brain.
(m) Hyperdense image in thalamic arteries.
(n) Periventricular echodensities.
(o) Hepatic echodensities.
(p) Intestinal echodensities.
(q) Cystic structures in the germinal zone.
I-b. If a pregnant woman is diagnosed with CMV during pregnancy, her doctor shall perform an amniocentesis to determine whether congenital CMV has passed to the unborn baby.
II. Notwithstanding any provision of law to the contrary, the commissioner of the department of health and human services shall establish fees, pursuant to RSA 541-A, to be paid directly by hospitals in their entirety, acknowledging that fees may be offset by reimbursement from commercial insurance, Medicaid, or other payors, paid to hospitals for the tests required under [paragraph] paragraphs I, I-a, and I-b. Nothing in this section is intended to prescribe the reimbursement method or the reimbursement level from a payor. The commissioner shall structure these fees to be reimbursable without out of pocket cost to the patient pursuant to 45 C.F.R. 147.130. All such fees shall be paid into the newborn screening fund, hereby established in the state treasury. Moneys from the newborn screening fund established under this section shall be nonlapsing and shall be continually appropriated for use by the department to cover laboratory analysis and related newborn screening program costs.