Committee substitute advances after debate over newborn cardiac screening language; pediatricians warn of harms

Lawmakers advanced a committee substitute to House Bill 76 after a contentious hearing that split clinicians, family advocates and several committee members.

The substitute removes language that had been interpreted as mandating immediate electrocardiograms or echocardiograms for newborns and instead instructs that further testing be guided by the professional judgment of the treating provider. The House committee recorded a do-not-pass on the original bill and a do-pass on the committee substitute by a 3–2 vote.

Supporters said the substitute keeps screening questions intended to raise awareness of serious congenital heart conditions and leaves diagnostic decisions to clinicians. “That’s the intent of this bill — to prevent the Farlanders’ experience,” a bill sponsor said, referencing testimony from a family whose child had an undetected heart defect for years and required hundreds of medical visits.

Pediatric specialists told the committee the substitute still risks harm and system strain. “This proposal is extremely concerning to all of us,” said Dr. Sergio Bartekian, one of only a handful of pediatric interventional cardiologists in the state, testifying that much of the questionnaire wording mirrors tools for older children and athletes rather than newborn screening. Dr. Bartekian said the amended text “would have bogged down the system” if it had mandated tests and that clinicians already follow medical judgment for further evaluation.

Dr. Melissa Mason, a general pediatrician practicing in Albuquerque, warned the screening questions would pick up many physiologic, normal findings in newborns and could lead to a large number of follow-up studies. “If we use those questions…we’re gonna pick up a whole lot of physiologic or normal holes in the heart that then have to be followed,” she said, adding concern that nurse practitioners and physician assistants in parts of the state might order tests more readily if the statute is unclear.

Clinicians also raised cost and access concerns for families in rural communities. Committee members asked whether Medicaid would cover transportation or air ambulance flights if a provider referred an infant for echocardiography in another city; witnesses and the sponsor replied that coverage depends on Medicaid policy and that decisions about urgent transport remain clinical judgments.

Family advocates and at least one parent who testified said the measure is intended to help catch otherwise missed congenital heart disease earlier. “We are not trying to place harm on families, but to bring awareness to families,” said Bob Farlander, who described his son’s prolonged, undetected heart condition.

The committee took several procedural steps during the hearing: it adopted a committee substitute, declined a motion to table (vote failed), then voted 3–2 to recommend a do-not-pass on the original House Bill 76 and a do-pass on the committee substitute. Several committee members said they had received large volumes of correspondence and that the substitute had been changed late in the process, limiting some public review.

What advanced is a substitute that removes explicit mandates for electrocardiogram/echocardiogram testing and relies on provider discretion, while retaining a screening questionnaire intended to flag family history or red flags that might prompt further evaluation.

Lawmakers and clinicians said the revised language aims to balance early detection with clinical judgment, but pediatric specialists said they would prefer guidance crafted in partnership with state pediatric cardiology and pediatric societies.

Votes at a glance
- Motion to adopt committee substitute: adopted (committee substitute adopted; roll call not specified).
- Motion to table committee substitute: failed (2 in favor, 3 opposed).
- Final committee action: Do not pass on House Bill 76; Do pass on committee substitute for HB76 (committee vote: 3 in favor, 2 opposed).

The substitute will move on in the legislative process according to committee procedure; the transcript shows the measure will return to later floor action.