Improving CARE for Youth Act
- Sponsor
- Rep. Dunn, Neal P. [R-FL-2]
- Committees
- Energy and Commerce Committee (primary)
- Last action
- Jul 22, 2026
Bottom line
The bill aims to improve access to integrated physical and behavioral healthcare for Medicaid beneficiaries by removing a federal barrier to same-day billing for these services.
What it actually does
This bill amends title XIX of the Social Security Act to prohibit state Medicaid plans from denying payment for mental health, substance use disorder, or primary care services solely because they are furnished on the same day. It defines these as 'same-day qualifying services' when provided by the same or different practitioners within the same outpatient facility, including via telehealth.
Proponents argue
Proponents argue that this bill removes a significant administrative and financial barrier to integrated care, allowing Medicaid beneficiaries, especially youth, to receive comprehensive physical and mental health services more efficiently. They contend that co-locating and co-billing these services encourages holistic treatment, reduces stigma associated with mental health care, and improves overall health outcomes by addressing both physical and behavioral health needs simultaneously, leading to earlier intervention and better management of chronic conditions.
Opponents contend
Opponents might argue that while the intent is good, this bill could lead to increased Medicaid expenditures without clear evidence of cost-effectiveness or improved outcomes, potentially straining state budgets. Some may also raise concerns about the potential for fraud or abuse if not properly overseen, or administrative complexities in ensuring appropriate billing for multiple services on the same day, especially across different practitioners.
The bill is exceptionally short and clear, allowing for quick comprehension of its direct impact on Medicaid policy.
Section 2(a) and 2(b)
Mandating Medicaid Coverage for Same-Day Primary Care and Behavioral Health Services
This provision amends Section 1902(a) of the Social Security Act to prevent state Medicaid plans from prohibiting payment for mental health services, substance use disorder services, or primary care services if they are furnished to an individual on the same day and would otherwise be covered. It defines 'same-day qualifying service' to include instances where a primary care service and a mental health or substance use disorder service are provided to an individual on the same day, by the same or different practitioners, within the same physician's office, Federally qualified health center, rural health clinic, or other outpatient facility, including through telehealth.
Supporters argue
Supporters argue that this provision directly addresses a long-standing barrier to integrated care, which is crucial for treating individuals with co-occurring physical and mental health conditions. They believe it will streamline care delivery, reduce the need for multiple appointments, and encourage a more holistic approach to patient health, ultimately leading to better outcomes and potentially reducing emergency room visits or more intensive care later.
Critics contend
Critics might express concern that mandating same-day billing could lead to 'upcoding' or inappropriate billing practices if not carefully monitored, potentially increasing costs for state Medicaid programs without a guaranteed improvement in quality of care. They might also argue that states should retain flexibility in their billing policies to manage their budgets and tailor programs to local needs.
Tradeoffs
The bill balances the goal of improving access to integrated care and reducing administrative burdens for providers against potential concerns about increased state Medicaid expenditures and the need for robust oversight to prevent billing abuses.