Improving CARE for Youth Act
- Sponsor
- Sen. Hassan, Margaret Wood [D-NH]
- Committees
- Finance Committee (primary)
- Last action
- Aug 4, 2026
Bottom line
The bill aims to enhance access to integrated physical and mental healthcare for Medicaid beneficiaries by removing a federal barrier to same-day service reimbursement.
What it actually does
This bill amends Title XIX of the Social Security Act to prevent state Medicaid programs from prohibiting payment for mental health services and primary care services furnished to an individual on the same day. It defines 'same-day qualifying service' to include both primary care furnished alongside a mental health service, and vice-versa, when provided by the same or different providers at the same outpatient facility.
Proponents argue
Supporters argue that this legislation will facilitate integrated care models, leading to improved health outcomes by allowing for the concurrent addressing of physical and mental health needs. They contend it will reduce administrative burdens for providers and patients, encourage earlier intervention for mental health conditions, and enhance overall patient engagement by making care more convenient.
Opponents contend
Critics might express concerns about the potential for increased Medicaid costs due to broader reimbursement, or administrative complexities for states in tracking and billing these 'same-day qualifying services' if not carefully implemented. Some may also argue that states should retain flexibility in their Medicaid program design without a federal mandate.
The bill is very concise and can be read quickly, making it accessible for immediate evaluation.
Section 2(a) and 2(b) of the bill, amending Section 1902(a) and adding Section 1902(zz) to the Social Security Act.
Mandating Medicaid Coverage for Same-Day Mental Health and Primary Care Services
This provision amends the Social Security Act to explicitly prohibit state Medicaid plans from denying payment for a mental health service or a primary care service solely because it was furnished on the same day as the other type of service. This applies when both services are provided to the same individual by the same or different providers at the same office, clinic, or other outpatient facility, thereby ensuring reimbursement for integrated care.
Supporters argue
Supporters argue that integrating mental and physical healthcare improves patient outcomes, especially for individuals with chronic conditions or co-occurring mental health disorders. This provision removes a significant financial barrier that often prevents clinics from offering comprehensive, co-located services, thereby promoting a more holistic approach to patient care and improving patient adherence.
Critics contend
Some might argue that this federal mandate could impose unfunded or underfunded costs on states, forcing them to cover services they might currently manage differently or not cover in this specific same-day context. There could also be concerns about potential for over-utilization if not properly managed without additional safeguards.
Tradeoffs
The bill balances the desire for improved patient access and integrated care models against potential increases in state Medicaid expenditures and the administrative adjustments required for state programs to comply with the new federal requirement.