S. 5236Senate119th Congress (2025-2027)In Committee

Improving CARE for Youth Act

AI-Generated Summary

Updated August 11, 2026 at 5:51 AM UTC

The bill changes Medicaid rules so that if a beneficiary receives both a mental‑health visit and a primary‑care visit on the same day at the same location, the Medicaid program must cover both services. It adds language to the Social Security Act to prevent Medicaid plans from denying payment for either service when they occur together. This affects Medicaid enrollees and the state Medicaid agencies that administer the program.

Key Provisions

Adds a new rule (paragraph 91) that Medicaid plans cannot refuse to pay for a mental‑health service or a primary‑care service when the two are provided on the same day to the same individual.
Creates a definition of “same‑day qualifying service,” meaning a primary‑care visit and a mental‑health visit that occur on the same day at the same office, clinic, or outpatient facility, whether delivered by the same or different providers.

Legislative Activity

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1 earlier action

SenateIntro Referral Latest Action

Read twice and referred to the Committee on Finance.

Finance Committee

August 4, 2026

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SenateIntro Referral

Introduced in Senate

August 4, 2026

SenateIntro Referral

Read twice and referred to the Committee on Finance.

Finance Committee

August 4, 2026

Bill Text

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Introduced in SenateIssued August 4, 2026

119th CONGRESS

2d Session

S. 5236

IN THE SENATE OF THE UNITED STATES

August 4, 2026

Ms. Hassan (for herself and Mr. Cassidy) introduced the following bill; which was read twice and referred to the Committee on Finance

A BILL

To amend title XIX of the Social Security Act to ensure Medicaid coverage of mental health services and primary care services furnished on the same day.

Short title

This Act may be cited as the Improving Coordination and Access to Resources Equitably for Youth Act or the Improving CARE for Youth Act.

Medicaid coverage of mental health services and primary care services furnished on the same day

(a)

In general

Section 1902(a) of the Social Security Act (42 U.S.C. 1396a(a)) is amended—

(1)

in paragraph (89), by striking ; and and inserting a semicolon;

(2)

in paragraph (90)(C), by striking the period at the end and inserting ; and; and

(3)

by inserting after paragraph (90)(C) the following new paragraph:

(91)

not prohibit payment under the plan for a mental health service or primary care service furnished to an individual for which payment would otherwise be payable under the plan, with respect to such individual, if such service were not a same-day qualifying service (as defined in subsection (zz)).

(b)

Same-Day qualifying services defined

Section 1902 of the Social Security Act (42 U.S.C. 1396a) is amended by adding at the end the following new subsection:

(zz)

Same-Day qualifying services defined

For purposes of subsection (a)(91), the term same-day qualifying service means—

(1)

a primary care service furnished to an individual by a provider at an office, clinic, or other outpatient facility on the same day a mental health service is furnished to such individual by such provider (or another provider) at the same office, clinic, or other outpatient facility; and

(2)

a mental health service furnished to an individual by a provider at an office, clinic, or other outpatient facility on the same day a primary care service is furnished to such individual by such provider (or another provider) at the office, clinic, or other outpatient facility.