Bill Proposes Enabling Same-Day Access to Physical and Mental Health Care for Kids on Medicaid

Lawmakers have introduced a new bill to Congress that would enable children with Medicaid to access physical and behavioral health care appointments on the same day.

Dubbed the Improving CARE for Youth Act, the bill aims to improve access to behavioral health services for pediatric patients. 

Congressman Dr. Neal Dunn (R-FL) and Congresswoman Angie Craig (Minn.-D) introduced the bill to the House on Tuesday.

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Presently, providers can only bill once per day for Medicaid patients. This bill would amend the Social Security Act to allow primary care doctors who want to refer a child to a behavioral health provider on their team to do so and have both visits reimbursed.

“Our youth’s mental health is worse than it’s ever been, especially following the destructive COVID-19 lockdowns. Protecting the future of the youth in our country is too important to be hindered by a Medicaid billing restriction,” Dunn said in a statement. “Fixing same-day billing for Medicaid beneficiaries may seem like a small change, but it will have a big impact. We must ensure all children have access to the quality care they need.”

There has been an increased focus from lawmakers and the medical community on integrating physical and behavioral health care.

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In January, the Centers for Medicare and Medicaid Services (CMS) announced a new program called the Innovation in Behavioral Health (IBH) Model. This model aims to connect adults with mental health conditions or substance use disorders to physical, behavioral, and social supports and primary care providers.

While many of these efforts are focused on the adult population, the pediatric mental health crisis continues to soar. In 2021, 42% of high school students said they felt sad or hopeless, and 29% said they experienced poor mental health, according to the CDC’s Youth Risk Behavior Surveillance Data and Summary Report.

Pediatricians are often the first health care providers to see children and teens presenting with behavioral health concerns. Still, some providers are focusing on bringing the collaborative care model to younger patients. For example, virtual pediatric behavioral health company Fort recently integrated with more than 450 primary care providers in New Jersey and Pennsylvania through a partnership with Advocate.

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