Grassley Pushes CMS to Provide Timely Follow Up Care for Children on Medicaid Who Have Experienced Suicidal Thoughts or Behaviors

WASHINGTON - Sen. Chuck Grassley (R-Iowa), a senior member and former chairman of the Senate Finance Committee, is urging the Centers for Medicare & Medicaid Services (CMS) to address reported failures to provide follow-up care for children on Medicaid who have experienced suicidal thoughts or behaviors. Patients with an identified suicide risk history are at 300 times greater risk of committing suicide within one week of their discharge from medical facilities.

A September Health and Human Services Office of Inspector General (HHS OIG) report discovered that, of the 258,458 unique hospitalizations or child emergency department visits for suicidal ideations or behaviors in 2023, half of the children did not receive a follow-up visit in the week following their discharge. In 21% of cases, children did not receive any follow-up visits 60 days after being discharged.

"I have long advocated for programs supporting Americans' mental health and demanded transparency from providers treating these issues," Grassley wrote. "The [HHS OIG] report is particularly alarming considering that Medicaid currently provides coverage to 27 million children, and suicide is currently the second leading factor of childhood deaths in America-increasing a staggering 166% between 2016 and 2022."

Experts from the American Academy of Pediatrics recommend a follow-up within 72 hours, and the Substance Abuse and Mental Health Services Administration's (SAMHSA) Lifeline requires a follow-up within 24- 72 hours of the initial contact.

In 2023, nearly 225,000 children aged 10-17 who were enrolled in Medicaid were hospitalized or visited the emergency department for suicidal thoughts or behaviors.

In the letter, Grassley asks CMS to share its progress in implementing the HHS OIG's recommendation, as well as explain whether the agency plans to require state Medicaid programs to ensure children are seen for a follow-up within seven days of treatment for suicidal ideations.

Read the full letter HERE and below.

February 4, 2026

VIA ELECTRONIC TRANSMISSION

Dr. Mehmet Oz

Administrator

Centers for Medicare & Medicaid Services

Dear Administrator Oz:

I'm writing today with concerns regarding a recent Department of Health and Human Services Office of Inspector General (HHS OIG) report entitled, "Most Children Enrolled in Medicaid Did Not Receive Timely Suicide-Related Followup Care." The report is particularly alarming considering that Medicaid currently provides coverage to 27 million children, and suicide is currently the second leading factor of childhood deaths in America-increasing a staggering 166% between 2016 and 2022.

I have long advocated for programs supporting Americans' mental health and demanded transparency from providers treating these issues. In 2022, I wrote to then-Department of Veterans Affairs (VA) Secretary Dennis McDonough raising concerns about the implementation of the VA Mission Act, which would ensure that veterans receive quality care in a timely manner. In 2023, I re-introduced the bipartisan Fighting Post-Traumatic Stress Disorder Act in an effort to help first responders who face long-term effects from providing emergency aid. More recently, on February 28, 2025, I wrote to then-Acting Administrator for the Centers for Medicare & Medicaid Services (CMS) Stephanie Carlton pressing for clear and accessible information on inpatient psychiatric facilities. In CMS's response, the agency stated that the Social Security Act prohibits disclosing accreditation surveys and this limited its ability to include information from inspection reports. As a result, I introduced legislation aimed at boosting transparency within psychiatric facilities by allowing the HHS Secretary to disclose hospital accreditation inspection reports.

Patients with a history of suicide are at 300 times more risk of committing suicide within one week of their discharge from medical facilities, making it crucial that they be seen for a follow-up appointment within this period. Experts from the American Academy of Pediatrics recommend a follow-up within 72 hours, the Substance Abuse and Mental Health Services Administration's (SAMHSA) Lifeline requires a follow-up within 24-72 hours of the initial contact, and the National Action Alliance for Suicide Prevention recommends a follow-up within seven days after discharge.

Alarmingly, the HHS OIG discovered that in half of the 258,458 unique hospitalizations or child emergency department visits for suicidal ideations or behaviors in 2023, children did not receive a follow-up visit in the week following being discharged. In 21 percent of cases, children did not receive any follow-up visits 60 days after being discharged, which is particularly troubling considering the risk continues months after treatment. The OIG has recommended that CMS should assist the 24 identified states, which provided less than half of children follow-up care within seven days of being treated for suicidal ideations or behaviors.

Accordingly, so Congress can conduct oversight, please answer the following questions no later than February 28, 2026:

• What steps has CMS taken to close the open recommendation from the September 2, 2025, report? Provide all records.

• Will CMS require State Medicaid programs to ensure children are seen for a follow-up within 7 days of treatment for suicidal ideations? If not, why not?

• What, if any, systems does CMS have in place for hospitals to communicate their need for additional assistance with these issues?

• Does CMS plan to develop or promote training modules for pediatricians, family physicians, and other non-behavioral providers to recognize and manage suicidal risk among children while they await specialist care? If not, why not?

Thank you for your prompt review and response. If you have any questions, please contact Tucker Akin with my Committee staff at (202) 224-5225.

Sincerely,

Charles E. Grassley

Chairman

Committee on the Judiciary

-30-

• Print
• Email
• Like
• Tweet