Senator Chuck Grassley (R-IA), recently sent a letter urging the Centers for Medicare and Medicaid Services (CMS) to address reported failures to provide follow-up care for children on Medicaid who have experienced suicidal thoughts or behaviors. 

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.  

Grassley stated the purpose of his letter to CMS, “CMS isn’t doing enough to follow-up with kids with suicidal behaviors, and of course I am pushing to improve their follow-up protocols.”  

The American Academy of Pediatrics recommends a follow-up within 72 hours, and the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Lifeline requires a follow-up within 24 to 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. 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.  

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.  

If you or someone you know is dealing with thoughts of suicide, 988 is the number for free and confidential support available 24 hours a day, seven days a week.