Federal Government Shutdown Updates
The federal government shut down October 1, not seeing another path forward after votes failed on both a House Republican and Democratic Continuing Resolution (CR). The US Department of Health and Human Services (HHS) have outlined their objectives during this government shutdown in a contingency plan linked here.
Read below for updates on what the legislative situation means for you and your agency.
Telehealth Flexibilities Ended September 30th
Amongst other things, this means that telehealth flexibilities (including those applicable to the face-to-face (F2F) encounter) have expired on their set date of September 30. This means home care providers will have to operate without telehealth flexibilities and ensure all F2F encounters are in-person to comply with the coverage requirements for Medicare.
Medicare Claims Processing Hold
The shutdown will also enforce a claims processing hold. When specific legislative payment provisions (known as "extenders”) are set to expire, CMS instructs all Medicare Administrative Contractors (MACs) to place a temporary hold on claims. This routine measure, usually lasting up to 10 business days, helps ensure that Medicare payments remain accurate and comply with statutory requirements. Because of the 14-day payment floor, the hold is expected to have minimal impact on providers. Providers may continue to submit claims as usual during this period, but payments will be delayed until the hold is lifted.
Because this government shutdown is at the federal—not state—level, state Medicaid agencies are expected to remain open and operational, allowing providers to continue working with state staff as usual. However, while routine business should proceed, some delays may occur in other areas due to the limited availability of CMS staff. This could impact the processing of state plan amendments, waivers, or responses to state inquiries about policy and operational guidance.
Federal Surveys
Medicare certification and recertification surveys for home health providers may be affected during the government shutdown, with some surveys potentially delayed or not conducted at all. Complaint surveys may still proceed, depending on their severity and whether the state or CMS determines they are necessary to protect patient safety. The only federal surveys that will continue during the shutdown are complaint investigations and those involving potential Immediate Jeopardy (IJ) situations.
CMS Administrative Delays
Due to reduced CMS staffing during the government shutdown, providers may experience delays in Medicare and Medicaid enrollments, appeals processing, and other administrative functions. The shutdown could also delay the release of the CY 2026 Home Health Final Rule.
E-Verify Unavailable
E-Verify is currently unavailable due to a lapse in appropriations for the Department of Homeland Security and a lapse in the statutory authority for the program. During this period, employers are unable to access their E-Verify accounts, and customer support services are not operational. However, employers are still required to complete and retain Form I-9, Employment Eligibility Verification, within the mandated timeframe for each individual hired to work for pay in the United States. More information can be found at this link.
|
Print Page
Email to a Friend
