With the recent federal government shutdown and resulting lapse in funding, the Centers for Medicare & Medicaid Services (CMS) has indicated that Medicare operations will continue and Medicaid has sufficient funding through the first quarter of FY 2026. Essential functions, such as CHIP and program integrity activities, will also remain in place.
However, CMS has announced that certain agency operations—including policy development, rulemaking, oversight, and outreach—will be slowed or suspended during the shutdown. A number of health programs and temporary payment provisions have also expired with the lapse in federal funding.
Additionally, physicians should be aware that several COVID-era flexibilities, including most Medicare telehealth services, have expired. Telehealth coverage is now largely limited to pre-pandemic rules, with a few exceptions such as certain behavioral health services. During the shutdown, patients can no longer receive telehealth services at home, and audio-only services will not be permitted.
KMA along with its national partners are monitoring the situation, including any potential impacts on Medicare claims processing and physician payment, and will continue to update members as more information becomes available.
For more details on the federal government shutdown and its impact on healthcare, members are encouraged to review the information provided by the American Medical Association.