Shutdown Disrupts Medicare Telehealth, Broad HHS Furloughs

The federal government shutdown that began Oct. 1 has prompted tens of thousands of HHS furloughs across agencies including the FDA, CDC, NIH, CMS and SAMHSA, pausing grant reviews, inspections, surveillance and other nonurgent work. Two COVID‑era programs — expanded Medicare telehealth flexibilities and the Acute Care Hospital‑at‑Home initiative — expired Sept. 30 when short‑term funding lapsed, reinstating pre‑pandemic geographic and provider restrictions and triggering a CMS temporary 10‑business‑day hold on telehealth claims that has forced some hospitals to discharge or move home‑care patients back to inpatient units. CMS says Medicaid funding runs through year‑end and that Medicare and Medicaid are mandatory and generally will continue to pay claims, but administrative furloughs and back‑end disruptions could delay payments, audits and program integrity work. Many providers are cutting off telehealth for Medicare patients, holding claims pending possible retroactive payment, or continuing services without assurance of timely reimbursement, creating immediate access barriers for seniors, mental‑health patients, rural enrollees, those relying on audio‑only visits or home‑site allowances, and hospital‑at‑home participants. Democrats are demanding Congress restore expanded Affordable Care Act premium subsidies to avoid steep premium spikes for millions, while Republicans oppose tying those provisions to funding bills. Experts warn that if the shutdown persists, operational pauses and program suspensions will worsen and become harder to reverse, straining community health centers and increasing risks across the health system.