Government Shutdown: Physician and Patient Impact

Beyond the economic impact on your patients who are federal employees, there are a few key points that Montgomery County Medical Society would like you to know as we are in the midst of the shutdown period.

As of October 1:

• Commercial payor coverage and payments will not be impacted by the shutdown.  
• Centers for Medicare and Medicaid Services (CMS) retains 53% of its staff to continue essential operations, while 47% of agency staff are being furloughed (i.e., temporarily on unpaid leave). CMS expects slowdowns or suspensions of the following agency activities:
  • health care facility survey and certification,
  • policy development and rulemaking,
  • contract oversight,
  • outreach and education, and
  • beneficiary casework.

 

• During the shutdown, the AMA is monitoring any potential delays in Medicare claims processing or other Medicare payment problems that could result from federal staffing reductions at CMS, including during the shutdown. Physicians and medical practice staff who experience Medicare payment delays or other obstacles that could be tied to reduced staffing levels at the agency or its Medicare Administrative Contractors (MACs) are asked to inform AMA advocacy staff of these problems by emailing ama.advocacy@ama-assn.org and including the subject heading “Medicare Payment Delay.”

 

• Medicare pandemic-era flexibilities on telehealth ended as Congress failed to extend them. The broad “anywhere, including the home” rule expired Sept 30.

 

• Medicaid telehealth is not affected at this time.

 

• Behavioral/mental health telehealth retains its special protections, but the in-person visit requirement—which had been delayed—kicks back in today for professionals and hospital-at-home staff (RHC/FQHC behavioral telehealth in-person requirement delayed to Jan 1, 2026). Audio-only for behavioral health remains allowed.

 

• Federally Qualified Health Clinics (FQHCs): their temporary ability to bill like PFS distant sites for non-behavioral telehealth was extended only through Dec 31, 2025 (CMS has proposed, but not finalized, another year). Plan for changeover if no final rule extends this.

 

• Medicare Advantage plans can be more permissive; so check plan rules since MA may continue broader telehealth even if traditional Medicare tightens.

 

• For Tricare, on-base care is suspended as of today. In-office care is unaffected at this time.

 

MCMS and MedChi will continue to monitor this evolving situation at the federal level, and inform you as soon as possible about any changes that will impact your practice of medicine.