The federal government shut down on Oct. 1 as lawmakers failed to reach a funding agreement. According to contingency plans from the Centers for Medicare and Medicaid Services (CMS), operations such as claims processing for Medicare, Medicaid and the Children's Health Insurance Program will continue. The agency has announced that Federal Marketplace activities like eligibility verification and activities related to Health Care Fraud and Abuse Control and the Center for Medicare and Medicaid Innovation will also continue without pause.

CMS is expected to furlough nearly half its staff, maintaining 53% of its workforce to carry out essential programs. Disruptions of the following agency activities are likely throughout the course of the government shutdown:

• Health care facility survey and certification.
• Policy development and rulemaking.
• Contract oversight.
• Outreach and education.
• Beneficiary casework.

Learn more at the CMS website.

Funding for several key health programs also expired as of Sept. 30, including community health centers, the National Health Service Corps, and teaching health centers with graduate medical education programs, among others.

Telehealth flexibilities in Medicare have also lapsed, resulting in the following changes:

• Geographic restrictions have returned, limiting telehealth services to rural areas as they were before the COVID-19 Public Health Emergency.
• "Originating sites" are now required, so Medicare patients will no longer be able to receive telehealth services in their homes.
• Audio-only services for Medicare patients have expired.
• The Acute Hospital Care at Home program has lapsed.

Congress has made funding and policies retroactive in past government shutdowns. However, since the likelihood and duration of the shutdown are unknown, clinicians should consider adjusting their patient schedules for telehealth services.

The College remains committed to ensuring patients have reliable and continuous access to telehealth services. The ACC Advocacy team is closely monitoring developments and will provide additional updates as they become available.

ACC Advocacy will continue to push for legislation to make telehealth flexibilities permanent. The Creating Opportunities Now For Necessary and Effective Care Technologies (CONNECT) For Health Act (H.R. 4206/S. 1261) is just one of the bills the ACC will be advocating for at this year's Legislative Conference, kicking off this Sunday, Oct. 5. ACC members are encouraged to send messages to their lawmakers highlighting how telehealth services make high-quality care more accessible to their patients.

Keywords: Centers for Medicare and Medicaid Services, U.S., Medicaid, Medicare, Federal Government, ACC Advocacy, Telemedicine