At 12:01 a.m. ET on October 1, 2025, the federal government shut down after Congress failed to enact funding for fiscal year 2026. Essential functions continue, but many federal activities are curtailed, and large numbers of employees are furloughed until a funding bill passes.
For health and aging services, the U.S. Department of Health & Human Services (HHS) has posted its contingency plan, including a Centers for Medicare & Medicaid Services (CMS) plan specific to Medicare, Medicaid, and survey operations.
Medicare and Medicaid
Medicare payments are part of mandatory federal spending and are expected to continue during the shutdown. CMS has indicated it will prioritize claims processing even though staffing for Medicare Administrative Contractors (MACs), call centers, and IT vendors is significantly reduced. Providers should be prepared for delays in resolving billing issues and processing of off-cycle revalidations. If your MAC requests additional documentation, you should continue to meet those deadlines unless CMS announces otherwise.
Medicaid reimbursement is funded through an advance appropriation in the Full-Year Continuing Appropriations and Extensions Act, 2025, which covers the first quarter of FY26. That means Medicaid payments should also continue for the time being. If the shutdown extends beyond that window, further congressional action will be required to sustain Medicaid funding.
MA Annual Open Enrollment will begin on October 15 as scheduled. The Medicare plan finder at Medicare.gov has already been updated with 2026 offerings.
According to the CMS lapse plan, certain outreach and education activities will cease or slow down, though there is not a lot of specifics. Engagement activities, Medicare card, and beneficiary activities and assistance will likely be affected. CMS will be operating with 50% staffing during this time.
For more information on telehealth, claims processing, and Medicare administrative contractors during this time, view this article from CMS.
Surveys and compliance
According to CMS’ plan, survey and certification activities are limited during the shutdown. Investigations of complaints alleging immediate jeopardy or serious harm to residents and patients will continue, but standard recertification surveys, initial certifications, and lower-level complaint investigations are suspended until federal appropriations are restored. Providers should remain prepared to respond to IJ-level complaints, but can expect fewer surveyor contacts in the coming weeks.
Public health reporting and deadlines
While the Centers for Disease Control and Prevention (CDC) has paused many of its data analysis and public communications functions, reporting requirements remain in place unless CMS announces otherwise. Nursing homes should continue entering respiratory illness and staff vaccination data into the National Healthcare Safety Network.
The October 1 deadline for implementation of the Hospice Outcomes and Patient Evaluation (HOPE) tool also remains in effect, with no announced extension despite the shutdown. Similarly, the calendar year 2026 Home Health Payment Rule is still expected to be finalized later this fall, though CMS acknowledges that some policymaking may be delayed.
What’s next from Washington
Negotiations over a continuing resolution or longer-term appropriations will determine the duration of the shutdown. Until a funding measure passes, CMS contingency plans remain in effect. LeadingAge continues to monitor these developments through its Fiscal Year 2026 Funding serial updates, which provide service-line specific impacts.
Finally, members are encouraged to join the weekly LeadingAge National Policy Pulse call every Monday at 3:30 p.m. ET to hear real-time updates on the shutdown and what it means for providers.
If you encounter a shutdown-related barrier—whether with claims processing, survey scheduling, or compliance reporting—please notify LeadingAge Ohio so we can escalate issues to our national partners and federal contacts.