ASE Update on Federal Shutdown

Updated October 21, 2025

We’ve entered the third week of the federal government shutdown, which began on October 1 after Congress failed to pass government funding legislation before the end of the fiscal year. As a result, while essential healthcare functions continue, many federal activities are operating with reduced staffing. Approximately 40% of the U.S. Department of Health and Human Services’ (HHS) workforce has been furloughed (including nearly half of CMS staff at 47%), and several major policies have expired, including Medicare telehealth flexibilities and the Acute Hospital Care at Home program. You can also expect slowdowns or suspensions in areas like facility surveys and certifications, policy development, rulemaking, contract oversight, outreach and education, and beneficiary casework. This is the first government shutdown in nearly seven years.

Additionally, on October 15, a federal judge issued a temporary restraining order on government layoffs after HHS admitted it mistakenly fired 800 of 1,760 employees due to data errors, though the agency still seeks to terminate 982 workers. The lawsuit, brought by a federal employees union, primarily affects CDC workers, with a preliminary injunction hearing expected within two weeks. 

Good news: CMS will continue making payments for the Children’s Health Insurance Program (CHIP), maintaining Federal Marketplace eligibility operations, and continuing programs like the Health Care Fraud and Abuse Control program and the Center for Medicare & Medicaid Innovation. CMS also has sufficient funding to support Medicaid through the first quarter of fiscal year 2026.

Congressional Action on the Ongoing Shutdown 

The Senate remains deadlocked over government funding, with Senate Democrats rejecting the continuing resolution (CR) passed by the House while Republicans block Democrats’ alternative proposal that includes $1.5 trillion in additional spending. The core dispute centers on enhanced ACA premium tax credits set to expire December 31. Democrats refuse to support any funding bill without extending these subsidies, while Speaker Mike Johnson and Senate Majority Leader John Thune insist on reopening the government first with a clean CR before negotiating the subsidies later. The House remains out of session and Speaker Johnson has indicated that the House will remain out of session until the government is reopened, pressuring the Senate to pass the House-passes CR. Senate Majority Leader Thune continues to force votes on the CR with Senate Democrats rejecting the House-passed stopgap spending bill ten times. Republicans need five more Democratic votes to overcome a filibuster, with only three Democrats currently supporting the bill and one Republican opposing it. 

Agency Communication for Providers 

• Medicare Operations
  • Claims holds:
    • CMS instructed all Medicare Administrative Contractors (MACs) to lift the claims hold and process claims with dates of service of October 1, 2025, and later for certain services impacted by select expired Medicare legislative payment provisions passed under the Full-Year Continuing Appropriations and Extensions Act, 2025 (Pub. L. 119-4, Mar. 15, 2025).  This includes claims paid under the Medicare Physician Fee Schedule, ground ambulance transport claims, and Federally Qualified Health Center (FQHC) claims.   
    • This includes telehealth claims that CMS can confirm are definitively for behavioral and mental health services.  CMS has directed all MACs to continue to temporarily hold claims for other telehealth services (i.e. those that CMS cannot confirm are definitively for behavioral and mental health services) and for acute Hospital Care at Home claims. 
  • Telehealth (absent Congressional action on/after October 1, 2025):
    • Pre-PHE limits resume for non-behavioral/mental health services (most home and non-rural originating sites not payable; hospice recertifications require face-to-face).
    • Audio-only services have lapsed for Medicare patients except those being treated for mental health or substance use disorders.
    • Practitioners who choose to perform telehealth services that are not payable by Medicare on or after October 1, 2025, may want to evaluate providing beneficiaries with an Advance Beneficiary Notice of Noncoverage (ABN).
    • Practitioners should monitor Congressional action and may choose to hold claims associated with telehealth services that are not payable by Medicare in the absence of Congressional action.
• Research & Trials
  • The NIH will be operating the minimum level needed to safeguard patient safety in ongoing research. The agency will be halting:
    • All basic and translational research conducted by NIH scientists.
    • All NIH grant peer review meetings, advisory council meetings, issuance of new awards, and program/grants management activities.
    • The admission of new patients at the NIH Clinical Center (unless deemed medically necessary by the NIH Clinical Center Director).
    • Initiation of new protocols at the NIH Clinical Center.
    • Training of graduate students and postdoctoral fellows at NIH facilities.
    • Scientific meetings at NIH facilities.
  • To determine if your research is impacted–coordinate with your institution’s research office.
• Patient communication: Reassure patients that clinical care continues; any scheduling or administrative delays are unrelated to individual coverage or clinical need.

ASE Advocacy During the Government Shutdown

• Telemedicine
  • ASE believes these critical patient-services should not be vulnerable to disruptions from government shutdowns. The Society continues to advocate for permanent legislation to protect telehealth access. ASE supports the CONNECT Act (Creating Opportunities Now for Necessary and Effective Care Technologies) (S.1261/ H.R.4206) , which would permanently extend Medicare telehealth flexibilities, allowing patients to receive care from their homes regardless of location, and preserving audio-only services that many rely on for accessible healthcare. The CONNECT Act would eliminate geographic restrictions, expand the types of providers who can deliver telehealth services, and ensure patients can continue receiving high-quality cardiovascular care without unnecessary barriers.
  • Take action: We encourage ASE members to contact their members of Congress to urge support for the CONNECT Act and other permanent telehealth legislation. Your voice matters in protecting patient access to telemedicine. Visit ASE’s Advocacy Resources or contact your representatives directly to share how telehealth flexibilities have improved care for your patients.
• National Institutes of Health (NIH) Funding 
  • ASE considers robust and sustained funding for the NIH is essential to advancing medical research, maintaining America’s global leadership in science, and ensuring life-saving discoveries that benefit patients nationwide. Even amid the ongoing government shutdown, the Society continues to actively advocate for predictable NIH funding growth that supports groundbreaking research, preserves our nation’s research infrastructure, and trains the next generation of scientists. 
  • The Society has joined coalition letters urging Congress to prioritize NIH funding in the FY 2026 appropriations process.  
    • In October 2025, the Society signed onto a letter with nearly 300 organizations from the Ad Hoc Group for Medical Research requesting at least $47.2 billion for NIH, in addition to funding for the Advanced Research Projects Agency for Health (ARPA-H). 
    • In September 2025, the Society joined 164 national organizations in supporting the Joint Associations Group’s Financial Accountability In Research (FAIR) model, which seeks to enhance transparency and accountability in research funding while blocking arbitrary caps on essential research costs and ensuring a transition period of at least two years for any new funding model implementation.  
  • As budget negotiations continue, the Society will work with congressional appropriators to ensure any final spending agreement includes the robust NIH investment necessary to maintain American scientific excellence. 

Additional Information and Resources:

• ASE Overview on NIH Funding: NIH Research Funding and Echocardiography
• CMS operations: HHS CMS Contingency
• NIH operations: HHS NIH Contingency
• Congress.gov: Past Government Shutdowns: Key Resources
• Committee for a Responsible Federal Budget: Government Shutdowns Q&A: Everything You Should Know
• Bipartisan Policy Center: What Happens if the Government Shuts Down?

ASE continues to monitor the impact of the government shutdown, and any impacted providers who have questions or need assistance are encouraged to email ASE advocacy staff at [email protected].