As of October 1st, the federal government is officially shut down after Congress failed to pass funding legislation. While the biggest direct impact will certainly be on furloughed federal workers and government agencies, if your practice relies on Medicare or Medicaid, or you are involved in research, there are ripple effects worth understanding.
Link to What Stays Open What Stays Open
- Medicare and Medicaid keep paying, as these programs are ‘mandatory spending,’ meaning the payments will continue despite the government being shut down.
- Medical care provided to veterans at the VA continues without impact, and VA facilities remain open.
- Some CMS/FDA functions will remain open during the shutdown, so government oversight by way of critical safety inspections will continue to take place.
Link to What Gets Impacted What Gets Impacted
- Although Medicare and Medicaid will continue authorizing payments, the processing of such payments may be delayed. Furloughed staff could mean slower claims processing, audits, or appeals.
- Special programs, such as the Hospital-at-Home program, will be put on hold until federal funding is restored. Read more on this matter here.
- Covid-era flexibilities for telehealth could expire, returning to the stricter pre-pandemic regulations for telehealth. Read more on this matter here.
- Research funding through the NIH, CDC, or other federal grants may be delayed or frozen.
- FDA approvals for new drugs or devices may be stall or be put on hold.
Link to Considerations For Physicians Considerations For Physicians
- Cash Flow: If you rely heavily on Medicare or Medicaid, even a few weeks of delays can create a challenge. Start planning for a delay now. If the delays end up resulting in additional expenses, keep documentation for each additional expense.
- Contracts: Your contracts may provide for relief in the event of a government shutdown or delayed federal payments. Review your contracts and see if there are any provisions relating to force majeure or delays in reimbursement.
- Compliance: Despite the government being shutdown, not every deadline is on pause. If you are undergoing an audit or have any other reporting requirements that are due, still plan on complying and check directly with the relevant federal agency to understand the impact.
- Patients: If you have patients under the Hospital-at-Home program, that you’ve been seeing under the telehealth flexibilities, or that are under any other special federal program, it’s important to communicate with these patients so that they understand what’s happening and can still seek appropriate treatment despite the shutdown.
- Research Funding: Talk with your funding institution to understand what spending may be on hold or if there are any changes or new restrictions to your current spending authority.
Link to Conclusion Conclusion
Although most physicians likely won’t feel the shutdown in their practice today, if the government shutdown continues for any considerable length of time, the effects may compound and eventually be felt. Delays in payments, program lapses, and research disruptions may add up over time. The practices that weather this best will be the ones that plan for delays, communicate clearly, and keep proper documentation and records.