Federal Shutdown Impacts Care at Home: Survey Delays, Telehealth Limits, and TRICARE Warnings
Federal Shutdown Impacts Care at Home: Survey Delays, Telehealth Limits, and TRICARE Warnings
CMS suspends most routine surveys, MassHealth reinstates in-person face-to-face encounters, and Congress weighs a new telehealth parity bill
Federal & State Updates: Surveys, Telehealth, TRICARE, and Upcoming Hearing
As the federal shutdown enters week two, agencies should prepare for survey delays, resume in-person F2F encounters for certification, and watch for TRICARE claim-payment interruptions. Massachusetts lawmakers will also take up a telehealth parity bill next week.
Federal News
CMS Guidance on Surveys During the Government Shutdown
CMS has released guidance (QSO-26-01-ALL) outlining which survey and certification activities will continue and which will be paused during the federal government shutdown.
- Home health: Routine standard (recertification) surveys are not supported during the shutdown. Only complaint investigations involving immediate jeopardy or harm, and certain enforcement or revisit surveys, will proceed.
- Hospice: Surveys supported under the Consolidated Appropriations Act (CAA) will continue during the shutdown.
- Initial certifications & revisits: Most initial Medicare certification surveys and revisits (unless tied to termination) are suspended until federal operations resume.
Action: Maintain full survey readiness so you are compliant when regular operations resume.
Government Shutdown Continues; Telehealth F2F Continues to Lapse
We are in week 2 of the government shutdown that began October 1. As noted last week, effective 12:00 a.m. on October 1, face-to-face (F2F) encounters for certification and recertification must be conducted in person. Audio-visual telehealth is no longer acceptable to meet this requirement.
The main sticking point in negotiations is extension of expiring tax credits that lower health insurance costs for millions of Americans and reversing prior Medicaid cuts. There has been no indication from congressional leadership or the White House of an imminent resolution.
In the meantime, MassHealth policy now requires in-person F2F encounters for both home health and hospice. Telehealth may still be used for other visits in special situations, but agencies should not rely on telehealth as a substitute for routine in-person care.
Department of Defense Issues TRICARE Guidance Amid Shutdown
The Department of Defense has released information on the status of health care operations and TRICARE coverage for active-duty military personnel during the ongoing shutdown.
Key note: TRICARE may be unable to process or pay medical claims for services provided on or after until federal funding is restored. The Defense Health Agency is coordinating with TRICARE contractors to inform providers of potential payment delays and to minimize disruption in care delivery.
State News: Hearing on Telehealth Expansion
Hearing Next Week on Telehealth Expansion Bill
On Tuesday, October 14, the Joint Committee on Financial Services will hold a hearing on multiple bills, including H.1130/S.763 — An Act relative to telehealth and digital equity for patients. The legislation would remove sunset dates and require reimbursement parity so that telehealth services are reimbursed on par with in-person services.
How to participate:
- Verbal testimony (in person or virtual): Register by Friday, October 10 at 5:00 p.m. ET using this registration form.
- Written testimony: Email jointcmte-financialservices@malegislature.gov and include “Financial Services Committee Testimony, [Relevant Bill Number]” in the subject line.