Government Shutdown 2025: Impacts on Home Health & Hospice
As of October 1, 2025, the federal government has entered a partial shutdown after lawmakers failed to reach a funding deal. With negotiations stalled, the impact is rippling across healthcare, including home health and hospice. While Medicare and Medicaid claims will continue, providers face new challenges in telehealth, hospital-at-home, administrative processes, and survey operations.
Telehealth & Hospital-at-Home Flexibilities Expire
Unless Congress passes an extension, Medicare’s pandemic-era telehealth flexibilities expire immediately. This means virtual face-to-face encounters can no longer be used for Medicare patients (The Guardian). Medicaid telehealth policies, however, vary by state and are not affected by this federal deadline.
The Acute Hospital Care at Home waiver also lapses, potentially forcing patients back into hospital settings and straining capacity. Medicaid telehealth policies vary by state and are unaffected by this deadline.
Medicare & Medicaid Payments Continue — But Expect Delays
Both programs are mandatory, so claims will continue to be paid. However, administrative activities may slow significantly:
- New enrollments, appeals, and waiver approvals could be delayed.
- The release of the 2026 Home Health Final Rule, expected by November 1, may slip until after funding is restored (Reuters).
Survey & Quality Reporting Disruptions
Survey operations are limited during a shutdown. While complaint-driven surveys for patient safety will still occur, recertification and certification surveys may be postponed. Providers should continue submitting all required quality reporting data until CMS issues additional guidance (AP News).
Additional Program Impacts
Discretionary programs, such as the Older Americans Act and the Social Services Block Grant, may experience interruptions in funding and service delivery.
Other Industry Updates
“Dark Days” Ahead for Claims Processing
Beginning October 2, Medicare will observe its traditional “Dark Days” until October 5. During this period, claims will not process until the system cycle runs on October 7. Providers can still submit NOE/NOA, but it is critical to maintain proof of submission in case exceptions are required.
Hospice-Specific Update
- Hospice face-to-face telehealth authority expired September 30, unless Congress passes an emergency extension.
- Providers should review patient encounters immediately and plan for in-person visits moving forward.
- HOPE Tool: October 1 also marks the official start of HOPE implementation for hospice providers.
Advocacy Action: Protect Home Health Access
Industry leaders, including the Home Care Association of Florida (HCAF), are urging providers to support the Home Health Stabilization Act. This bipartisan legislation would freeze 2026 payment rates at 2025 levels and require a positive adjustment, preventing steep CMS payment cuts.
The Bigger Picture in Washington
The House narrowly passed a short-term funding bill, but the Senate rejected it. Disputes center on Affordable Care Act premium tax credits, with Democrats seeking a one-year extension and Republicans preferring to delay (The Guardian; AP News).
The Office of Management and Budget (OMB) has directed federal agencies to prepare reduction-in-force plans. Unlike past shutdowns where furloughed workers returned once funding resumed, this directive suggests some federal employees may not return, raising long-term concerns for healthcare and human services programs (Reuters).
How SimiTree Can Help
SimiTree partners with home health and hospice organizations nationwide to provide compliance, financial, and operational support during times of uncertainty. From billing and coding assistance to survey preparation and advocacy, our team helps agencies stay compliant, protect revenue, and continue delivering quality care to patients.
Your success is our mission.